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Level 1 trauma

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https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#1
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28921171/high-fibrin-fibrinogen-degradation-product-to-fibrinogen-ratio-is-associated-with-28-day-mortality-and-massive-transfusion-in-severe-trauma
#2
D H Lee, B K Lee, S M Noh, Y S Cho
PURPOSE: There is a lack of association between coagulation biomarkers and long-term mortality in severe trauma. We aimed to investigate the association between coagulation biomarkers on admission and outcome of late stage of trauma. METHODS: This retrospective observational study included patients admitted with severe trauma between 2012 and 2015. We used the area under the receiver operating characteristic curve (AUROC) of coagulation biomarkers to determine 28-day mortality...
September 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#3
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28919116/global-regional-and-national-age-sex-specific-mortality-for-264-causes-of-death-1980-2016-a-systematic-analysis-for-the-global-burden-of-disease-study-2016
#4
(no author information available yet)
BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year...
September 16, 2017: Lancet
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#5
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28917026/venous-thromboembolism-rates-in-transferred-patients-a-cross-sectional-study
#6
Samuel Lai, Eric Ton, Marianne Lovejoy, William Graham, Alpesh Amin
BACKGROUND: Patients undergoing a transfer during a hospitalization may be more likely to be diagnosed with a venous thromboembolism (VTE) than patients who are not transferred. OBJECTIVE: To determine whether transferred patients have an increased prevalence of VTE diagnosis. DESIGN: This was a cross-sectional study comparing VTE diagnosis rates between transferred patients and non-transferred patients. For the years 2012-2014, the University HealthSystem Consortium database of multiple community and academic medical centers throughout the United States was parsed using ICD-9 VTE diagnosis codes and patient's point of origin...
September 15, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28915647/necroptosis-as-a-potential-therapeutic-target-in-multiple-organ-dysfunction-syndrome
#7
Yao-Li Cui, Li-Hua Qiu, Shi-Yong Zhou, Lan-Fang Li, Zheng-Zi Qian, Xian-Ming Liu, Hui-Lai Zhang, Xiu-Bao Ren, Yong-Qiang Wang
PURPOSE: To investigate how necroptosisis, i.e. programmed necrosis, is involved in MODS, and to examine whether Nec-1, a specific necroptosis inhibitor, ameliorates multiorgan injury in MODS. EXPERIMENTAL DESIGN: A model of MODS was established in six-week old SD rats using fracture trauma followed by hemorrhage. Control animals received sham surgery. Cell death form and necrosome formation were measured by fluorescence-activated cell sorting and western blotting...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915523/-biologic-reconstruction-of-full-sized-cartilage-defects-of-the-hip-a-guideline-from-the-dgou-group-clinical-tissue-regeneration-and-the-hip-committee-of-the-aga
#8
Stefan Fickert, Matthias Aurich, Dirk Albrecht, Peter Angele, Lorenz Büchler, Michael Dienst, Christoph Erggelet, Jürgen Fritz, Christoph Gebhart, Hans Gollwitzer, Moritz Kindler, Christoph Lampert, Henning Madry, Gregor Möckel, Phillip Niemeyer, Jörg Schröder, Christian Sobau, Gunter Spahn, Wolfgang Zinser, Stefan Landgraeber
Background Symptomatic pre-arthritic deformities such as femoroacetabular impingement (FAI) or hip dysplasia often lead to localised cartilage defects and subsequently to osteoarthritis. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) and the hip committee of the AGA (German speaking Society for Arthroscopy and Joint Surgery) provides an overview of current knowledge of the diagnosis and surgical treatment of cartilage defects, in order to infer appropriate therapy recommendations for the hip...
September 15, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28915217/estradiol-modulates-local-gut-injury-induced-by-intestinal-ischemia-reperfusion-in-male-rats
#9
Fernanda Yamamoto Ricardo-da-Silva, Evelyn Thaís Fantozzi, Sara Rodrigues-Garbin, Ricardo Martins Oliveira-Filho, Bernardo Boris Vargaftig, Ana Cristina Breithaupt-Faloppa, Wothan Tavares de Lima
Intestinal ischemia and reperfusion (I/R) triggers a systemic inflammatory response characterized by leukocyte mobilization from the bone marrow, release of cytokines to the circulation, and increased microvascular permeability, leading to high mortality. Females have shown attenuated inflammatory response to trauma when compared with males, indicating a role for female sex hormones in this process. Here, we have evaluated the effect of estradiol on the local gut injury induced by I/R in male rats. I/R was induced by the clamping of the superior mesenteric artery for 45 min, followed by 2 h of reperfusion...
October 2017: Shock
https://www.readbyqxmd.com/read/28915204/laparoscopy-for-trauma-and-the-changes-in-its-use-from-1990-to-2016-a-current-systematic-review-and-meta-analysis
#10
Roberto Cirocchi, Arianna Birindelli, Kenji Inaba, Matteo Mandrioli, Alice Piccinini, Renata Tabola, Luigi Carlini, Gregorio Tugnoli, Salomone Di Saverio
BACKGROUND: The role of laparoscopy in the diagnosis and treatment of stable abdominal trauma patients is still a matter of serious debate and only incomplete data are available. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of the literature between January 1990 and August 2016. RESULTS: Overall, 9817 laparoscopies were performed for abdominal trauma; only 26.2% of the cases were converted to a laparotomy. The incidence of therapeutic laparotomies showed a reduction from 69% to 47...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28914713/the-hyperfibrinolytic-phenotype-is-the-most-lethal-and-resource-intense-presentation-of-fibrinolysis-in-massive-transfusion-patients
#11
John R Taylor, Erin E Fox, John B Holcomb, Sandro Rizoli, Kenji Inaba, Martin A Schreiber, Karen Brasel, Thomas M Scalea, Charles E Wade, Eileen Bulger, Bryan A Cotton
BACKGROUND: Among bleeding patients, we hypothesized that the hyperfibrinolytic (HF) phenotype would be associated with the highest mortality, while shutdown (SD) patients would have the greatest complication burden. METHODS: Severely injured patients predicted to receive a massive transfusion at 12 level-1 trauma centers were randomized to one of two transfusion ratios as described in the PROPPR trial. Fibrinolysis phenotypes were determined based on admission clot lysis at 30 minutes (LY30): SD ≤0...
September 13, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28913856/multiplate-and-teg-platelet-mapping-in-a-population-of-severely-injured-trauma-patients
#12
M J George, J Burchfield, B MacFarlane, Y-W W Wang, J C Cardenas, N J White, B S Gill, C E Wade
OBJECTIVES: The objectives of this study were to compare thromboelastography platelet mapping (TEG PM) with impedance aggregometry (Multiplate, MP) in a single trauma population and relate their results clinically. BACKGROUND: Platelet function as measured by thromboelastography and impedance aggregometry demonstrates significant reductions that persist for days following traumatic injury. However, no study compares these devices and the correlation between them is not known...
September 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28913737/minimally-invasive-endoscopic-thyroid-surgery-using-a-collar-access-experience-in-246-cases-with-the-cevits-technique
#13
Franz G Messenbaeck, Michael Weitzendorfer, Cornelia Kaminski, Kai Witzel
BACKGROUND: The arguments for applying minimally invasive techniques are, besides cosmetic results, reduced access trauma and less postoperative pain. In thyroid surgery, cosmetic aspects are gaining importance. Whether minimally invasive endoscopic thyroid surgery is less painful has not been shown yet. METHOD: In this study, we analyse the outcome of 246 patients who underwent cervical endoscopic video-assisted thyroid surgery (CEViTS) regarding the surgery itself, their postoperative pain and satisfaction with the procedure...
September 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28911289/incidence-of-elevated-procalcitonin-and-presepsin-levels-after-severe-trauma-a-pilot-cohort-study
#14
K Hoshino, Y Irie, M Mizunuma, K Kawano, T Kitamura, H Ishikura
Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28906307/lc-i-pelvic-ring-injury-not-benign-to-the-developing-fetus
#15
John C Weinlein, Rakesh P Mashru, Edward A Perez, Sara E Johnson
OBJECTIVE: To determine if certain patterns of pelvic ring injury are associated with more frequent intra-uterine fetal demise (IUFD). DESIGN: Retrospective review SETTING:: Level 1 trauma center. PATIENTS/PARTICIPANTS: Of 44 pregnant patients with pelvic and/or acetabular fractures, 40 had complete records that allowed determination of fetal viability. Chi-square tests were used for categorical variables (Fisher's exact tests when expected cell counts were fewer than five) and t-tests were used for continuous variables...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28906305/risk-of-knee-sepsis-following-treatment-of-open-tibia-fractures-a-multicenter-comparison-of-suprapatellar-and-infrapatellar-approaches
#16
Geoffrey S Marecek, Luke T Nicholson, Frances H Broghammer, Michael Talerico, Caroline Tougas, Derek J Donegan, John A Scolaro
OBJECTIVES: The suprapatellar approach for medullary nailing of the tibia is increasing. This requires intra-articular passage of instruments, which theoretically places the knee at risk for postoperative sepsis in the setting of open fracture. We hypothesized that the risk of knee sepsis is similar after suprapatellar or infrapatellar nailing of open tibia fractures. DESIGN: Retrospective, multicenter. SETTING: Three urban Level-1 trauma centers PATIENTS:: All patients treated with medullary nailing for open diaphyseal tibia fractures (OTA 42) from 2009 to 2015...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28906304/comparison-of-expert-opinion-majority-rule-and-a-clinical-prediction-rule-to-estimate-distal-radius-malalignment
#17
Toni Luokkala, Tapio Flinkkilä, Juha Paloneva, Teemu V Karjalaine
OBJECTIVES: To investigate the ability of individual surgeons (expert opinion [EO]) to predict distal radius fracture healing above a threshold malalignment compared with the majority prediction of the group of surgeons ("majority rule," [MR]) and a statistically derived clinical prediction formula (Edinburgh wrist calculator [EWC]). DESIGN: Comparative diagnostic study from prospectively collected data of consecutive patients. SETTING: Two academic level 1 and one academic level 2 trauma centers...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28904675/von-willebrand-s-disease-case-report-and-review-of-literature
#18
Hanae Echahdi, Brahim El Hasbaoui, Mohamed El Khorassani, Aomar Agadr, Mohamed Khattab
Von Willebrand Disease (VWD) is the most common human inherited bleeding disorder due to a defect of Von Willebrand Factor (VWF), which a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels < 50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50IU/dL)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#19
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28900387/social-isolation-in-early-versus-late-adolescent-mice-is-associated-with-persistent-behavioral-deficits-that-can-be-improved-by-neurosteroid-based-treatment
#20
Andrea Locci, Philippe Geoffroy, Michel Miesch, Ayikoe-Guy Mensah-Nyagan, Graziano Pinna
Early trauma and stress exposure during a critical period of life may increase the risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adulthood. The first-choice treatment for MDD and PTSD are selective serotonin reuptake inhibitor (SSRI) antidepressants. Unfortunately, half of MDD and PTSD patients show resistance to the therapeutic effects of these drugs and more efficient treatments are essential. Both MDD and PTSD patients present reduced levels of allopregnanolone (Allo), a potent endogenous positive allosteric modulator of GABA action at GABAA receptors which are normalized by SSRIs in treatment responders...
2017: Frontiers in Cellular Neuroscience
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