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Trauma surgery

Thaís Flôr da Rocha, Juliana Gibbon Neves, Karin Viegas
Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48...
September 2016: Revista Brasileira de Enfermagem
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
October 25, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
R Claeys, M Walsdorff, S Pargov, R Matasa, R Duttmann, M Cannie
Non-traumatic wrist pain remains a diagnostic challenge. An accurate diagnosis is crucial in order to choose the appropriate treatment. We report the case of a 23-year-old female with a four-month history of mainly nocturnal wrist pain. There was no history of trauma or prior surgery. Radiographs and CT scans showed a lytic lesion with central nidus and sclerotic margins in the pisiform bone. Bone scan showed increased uptake in the pisiform bone. The diagnosis of osteoid osteoma was confirmed by histopathological analysis after complete surgical resection...
September 2016: Hand Surgery and Rehabilitation
Hammouda Hamdy Ghoraba, Mohamed Amin Heikal, Hosam Osman Mansour, Haithem Mamon Abdelfattah, Emad Mohamed Elgemai, Adel Galal Zaky
The aim of this study is to report the difference in either anatomical or functional outcome of vitreoretinal intervention in cases of gunshot perforating eye injury if done 2-4 weeks or after the 4th week after the original trauma. Patients were treated with pars plana vitrectomy and silicon oil. Surgeries were performed in the period from February 2011 until the end of December 2014. 253 eyes of 237 patients were reviewed. 46 eyes were excluded. 207 eyes of 197 patients were analyzed. The included eyes were classified based on the timing of vitrectomy in relation to the initial trauma into two groups: 149 eyes (the first group) operated on between the 3rd and the 4th week and 58 eyes (the second group) operated on after the 4th week after the trauma...
2016: Journal of Ophthalmology
Zhonghui Guan, Judith Hellman, Mark Schumacher
Tissue injury, whether by trauma, surgical intervention, metabolic dysfunction, ischemia, or infection, evokes a complex cellular response (inflammation) that is associated with painful hyperalgesic states. Although in the acute stages it is necessary for protective reflexes and wound healing, inflammation may persist well beyond the need for tissue repair or survival. Prolonged inflammation may well represent the greatest challenge mammalian organisms face, as it can lead to chronic painful conditions, organ dysfunction, morbidity, and death...
2016: F1000Research
Indranil Bhattacharya, Chafik Ghayor, Franz E Weber
2500 years ago, Hippocrates realized that bone can heal without scaring. The natural healing potential of bone is, however, restricted to small defects. Extended bone defects caused by trauma or during tumor resections still pose a huge problem in orthopedics and cranio-maxillofacial surgery. Bone tissue engineering strategies using stem cells, growth factors, and scaffolds could overcome the problems with the treatment of extended bone defects. In this review, we give a short overview on bone tissue engineering with emphasis on the use of adipose tissue-derived stem cells and small molecules...
September 2016: Transfusion Medicine and Hemotherapy
Clay Cothren Burlew, Kimberly A Davis, John J Fildes, Thomas J Esposito, Christopher J Dente, Gregory J Jurkovich
Over the past decade, the American Association for the Surgery of Trauma (AAST) Acute Care Surgery (ACS) fellowship program has matured to 20 verified programs. As part of an ongoing curricular evaluation, we queried the current practice patterns of the graduates of ACS fellowship programs regarding their view on their ACS training. Surveys were submitted by 56 of 77 graduates for a completion rate of 73%. While 93% of graduates practice in urban/suburban areas, there was a mixture of University, University-affiliated, and community institutions and an almost even division of level I and II designation...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Paula Ferrada, Rao R Ivatury, David A Spain, Kimberly A Davis, Michel Aboutanos, John J Fildes, Thomas M Scalea
INTRODUCTION: Acute Care Surgery (ACS), Trauma and Surgical Critical Care (SCC) fellowships graduate fellows deemed qualified to perform complex cases immediately upon graduation. We hypothesize international fellow rotations (IFR) can be a resource to supplement operative case exposure METHODS: A survey was sent to all program directors of ACS and SCC fellowships via email. Data was captured and analyzed using the Research Electronic Data Capture (REDCap) tool. RESULTS: The survey was sent to 113 program directors (PDs) with a response rate of 42%...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Amanda N Fletcher, Agostino Molteni, Rakesh Ponnapureddy, Chirag Patel, Mark Pluym, Alan M Poisner
BACKGROUND: Fat embolism (FE) and the consequent fat embolism syndrome (FES) occurring after trauma or surgery can lead to serious pulmonary injury, including ARDS and death. Current treatment of FES is limited to supportive therapy. We have shown in a rat model that the renin angiotensin system (RAS) plays a significant role in the pathophysiology of FE since drugs interfering with the RAS, captopril and losartan, reduce the histopathologic pulmonary damage. The purpose of the current study was to determine if inhibition of renin by aliskiren, an FDA-approved drug for treating hypertension, would produce effective protection in the same model...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Franck Leclère, Emilie Desnouveaux, Vincent Casoli
INTRODUCTION: The goal of lower extremity reconstruction after trauma is the coverage of defects to give patients a healed wound and to let them resume their life, ambulate, and return to work while preventing amputation. In this article we describe an innovative use of Integra® for free flap pedicle coverage in lower extremity reconstruction. MATERIALS AND METHODS: Between January 2011 and December 2015, ten patients, 4 women and 6 men, underwent a lower limb reconstruction with an association of free flap and integra® to cover the flap pedicle...
October 25, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Chulananda Goonasekera, Kamal Ali, Ann Hickey, Lekshmi Sasidharan, Malcolm Mathew, Mark Davenport, Anne Greenough
BACKGROUND: Mortality following surgical repair of congenital diaphragmatic hernia (CDH) remains high. The volume and type of perioperative intravenous fluid administered, baro-trauma, oxygen toxicity, and the duration of anesthesia are thought to affect outcome in surgical populations. AIMS: The aim of this retrospective observational study was to determine whether the perioperative volume or type of fluids and/or the duration of anesthesia were associated with postoperative mortality and if mortality was predicted by the oxygenation index (OI) prior to or following CDH surgical repair...
October 25, 2016: Paediatric Anaesthesia
P Roldan-Ramos, L A Reyes-Figueroa, J Rumia, E Martinez-Lizana, A Donaire, M Carreno-Martinez
AIM: To describe clinical results and complications derived from vagal nerve stimulation therapy in drug resistant epileptic patients unsuitable for other surgical treatments, since the first implant in an epilepsy national referral centre. PATIENTS AND METHODS: A retrospective analysis of the patients implanted in our centre was held. Data related to baseline characteristics of their epilepsy and therapy complications was collected. RESULTS: 32 new implants in 31 patients are included, mean age of 34 years, 29...
November 1, 2016: Revista de Neurologia
Yohan Cho, Joon Yub Kim, Jai Hyung Park
PURPOSE: The purpose of this study was to analyze the questions in the hip and pelvis section of the Korean Orthopaedic In-Training Examination (KOITE). MATERIALS AND METHODS: We analyzed all KOITE questions pertaining to hip and pelvis surgery between 2010 and 2014. A thorough analysis of the contents was performed after categorizing as tested topics, imaging modalities used, taxonomic classification, and recommended references. We also analyzed the scores of the hip and pelvis section of the KOITE...
September 2016: Hip Pelvis
Georg D Strbac, Albrecht Schnappauf, Katharina Giannis, Michael H Bertl, Andreas Moritz, Christian Ulm
INTRODUCTION: The aim of this study was to introduce an innovative method for autotransplantation of teeth using 3-dimensional (3D) surgical templates for guided osteotomy preparation and donor tooth placement. METHODS: This report describes autotransplantation of immature premolars as treatment of an 11-year-old boy having suffered severe trauma with avulsion of permanent maxillary incisors. This approach uses modified methods from guided implant surgery by superimposition of Digital Imaging and Communications in Medicine files and 3D data sets of the jaws in order to predesign 3D printed templates with the aid of a fully digital workflow...
October 21, 2016: Journal of Endodontics
Dennis Grech, Zhifeng Li, Patrick Morcillo, Evelyne Kalyoussef, David D Kim, Alex Bekker, Luis Ulloa
Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery...
October 2016: Journal of Acupuncture and Meridian Studies
Daniel H Wiznia, Theodore Zaki, Julianna Maisano, Chang-Yeon Kim, Thomas M Halaszynski, Michael P Leslie
BACKGROUND AND OBJECTIVES: The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. METHODS: Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states...
October 21, 2016: Regional Anesthesia and Pain Medicine
S Santiago-Martínez, A Laín, G Guillén, R Gander, S López-Fernández, F Pumarola, L Seidler, J Lloret
INTRODUCTION: Paediatric LTI is associated with significant morbid-mortality. Although historically first line treatment was surgical, conservative management is making headway. The purpose of this study was to analyze the management and surgical indications of LTI treated at our institution. MATERIAL AND METHODS: Retrospective study of patients with LTI treated between 2007 and 2014. RESULTS: Six out of seven patients, with a median age of 4 years (2-15), had blunt traumas and one had an open trauma...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Jung-Won Cho, Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
BACKGROUND: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. CASE REPORT: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Alison F Ward, Timothy Lee, Jennifer B Ogilvie, Kepal N Patel, Karen Hiotis, Costas Bizekis, Michael Zervos
One to two percent of ectopic parathyroid adenomas are found in the lower mediastinum and often these are best accessed via a sternotomy or thoracotomy. Video-assisted thoracoscopic surgery (VATS) is an alternative approach with less surgical trauma, decreased morbidity, shorter hospital stays, and superior cosmetic results. Ten years after the first VATS resection of an ectopic mediastinal parathyroid, a robot-assisted thoracoscopic approach was described. Here we describe a series of five robot assisted complete thymectomies in patients with primary hyperparathyroidism due to mediastinal ectopic parathyroid adenomas...
October 22, 2016: Journal of Robotic Surgery
Racquel E Kohler, Jared Tomlinson, Tiyamike Eletima Chilunjika, Sven Young, Mina Hosseinipour, Clara N Lee
PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi...
October 22, 2016: Quality of Life Research
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