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Trauma surgery

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https://www.readbyqxmd.com/read/28930946/evaluating-the-traditional-day-and-night-shift-in-an-acute-care-surgery-fellowship-is-the-swing-shift-a-better-choice
#1
Paul J Chestovich, Christopher F McNicoll, Nichole K Ingalls, Deborah A Kuhls, Douglas R Fraser, Shawna L Morrissey, John J Fildes
BACKGROUND: Fellowship trainees in Acute Care Surgery require experience in the management of complex and operative trauma cases. Trauma center staffing usually follows standard 12 or 24 hour shifts, with resident and fellow trainees following a similar schedule. Although trauma admissions can be generally unpredictable, we analyzed temporal trends of trauma patient arrival times to determine the best time frame to maximize trainee experience during each day. METHODS: We reviewed ten years (2007-2016) of trauma registry data for blunt and penetrating trauma activations...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930942/surgical-residents-interpretation-of-diagnostic-radiologic-imaging-in-the-traumatically-injured-patient
#2
Elias Fakhoury, Daria Abolghasemi, Justin McKinney, Alena Naumova, Scott Wessner, Osama Elsawy, Jamshed Zuberi, Robert V Madlinger
BACKGROUND: Senior surgical residents are of paramount importance in directing further therapeutic modalities based on their interpretation of critical diagnostic imaging. We propose that senior surgical residents are proficient with interpreting radiologic imaging studies in the trauma patient. METHODS: A prospective cohort study was performed comparing surgery resident interpretations of computerized tomography (CT) scans of the head, maxillofacial bones, spine (cervical, thoracic, lumbar), chest, abdomen, pelvis, and chest X-rays versus final radiologists' reports at a level II trauma center from September 2014 to May 2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930931/multiple-concomitant-traumatic-pseudoaneurysms-of-the-superficial-temporal-artery
#3
Doga Gurkanlar, Sevda Lafci Fahrioğlu
The authors present a case with a 22-year-old man suffering from a 2 pseudoaneurysms at the temporal region following trauma. The second pseudoaneurysm was diagnosed through an astute use of digital subtraction angiography along with ultrasound to the right external carotid artery which was preferred due to the presence of a vascular pathology at the region of the trauma. During surgery, the distal and proximal ends of both aneurysms were ligated and resected. The concomitant pseudoaneurysms and the use of digital subtraction angiography should be kept in mind in such trauma patients to prevent additional surgical interventions...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930926/fractures-of-the-nasal-bones-is-external-splinting-really-warranted
#4
Ourania Schoinohoriti, Dimosthenis Igoumenakis, George Rallis
BACKGROUND: It has been advocated that reduction of nasal bone fractures should be followed by internal packing and/or external splinting. Despite the ample literature concerning the advantages and limitations of various splint types, the necessity and effectiveness of external splinting has not been well documented. OBJECTIVE: To present the authors' experience and review the literature on treatment of nasal bone fractures, focusing on the indications and effectiveness of external splinting following closed reduction...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#5
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#6
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929807/splenic-artery-embolization-in-blunt-trauma-a-single-center-retrospective-comparison-of-the-use-of-gelatin-sponge-versus-coils
#7
Pasteur Rasuli, Bardia Moosavi, Gordon J French, William Petrcich, Ian Hammond
OBJECTIVE: The purpose of this study was to compare the efficacy of gelatin sponge with that of coils for splenic artery embolization in the treatment of blunt splenic injury. MATERIALS AND METHODS: A single-center retrospective review was performed with the records of 63 patients (45 men, 18 women; mean age, 45.5 years; range, 16-84 years) with blunt splenic injury treated at a tertiary care trauma center by splenic artery embolization with gelatin sponge (n = 30 patients) or metallic coils (n = 33 patients) between 2005 and 2014...
September 20, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28929612/comparison-of-laparoscopic-toupet-and-laparoscopic-nissen-fundoplications-in-neurologically-normal-children
#8
Go Miyano, Masaya Yamoto, Hiromu Miyake, Masakatsu Kaneshiro, Keiichi Morita, Hiroshi Nouso, Mariko Koyama, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Koji Fukumoto, Atsuyuki Yamataka, Naoto Urushihara
INTRODUCTION: We compared laparoscopic Toupet fundoplication (LTF) and laparoscopic Nissen fundoplication (LNF) in neurologically normal children. METHODS: Forty neurologically normal children who were followed up for more than 3 years after LTF (n = 22) or LNF (n = 18) were reviewed retrospectively. LTF and LNF were performed between 2006 and 2012. RESULTS: There were no significant differences in gender (LTF, 15 male and 7 female patients; LNF:, 12 male and 6 female patients), mean age at surgery (LTF vs LNF: 2...
September 20, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28929069/our-experience-of-treating-wide-spectrum-of-external-ear-canal-atresia-of-different-etiologies-in-pediatric-patients
#9
Kranti Bhavana
External auditory canal atresia (EACA) is a common otologic condition. Etiology can vary from congenital to acquired causes. It causes considerable difficulty to the patient. Bilateral ear canal atresia in children can lead to speech delays due to hearing impairment caused by this condition. Though easily diagnosed it is one of the most difficult conditions to treat. Acquired conditions can affect any age group. Restenosis following treatment is very common. This article focuses on the treatment of EACA due to different etiologies and emphasizes on special points of surgical treatment and follow up...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929059/incidence-of-facial-nerve-canal-dehiscence-in-primary-and-revision-cholesteatoma-surgery
#10
Mohammad Faramarzi, Sareh Roosta
The aim of this retrospective study was to determine the incidence of facial canal dehiscence (FCD) in primary and revision cholesteatoma surgery in a tertiary referral center. Moreover, our second goal was to identify association between FCD and other intra-operative pathological findings in a group of patients with cholesteatoma surgery. Inclusion criteria were primary and revision canal wall up and canal wall down tympanomastoidectomy in patients who suffers from chronic otitis media (COM) with cholesteatoma...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28928953/treatment-of-femoral-shaft-fractures-with-monoaxial-external-fixation-in-polytrauma-patients
#11
Gianluca Testa, Domenico Aloj, Alessandro Ghirri, Eraclite Petruccelli, Vito Pavone, Alessandro Massé
Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device...
2017: F1000Research
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#12
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927935/different-effect-of-percutaneous-plate-insertion-via-anteromedial-vs-anterolateral-approach-on-intracompartmental-pressure-of-the-leg-a-cadaveric-study
#13
Chavarin Amarase, Wanchat Thimasarn, Saran Tantavisut, Thanasil Huanmanop, Yongsak Wangroongsub, Worawat Limthongkul
BACKGROUND: Currently Minimally Invasive Plate Osteosynthesis (MIPO) technique for tibial shaft fracture management has gained wide attention. However, an increased intracompartmental pressure after the plate insertion may result in postoperative acute compartment syndrome. We reported the difference of immediate effect of percutaneous plate insertion using 2 approaches of MIPO technique on anterior compartment pressure of the legs. MATERIALS AND METHODS: Eight soft cadaveric legs (one female and three males) without previous history of skeletal trauma or surgery were infused with normal saline to create the sustained intracompartmental pressure of 20mm Hg in all four compartments...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28927209/intraoperative-imaging-in-traumatic-peripheral-nerve-lesions-correlating-histologic-cross-sections-with-high-resolution-ultrasound
#14
S Shelby Burks, Iahn Cajigas, Jean Jose, Allan D Levi
BACKGROUND: Intraoperative ultrasound (US) has been used as a guide during surgery to better identify deep neuroanatomical structures. OBJECTIVE: To correlate histologic cross-sections from nerve samples taken at the time of surgery with axial, high-resolution US images at similar locations and validate this important tool for intraoperative guidance in nerve surgery. METHODS: Three subjects undergoing nerve repair procedures after traumatic nerve injuries were enrolled prospectively...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28926849/-a-nationwide-survey-of-undergraduate-training-in-orthopaedics-and-trauma-surgery
#15
Miriam Ruesseler, Susanne Froehlich, Sigrid Ruesseler, Julian Zabel, Jasmina Sterz, Udo Obertacke
Background Musculoskeletal conditions are the most frequent cause of long-term pain and disability. Scientifically funded, structured training would be highly desirable for all medical students and of great economic relevance for the health care system. The present article portrays the status quo of undergraduate training in orthopaedics and trauma surgery, with a comparison to the status quo of 2008. Material and Methods A 51-item questionnaire was sent to all heads of the departments of orthopaedics or trauma surgery at the 37 medical faculties in Germany...
September 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28924070/-a-case-of-cerebral-venous-sinus-thrombosis-secondary-to-subclinical-basedow-disease
#16
Ichiro Kawahara, Keisuke Toyoda, Makoto Hirose, Naoki Kitagawa
Cerebral venous sinus thrombosis(CVST)is a rare condition accounting for <1% of all strokes. It has been linked to a multitude of risk factors, including infections, oral contraceptive use, coronary disease, malignant disease, trauma, surgery, coagulopathy and several others. However, the association between hyperthyroidism and CVST is poorly understood. We describe here a rare case of CVST, secondary to subclinical Basedow disease. A 68-year-old woman with general fatigue, headache, speech disturbance and slow behavior was admitted to our hospital...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28924066/-factors-contributing-to-surgical-intervention-for-subacute-subdural-hematoma-enlargement-in-patients-with-mild-head-injuries
#17
Yosuke Akamatsu, Tohru Sasaki, Masayuki Kanamori, Shinsuke Suzuki, Hiroshi Uenohara, Teiji Tominaga
Delayed neurological deterioration following mild head injury(MHI)usually occurs within 24 hours. However, some cases require delayed surgical evacuation of an acute subdural hematoma(ASDH), owing to subacute progressive hematoma enlargement. This study aimed to determine radiological or clinical parameters associated with surgical intervention in ASDH cases in which surgery was not initially considered necessary. From 2010 to 2015, 64 patients were non-surgically treated for ASDH following MHI. We evaluated the various outcomes of eventual surgical ASDH evacuation after the first 48 hours following injury, due to hematoma enlargement and clinical deterioration...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#18
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#19
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920036/hematoma-block-versus-general-anesthesia-in-distal-radius-fractures-in-patients-over-60-years-in-trauma-emergency
#20
Ali Tabrizi, Fardin Mirza Tolouei, Ebrahim Hassani, Hassan Taleb, Asghar Elmi
BACKGROUND: Distal radius fractures are among common fractures in the elderly. Regarding the age, background diseases, and possible risks, analgesia method is of great importance in this group. OBJECTIVES: The aim of this study was to compare two analgesia methods including hematoma block and general anesthesia in people over 60 years in the orthopedic emergency department. METHODS: 68 elderly patients referring to the emergency department of a medical teaching center were selected based on the inclusion criteria for a non-randomized clinical trial...
February 2017: Anesthesiology and Pain Medicine
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