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https://www.readbyqxmd.com/read/29776837/evaluation-of-massive-transfusion-protocol-practices-by-type-of-trauma-at-a-level-i-trauma-center
#1
Roshan Givergis, Swapna Munnangi, Katayoun Fayaz M Fomani, Anthony Boutin, Luis Carlos Zapata, Ld George Angus
PURPOSE: To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. METHODS: A retrospective analysis was performed on a sample of 76 trauma patients with MTP activation between March 2010 and January 2015 at a regional trauma center. Patient demographics, transfusion practices, and clinical outcomes were compared by type of trauma sustained. RESULTS: Penetrating trauma patients who required MTP activation were significantly younger, had lower injury severity score (ISS), higher probability of survival (POS), decreased mortality, and higher Glasgow Coma scale (GCS) compared to blunt trauma patients...
April 18, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29776836/analysis-of-incidence-of-traumatic-brain-injury-in-blunt-trauma-patients-with-glasgow-coma-scale-of-12-or-less
#2
Alexander Becker, Kobi Peleg, Oded Olsha, Adi Givon, Boris Kessel
PURPOSE: Early diagnosis of traumatic brain injury (TBI) is important for improving survival and neurologic outcome in trauma victims. The purpose of this study was to assess whether Glasgow Coma Scale (GCS) of 12 or less can predict the presence of TBI and the severity of associated injuries in blunt trauma patients. METHODS: A retrospective cohort study including 303,435 blunt trauma patients who were transferred from the scene to hospital from 1998 to 2013. The data was obtained from the records of the National Trauma Registry maintained by Israel's National Center for Trauma and Emergency Medicine Research, in the Gertner Institute for Epidemiology and Health Policy Research...
April 16, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#3
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29774826/patients-with-diffuse-axonal-injury-can-recover-to-a-favourable-long-term-functional-and-quality-of-life-outcome
#4
Marleen Maria van Eijck, Joukje van der Naalt, Mariska de Jongh, Guus G Schoonman, Annemarie Wilhelma Oldenbeuving, Jo Peluso, Jolanda de Vries, Gerwin Roks
Functional outcome and quality of life are difficult to predict in patients with diffuse axonal injury (DAI) after traumatic brain injury (TBI). The primary aim of this cross-sectional cohort study was to assess the long-term functional outcome in patients with DAI and to identify prognostic factors. Secondly, health-related quality of life (HRQL) at long-term follow-up was assessed. Patients aged ≥16 with TBI and DAI (admitted 2008-2014) were included. Clinical and imaging data were collected. The primary outcome parameter was the Glasgow Coma Scale Extended (GOSE) at long-term follow-up...
May 18, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29772365/location-of-thalamic-hemorrhage-impacts-prognosis
#5
Brandon L Neisewander, Kimberly Hu, Zach Tan, Jack Zakrzewski, Pouyan Kheirkhah, Prateek Kumar, Miloni Shah, Douglas Cotanche, Kalpesh Shah, Darian R Esfahani, Ankit I Mehta
OBJECT: Approximately 12% of intracerebral hemorrhages (ICH) occur in the thalamus. Understanding the anatomical regions involved with thalamic hemorrhages is potentially useful, offering the physician a more accurate prognosis for patient outcomes. This study was performed to determine if thalamic hemorrhage location observed on a computed tomography scan (CT) is predictive of neurologic outcomes. METHODS: A sample of 168 thalamic hemorrhage patients admitted to a tertiary care center was analyzed...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770221/risperidone-induced-type-2-diabetes-presenting-with-diabetic-ketoacidosis
#6
Clarissa Ern Hui Fang, Mohammed Faraz Rafey, Aine Cunningham, Sean F Dinneen, Francis M Finucane
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2 ). Dipstick urinalysis showed ketonuria and glycosuria...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29766126/factor-viia-administration-in-traumatic-brain-injury-an-aast-mitc-propensity-score-analysis
#7
Sarah Lombardo, D Millar, Gregory J Jurkovich, Raul Coimbra, Ram Nirula
Background: Recombinant factor VIIa (rFVIIa) has been used off-label as an adjunct in the reversal of warfarin therapy and management of hemorrhage after trauma. Only a handful of these reports are rigorous studies, from which results regarding safety and effectiveness have been mixed. There remains no clear consensus as to the role of rFVIIa in traumatic brain injury (TBI). Methods: Eleven level 1 trauma centers provided clinical data and head CT scans of patients with a Glasgow Coma Scale (GCS) score of ≤13 and radiographic evidence of TBI...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766125/trauma-early-mortality-prediction-tool-tempt-for-assessing-28-day-mortality
#8
Ryan C Kunitake, Lucy Z Kornblith, Mitchell Jay Cohen, Rachael A Callcut
Background: Prior mortality prediction models have incorporated severity of anatomic injury quantified by Abbreviated Injury Severity Score (AIS). Using a prospective cohort, a new score independent of AIS was developed using clinical and laboratory markers present on emergency department presentation to predict 28-day mortality. Methods: All patients (n=1427) enrolled in an ongoing prospective cohort study were included. Demographic, laboratory, and clinical data were recorded on admission...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766124/routine-repeat-head-ct-may-not-be-necessary-for-patients-with-mild-tbi
#9
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29763809/the-impact-of-methamphetamines-in-patients-with-traumatic-brain-injury-a-retrospective-review
#10
Jason Duong, Christopher Elia, Ariel Takayanagi, Taylor Lanzilotta, Ajay Ananda, Dan Miulli
OBJECTIVE: Both neurotoxic and neuroprotective effects of methamphetamines (METH) are being studied. There are few studies evaluating the effects of METH on patients with traumatic brain injury (TBI). The objective of this study is to compare clinical outcomes after TBI in METH users versus non-METH users. PATIENT AND METHODS: A retrospective review of 304 patients with severe traumatic head injury were performed. Patients were evaluated and stratified based on toxicology screening for methamphetamines (METH) or none...
April 27, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29762777/the-intracerebral-hemorrhage-score-a-self-fulfilling-prophecy
#11
D Jay McCracken, Brendan P Lovasik, Courtney E McCracken, Jason M Frerich, Margaret E McDougal, Jonathan J Ratcliff, Daniel L Barrow, Gustavo Pradilla
BACKGROUND: The ICH Score has become the standard for risk-stratification of 30-d mortality in patients with intracerebral hemorrhage (ICH), but treatment has evolved over the last 17 yr since its inception. We sought to determine if the ICH Score remains an accurate predictor of 30-d mortality in these high acuity patients. OBJECTIVE: To determine the role the ICH Score has on mortality in current treatment of patients. METHODS: A retrospective review of 554 patients treated for acute, spontaneous ICH at 2 large academic institutions between 2010 and 2014 was carried out...
May 14, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29761118/susceptibility-weighted-and-diffusion-kurtosis-imaging-to-evaluate-encephalomalacia-with-epilepsy-after-traumatic-brain-injury
#12
Wenbin Li, Xuan Wang, Xiaoer Wei, Mingliang Wang
Objective: Encephalomalacia after traumatic brain injury (TBI) is one of the factors leading to epilepsy. In this study, magnetic resonance imaging (MRI) was used to explore the brain image features of epilepsy after traumatic encephalomalacia, and to provide objective evidence for predicting the possible occurrence of epilepsy after traumatic encephalomalacia. Methods: Two-hundred-fifty-two patients with traumatic encephalomalacia were prospectively enrolled in the study...
May 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#13
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29758367/clinical-and-neurosurgical-management-of-cranial-machete-injuries-the-experience-of-a-tertiary-referral-center-in-nicaragua
#14
Luis Zapata, Ernest J Wright, Peter Nakaji
BACKGROUND: The neurosurgical literature rarely describes managing open head injuries caused by machetes, although this is a common head injury in developing countries. We present our experience managing cranial machete injuries in Nicaragua over a 5-year period. METHODS: A retrospective chart review identified patients admitted to a neurosurgery service for cranial machete injury. RESULTS: Among 51 patients studied, the majority (n=42, 82%) presented with mild neurological deficits (Glasgow Coma Scale score ≥14)...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29751189/risk-factors-predicting-posttraumatic-hydrocephalus-after-decompressive-craniectomy-in-traumatic-brain-injury
#15
Guangfu Di, Qianxin Hu, Dongming Liu, Xiaochun Jiang, Jiu Chen, Hongyi Liu
OBJECTIVE: To identify the risk factors for predicting posttraumatic hydrocephalus (PTH) development after traumatic brain injury (TBI) in patients who underwent decompressive craniectomy (DC). METHODS: This retrospective study included 121 patients who underwent DC after TBI between January 2013 and December 2016 at Yijishan Hospital by 6 different neurosurgeons and were still alive at 6-month follow-up. They were divided into PTH group and non-PTH group according to the presence of PTH...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29743761/predictors-of-mortality-in-acute-kidney-injury-patients-admitted-to-medicine-intensive-care-unit-in-a-rural-tertiary-care-hospital
#16
Amrish Saxena, Shrikant V Meshram
Background: Acute kidney injury (AKI) is a challenging problem faced by intensive care clinicians worldwide, and it is associated with high morbidity and mortality, especially in critically ill patients. Materials and Methods: A hospital-based prospective, observational study was conducted in patients of AKI admitted to the Intensive Care Unit (ICU) of the Department of Medicine in a rural tertiary care hospital located in central India. Data of all consecutive AKI inpatients related to demographic variables, clinical profile, and laboratory investigations were collected from patient's medical records...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742589/clinical-factors-associated-with-icu-specific-care-following-supratentoral-brain-tumor-resection-and-validation-of-a-risk-prediction-score
#17
Lynze R Franko, Todd Hollon, Joseph Linzey, Christopher Roark, Venkatakrishna Rajajee, Kyle Sheehan, Magnus Teig, Shawn Hervey-Jumper, Jason Heth, Daniel Orringer, Craig A Williamson
OBJECTIVES: The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratentorial tumor resection require care, aside from frequent neurologic checks, that is specific to an ICU and to determine the frequency of new complications during ICU admission. Additionally, clinical predictors of ICU-specific care are identified, and a scoring system to discriminate patients most likely to require ICU-specific treatment is validated...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#18
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29742138/a-novel-early-risk-assessment-tool-for-detecting-clinical-outcomes-in-patients-with-heat-related-illness-j-erato-score-development-and-validation-in-independent-cohorts-in-japan
#19
Kei Hayashida, Yutaka Kondo, Toru Hifumi, Junya Shimazaki, Yasutaka Oda, Shinichiro Shiraishi, Tatsuma Fukuda, Junichi Sasaki, Keiki Shimizu
BACKGROUND: We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness. METHODS: Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system...
2018: PloS One
https://www.readbyqxmd.com/read/29738860/traumatic-brain-injury-due-to-missile-wounds-in-the-north-of-palestine-a-single-institution-s-experience-with-520-consecutive-civilian-patients
#20
Rami Darwazeh, Mazhar Darwazeh, Ibrahim Sbeih, Yi Yan, Jianmin Wang, Xiaochuan Sun
BACKGROUND: Literature about traumatic brain injury (TBI) due to missile wounds is rather scanty. Therefore, we availed ourselves the opportunity to shed some light on this dark field. METHODS: This retrospective study was carried out, between September-2000 to September-2010, on 520 civilian patients who sustained TBI due to missiles in the north of Palestine. Thorough detailed analyses of patients' admission Glasgow coma scale (GCS) scores, pupillary reactivity to light, site and mode of injuries, type of injurious agents, missile trajectory, method of treatment, radiological manifestations, complications and outcome were made...
May 5, 2018: World Neurosurgery
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