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https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#1
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28811931/non-traumatic-rupture-of-the-superior-thyroid-artery-with-concomitant-parathyroid-adenoma-and-multinodular-goiter
#2
Natsuko Hanashiro, Tsuneo Yamashiro, Yuko Iraha, Kennosuke Karube, Hirofumi Matsumoto, Sadayuki Murayama
Cervical hemorrhage due to non-traumatic, spontaneous rupture of the thyroid artery is rare, which usually results from arterial abnormalities or parathyroid or thyroid disorders. This report describes a 72-year-old woman who presented with a sore throat and slight neck swelling. Computed tomography (CT) revealed a large hematoma in the neck and mediastinum, due to extravasation from the major branch of the left superior thyroid artery. A follow-up CT the next day demonstrated that the extravasation had resolved...
July 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28808809/evidence-of-dengue-virus-replication-in-a-non-traumatic-spleen-rupture-case
#3
Luiz José de Souza, João de Azevedo, Liza Ingride Acha Kohler, Lorena de Freitas Barros, Mariana Arêdes Lima, Emiliana Mandarano Silva, Ronaldo Mohana-Borges, Priscila Conrado Guerra Nunes, Marciano Viana Paes
The present report describes a case of splenic rupture due to dengue, a rare complication of dengue that should be considered in any patient with suspected dengue disease who started with left upper quadrant abdominal pain and hypotension. The pathophysiology of this entity is not yet well elucidated, but one of the theories present in the literature is that it is due to a depletion of coagulation factors and platelets leading to intra-splenic hemorrhage and rupture. The RT-PCR technique detected serotype 1 and histopathological studies of the spleen revealed significant atrophy of lymphoid follicles and extensive hemorrhage areas...
August 14, 2017: Archives of Virology
https://www.readbyqxmd.com/read/28806641/acute-ethanol-administration-results-in-a-protective-cytokine-and-neuroinflammatory-profile-in-traumatic-brain-injury
#4
Akila Chandrasekar, Florian Olde Heuvel, Annette Palmer, Birgit Linkus, Albert C Ludolph, Tobias M Boeckers, Borna Relja, Markus Huber-Lang, Francesco Roselli
Ethanol intoxication is a common comorbidity in traumatic brain injury. To date, the effect of ethanol on TBI pathogenic cascades and resulting outcomes remains debated. A closed blunt weight-drop murine TBI model has been implemented to investigate behavioral (by sensorimotor and neurological tests), and neuro-immunological (by tissue cytokine arrays and immuno-histology) effects of ethanol intoxication on TBI. The effect of the occurrence of traumatic intracerebral hemorrhage was also studied. The results indicate that ethanol pretreatment results in a faster and better recovery after TBI with reduced infiltration of leukocytes and reduced microglia activation...
August 11, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#5
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28802071/microrna-137-and-195-inhibit-vasculogenesis-in-brain-arteriovenous-malformations
#6
Jun Huang, Jianping Song, Meijie Qu, Yang Wang, Qinzhu An, Yaying Song, Wei Yan, Bingshun Wang, Xiaojin Wang, Song Zhang, Xi Chen, Bing Zhao, Peixi Liu, Tongyi Xu, Zhijun Zhang, David A Greenberg, Yongting Wang, Pingjin Gao, Wei Zhu, Guo-Yuan Yang
OBJECTIVES: Brain arteriovenous malformations (AVMs) are the most common cause of non-traumatic intracerebral hemorrhage in young adults. The genesis of brain AVM remains enigmatic. We investigated microRNA (miRNA) expression and its contribution to the pathogenesis of brain AVMs. METHODS: We used a large-scale miRNA analysis on 16 samples including AVMs, hemangioblastoma, and controls to identify a distinct AVM miRNA signature. AVM smooth muscle cells (AVMSMCs) were isolated and identified by flow cytometry and immunohistochemistry and candidate miRNAs were then tested in these cells...
August 12, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28801841/the-use-of-aortic-balloon-occlusion-in-traumatic-shock-first-report-from-the-abo-trauma-registry
#7
M Sadeghi, K F Nilsson, T Larzon, A Pirouzram, A Toivola, P Skoog, K Idoguchi, Y Kon, T Ishida, Y Matsumara, J Matsumoto, V Reva, M Maszkowski, A Bersztel, E Caragounis, M Falkenberg, L Handolin, B Kessel, D Hebron, F Coccolini, L Ansaloni, J J Morrison, T M Hörer, M J Madurska
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014...
August 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28780251/convexity-subarachnoid-hemorrhage-due-to-cardioembolic-stroke-in-a-woman-with-thyrotoxicosis-%C3%AE-case-report
#8
Ioanna Spanou, Sophia Vassilopoulou, Eleni Koroboki, Argyro Tountopoulou, Georgios Velonakis, Dimos Dimitrios Mitsikostas
BACKGROUND: Non-traumatic convexity subarachnoid hemorrhage (cSAH) is a rarely reported condition with a wide spectrum of etiologies. Cerebral ischemia secondary to extracranial or intracranial atherosclerotic disease has been identified as a relatively uncommon cause of cSAH. CASE REPORT: We report a case of cSAH caused by cardioembolic stroke. A 69-year old female patient developed suddenly left-sided face and body weakness and numbness and visual neglect on the left...
August 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28774762/epidemiology-of-mild-traumatic-brain-injury-with-intracranial-hemorrhage-focusing-predictive-models-for-neurosurgical-intervention
#9
Alessandro Orlando, A Stewart Levy, Matthew M Carrick, Allen Tanner, Charles W Mains, David Bar-Or
OBJECTIVE: To adumbrate differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries (mTBIs), and help identify which ICH types are most likely to benefit from the creation of predictive models for NI. METHODS: This was a multi-center retrospective study of adult patients over three years at four Trauma Centers in the USA. Patients were included if they presented with a mTBI (GCS 13-15) and a head CT positive for ICH...
July 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28771476/evaluation-of-novel-computerized-tomography-scoring-systems-in-human-traumatic-brain-injury-an-observational-multicenter-study
#10
MULTICENTER STUDY
Eric Peter Thelin, David W Nelson, Juho Vehviläinen, Harriet Nyström, Riku Kivisaari, Jari Siironen, Mikael Svensson, Markus B Skrifvars, Bo-Michael Bellander, Rahul Raj
BACKGROUND: Traumatic brain injury (TBI) is a major contributor to morbidity and mortality. Computerized tomography (CT) scanning of the brain is essential for diagnostic screening of intracranial injuries in need of neurosurgical intervention, but may also provide information concerning patient prognosis and enable baseline risk stratification in clinical trials. Novel CT scoring systems have been developed to improve current prognostic models, including the Stockholm and Helsinki CT scores, but so far have not been extensively validated...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28768486/lumbar-puncture-as-possible-cause-of-sudden-paradoxical-herniation-in-patient-with-previous-decompressive-craniectomy-report-of-two-cases
#11
Liang Shen, Sheng Qiu, Zhongzhou Su, Xudong Ma, Renfu Yan
BACKGROUND: Lumbar puncture is often used for the diagnosis and treatment of subarchnoid hemorrhage, infection of Cerebro-spinal Fluid (CSF), hydrocephalus in neurosurgery department patients. It is general that paradoxical herniation followed by lumbar puncture is quite rare in decompressive craniectomy cases; the related reports are very few. Moreover, most of the paradoxical herniation cases are chronic, which often occur weeks or even months after the lumbar puncture, to date, barely no reports on the acute onset paradoxical herniation have been found...
August 2, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28767544/compensatory-reserve-index-performance-of-a-novel-monitoring-technology-to-identify-the-bleeding-trauma-patient
#12
Michael Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwacha, David Wampler, Mark DeRosa, Brian Eastridge
INTRODUCTION: Hemorrhage is one of the most substantial causes of death after traumatic injury. Standard measures, including systolic blood pressure (SBP), are poor surrogate indicators of physiologic compromise until compensatory mechanisms have been overwhelmed. Compensatory Reserve Index (CRI) is a novel monitoring technology with the ability to assess physiologic reserve. We hypothesized CRI would be a better predictor of physiologic compromise secondary to hemorrhage than traditional vital signs...
August 1, 2017: Shock
https://www.readbyqxmd.com/read/28765023/a-multicenter-retrospective-cohort-study-of-talk-and-die-after-traumatic-brain-injury
#13
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting, and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. METHODS: We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28758072/effects-of-early-cranioplasty-on-the-restoration-of-cognitive-and-functional-impairments
#14
Byung Wook Kim, Tae Uk Kim, Jung Keun Hyun
OBJECTIVE: To delineate the effect of early cranioplasty on the recovery of cognitive and functional impairments in patients who received decompressive craniectomy after traumatic brain injury or spontaneous cerebral hemorrhage. METHODS: Twenty-four patients who had received cranioplasty were selected and divided according to the period from decompressive craniectomy to cranioplasty into early (≤90 days) and late (>90 days) groups. The Korean version of the Mini-Mental State Examination (K-MMSE), Korean version of the Modified Barthel Index (K-MBI), and Functional Independence Measure (FIM) were evaluated at admission just after decompressive craniectomy and during the follow-up period after cranioplasty...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28755920/external-ventricular-drainage-preceding-the-removal-of-a-nail-from-the-intracranial-space-as-a-safe-management-strategy-for-predicted-secondary-intraventricular-hemorrhage
#15
Takumi Morita, Yoshinori Maki, Daisuke Yamada, Ryota Ishibashi, Masaki Chin, Sen Yamagata
BACKGROUND: Intracranial nail gun injury is a rare traumatic event and can result from a suicide attempt. Cerebral angiography is essential in the evaluation of damage to the intracranial vessels, and surgical removal of nails is generally the optimal treatment. Intraventricular hemorrhage can happen following removal of intracranial nails. Endovascular surgery or intraoperative computed tomography has been reported to be useful for detection and treatment of intraventricular hemorrhage...
July 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28751950/orbital-compartment-syndrome-despite-significant-traumatic-expansion-of-the-orbital-cavity
#16
Deepak Gupta, Bijan Beigi
Periorbital injury can present with various permutations of bone trauma, soft-tissue edema, and hematomas that might involve proptosis and restricted motility. We report a case of a 32-year-old patient who sustained a traumatic orbital compartment syndrome simultaneously with a large, significantly displaced, orbital-floor blow-out fracture. Clinical signs consistent with both conditions were elicited. The initial management was as for orbital compartment syndrome. The clinical diagnosis was confirmed with computed tomographic imaging...
September 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28747144/abcg2-c-421c-a-is-associated-with-outcomes-following-severe-traumatic-brain-injury
#17
Solomon M Adams, Yvette P Conley, Dianxu Ren, David O Okonkwo, Ava Puccio, C Edward Dixon, Robert Sb Clark, Patrick M Kochanek, Philip E Empey
Traumatic brain injury (TBI) is a leading cause of death with no pharmacologic treatments that improve outcomes. Transporter proteins participate in TBI recovery by maintaining the CNS biochemical milieu. Genetic variations in transporters that alter expression and/or function have been associated with TBI outcomes. The ATP-binding cassette transporter, ABCG2, is a uric acid (UA) transporter that effluxes UA from cells in the CNS and is responsible for systemic UA clearance. Uric acid is a CNS antioxidant and/or a biomarker that might support TBI recovery...
July 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28744762/mortality-after-primary-intracerebral-hemorrhage-in-relation-to-post-stroke-seizures
#18
Danny Claessens, Kim Bekelaar, Floris H B M Schreuder, Bianca T A de Greef, Mariëlle C G Vlooswijk, Julie Staals, Robert J van Oostenbrugge, Rob P W Rouhl
Seizures after intracerebral hemorrhage are repeatedly seen. Whether the development of seizures after intracerebral hemorrhage affects survival in the long term is unknown. This study aims to determine the relation between seizures (i.e., with and without anti-epileptic therapy) and long-term mortality risk in a large patient population with intracerebral hemorrhage. We retrospectively included patients with a non-traumatic ICH in all three hospitals in the South Limburg region in the Netherlands between January 1st 2004 and December 31st 2009, and we assessed all-cause mortality until March 14th 2016...
July 25, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28744321/an-18-f-positron-emitting-fluorescent-cerebrospinal-fluid-probe-for-imaging-damage-to-the-brain-and-spine
#19
Harikrishna Kommidi, Hua Guo, Nandi Chen, Dohyun Kim, Bin He, Amy P Wu, Omer Aras, Richard Ting
Fluorescein is modified to bear (18)F so that it can act as both a positron emitter, and a fluorophore, allowing detection by positron emission tomography (PET), scintillation, and fluorescent imaging (FL). [(18)F]-2 is injected into the intrathecal space of rats and used to observe the cerebrospinal fluid (CSF) that bathes the brain and spine. Injury in three different applications is visualized with [(18)F]-2: 1) detection of a 0.7 mm paranasal-sinus CSF leak (CSFL); 2) detection of 0.5 mm puncture damage to the thoracic spine (acute spinal cord injury); and 3) detection of intracerebral hemorrhage/edema because of traumatic brain injury...
2017: Theranostics
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#20
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
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