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D Baldwin, K L Chow, H Mashbari, E Omi, J K Lee
BACKGROUND: Blunt cardiac trauma is diagnosed in less than 10% of trauma patients and covers the range of severity from clinically insignificant myocardial contusions to lethal multi-chamber cardiac rupture. The most common mechanisms of injury include: motor vehicle collisions (MVC), pedestrians struck by motor vehicles and falls from significant heights. A severe complication from blunt cardiac trauma is cardiac chamber rupture with pericardial tear. It is an exceedingly rare diagnosis...
June 19, 2018: Journal of Cardiothoracic Surgery
M Barras, E Pearson, I Cousin, C Le Rouzic, M Thepaut, J-C Gentric, J-M Roue, S Yevich, P de Vries
Penetrating laceration injury in the pediatric population may present as an acute or delayed life-threatening injury. Although emergent intra-arterial embolization is commonly utilized in adults, few cases have been reported for children. Surgical treatment for severe renal laceration injuries may require complete nephrectomy; an unfortunate outcome for a pediatric patient if a renal-preserving alternative is feasible. We present a case of penetrating renal laceration in a 10-year-old boy treated with intra-arterial embolization of the lacerated dominant renal artery and subsequent renal perfusion by an uninjured accessory renal artery allowing for renal preservation...
June 14, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Elie Nkwabong, Jean Marc Njemba Medou, Joseph Nelson Fomulu
OBJECTIVE: To identify in our setting the outcome of labor among women admitted at advanced cervical dilatation. METHODS: This prospective cohort study was carried out between 1 December, 2015 and 31 March, 2016. Women carrying live term singletons in vertex presentation admitted with a cervical dilatation > 5 cm (late arrival group) or ≤ 5 cm (early arrival group) were followed up till delivery. The main variables studied included mode of delivery, genital lacerations, postpartum hemorrhage (PPH)...
June 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
Daniela Klaus-Halla, Bettina Mair, Carola Sauter-Louis, Holm Zerbe
OBJECTIVE: In cows with uterine torsion, clinical parameters and different treatments were evaluated with regards to their success. The aim of the study was to investigate important factors for diagnosis and prognosis of uterine torsion and their consequences for treatment decisions. MATERIAL AND METHODS: The study presents 114 cases of uterine torsion documented under field conditions. The cows were examined before retorsion of the uterus and immediately post partum...
June 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
Caryn A Turner, Jean A Orman, Zsolt T Stockinger, Steven J Hudak
Introduction: Genitourinary surgery constitutes approximately 1.15% of procedures performed for combat injuries. During forward deployment, surgeons usually deploy without urology support. To better understand the training and skills maintenance needs for genitourinary procedures by describing in detail the genitourinary surgical workload during 15 years of combat operations and compare our findings with those from previously published articles. Material and Methods: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Roles 2 and 3 medical treatment facilities in Iraq and Afghanistan, from January 2002 to May 2016...
June 13, 2018: Military Medicine
Nor Hazla Mohamed Haflah, Min Hwei Ng, Mohd Heikal Mohd Yunus, Amaramalar Selvi Naicker, Ohnmar Htwe, Kamarul Arifin Abdul Razak, Ruszymah Idrus
CASE: A 22-year-old man sustained a laceration that measured 180 cm, after debridement, over the anterolateral aspect of the right leg following a road traffic accident. The wound was treated with MyDerm (Universiti Kebangsaan Malaysia), a cell-based, bilayered, bioengineered dermal substitute that contains no animal-derived components and is fully autologous. For its construction, only a small area of skin was harvested from the left groin, which was closed primarily with absorbable sutures...
June 13, 2018: JBJS Case Connector
Anthony Lathrop, Carrie F Bonsack, David M Haas
BACKGROUND: Water birth has become an increasingly popular childbirth option, but has also come under scrutiny because of its possible risks and benefits. The primary objective of this study was to explore potential benefits of water birth by comparing the experiences of women who gave birth in water versus conventionally. We also compared maternal and newborn outcomes. METHODS: We performed a prospective study of 66 women who had water births and 132 who had conventional births...
June 13, 2018: Birth
Lynn Unruh, Yara Asi
Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries...
June 1, 2018: Workplace Health & Safety
Jared Weston, Sushil Pandey, Evan Matthews, Evan Bursle
Introduction: We describe the first detailed case report of human infection with Mycobacterium stomatepiae . Infection with non-tuberculous mycobacteria (NTM) related to M. stomatepiae is well described, despite the lack of previous confirmed reports of M. stomatepiae- related human disease. Localised cervical lymphadenitis is the most common NTM disease in children, with species closely related to M. stomatepiae, such as Mycobacterium triplex and Mycobacterium florentinum , having been shown to be rare causative agents...
May 2018: JMM Case Reports
Yuval Shapira, Vanessa Sammons, Joanne Forden, Gui Fang Guo, Alexander Kipp, Jill Girgulis, Tanmay Mishra, Jacob Daniel de Villers Alant, Rajiv Midha
BACKGROUND: Brief electrical stimulation (ES) therapy to the nerve may improve outcome in lacerated, repaired nerves. However, most human nerve injuries leave the nerve in continuity with variable and often poor functional recovery from incomplete axon regeneration and reinnervation. OBJECTIVE: To evaluate the effect of brief ES in an experimental model for neuroma-in-continuity (NIC) injuries in rodents. METHODS: Lewis rats were randomly assigned to 1 of 4 groups: NIC injury immediately followed by brief (1 h) ES; NIC injury without ES; sham-operated controls; sciatic nerve transection without repair...
June 11, 2018: Neurosurgery
Lynn M Yee, Emily S Miller
OBJECTIVE: To estimate whether there are differences in obstetric interventions or outcomes by the gender of the delivering physician. METHODS: We conducted a retrospective cohort study of all nulliparous women delivering singleton, vertex, live births at 37 weeks of gestation or greater at a tertiary care institution (2014-2015). Patient clinical characteristics were analyzed by delivering physician gender. The primary outcomes were delivery mode and episiotomy...
June 6, 2018: Obstetrics and Gynecology
N O C Onyemaechi, O E Nwankwo, R A Ezeadawi
Background: The study aimed to describe the pattern of injuries among patients presenting at a tertiary care hospital in Enugu southeast Nigeria. Patients and Methods: A retrospective review of records of all injured patients seen in our hospital over a 12-month period was done. Results: A total of 789 patients had complete medical records and were included in the study. Road traffic accident (RTA) was the most common cause of injury. Lacerations/abrasions, fractures, and traumatic brain injury (TBI) were the most frequently seen injuries...
June 2018: Nigerian Journal of Clinical Practice
Dimitrios Papanagnou, Danica Stone, Shruti Chandra, Phillip Watts, Anna Marie Chang, Judd E Hollander
Introduction Given the rapid expansion of telehealth (TH), there is an emerging need for trained professionals who can effectively deliver TH services. As there is no formal TH training program for residents, the Department of Emergency Medicine (DEM) at Thomas Jefferson University (TJU) developed a pilot training program for senior post-graduate-year three (PGY-3) residents that exposed them to TH practices. The objective of the study was to determine the feasibility of developing a resident-led, post-Emergency-Department (ED) visit TH follow-up program as an educational opportunity to 1) address patient satisfaction; and 2) expose senior residents to TH delivery...
April 5, 2018: Curēus
R Pinet, G Raimbeau, Y Saint-Cast, P-A Fouque, F Rabarin
The superficial branch of the radial nerve (SBRN) at the wrist is susceptible to trauma and lacerations. These lesions can develop into painful neuromas with debilitating consequences. The aim of our study was to demonstrate the effectiveness of systematic use of vein conduits associated with microsurgical suture repair in SBRN injuries to prevent the occurrence of these neuromas. Our study was retrospective and performed at a single site. An independent examiner performed the clinical assessment. The study included 33 patients and the mean follow-up was 63 months...
May 29, 2018: Hand Surgery and Rehabilitation
Imad El Majzoub, Christopher El Khuri, Karim Hajjar, Ralphe Bou Chebl, Farid Talih, Maha Makki, Aurelie Mailhac, Gilbert Abou Dagher
Background: Emergency Department (ED) visits for suicide attempts have been described worldwide; however, the populations studied were predominantly Western European, North American, or East Asian. This study aims to describe the epidemiology of ED patients presenting post-suicide attempt to an academic medical center in Lebanon and to report on factors that affect ED disposition. Methods: A retrospective cohort study was conducted between 2009 and 2015. Patients of any age group were included if they had presented to the ED after a suicide attempt...
2018: Annals of General Psychiatry
Arash Fattahi, Amin Jahanbakhshi, Ardeshir Shahivand, Alireza Dastmalchi
Spinal penetrating trauma has a complex neurosurgical management. This study presents a 55-year-old male admitted in our center with a 1 × 1 centimeter laceration on the sacral area skin due to a wooden penetrating object. The computed tomography (CT) of the spine revealed a hypodense penetrating object that was introduced from the posterior aspect of the sacrum into dural space and then stopped in the S1 vertebral body. We performed a laminectomy of intact superior portion of the S1 lamina and released the wood from the surrounding bone, and finally, we pulled it out...
2018: Case Reports in Medicine
Chadwick Shirk, Wesley Eilbert
Isolated anterior urethral injuries in males related to sexual activity have rarely been reported. Human bites to the penis are also rarely discussed in the medical literature. We report an isolated anterior urethral laceration in a male caused by a biting injury sustained during fellatio.
November 2017: Clinical practice and cases in emergency medicine
Scott B Crawford
Mallet finger is a common injury often treated without operative intervention. When there is concern for skin integrity or a large articular component is involved, simple operative repair may be needed. This has been performed with transarticular Kirschner wire (K-wire) placement. This case discusses the novel use of an intraosseous vascular access device (IOVAD) as a potential adjunct to stabilization and alternative to treatment with operative K-wire fixation. A 53-year-old man was successfully treated using the inner trocar of the EZ-IO® system for a mallet finger injury with laceration, shown in comparison with another standard manual pinning approach using an 18-gauge needle...
February 2018: Clinical practice and cases in emergency medicine
Gregory W Reinhold, Tina K Melonakos, Daniel T Lyman
A 79-year-old female called 911 for abdominal pain in her left upper quadrant with radiation through to her back and left shoulder for three hours. Upon arrival to the emergency department her physical exam was positive only for tenderness in the left upper quadrant of her abdomen. The patient denied any history of trauma but reported she "did sneeze three times" just prior to the onset of her pain. Computed tomography angiography of the abdomen and pelvis was obtained to evaluate for vascular pathology...
August 2017: Clinical practice and cases in emergency medicine
Austin Badeau, Shadi Lahham, Megan Osborn
Laceration injuries comprise over 8% of all emergency department (ED) visits annually.1 Given that laceration injuries represent a significant volume of ED visits, emergency physicians (EP) should be comfortable treating these types of injuries. We present the case of a 34-year-old male who presented to the ED as a trauma activation who suffered multiple injuries including complex full-thickness lacerations to his face. While there are scenarios in which consulting a specialist is necessary, knowledge and application of basic wound closure principles allows for many complex lacerations to be repaired by EPs...
August 2017: Clinical practice and cases in emergency medicine
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