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https://www.readbyqxmd.com/read/28225743/damage-control-resuscitation-in-patients-with-severe-traumatic-hemorrhage-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#1
Jeremy W Cannon, Mansoor A Khan, Ali S Raja, Mitchell J Cohen, John J Como, Bryan A Cotton, Joseph J Dubose, Erin E Fox, Kenji Inaba, Carlos J Rodriguez, John B Holcomb, Juan C Duchesne
BACKGROUND: The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control resuscitation (DCR). This guideline evaluates several aspects of DCR including the role of massive transfusion (MT) protocols, the optimal target ratio of plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, and the role of recombinant activated factor VII (rVIIa) and tranexamic acid (TXA). METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a subcommittee of the Practice Management Guidelines (PMG) Section of EAST conducted a systematic review using MEDLINE and EMBASE...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225742/review-of-military-and-civilian-trauma-registries-does-consensus-matter
#2
Thijs T C F van Dongen, Johan de Graaf, Eelco P Huizinga, Howard R Champion, Rigo Hoencamp, Luke P H Leenen
BACKGROUND: Structural collection of data from combat injuries is important to improve provided care and the outcome of (combat) casualties. Trauma registries are used in civilian and military health care systems for systematic administration of injury data. However, these registries often use different methods of data management, compromising international comparison of trauma systems. The aim of this review is to aid in reaching international (coalition-wide) consensus for compatible data collection methods with uniform definitions, which is needed for transnational research and subsequent improvement of medical support organizations...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225739/damage-control-laparotomy-utilization-rates-are-highly-variable-among-level-i-trauma-centers-pragmatic-randomized-optimal-platelet-and-plasma-ratios-findings
#3
Justin Jeremiah Joseph Watson, Jamison Nielsen, Kyle Hart, Priya Srikanth, John D Yonge, Christopher R Connelly, Phillip M Kemp Bohan, Hillary Sosnovske, Barbara C Tilley, Gerald van Belle, Bryan A Cotton, Terence S OʼKeeffe, Eileen M Bulger, Karen J Brasel, John B Holcomb, Martin A Schreiber
BACKGROUND: Damage control laparotomy (DCL) is intended to limit deleterious effects from trauma-induced coagulopathy. DCL has been associated with mortality reduction, but may increase complications including sepsis, abscess, respiratory failure, hernia, and gastrointestinal fistula. We hypothesized that (1) DCL incidence would vary between institutions; (2) mortality rates would vary with DCL rates; (3) standard DCL criteria of pH, international normalized ratio, temperature and major intra-abdominal vascular injury would not adequately capture all patients...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#4
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225378/traumatic-ventricular-septal-defect-in-a-1-year-old-boy-after-accidental-chest-compression-by-an-adult
#5
Huang-Wei Wu, Jen-Hung Chien, Ken-Pen Weng, Chu-Chuan Lin, Bo-Hau Chen, Shih-Ming Huang, Yu-Chi Hung
We report a 1-year-old boy with a delayed diagnosis of traumatic ventricular septal defect (VSD) related to chest compression. His cardiac function was stable after adequate medical treatment. Spontaneous closure of traumatic VSD occurred to this patient at the age of 4 years. This is a rare case of traumatic VSD associated with accidental chest compression, which is similar to rupture of the ventricular septum after blunt chest trauma. It should be kept in mind that traumatic VSD and concomitant thoracic injuries can develop during chest compression...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224290/pediatric-ocular-trauma-score-as-a-prognostic-tool-in-the-management-of-pediatric-traumatic-cataracts
#6
Mehul A Shah, Rupesh Agrawal, Ryan Teoh, Shreya M Shah, Kashyap Patel, Satyam Gupta, Siddharth Gosai
OBJECTIVE: To introduce and validate the pediatric ocular trauma score (POTS) - a mathematical model to predict visual outcome trauma in children with traumatic cataract METHODS: In this retrospective cohort study, medical records of consecutive children with traumatic cataracts aged 18 and below were retrieved and analysed. Data collected included age, gender, visual acuity, anterior segment and posterior segment findings, nature of surgery, treatment for amblyopia, follow-up, and final outcome was recorded on a precoded data information sheet...
February 22, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28224191/predicting-the-post-operative-length-of-stay-for-the-orthopaedic-trauma-patient
#7
Deepak Chona, Nikita Lakomkin, Catherine Bulka, Idine Mousavi, Parth Kothari, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
PURPOSE: Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. METHODS: All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28223875/toxic-keratitis-after-use-of-wrongly-labeled-non-ophthalmic-medication
#8
Mohammad A Al-Amry, Nada Al-Abdan, Saleh A Al-Othaimeen
We present a 24-year-old female with trauma to her right eye. The patient was prescribed topical Tobramicin-dexamethasone eye drops but the pharmacy dispensed diclofenac diethyl amine ointment. The patient presented to the emergency room with lid edema, conjunctival injection and a corneal epithelial defect and toxic keratitis. The patient was successfully managed with copious irrigation, bandage contact lens and topical antibiotic therapy.
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223831/cost-analysis-of-facial-injury-treatment-in-two-university-hospitals-in-malaysia-a-prospective-study
#9
Bin Sulong Saperi, Roszalina Ramli, Zafar Ahmed, Amrizal Muhd Nur, Mohd Ismail Ibrahim, Muhd Fazlynizam Rashdi, Rifqah Nordin, Normastura Abd Rahman, Azizah Yusoff, Abd Jabar Nazimi, Roselinda Abdul Rahman, Noorhayati Abdul Razak, Norlen Mohamed
OBJECTIVE: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. MATERIALS AND METHODS: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28223817/emergency-thoracic-ultrasound-and-clinical-risk-management
#10
Maria Concetta Interrigi, Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato
PURPOSE: Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. PATIENTS AND METHODS: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28223249/predicted-unfavorable-neurological-outcome-is-overestimated-by-the-marshall-ct-score-crash-and-impact-models-in-severe-tbi-patients-management-with-early-decompressive-craniectomy
#11
Jose D Charry, Jorman H Tejada, Miguel A Pinzon, Wilson A Tejada, Juan D Ochoa, Manuel Falla, Jesus H Tovar, Ana M Cuellar-Bahamón, Juan P Solano
INTRODUCTION: Traumatic Brain Injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed in order to establish neurologic outcome. We tested prognostic models (the Marshall CT score, IMPACT, and CRASH) for 14-day mortality, 6-month mortality, and 6-month outcome in TBI patients in a university Hospital in Colombia. METHODS: A 127 patients' cohort with TBI was treated in a regional trauma center in Colombia over 2 years and Bivariate and Multivariate analyses were used...
February 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#12
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28221333/idiopathic-bilateral-profound-hypotony-in-an-unknown-progressive-neurodegenerative-disorder
#13
Lorraine M Provencher, Pamela C Carter, Wallace L M Alward
PURPOSE: To present a unique case of idiopathic bilateral hypotony in a patient with progressive, undiagnosed neurological decline, possibly due to mitochondrial disease, and to explore mechanisms of disease and potential treatment options. METHODS: This is a case report. PATIENT: A 17-year-old boy with a history of chronic progressive bilateral vision loss and hypotony in the setting of progressive gait abnormalities, lower extremity spasticity, nystagmus, and urinary retention starting around age 8...
February 17, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#14
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219416/the-safe-screw-path-along-inferior-border-of-the-arcuate-line-at-acetabular-area-an-anatomical-study-based-on-ct-scans
#15
Chun Bi, Jiandong Wang, Xiaoxi Ji, Zhijian Ma, Fang Wang, Xiangsen Zeng, Dongmei Wang, Qiugen Wang
BACKGROUND: Misplaced screw during the internal fixation of acetabular fractures may penetrate the hip joint which might cause chondrolysis and traumatic osteoarthritis in the future. This study aims to acquire the safe path for screw insertion along inferior border of the arcuate line fixation route at acetabular area. METHODS: Computed tomography (CT) scans of 98 patients without pelvic trauma were rebuilt for three-dimensional models of pelvis. After depicting the fixation route curve, five cross-sections perpendicularly to the curve were established from the anterior of pelvis to the posterior along inferior border of the arcuate line...
February 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28219101/-reorientation-of-medical-procedures-covered-by-statutory-accident-insurance
#16
T C Auhuber, C Reimertz, W-D Müller, R Hoffmann
As of 01/01/2014, the German Statutory Accident Insurance (DGUV) has reorganized inpatient medical procedures. The central element of reorientation is the reorganization of the catalogue of types of accidents and type of medical procedures of hospitalized injured patients in 3 care stages. In addition, the reorientation also concentrates on hospitals with the highest performance and the best qualification and also focuses on severe and most severe injuries.This reorientation is also based on the White Paper of the German Society for Trauma Surgery (DGU), especially on the Trauma Network DGU...
February 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28217583/profile-of-trauma-patients-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#17
Kundavaram Paul Prabhakar Abhilash, Nilanchal Chakraborthy, Gautham Raja Pandian, Vineet Subodh Dhanawade, Thomas Kurien Bhanu, Krishna Priya
BACKGROUND: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217260/robotic-liver-surgery-is-the-optimal-approach-as-bridge-to-transplantation
#18
Paolo Magistri, Giuseppe Tarantino, Roberto Ballarin, Andrea Coratti, Fabrizio Di Benedetto
The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas (HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers...
February 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28215932/a-new-method-for-traumatic-renal-injury-in-a-canine-model
#19
Zhi-Qiang Cao, Ming Liang, Shawn Xiang Li, Xin Li, Yaling Han
BACKGROUND: Selective transcatheter angiographic embolization (TAE) is an important method for efficient and accurate hemostasis in organ injuries during emergency settings. Sometimes, TAE cannot be performed on patients because of the limitations imposed by their condition. METHODS: A total of 32 canines with traumatic right renal wounds were prepared by stab injuries. The canines were randomly divided into four groups according to different treatments. Group A was the renal neoplasty group (n=8)...
February 16, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28215570/the-cardiac-electrophysiology-of-patients-with-spinal-cord-injury
#20
Michael Manogue, David S Hirsh, Michael Lloyd
Spinal cord injury (SCI) is a clinical syndrome encountered frequently in trauma centers and is accompanied by both acute and chronic heart rhythm abnormalities. The injury is characterized by sympathetic nervous system (SNS) impairment with preservation of parasympathetic output via the vagus nerve. Severe bradycardia in the form of life-threatening sinus arrest or complete heart block may be observed in the acute recovery phase. Therapy for arrhythmias in the acute phase includes atropine, intravenous chronotropes, methylxanthines for prevention of episodic bradycardia, and pacemaker implantation in severe cases...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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