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Level 1 trauma

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https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#1
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28095555/megasessions-for-robotic-hair-restoration
#2
Joa O Carlos Pereira, Joa O Carlos Pereira Filho, Joa O Pedro Cabrera Pereira
A robotic system can select and remove individual hair follicles from the donor area with great precision and without fatigue. This report describes the use of the robotic system in a megasession for hair restoration. Patients were instructed to cut their hair to 1.0 to 1.2 mm before surgery. The robot selected and removed 600 to 800 grafts per hour so the follicular units (FU)s could be transplanted manually to recipient sites. The robot arm consists of a sharp inner punch and a blunt outer punch which together separate FUs from the sur- rounding tissue...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28093693/a-simple-post-mortem-room-angiography-method-for-the-investigation-of-traumatic-basal-subarachnoid-hemorrhage
#3
Christopher P Johnson, Mike Murphy, George A Johnson, Stephen M Wills, Jonathan E Medcalf
Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room...
January 17, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28091818/lumbar-microdiscectomy-for-sciatica-in-adolescents-a-multicentre-observational-registry-based-study
#4
Sasha Gulati, Mattis A Madsbu, Tore K Solberg, Andreas Sørlie, Charalampis Giannadakis, Marius K Skram, Øystein P Nygaard, Asgeir S Jakola
BACKGROUND: Lumbar disc herniation (LDH) is rare in the adolescent population. Factors predisposing to LDH in adolescents differ from adults with more cases being related to trauma or structural malformations. Further, there are limited data on patient-reported outcomes after lumbar microdiscectomy in adolescents. Our aim was to compare clinical outcomes at 1 year following single-level lumbar microdiscectomy in adolescents (13-19 years old) compared to younger adults (20-50 years old) with LDH...
January 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#5
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28088939/complications-in-the-management-of-closed-high-energy-proximal-tibial-plateau-fractures
#6
Kavin Khatri, Vijay Sharma, Darsh Goyal, Kamran Farooque
PURPOSE: To report complications in the management of complex closed proximal tibial fractures. METHOD: A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088937/traumatic-cardiac-injury-experience-from-a-level-1-trauma-centre
#7
Biplab Mishra, Amit Gupta, Sushma Sagar, Maneesh Singhal, Subodh Kumar
PURPOSE: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. METHODS: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088740/associations-between-adverse-childhood-experiences-student-teacher-relationships-and-non-medical-use-of-prescription-medications-among-adolescents
#8
Myriam Forster, Amy L Gower, Iris W Borowsky, Barbara J McMorris
OBJECTIVE: Few studies have investigated associations between adverse childhood experiences (ACE) and nonmedical use of prescription medication (NMUPM) in population-based samples of adolescents, and even fewer have examined whether promotive factors might buffer these effects. The present study assesses the direct effects of ACE and positive student-teacher relationships on NUMPD and whether positive student-teacher relationships moderate this association. DESIGN: Data were from the 2013 Minnesota Student Survey (MSS), an in-school survey administered every three years to students throughout Minnesota...
January 6, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#9
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28080292/effect-of-the-endoclear-%C3%A2-device-on-biofilm-in-endotracheal-tubes
#10
James M Bardes, Dana Gray, Alison Wilson
BACKGROUND: Organisms trapped in biofilms cause more than 80% of medical infections. Significant investments are being made to develop methods of removing these biofilms. The endOclear(®) device is reported to remove biofilm from endotracheal tubes (ETTs) and to decrease pneumonia rates and ventilator time. METHODS: This was an observational study performed at a university Level 1 trauma center intensive care unit. A series of 40 ETTs were collected at extubation, with half of the patients having been treated daily with the endOclear(®) device...
January 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28079731/midterm-radiographic-and-functional-outcomes-of-the-anterior-internal-pelvic-fixator-infix
#11
Rahul Vaidya, Adam Jonathan Martin, Matthew Roth, Frederick Tonnos, Bryant Oliphant, Jon Carlson
OBJECTIVE: To describe our experience using the anterior internal pelvic fixator (INIFX) for treating pelvic ring injuries. DESIGN: Case Series SETTING:: Level 1 Trauma Center PATIENTS:: Eighty-three patients with pelvic ring injuries treated with INFIX. Follow up avg. 35 months (range 12-80.33) INTERVENTION:: Surgical treatment of pelvic ring injuries included reduction, appropriate posterior fixation, and INFIX placement. OUTCOME MEASUREMENTS: Reduction using the pelvic deformity index (PDI) and pubic symphysis(PS) widening, Majeed functional scores, complications; infection, implant failure, heterotopic ossification (HO), nerve injury, and pain...
January 5, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28079258/combined-effect-of-therapeutic-strategies-for-bleeding-injury-on-early-survival-transfusion-needs-and-correction-of-coagulopathy
#12
K Balvers, S van Dieren, K Baksaas-Aasen, C Gaarder, K Brohi, S Eaglestone, S Stanworth, P I Johansson, S R Ostrowski, J Stensballe, M Maegele, J C Goslings, N P Juffermans
BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. METHODS: A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate)...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#13
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28074458/endovascular-treatment-of-peripheral-and-visceral-arterial-injuries-in-patients-with-acute-trauma
#14
Aysun Erbahçeci Salık, Filiz Saçan İslim, Barbaros Erhan Çil
BACKGROUND: The present study is an evaluation of the efficacy of endovascular treatment in emergency setting for patients with acute peripheral and visceral arterial injury secondary to penetrating or blunt trauma. METHODS: Twelve patients (11 men) aged 35.8±11.3 years (range: 18-56 years) with penetrating or blunt trauma who underwent endovascular treatment in our department between March 2010 and June 2014 for peripheral and visceral arterial injury were retrospectively reviewed...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28074305/clinical-effectiveness-of-low-level-laser-treatment-on-peripheral-somatosensory-neuropathy
#15
REVIEW
Alireza Fallah, Alireza Mirzaei, Norbert Gutknecht, Amir Saberi Demneh
Peripheral sensory neuropathy treatment is one of the common treatment problems and causes morbidity and mortality in people suffering from that. Although treatment depends on the underlying cause of the condition, nevertheless, in some cases, there is no cure for it, and it requires palliative and symptomatic treatment. In laboratory studies, low-level laser has been effective in the nerves protection and restoration. The aim of this article is to investigate the clinical efficacy of low-level laser on improvement of the peripheral somatosensory neuropathy...
January 10, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28073612/gonorrhea-and-chlamydia-in-the-emergency-department-continued-need-for-more-focused-treatment-for-men-women-and-pregnant-women
#16
Sean P Wilson, Taher Vohra, McKenna Knych, Jared Goldberg, Christopher Price, Sean Calo, Meredith Mahan, Joseph Miller
INTRODUCTION: Delay in current nucleic acid amplification testing for Neisseria gonorrhoeae and Chlamydia trachomatis has led to recommendations for presumptive treatment in patients with concern for infection and unreliable follow-up. In the urban setting, it is assumed that many patients have unreliable follow-up, therefore presumptive therapy is thought to be used frequently. We sought to measure the frequency of disease and accuracy of presumptive treatment for these infections. METHODS: This was an observational cohort study performed at an urban academic Level 1 trauma center ED with an annual census of 95,000 visits per year...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28073574/massive-donor-transfusion-potentially-increases-recipient-mortality-after-lung-transplantation
#17
Catherine F Borders, Yoshikazu Suzuki, Jared Lasky, Christian Schaufler, Djamila Mallem, James Lee, Kevin Carney, Scarlett L Bellamy, Christian A Bermudez, A Russell Localio, Jason D Christie, Joshua M Diamond, Edward Cantu
OBJECTIVE: Donor blood transfusion has been identified as a potential risk factor for primary graft dysfunction and by extension early mortality. We sought to define the contributing risk of donor transfusion on early mortality for lung transplant. METHODS: Donor and recipient data were abstracted from the Organ Procurement and Transplantation Network database updated through June 30, 2014, which included 86,398 potential donors and 16,255 transplants. Using the United Network for Organ Sharing 4-level designation of transfusion (no blood, 1-5 units, 6-10 units, and >10 units, massive), we analyzed all-cause mortality at 30-days with the use of logistic regression adjusted for confounders (ischemic time, donor age, recipient diagnosis, lung allocation score and recipient age, and recipient body mass index)...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28072708/life-threatening-motor-vehicle-crashes-in-bright-sunlight
#18
Donald A Redelmeier, Sheharyar Raza
: Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072669/swimming-pool-electrical-injuries-steps-toward-prevention
#19
Jun Tashiro, Cathy A Burnweit
OBJECTIVE: Electrical injuries in swimming pools are an important pediatric public health concern. We sought to (1) improve our understanding of the clinical presentation and outcomes following and (2) describe the epidemiology of swimming pool electrical injuries in the United States. METHODS: We reviewed 4 cases of pediatric (<18 y old) electrical injury from a single, urban level 1 pediatric trauma center. We also queried the National Electronic Injury Surveillance System (NEISS) for emergency department visits due to electrical injury associated with swimming pools, occurring between 1991 and 2013...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072651/relationship-of-sacral-fractures-to-nerve-injury-is-the-denis-classification-still-accurate
#20
Jannat M Khan, Alejandro Marquez-Lara, Anna N Miller
OBJECTIVE: Use modern computed tomographic imaging to reassess neurological injury risks associated with zone I-III sacral fractures as originally described by Denis, et al. DESIGN: Restrospective Case-control study. SETTING: University Level I Trauma Center. PATIENTS/PARTICIPANTS: 1507 consecutive patients who presented with sacral fractures between January 2000 and August 2012. MAIN OUTCOME MEASUREMENTS: Patients were stratified based on the diagnosis of acute neurological injury...
December 28, 2016: Journal of Orthopaedic Trauma
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