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https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#1
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28902951/brachioradial-pruritus-and-notalgia-paraesthetica-a-comparative-observational-study-of-clinical-presentation-and-morphological-pathologies
#2
Manuel P Pereira, Hannah Lüling, Anette Dieckhöfer, Sabine Steinke, Claudia Zeidler, Sonja Ständer
Brachioradial pruritus (BRP) and notalgia paraesthetica (NP) represent 2 of the most common neuropathic itch syndromes. A total of 58 consecutive patients presenting at the Center for Chronic Pruritus, University Hospital Münster, were analysed with regard to clinical presentation, anatomical and morphological pathologies, impairment in quality of life, and response to treatment with topical capsaicin. Patients with BRP reported stinging and burning more often than those with NP. In the BRP group structural magnetic resonance imaging abnormalities more frequently correlated with localization of the symptoms compared with in patients with NP...
September 13, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28902023/novel-modality-for-neck-rejuvenation-a-prospective-multicenter-trial-of-percutaneous-radiofrequency-ablation-of-the-cervical-branch-of-the-facial-nerve
#3
Daniel Rivlin, D Ryan Skinner, Christina Y Steinmetz-Rodriguez, Jordan S Fabrikant, Marie A Stoddard, Jeffrey J So, Shauntell J Solomon, Ronald L Moy
BACKGROUND: Neck rejuvenation offers few modalities of treatments limited to either invasive plastic surgery or temporary neuromodulation using botulinum toxin. OBJECTIVE: To access the efficacy, longevity, and safety of percutaneous monopolar radiofrequency (RF) ablation of the cervical branch of the facial nerve innervating the platysma for neck rejuvenation. MATERIALS AND METHODS: This prospective, multicenter trial enrolled 19 adult patients with noticeable platysmal banding at 2 different centers...
September 8, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28900039/the-contributing-risk-of-tobacco-use-for-ards-development-in-burn-injured-adults-with-inhalation-injury
#4
Majid Afshar, Giora Netzer, Michael J Mosier, Richard S Cooper, William Adams, Ellen L Burnham, Elizabeth J Kovacs, Ramon Durazo-Arvizu, Stephanie Kliethermes
BACKGROUND: This study aims to determine the relationship between tobacco use, inhalation injury, and ARDS in burn-injured adults. METHODS: This study was an observational cohort of 2,485 primary burn admissions to a referral burn center between January 1, 2008 and March 15, 2015. Subjects were evaluated by methods used to account for mediation and traditional approaches (multivariable logistic regression and propensity score analysis). Mediation analysis examined both the (1) indirect effect of tobacco use via inhalation injury as the mediator on ARDS development and (2) the direct effect of tobacco use alone on ARDS development...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28899444/use-of-implementation-science-for-a-sustained-reduction-of-central-line-associated-bloodstream-infections-in-a-high-volume-regional-burn-unit
#5
Geeta Sood, Julie Caffrey, Kelly Krout, Zeina Khouri-Stevens, Kevin Gerold, Stefan Riedel, Janet McIntyre, Lisa L Maragakis, Renee Blanding, Jonathan Zenilman, Richard Bennett, Peter Pronovost
OBJECTIVE We describe the use of implementation science at the unit level and organizational level to guide an intervention to reduce central-line-associated bloodstream infections (CLABSIs) in a high-volume, regional, burn intensive care unit (BICU). DESIGN A single center observational quasi-experimental study. SETTING A regional BICU in Maryland serving 300-400 burn patients annually. INTERVENTIONS In 2011, an organizational-level and unit-level intervention was implemented to reduce the rates of CLABSI in a high-risk patient population in the BICU...
September 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#6
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28891876/impact-of-a-nurse-residency-program-on-transition-to-specialty-practice
#7
Susan A Boyer, Krystal K Valdez-Delgado, Jody L Huss, Amber J Barker, Elizabeth A Mann-Salinas
A nurse residency program can support transition for new-to-specialty nurses but requires commitment of time and resources. This implementation project used a specialty residency program shown to be effective in a Burn Center, and translated it into the Emergency Department and Maternal Child Health area located within the same medical treatment facility. Preceptor survey responses and leadership assessment of program suitability provided data related to intervention impact. The evidence pertaining to developing specialty knowledge, skills, competency, and clinical reasoning validated program efficacy...
September 2017: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/28890948/green-environment-and-incident-depression-in-south-africa-a-geospatial-analysis-and-mental-health-implications-in-a-resource-limited-setting
#8
Andrew Tomita, Alain M Vandormael, Diego Cuadros, Enrico Di Minin, Vuokko Heikinheimo, Frank Tanser, Rob Slotow, Jonathan K Burns
BACKGROUND: Unprecedented levels of habitat transformation and rapid urbanisation are changing the way individuals interrelate with the natural environment in developing countries with high economic disparities. Although the potential benefit of green environments for mental health has been recognised, population-level evidence to this effect is scarce. We investigated the effect of green living environment in potentially countering incident depression in a nationally representative survey in South Africa...
July 2017: The Lancet. Planetary health
https://www.readbyqxmd.com/read/28888298/rehabilitation-in-the-acute-versus-outpatient-setting
#9
REVIEW
Gabriel Hundeshagen, Oscar E Suman, Ludwik K Branski
Rehabilitation of patients with burn injuries aims to restore strength, coordination, and mobility as closely to normal as possible and should begin immediately after initial admission. In the acute phase, baseline assessments are made against which all subsequent rehabilitation success is held. In the intermediate phase, active, full range-of-motion movement, ambulation of steadily increasing distances, and resistive exercise and stretching aid in the prevention of muscle and bone atrophy and preserve muscle memory and coordination...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28883446/biomass-burning-in-the-amazon-region-causes-dna-damage-and-cell-death-in-human-lung-cells
#10
Nilmara de Oliveira Alves, Alexandre Teixeira Vessoni, Annabel Quinet, Rodrigo Soares Fortunato, Gustavo Satoru Kajitani, Milena Simões Peixoto, Sandra de Souza Hacon, Paulo Artaxo, Paulo Saldiva, Carlos Frederico Martins Menck, Silvia Regina Batistuzzo de Medeiros
Most of the studies on air pollution focus on emissions from fossil fuel burning in urban centers. However, approximately half of the world's population is exposed to air pollution caused by biomass burning emissions. In the Brazilian Amazon population, over 10 million people are directly exposed to high levels of pollutants resulting from deforestation and agricultural fires. This work is the first study to present an integrated view of the effects of inhalable particles present in emissions of biomass burning...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28877134/the-use-of-intravenous-and-inhaled-colistin-therapy-during-a-burn-center-outbreak-of-multidrug-resistant-acinetobacter-baumannii
#11
Tomas J Saun, Alan D Rogers, Jerome A Leis, Robert Cartotto
The authors report on the use of combination intravenous and inhaled colistin therapy in 2 patients with major burns admitted to an American Burn Association-verified burn center during a multidrug-resistant (MDR) Acinetobacter baumannii outbreak. Both patients had documented, culture-proven MDR Acinetobacter ventilator-associated pneumonia and bacteremia leading to sepsis. Both patients were successfully extubated and subsequently discharged from hospital. In this article, the authors provide the timeline of events and treatments that were used in these 2 cases...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877128/antioxidant-and-trace-element-supplementation-reduce-the-inflammatory-response-in-critically-ill-burn-patients
#12
Sarah Rehou, Shahriar Shahrokhi, Rimona Natanson, Mile Stanojcic, Marc G Jeschke
Oxidative stress after burn injury induces inflammatory and hypermetabolic responses associated with adverse outcomes. We propose that antioxidant and trace element supplementation may reduce oxidative stress and subsequently alleviate inflammation and hypermetabolism, thus improving clinical outcomes. We conducted a cohort study of adult patients with an acute burn injury admitted to our provincial burn center. Patients in the antioxidant group received an intravenous infusion of multivitamins and trace elements for the first 14 days after admission...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28873104/management-of-trauma-and-burn-scars-the-dermatologist-s-role-in-expanding-patient-access-to-care
#13
Nathanial R Miletta, Matthias B Donelan, Chad M Hivnor
Recent advances in laser surgery and our understanding of wound healing have ushered in a new era of trauma and burn scar management. Traditional therapy has centered around scar excision followed by primary closure or tissue replacement with flaps and grafts. This approach represents a perpetuation of the common fallacy that extensive scar improvement requires extensive surgical intervention. Laser surgery in conjunction with pharmacotherapy and minor tissue-conserving surgery produces well-healed and remodeled existing tissue that provides the most natural appearance and function of the skin...
July 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28871333/-thermal-injuries-clinical-and-acute-management-in-pediatric-practice
#14
REVIEW
K Schriek, M Sinnig
BACKGROUND: Each year 30,000 children suffer from burn injuries in Germany and 2000 of these children must be treated in special pediatric burn centers. Approximately two thirds of these children are less than 4 years old, 70% of thermal injuries are due to scalding with hot liquids. OBJECTIVES: The aim of this article is to give an overview of the characteristics of pediatric burn trauma with recommendations for initial treatment, surgical therapy as well as follow-up treatment...
September 4, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28869387/report-on-the-observer-training-at-brooke-army-medical-center-in-san-antonio-texas-usa
#15
A Bajus
A short report describing the unique experience of visiting the famous Brooke Army Medical Center (BAMC) in San Antonio, Texas, USA and its Burn Center and Plastic Surgery Department in the period between June 27 and August 26, 2016.
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28869381/meek-micrografting-technique-and-its-use-in-the-treatment-of-severe-burn-injuries-at-the-university-hospital-ostrava-burn-center
#16
H Klosová, Z Němečková Crkvenjaš, J Štětinský
BACKGROUND: Early necrectomy and skin autotransplantation are prerequisites for successful treatment of extensive burns. Insufficient autograft donor site availability is a limiting factor. The Meek micrografting technique, published by C. P. Meek in 1958, appears to be a potential solution. Skin grafts are cut into micrografts and expanded at a ratio of 1:3, 1:4, 1:6 or 1:9. Thus, even in cases with limited donor site availability, it is possible to cover large areas after necrectomy...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28865914/quality-of-life-of-burn-survivors-treated-in-the-military-burn-center
#17
Linda H Yoder, D Curk McFall, Dale N Glaser
BACKGROUND: Limited research explains the quality of life (QOL) among burn survivors during post-hospitalization rehabilitation. PURPOSE: To determine the QOL of military and civilian burn survivors treated in the military burn center. METHODS: In this longitudinal study, QOL was examined in 131 burn survivors (88 civilians; 43 military). Participants completed the Abbreviated Burn Specific Health Scale (BSHS-A) and the Satisfaction with Life Scale (SWLS) over 5 time points post-discharge...
July 15, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28855431/us-guided-percutaneous-microwave-ablation-for-the-treatment-of-benign-thyroid-nodules
#18
Wenjun Wu, Xiaohua Gong, Qi Zhou, Xiong Chen, Xiaojun Chen, Bimin Shi
The aim of this study was to define the effectiveness and safety of ultrasound(US)-guided percutaneous microwave ablation(MWA) for benign thyroid nodules with one session treatment. A total 121 benign thyroid nodules in 100 euthyroid patients underwent MWA in one medical center between August 2014 and December 2015. MWA was performed with an internally cooled antenna under local anesthesia. The volume of the nodule, cosmetic score and symptom score were compared before and after the procedure. The volume reduction rate(VRR) was also evaluated...
August 29, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28855061/burns-in-a-major-burns-center-in-east-china-from-2005-to-2014-incidence-and-outcome
#19
Xiaoming Fan, Bing Ma, Ding Zeng, Xiao Fang, Haihang Li, Shichu Xiao, Guangyi Wang, Hongtai Tang, Zhaofan Xia
OBJECTIVE: Information about epidemiology on burns is rare in China. The aim of this article is to describe the pattern of burns in East China during a 10-year time period. METHOD: A retrospective data analysis was performed on all hospitalized patients to the burn center at the Changhai hospital, one of major burn centers in East China, from 2005 to 2014. RESULTS: We included 3376 patients in this study. Among them, 48.1% were from 27 provinces out of Shanghai and nearly 90% were from East China...
August 27, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28854887/acquisition-and-clearance-of-multidrug-resistant-acinetobacter-baumannii-on-healthy-young-adults-concurrently-burned-in-a-dust-explosion-in-taiwan-the-implication-for-antimicrobial-stewardship
#20
Po-Yen Huang, Shian-Sen Shie, Jung-Jr Ye, Shih-Pin Lin, Tsui-Ping Liu, Ting-Shu Wu, Tsu-Lan Wu, Shiow-Shuh Chuang, Ming-Huei Cheng, Yu-Chia Hsieh, Ching-Tai Huang
BACKGROUND: Information is limited about the effect of restricted carbapenem use on clearance of multi-drug resistant Acinetobacter baumannii (MDRAB). We sought to determine the time effect of antibiotic exposure on multi-drug resistant Acinetobacter baumannii (MDRAB) acquisition and clearance. METHODS: We conducted a retrospective observational study at the intensive care units of a tertiary medical center. Forty-two of a cohort of previously healthy young adults who were concurrently burned by a dust explosion was included...
August 30, 2017: BMC Infectious Diseases
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