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Level 1 trauma

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https://www.readbyqxmd.com/read/28721572/i-fabp-is-a-novel-marker-for-the-detection-of-intestinal-injury-in-severely-injured-trauma-patients
#1
M Voth, M Duchene, B Auner, T Lustenberger, B Relja, I Marzi
BACKGROUND: Intestinal injury is a rare injury in multiply traumatized patients, and its diagnosis remains difficult. Delayed diagnosis of an intestinal injury increases the risk of sepsis, multiple organ failure and mortality. The intestinal fatty acid-binding protein (I-FABP) is solely expressed in the intestine and is released extracellulary after tissue damage. This study evaluates the validity of I-FABP as an early biomarker to detect an abdominal injury and particularly an injury to the intestine...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28720040/distal-radius-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-level-i-trauma-center
#2
James C Kyriakedes, Eugene Y Tsai, Douglas S Weinberg, Charles C Yu, Harry A Hoyen, Kevin Malone, Blaine T Bafus
BACKGROUND: The aim of this study is to determine whether the American Academy of Orthopaedic Surgeons' (AAOS) Appropriate Use Criteria (AUC) for distal radius fractures correlates with actual treatment by orthopedic hand surgeons at a level I trauma center. METHODS: ICD-9 codes were used to retrospectively identify patients who presented with wrist fractures over 1 year. Patients with isolated distal radius fractures were evaluated using the AAOS AUC application for distal radius fractures...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716132/a-patient-safety-and-professional-perspective-on-non-conveyance-in-ambulance-care-a-systematic-review
#3
REVIEW
Remco H A Ebben, Lilian C M Vloet, Renate F Speijers, Nico W Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen, Sivera A A Berben
BACKGROUND: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. METHODS: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#4
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28715950/efficacy-of-the-novel-medical-adhesive-mar-vivo-107-in-an-acute-porcine-liver-resection-model
#5
Hirokazu Tanaka, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto, René H Tolba
BACKGROUND: Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). MATERIALS AND METHODS: Twelve German Landrace pigs were randomly assigned to 2 groups...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#6
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#7
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28713688/childhood-trauma-and-factors-associated-with-depression-among-inpatients-with-cardiovascular-disease
#8
Felipe José Nascimento Barreto, Frederico Duarte Garcia, Paulo Henrique Teixeira Prado, Paulo Marcos Brasil Rocha, Nádia Souza Las Casas, Felipe Barbosa Vallt, Humberto Correa, Maila Castro Lourenço Neves
AIM: To identify factors associated with depressive symptoms among inpatients with cardiovascular disease (CVD). METHODS: This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review...
June 22, 2017: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28712961/disruption-in-non-anastomotic-section-of-an-axillofemoral-bypass-a-thorough-critical-review-of-the-literature
#9
REVIEW
S Valverde García, R Peña Cortés, J Torre Eiriz, M B García-Cenador, F S Lozano Sánchez
This work is a thorough non-systematic critical review (PubMed/Medline 1950-september 2016) of "disruption in non-anastomotic section of an axillofemoral bypass". Fourteen cases were selected (including that provided by the authors of this publication) dating from 1963 to 2016 (53 years). This type of disruption is a very unusual complication in axillofemoral bypass. The cases described reveal that this disorder is more frequent in unifemoral bypass (9 cases), in ringed PTFE (10), in blunt trauma (8) and at costal level (12) especially on the left side (8)...
July 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28711309/influence-of-needle-bevel-design-on-injection-pain-and-needle-deformation-in-dental-local-infiltration-anaesthesia-randomized-clinical-trial
#10
M Dau, I Buttchereit, C Ganz, B Frerich, E N Anisimova, M Daubländer, P W Kämmerer
The aims of this in vivo study were to evaluate the impact of needle bevel design on patients' pain perception and the mechanical deformation of the needle tip after the injection. In a prospective single-blinded trial, 150 patients received conventional infiltration anaesthesia for dental treatment by one examiner. Patients were randomized for one out of three different needle bevel types (scalpel-designed bevel needle (SB), n=50; triple bevel needle (TB), n=50; regular bevel needle (RB), n=50). Subjects' self-reported injection pain perception was evaluated using a numeric rating scale (NRS)...
July 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28710466/dramatic-increases-in-blood-glutamate-concentrations-are-closely-related-to-traumatic-brain-injury-induced-acute-lung-injury
#11
Wei Bai, Wan-Li Zhu, Ya-Lei Ning, Ping Li, Yan Zhao, Nan Yang, Xing Chen, Yu-Lin Jiang, Wen-Qun Yang, Dong-Po Jiang, Li-Yong Chen, Yuan-Guo Zhou
Traumatic brain injury-induced acute lung injury (TBI-ALI) is a serious complication after brain injury for which predictive factors are lacking. In this study, we found significantly elevated blood glutamate concentrations in patients with TBI or multiple peripheral trauma (MPT), and patients with more severe injuries showed higher blood glutamate concentrations and longer durations of elevated levels. Although the increase in amplitude was similar between the two groups, the duration was longer in the patients with TBI...
July 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28709458/markers-of-nitric-oxide-are-associated-with-sepsis-severity-an-observational-study
#12
Martin Sebastian Winkler, Stefan Kluge, Maximilian Holzmann, Eileen Moritz, Linda Robbe, Antonia Bauer, Corinne Zahrte, Marion Priefler, Edzard Schwedhelm, Rainer H Böger, Alwin E Goetz, Axel Nierhaus, Christian Zoellner
BACKGROUND: Nitric oxide (NO) regulates processes involved in sepsis progression, including vascular function and pathogen defense. Direct NO measurement in patients is unfeasible because of its short half-life. Surrogate markers for NO bioavailability are substrates of NO generating synthase (NOS): L-arginine (lArg) and homoarginine (hArg) together with the inhibitory competitive substrate asymmetric dimethylarginine (ADMA). In immune cells ADMA is cleaved by dimethylarginine-dimethylaminohydrolase-2 (DDAH2)...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#13
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708778/radiographic-investigation-of-the-distal-extension-of-fractures-into-the-articular-surface-of-the-tibia-the-ridefast-study
#14
Lucas S Marchand, Ajinkya A Rane, Zachary M Working, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To determine whether radiographic measurements are predictive of involvement of the distal tibia articular surface in tibial shaft fractures. DESIGN: Retrospective review. SETTING: Academic level-I trauma hospital. PATIENTS: Two-hundred seventeen patients with tibial shaft fractures distal to the isthmus (AO/OTA: 42-A1-3;42-B1-3;42-C1-3;43-A1-3). INTERVENTION: Analysis of AP and lateral radiographs...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708777/intraoperative-topical-antibiotics-for-infection-prophylaxis-in-pelvic-and-acetabular-surgery
#15
Matthew T Owen, Emily M Keener, Zane B Hyde, Reaves M Crabtree, Parke W Hudson, Russell L Griffin, Jason A Lowe
OBJECTIVES: Determine if topical vancomycin and tobramycin powder reduces the incidence of surgical site infection (SSI) following pelvic ring and acetabulum fracture surgery. DESIGN: Retrospective cohort study SETTING:: University of Alabama at Birmingham, Academic Level I Trauma Center PATIENTS/PARTICIPANTS:: 219 patients (140 meeting inclusion criteria) with pelvic and acetabular fractures who underwent open reduction and internal fixation (ORIF) from March 2012 to November 2013...
June 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708283/acute-stress-symptoms-in-seriously-injured-patients-precipitating-versus-cumulative-trauma-and-the-contribution-of-peritraumatic-distress
#16
John Briere, Colin P Dias, Randye J Semple, Catherine Scott, Noémie Bigras, Natacha Godbout
The relationship between type of trauma exposure, cumulative trauma, peritraumatic distress, and subsequent acute stress disorder (ASD) symptoms was examined prospectively in 96 individuals presenting with acute medical injuries to a Level 1 emergency/trauma department. Common precipitating traumas included motor vehicle-related events, stabbings, shootings, and physical assaults. At 2 to 3 weeks follow-up, 22.9% of participants had developed ASD. Univariate analysis revealed no relationship between type of precipitating trauma and ASD symptoms, whereas robust path analysis indicated direct effects of gender, lifetime cumulative trauma exposure, and peritraumatic distress...
July 14, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28707425/experiential-acceptance-and-trait-mindfulness-as-predictors-of-analogue-post-traumatic-stress
#17
Paul A Boelen, Lonneke I M Lenferink
OBJECTIVES: Experiential acceptance and trait-mindfulness are associated with post-traumatic stress disorder (PTSD) after traumatic events. This study was a preliminary attempt to examine (1) associations of experiential acceptance and trait-mindfulness with post-traumatic stress (PTS) associated with negative, but not necessarily traumatizing, life events ('analogue' PTS), (2) the role of these variables in the context of neuroticism as well as worry and rumination - two other regulatory strategies associated with PTS, and (3) the impact of pre-trauma tendencies towards experiential acceptance and mindfulness on analogue PTS...
July 14, 2017: Psychology and Psychotherapy
https://www.readbyqxmd.com/read/28706393/cotrimoxazole-a-wonder-drug-in-the-era-of-multiresistance-case-report-and-review-of-literature
#18
Priyam Batra, Vishant Deo, Purva Mathur, Amit Kumar Gupta
Antimicrobial resistance is one of the greatest threats to human health worldwide. The rate of development of newer antibiotics is much slower than the rate of development of antibiotic resistance. A survey reported that it takes 15 years and US$800 million (including preclinical and clinical costs) to bring a single drug to the market, whereas the reuse of the older drugs for antimicrobial use takes $17 million, thereby circumventing 40% of the overall cost. The first case is a patient with nosocomial pyrexia of unknown origin who was given treatment with tigecycline and cefepime/tazobactam but failed to respond to the same...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#19
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#20
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
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