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https://www.readbyqxmd.com/read/29906381/points-pearls-management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#1
Andria Tatem, Rupa Kapoor, Bryan Wilson
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29905624/a-modified-posterior-c1-c2-fusion-technique-for-the-management-of-traumatic-odontoid-type-ii-fractures-by-using-intraoperative-spinal-navigation-mid-term-results
#2
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: To assess mid-term safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. DESIGN: Longitudinal prospective cohort study. SETTING: Urban Level 1 Trauma Center in Southwest Germany. PATIENTS/PARTICIPANTS: Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤ 24 hours. MAIN OUTCOME MEASUREMENTS: The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications...
June 4, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29905599/when-the-injury-s-healing-process-meets-the-needs-of-a-top-level-volleyball-player-a-non-conventional-treatment-of-a-mallet-fracture-re-injury
#3
Daniele Checcarelli, Mauro Zampolini, Michele Berloco, Claudia Fusco, Levent Özçakar
Managing top-level athlete's recovery after an injury is very complicated because it requires a challenging combination of clinical and social/professional aspects with the need to return as soon as possible to sports play. Herein, we report a top-level volleyball player for whom a finger splint combined with a custom made thermoplastic protection was used for the conservative management of a Mallet fracture re-injury. This way our player continued training and competitions in contrast to conventional rehabilitation protocols which suggest to avoid new traumas until the healing phase is completed...
June 13, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29905549/recent-principles-of-antimicrobial-treatment-in-polytrauma-induced-sepsis-and-septic-shock-review
#4
B Kanashvili, Kh Saganelidze, L Ratiani
20% of trauma deaths occur late after the injury. It is usually the result of sepsis, multi-system organ failure, or other complications. In Polytrauma induced sepsis and septic shock patients, antibacterial management is crucial. The knowledge of recent aspects of treatment is decreasing the costs and the resistance of pathogens, morbidity and mortality. Different models of treatment are suggested by authors, basically they are depended on: the patients age, there health condition, the factors of immunodeficiency, at the location of infection and others...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29904614/treatment-of-arrow-wounds-a-review
#5
REVIEW
Rafik Shereen, Rod J Oskouian, Marios Loukas, R Shane Tubbs
The arrow is one of the oldest weapons invented that has ties back to ancient civilization. With the advancement of modern weaponry, literature concerning the management of this traumatic wound has dwindled.  However, there are older written accounts that have led to our understanding of how we manage injuries inflicted by the arrow. One of the more comprehensive accounts was produced in the 19th century by a United States (US) Lieutenant Colonel named JH Bill. Recent cases in forensic pathology, as well as instances of trauma concerning arrowhead injuries, have documented a lack of comprehensive literature for the management of such injuries...
April 13, 2018: Curēus
https://www.readbyqxmd.com/read/29904601/incidence-and-risk-factors-for-complications-after-definitive-skeletal-fixation-of-lower-extremity-in-multiple-injury-patients-a-retrospective-chart-review
#6
Thananit Sangkomkamhang, Wilaiphorn Thinkhamrop, Bandit Thinkhamrop, Wongsa Laohasiriwong
Background : The management of multiple injuries is complex. Type and timing of treatment for lower extremity fractures is a controversial subject. Although many studies have demonstrated the safety and effectiveness of early treatment, others have suggested that early definitive stabilization may cause complications, especially with chest and head injuries. The aim of this study was to determine the complications and effects of timing of fixation, and investigate risk factors for complications in multiple injuries patients with lower extremity fractures...
2018: F1000Research
https://www.readbyqxmd.com/read/29902388/phthisis-bulbi-a-clinicopathological-perspective
#7
Koushik Tripathy, Rohan Chawla, Shreyas Temkar, Pradeep Sagar, Seema Kashyap, Neelam Pushker, Yog Raj Sharma
Phthisis bulbi denotes end-stage eye disease characterized by shrinkage and disorganization of the eye with the resultant functional loss. The major factors associated with the pathogenesis of phthisis are hypotony, deranged blood-ocular barriers, and inflammation. Common causes include trauma, surgery, infection, inflammation, malignancy, retinal detachment, and vascular lesions. A phthisical globe shows a small squared off shape, opaque and thickened cornea, thickened sclera, neovascularization of iris, cataract, cyclitic membrane, ciliochoroidal detachment, and retinal detachment...
June 14, 2018: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/29901722/genitourinary-surgical-workload-at-deployed-u-s-facilities-in-iraq-and-afghanistan-2002-2016
#8
Caryn A Turner, Jean A Orman, Zsolt T Stockinger, Steven J Hudak
Introduction: Genitourinary surgery constitutes approximately 1.15% of procedures performed for combat injuries. During forward deployment, surgeons usually deploy without urology support. To better understand the training and skills maintenance needs for genitourinary procedures by describing in detail the genitourinary surgical workload during 15 years of combat operations and compare our findings with those from previously published articles. Material and Methods: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Roles 2 and 3 medical treatment facilities in Iraq and Afghanistan, from January 2002 to May 2016...
June 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29901592/the-heterogeneous-management-of-pediatric-ankle-traumas-a-retrospective-descriptive-study
#9
Philippe Voizard, James Moore, Stéphane Leduc, Marie-Lyne Nault
Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901544/limits-of-intravascular-contrast-extravasation-on-computed-tomography-scan-to-define-the-need-for-pelvic-angioembolization-in-pelvic-blunt-trauma-a-specific-assessment-on-the-risk-of-false-positives
#10
Séverin Ramin, Margaux Hermida, Ingrid Millet, Thibault Murez, Valérie Monnin, Mazen Hamoui, Xavier Capdevila, Jonathan Charbit
BACKROUND: The objective was to assess the predictive performance of different intravascular contrast extravasation (ICE) characteristics for need for pelvic transarterial embolization (TAE) to determine the risk factors of false-positives. METHODS: A retrospective study was performed in our trauma center between 2010 and 2015. All severe trauma patients with pelvic fracture were included. Pelvic ICE characteristics on computed tomography (CT) scan were studied: arterial (aSICE), portal surface (pSICE), and extension (exSICE) anatomic relationships...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29901543/early-arterial-access-for-reboa-is-related-to-survival-outcome-in-trauma
#11
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yohei Okada, Yuri Kon, Kazuyuki Oka, Kenichiro Ishida, Yukitoshi Toyoda, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been employed in refractory hemorrhagic shock patients. Since the optimal timing of arterial access remains unclear, we evaluated the pre-occlusion status of patients and elapsed time from the arrival to the hospital are associated with the survival outcomes in the REBOA patients. METHODS: From August 2011-December 2016, The DIRECT-IABO investigators registered refractory hemorrhagic shock patients undergoing REBOA from 23 hospitals in Japan...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29901541/the-magic-number-are-improved-outcomes-observed-at-trauma-centers-with-undertriage-rates-below-5-percent
#12
Shreya Jammula, Eric H Bradburn, Brian W Gross, Alan D Cook, Michael J Reihart, Frederick B Rogers
BACKGROUND: The American College of Surgeons Committee on Trauma (ACSCOT) advises trauma centers maintain <5% undertriage rate (UTR), but provides limited rationale for this figure. We sought to determine whether patients managed at Level I/II trauma centers with a UTR<5% had improved outcomes compared to centers with >5% UTR. We hypothesized that similar overall adjusted outcomes would be observed at trauma centers in Pennsylvania regardless of their compliance with ACSCOT undertriage recommendation...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29901457/cystic-intestinal-pneumatosis-of-the-small-gut-etiopathogenesis-and-review-of-literature
#13
Luca Napolitano, Mathew Waku, Gustavo Maggi, Franco Ciarelli
Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan and endoscopy and are usually characterized by the typical pattern of gas bubbles in the wall of the intestine...
March 19, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29900820/outcomes-of-renal-salvage-for-penetrating-renal-trauma-a-single-institution-experience
#14
S Johar Raza, Perry Xu, Justin Barnes, Robert Fisher, Allison May, Oussama Darwish, Brian Dang, Prajakta Adsul, Carl A Freeman, Sameer A Siddiqui
INTRODUCTION: Conservative management of penetrating renal trauma is emerging, with data originating from centers with variable level of trauma care. This study reviews the outcomes of renal salvage after penetrating trauma at a level I trauma center. MATERIALS AND METHODS: An institutional review board approved trauma registry at Saint Louis University Hospital was retrospectively analyzed, for patients with penetrating renal trauma from 2009 to 2014. Patients were divided into nephrectomy group (NG) or non-nephrectomy group (non-NG), and compared...
June 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29899777/basal-ganglia-infarct-following-trivial-trauma-in-a-child-case-report-and-review-of-literature
#15
Satyashiva Munjal, Amit Srivastava, Kavita Kapoor, Veer Singh Mehta
A 2-year-old boy was presented to us with right-side hemiparesis after trivial fall. Diffusion-weighted magnetic resonance imaging showed an infarct in left basal ganglia and thalamic region. Secondary causes of stroke were ruled out. The child was managed conservatively. Basal ganglia infarct secondary to minor trauma is a rare event. Possible mechanisms leading to such an event and its management are discussed.
January 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29897630/attachment-based-therapy-for-elder-suffering-ptsd-symptoms-a-narrative-of-modeling-efficacy-for-improved-outcomes
#16
Brittany Steelman
PURPOSE: This paper will acquaint the psychiatric nurse with attachment theory-based therapy through a narrative of post traumatic stress disorder (PTSD) treatment of a Vietnam veteran with a history of compound trauma in childhood. DESIGN AND METHODS: Application of attachment-based therapy is discussed within the context of its guiding principles and tenets. FINDINGS: Attachment-based therapy is effective in reducing PTSD symptoms in a Vietnam veteran through forming secure base scripts from which the patient better evaluated and managed stressors, resulting in improved life functioning...
June 13, 2018: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/29897142/clinical-and-microbiological-properties-of-staphylococcus-lugdunensis-skin-infections
#17
Hiba Zaaroura, Yuval Geffen, Reuven Bergman, Emily Avitan-Hersh
Staphylococcus lugdunensis is an emerging pathogen in skin and soft tissue infections that was previously considered a commensal. The aim of this study was to elucidate the characteristics of skin infections by S. lugdunensis and its appropriate management, in a tertiary referral medical center. The clinical files, bacterial cultures and histopathology reports of all S. lugdunensis isolates from skin infections over a period of 8 years (September 2009-September 2017) were reviewed. S. lugdunensis was isolated from 29 patients with skin infections, aged 7-89 years (mean 33...
June 13, 2018: Journal of Dermatology
https://www.readbyqxmd.com/read/29896936/understanding-patients-and-dentists-perspectives-in-dental-trauma-management-a-mixed-methods-study
#18
Wataru Ode, Violeta Lopez, Mun Loke Wong, Lone Schou, Victoria Soo Hoon Yu
BACKGROUND/AIM: Patients suffering dental trauma are unprepared for the disability challenge and necessary rehabilitation, while a traumatic event places an expanded demand on the dentist who is focused on treating disease. The aim of this study was to examine the impact of traumatic dental injuries (TDI) on patients, and to compare patients' and dentists' perceptions of the event. MATERIAL AND METHODS: TDI patients (aged ≥ 21 years) attending a tertiary dental hospital from 2011 - 2013 and their dentists were recruited with informed consent...
June 13, 2018: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/29896626/effect-of-negative-pressure-wound-therapy-vs-standard-wound-management-on-12-month-disability-among-adults-with-severe-open-fracture-of-the-lower-limb-the-wollf-randomized-clinical-trial
#19
Matthew L Costa, Juul Achten, Julie Bruce, Elizabeth Tutton, Stavros Petrou, Sarah E Lamb, Nick R Parsons
Importance: Open fractures of the lower limb occur when a broken bone penetrates the skin. There can be major complications from these fractures, which can be life-changing. Objectives: To assess the disability, rate of deep infection, and quality of life in patients with severe open fracture of the lower limb treated with negative pressure wound therapy (NPWT) vs standard wound management after the first surgical debridement of the wound. Design, Setting, and Participants: Multicenter randomized trial performed in the UK Major Trauma Network, recruiting 460 patients aged 16 years or older with a severe open fracture of the lower limb from July 2012 through December 2015...
June 12, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29895725/pediatric-headache-clinic-model-implementation-of-integrative-therapies-in-practice
#20
REVIEW
Anna Esparham, Anne Herbert, Emily Pierzchalski, Catherine Tran, Jennifer Dilts, Madeline Boorigie, Tammie Wingert, Mark Connelly, Jennifer Bickel
The demand for integrative medicine has risen in recent years as research has demonstrated the efficacy of such treatments. The public has also become more conscientious of the potential limitations of conventional treatment alone. Because primary headache syndromes are often the culmination of genetics, lifestyle, stress, trauma, and environmental factors, they are best treated with therapies that are equally multifaceted. The Children&rsquo;s Mercy Hospital, Kansas City, Missouri Headache Clinic has successfully incorporated integrative therapies including nutraceuticals, acupuncture, aromatherapy, biofeedback, relaxation training, hypnosis, psychology services, and lifestyle recommendations for headache management...
June 12, 2018: Children
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