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https://www.readbyqxmd.com/read/28110260/road-traffic-injuries-among-children-and-adolescents-in-singapore-who-is-at-greatest-risk
#1
Shu-Ling Chong, Arif Tyebally, Su Yah Chew, Yang Chern Lim, Xun Yi Feng, Sock Teng Chin, Lois K Lee
INTRODUCTION: Pediatric road traffic injuries remain a significant cause of death and disability in many countries in Asia, despite the implementation of road traffic safety laws. We aim to describe the injuries, the use of restraints among road users, and risk factors associated with severe injuries for children in Singapore. METHODS: We performed a retrospective chart review of road traffic injuries presenting to the only two pediatric tertiary care hospitals in Singapore, from January 2012 to April 2016...
January 19, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28108618/timing-of-decompressive-hemicraniectomy-for-stroke-a-nationwide-inpatient-sample-analysis
#2
Hormuzdiyar H Dasenbrock, Faith C Robertson, Henrikas Vaitkevicius, M Ali Aziz-Sultan, Donovan Guttieres, Ian F Dunn, Rose Du, William B Gormley
BACKGROUND AND PURPOSE: Previous clinical trials were not designed to discern the optimal timing of decompressive craniectomy for stroke, and the ideal surgical timing in patients with space-occupying infarction who do not exhibit deterioration within 48 hours is debated. METHODS: Patients undergoing decompressive craniectomy for stroke were extracted from the Nationwide Inpatient Sample (2002-2011). Multivariable logistic regression evaluated the association of surgical timing with mortality, discharge to institutional care, and poor outcome (a composite end point including death, tracheostomy and gastrostomy, or discharge to institutional care)...
January 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#3
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28107241/polytrauma-patients-with-associated-spine-fractures-an-assessment-of-surgical-intervention-on-patient-outcome
#4
Steven R Niedermeier, Safdar N Khan
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To examine perioperative characteristics among polytraumatized patients with operative, unstable spine fractures with and without concomitant operative long bone injuries. SUMMARY OF BACKGROUND DATA: Treatment of polytrauma patients has delicate and time-sensitive protocols to ensure successful recovery. The literature defines standards for vertebral injury and surgical intervention...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#5
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#6
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28102337/deep-brain-stimulation-for-myoclonus-dystonia-syndrome-with-double-mutations-in-dyt1-and-dyt11
#7
Jia-Wei Wang, Ji-Ping Li, Yun-Peng Wang, Xiao-Hua Zhang, Yu-Qing Zhang
Myoclonus-dystonia syndrome (MDS) is a rare autosomal dominant inherited disorder characterized by the presentation of both myoclonic jerks and dystonia. Evidence is emerging that deep brain stimulation (DBS) may be a promising treatment for MDS. However, there are no studies reporting the effects of DBS on MDS with double mutations in DYT1 and DYT11. Two refractory MDS patients with double mutations were treated between 2011 and 2015 in our center. Genetic testing for DYT1 and DYT11 was performed through polymerase chain reaction amplification and direct sequencing of the specific exons of genes...
January 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28102155/surgical-treatment-of-radial-head-fractures-outcomes-and-complications
#8
Bartosz Chwedczuk, Piotr Piekarczyk, Krzysztof Kwiatkowski, Krzysztof Piątkowski
BACKGROUND: Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications. MATERIAL AND METHODS: The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. The treatment outcomes were assessed according to the Broberg and Morrey rating system and the QuickDASH score...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28101038/successful-management-in-a-case-of-traumatic-retinal-detachment-due-to-open-globe-injury-using-microincisional-vitrectomy
#9
Wei-Yu Lai, Tsung-Tien Wu
BACKGROUND: Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed. CASE PRESENTATION: A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#10
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28098065/the-treatment-of-post-thrombotic-syndrome
#11
Karina Schleimer, Mohammad Esmaeil Barbati, Alexander Gombert, Volker Wienert, Jochen Grommes, Houman Jalaie
BACKGROUND: Post-thrombotic syndrome (PTS) arises in 20-50% of patients who have sustained a deep vein thrombosis and markedly impairs their quality of life. METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed and the Cochrane Library, and on the guidelines of the German Societies of Phlebology and Vascular Surgery (Deutsche Gesellschaft für Phlebologie, Deutsche Gesellschaft für Gefässchirurgie). RESULTS: The treatment options are conservative treatment with compression and patient exercises, endovascular recanalization with stent angioplasty, and open bypass surgery of the iliac obstructions...
December 16, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28097116/kikuchi-fujimoto-disease-misdiagnosed-as-relapse-of-the-infection-after-treatment-of-periprosthetic-hip-joint-infection
#12
Kyung-Keun Min, Byung-Woo Min, Kyung-Jae Lee, Jung-Hoon Choi
Periprosthetic joint infection (PJI) of the hip can be difficult to treat and can lead to a number of problems including: i) severe functional decline of the hip joint and ii) increasing financial burden for patients due to long treatment periods and the need for repeated surgical interventions. Because there is risk of inadequate control of infection or relapse of a preexisting infection following the treatment of PJI through surgery, it is important to closely observe clinical symptoms such as systemic fever...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28091894/mechanisms-of-action-of-surgical-interventions-on-weight-related-diseases-the-potential-role-of-bile-acids
#13
REVIEW
Mohsen Mazidi, Pedro Paulo P de Caravatto, John R Speakman, Ricardo V Cohen
Surgical interventions for weight-related diseases (SWRD) may have substantial and sustainable effect on weight reduction, also leading to a higher remission rate of type 2 diabetes (T2D) mellitus than any other medical treatment or lifestyle intervention. The resolution of T2D after Roux-en-Y gastric bypass (RYGB) typically occurs too quickly to be accounted for by weight loss alone, suggesting that these operations have a direct impact on glucose homeostasis. The mechanisms underlying these beneficial effects however remain unclear...
January 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28091851/operative-treatments-for-reflux-after-bariatric-surgery-current-and-emerging-management-options
#14
Daniela Treitl, Derek Nieber, Kfir Ben-David
Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux...
January 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28089404/the-schhs-hip-fracture-clinical-network-experience-improving-care-and-outcomes-through-an-interprofessional-approach
#15
Gillian Puckeridge, Morné Terblanche, Debbie Massey
BACKGROUND: Hip fractures are a major global health care issue, with the 1.26 million estimated cases in 1990 predicted to increase to 4.5 million by 2050. Varying models of care have been developed to improve outcomes following fragility hip fractures. Most of these care models embrace an interprofessional approach to care. Specialist orthopedic nurses play an important role in the management of fragility hip fracture patients and their contribution to the interprofessional health care team is an important predictor of patient outcomes...
December 18, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28089261/is-previous-nonarthroplasty-surgery-a-risk-factor-for-periprosthetic-infection-in-primary-shoulder-arthroplasty
#16
Jean-David Werthel, Taku Hatta, Bradley Schoch, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: The purpose of this study was to determine the risk of periprosthetic infection after primary shoulder arthroplasty (SA) in patients undergoing previous nonarthroplasty shoulder surgery compared with those without previous surgery. MATERIALS AND METHODS: All patients undergoing primary SA at our institution between 1970 and 2012 were included in this study. The cohort consisted of 4577 patients treated with 2890 total SAs, 1233 hemiarthroplasties, and 454 reverse SAs; 813 (18%) patients had undergone prior nonarthroplasty shoulder surgery on the operative side...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087505/2016-update-of-the-asas-eular-management-recommendations-for-axial-spondyloarthritis
#17
Désirée van der Heijde, Sofia Ramiro, Robert Landewé, Xenofon Baraliakos, Filip Van den Bosch, Alexandre Sepriano, Andrea Regel, Adrian Ciurea, Hanne Dagfinrud, Maxime Dougados, Floris van Gaalen, Pál Géher, Irene van der Horst-Bruinsma, Robert D Inman, Merryn Jongkees, Uta Kiltz, Tore K Kvien, Pedro M Machado, Helena Marzo-Ortega, Anna Molto, Victoria Navarro-Compàn, Salih Ozgocmen, Fernando M Pimentel-Santos, John Reveille, Martin Rudwaleit, Jochen Sieper, Percival Sampaio-Barros, Dieter Wiek, Jürgen Braun
To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009...
January 13, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28087488/cathepsin-k-targeted-sub-micron-particles-for-regenerative-repair-of-vascular-elastic-matrix
#18
Brenton Jennewine, Jonathan Fox, Anand Ramamurthi
: Abdominal Aortic Aneurysms (AAA) involve slow dilation and weakening of the aortic wall due to breakdown of structural matrix components, such as elastic fibers by chronically overexpressed matrix metalloproteinases (MMPs), primarily, MMPs-2 and -9. Auto-regenerative repair of disrupted elastic fibers by smooth muscle cells (SMCs) at the AAA site is intrinsically poor and together with chronic proteolysis prevents restoration of elastin homeostasis, necessary to enable AAA growth arrest or regression to a healthy state...
January 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28087482/prolonged-acute-suppression-of-cysteinyl-leukotriene-to-reduce-capsular-contracture-around-silicone-implants
#19
Byung Hwi Kim, Min Park, Hyo Jin Park, Seung Ho Lee, Sung Yoon Choi, Chun Gwon Park, Su Min Han, Chan Yeong Heo, Young Bin Choy
: We hypothesize that periodically early, local suppression of cysteinyl leukotrienes (CysLTs), which are potent inflammatory mediators, can reduce the fibrotic capsular contracture around silicone implants. We tested this hypothesis with the silicone implants enabled with the sustained release of montelukast, a CysLT receptor antagonist, for 3 and 15 days. In this work, we inserted each of the distinct implants into the pocket of the subpanniculus carnosus plane of living rats and performed histological and immunofluorescent (IF) analyses of the tissues biopsied at predetermined periods for 12 weeks after implant insertion...
January 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28079242/application-of-baros-questionnaire-in-obese-patients-undergoing-bariatric-surgery-with-2-years-of-evolution
#20
Caetano de Queiroz, José Afonso Sallet, Pedro Gabriel Melo DE Barros E Silva, Luzia da Gloria Pereira de Sousa Queiroz, Jélis Arenas Pimentel, Paulo Clemente Sallet
BACKGROUND: -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera-tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery...
January 2017: Arquivos de Gastroenterologia
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