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Level 1 trauma

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https://www.readbyqxmd.com/read/29334571/use-of-french-lyophilized-plasma-transfusion-in-severe-trauma-patients-is-associated-with-an-early-plasma-transfusion-and-early-transfusion-ratio-improvement
#1
Cédric Nguyen, Julien Bordes, Pierre-Julien Cungi, Pierre Esnault, Michael Cardinale, Quentin Mathais, Jean Cotte, Sébastien Beaume, Anne Sailliol, Bertrand Prunet, Eric Meaudre
BACKGROUND: Early transfusion of high ratio of fresh frozen plasma (FFP) and red blood cells (RBC) is associated with mortality reduction. However, time to reach high ratio is limited by the need to thaw the FFP. French lyophilized plasma (FLYP) used by French army and available in military teaching hospital does not need to be thawed and is immediately available. We hypothesize that the use of FLYP may reduce time to reach a plasma:RBC ratio of 1/1. METHODS: A retrospective study performed in a Level 1 trauma center between January 2012 and December 2015...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334570/the-effect-of-prehospital-transport-time-injury-severity-and-blood-transfusion-on-survival-of-us-military-casualties-in-iraq
#2
Russ S Kotwal, Laura L F Scott, Jud C Janak, Bruce W Tarpey, Jeffrey T Howard, Edward L Mazuchowski, Frank K Butler, Stacy A Shackelford, Jennifer M Gurney, Zsolt T Stockinger
BACKGROUND: Reducing time from injury to care can optimize trauma patient outcomes. A previous study of prehospital transport of US military casualties during the Afghanistan conflict demonstrated the importance of time and treatment capability for combat casualty survival. METHODS: A retrospective descriptive analysis was conducted to analyze battlefield data collected on US military combat casualties during the Iraq conflict from March 19, 2003 to August 31, 2010...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29333764/education-is-the-strongest-socioeconomic-predictor-of-smoking-in-pregnancy
#3
Juho Härkönen, Matti Lindberg, Linnea Karlsson, Hasse Karlsson, Noora M Scheinin
AIMS: To investigate socioeconomic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class, and current economic conditions. DESIGN: Cross-sectional analysis with linked survey and register data. SETTING: South-Western Finland. PARTICIPANTS: 2,667 pregnant women (70% of the original sample (N=3,808)) from FinnBrain, a prospective pregnancy cohort study. MEASUREMENTS: The outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register...
January 14, 2018: Addiction
https://www.readbyqxmd.com/read/29331979/now-you-see-me-a-pragmatic-cohort-study-comparing-first-and-final-radiological-diagnoses-in-the-emergency-department
#4
Björn Mattsson, David Ertman, Aristomenis Konstantinos Exadaktylos, Luca Martinolli, Wolf E Hautz
OBJECTIVES: To (1) compare timely but preliminary and definitive but delayed radiological reports in a large urban level 1 trauma centre, (2) assess the clinical significance of their differences and (3) identify clinical predictors of such differences. DESIGN, SETTING AND PARTICIPANTS: We performed a retrospective record review for all 2914 patients who presented to our university affiliated emergency department (ED) during a 6-week period. In those that underwent radiological imaging, we compared the patients' discharge letter from the ED to the definitive radiological report...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#5
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29330668/impact-of-duplicate-ct-scan-rate-after-implementation-of-transfer-image-repository-system-at-a-level-1-trauma-center
#6
Charles W Sheppard, Amy L Groll, Cindy L Austin, Simon J Thompson
PURPOSE: The regionalization of trauma in the USA results in frequent transfers of patients from a primary hospital ED to a higher level trauma facility. While many hospitals have a Picture Archive Communication System (PACS) which captures digital radiological images, these are often not available to the receiving institution resulting in duplicate imaging. The state of Arkansas instituted a trauma image repository (TIR) in July 2013. We examined whether implementation of this repository would impact CT scan duplication in the trauma system...
January 12, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29330634/corrective-osteotomies-using-patient-specific-3d-printed-guides-a-critical-appraisal
#7
Wouter Rosseels, Michiel Herteleer, An Sermon, Stefaan Nijs, Harm Hoekstra
INTRODUCTION: Over the last decade, the technique of 3D planning has found its way into trauma surgery. The use of this technique in corrective osteotomies for treatment of malunions provides the trauma surgeon with a powerful tool. However, this technique is not entirely straightforward. We aimed to define potential pitfalls of this technique and possible solutions to overcome these shortcomings. MATERIALS AND METHODS: Ten patients with either a uni-, bi- or triplanar malunion of the long bones were included in this study...
January 12, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29330633/a-seven-center-examination-of-the-relationship-between-monthly-volume-and-mortality-in-trauma-a-hypothesis-generating-study
#8
Stanislaw P Stawicki, Keith Habeeb, Niels D Martin, M Shay O'Mara, James Cipolla, David C Evans, Creagh Boulger, Babak Sarani, Charles H Cook, Alok Gupta, William S Hoff, Peter G Thomas, Jeffrey M Jordan, Weidun Alan Guo, Mark J Seamon
INTRODUCTION: The relationship between trauma volumes and patient outcomes continues to be controversial, with limited data available regarding the effect of month-to-month trauma volume variability on clinical results. This study examines the relationship between monthly trauma volume variations and patient mortality at seven Level I Trauma Centers located in the Eastern United States. We hypothesized that higher monthly trauma volumes may be associated with lower corresponding mortality...
January 12, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29330199/association-between-community-socioeconomic-characteristics-and-access-to-youth-flag-football
#9
Emily Kroshus, Aly J Sonnen, Sara Pd Chrisman, Frederick P Rivara
BACKGROUND: The American Academy of Pediatrics has recommended that opportunities for non-tackling American football (e.g., flag football) be expanded, given concerns about the risks of brain trauma from tackle football. This study tested the hypothesis that flag football would be more accessible in communities characterised by higher socioeconomic status residents. METHODS: In July 2017, the locations of community-based organisations offering youth flag and tackle football for youth between the ages of 6 and 13 in two US states (Georgia and Washington) were aggregated (n=440)...
January 12, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#10
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29328004/thoracolumbar-injury-classification-and-severity-score-in-children-a-reliability-study
#11
Ross L Dawkins, Joseph H Miller, Omar I Ramadan, Michael C Lysek, Elizabeth N Kuhn, Brandon G Rocque, Michael J Conklin, R Shane Tubbs, Beverly C Walters, Bonita S Agee, Curtis J Rozzelle
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29327312/examining-the-prospective-relationship-between-pre-disaster-respiratory-sinus-arrhythmia-and-post-disaster-posttraumatic-stress-disorder-symptoms-in-children
#12
Amy J Mikolajewski, Michael S Scheeringa
Previous studies have examined the concurrent relationship between posttraumatic stress disorder (PTSD) and a range of psychophysiological variables, including respiratory sinus arrhythmia (RSA). However, there is a lack of research examining the prospective development of trauma symptomatology, and the directionality of the association between RSA level and PTSD has yet to be determined. The current study is the first prospective study to examine whether RSA level and RSA reactivity are risk factors for PTSD symptoms in children...
January 12, 2018: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/29327268/serum-thiol-levels-and-thiol-disulphide-homeostasis-in-gunshot-injuries
#13
Hasan Buyukaslan, Umut Gulacti, Mehmet Tahir Gökdemir, Ramazan Giden, Hakim Celik, Özcan Erel, Erman Mustafa Dörterler
BACKGROUND: Gunshot injuries result in serious traumatic tissue damage due to high velocity of the bullet, deep penetration, and ballistic effect. Trauma is known to be related with oxidative stress. Serum thiol levels and disulphide/thiol homeostasis are novel oxidative stress biomarkers. In this study, we aimed to investigate serum thiol levels and disulphide/thiol homeostasis in injury patterns of patients admitted to the emergency department with a gunshot injury. METHOD: A total of 128 participants were included in the study...
January 11, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29326762/outcome-determinants-of-patients-with-traumatic-pelvic-fractures-a-cohort-study-in-a-level-i-trauma-center-in-southern-iran
#14
S Paydar, M Chaabi, M Akhavan, Z Ghahramani, M Dehghankhalili
Pelvic fracture is a result of devastating injuries and is usually encountered in conjunction with other life-threatening injuries. The aim of the current study was to determine the outcome determinants of patients with pelvic fractures referred to a large trauma center in southern Iran. This retrospective cross-sectional study was conducted in a level I trauma center over a period of three years from 2012 to 2015. We included all patients with pelvic fractures whose medical records had sufficient data. Data were compared between good condition and poor conditions...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29325878/can-we-identify-futility-in-kids-an-evaluation-of-admission-parameters-predicting-100-mortality-in-1292-severely-injured-children
#15
Kyle J Kalkwarf, Shane D Jensen, Myron Allukian, Matthew T Harting, Charles S Cox, Erin E Fox, Charles E Wade, Bryan A Cotton
BACKGROUND: Objective parameters predicting futility of care in severely injured pediatric patients are lacking. While futility of care has been investigated in a limited number of studies in trauma patients, none of these studies achieves a 100% success rate in a large cohort of pediatric patients. The purpose of the current study was to identify extreme laboratory values that could be used to predict 100% mortality in severely injured children. STUDY DESIGN: Registry-based, historical cohort of all severely injured children (level 1 trauma, <16 years old), who were not dead on arrival, between January 2010 and December 2016 from a single level 1 trauma center...
January 8, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29323806/spine-and-spinal-cord-injuries-after-falls-from-tree-stands-during-the-wisconsin-deer-hunting-season
#16
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322585/scapular-fractures-in-the-pan-scan-era
#17
Cortlyn Brown, Karim Elmobdy, Ali S Raja, Robert M Rodriguez
BACKGROUND: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete. OBJECTIVES: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture...
January 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29322214/protective-role-of-nrf2-against-mechanical-stretch-induced-apoptosis-in-mouse-fibroblasts-a-potential-therapeutic-target-of-mechanical-trauma-induced-stress-urinary-incontinence
#18
Qiannan Li, Bingshu Li, Cheng Liu, Linlin Wang, Jianming Tang, Li Hong
INTRODUCTION AND HYPOTHESIS: We investigated the protective effect and underlying molecular mechanism of nuclear factor-E2-related factor 2 (Nrf2) against mechanical-stretch-induced apoptosis in mouse fibroblasts. METHODS: Normal cells, Nrf2 silencing cells, and Nrf2 overexpressing cells were respectively divided into two groups-nonintervention and cyclic mechanical strain (CMS)-subjected to CMS of 5333 μ (1.0 Hz for 4 h), six groups in total (control, CMS, shNfe212, shNfe212 + CMS, LV-shNfe212, and LV-shNfe212 + CMS)...
January 10, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29321366/venous-thromboembolism-associated-with-protein-s-deficiency-due-to-arg451-mutation-in-pros1-gene-a-case-report-and-a-literature-review
#19
Ewa Wypasek, Marek Karpinski, Martine Alhenc-Gelas, Anetta Undas
Protein S (PS) is a vitaminK-dependent glycoproteinwhich plays an important role in the regulation of blood coagulation. PS deficiency has been found in 1.5-7% of thrombophilic patients. Here, we report the first Polish case with PS deficiency caused by the p.Arg451* in the PROS1 gene detected in a 21-year-old man with trauma-induced venous thromboembolism. To our knowledge, we provided the review of all the available data on this mutation (a total of 56 cases). The proband, his mother and his sister were screened for thrombophilia...
December 2017: Journal of Genetics
https://www.readbyqxmd.com/read/29319774/renal-artery-pseudoaneurysm
#20
Luiz Inácio Roman, Cauana Fabrício Efel, Victória Teles França, Carolina Meert Merten, Claus Dieter Dummer
The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT). This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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