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Trauma, emergency surgery

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https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#1
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29670802/isolated-right-sided-posttraumatic-diaphragmatic-hernia
#2
Ibrahim Amadou Magagi, Oumarou Habou, Harissou Adamou, Ousseini Adakal, Mahamoud Omid Ali Ada, Hellé Moustapha, Habibou Abarchi
Diaphragm is a compliant musculoaponeurotic barrier located between thoracic and abdominal cavities. Traumatic diaphragmatic rupture is a rare clinicopathological entity. We report a case of right-sided posttraumatic hernia in a child following blunt trauma to highlight diagnostic difficulties and therapeutic specific aspects. A 10-year-old boy was admitted to the emergency surgical department with thoracic trauma following pedestrian accident. At admission a haemothorax was suspected and treated by pleural drainage...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29661069/the-black-cloud-phenomenon-in-hand-surgery
#3
Emily Zhao, Nathan Tiedeken, William Wang, John Fowler
BACKGROUND: The term black cloud for a surgeon is generally used to describe someone who is unusually busy compared with his or her counterparts, and it is a superstition that tends to pervade the medical world. The purpose of this study is to investigate whether black clouds exist in hand surgery. METHODS: We examined one academic year's worth of hand surgery-specific call at a level I trauma center and tabulated the number of hand-related patient transfers and add-on cases per surgeon...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29659475/frailty-screening-and-a-frailty-pathway-decrease-length-of-stay-loss-of-independence-and-30-day-readmission-rates-in-frail-geriatric-trauma-and-emergency-general-surgery-patients
#4
Kathryn E Engelhardt, Quentin Reuter, Jessica Liu, Jonathan F Bean, Joliette Barnum, Michael B Shapiro, Allison Ambre, Amanda Dunbar, Mara Markzon, Tara Reddy, Christine Schilling, Joseph Posluszny
BACKGROUND: Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of post-discharge institutionalization than their non-frail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement (QI) project was to first develop a frailty screening program, and, then, if frail, implement a novel Frailty Pathway to reduce LOS, 30-day readmissions, and loss of independence (LOI)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659473/external-validation-of-a-5-variable-clinical-prediction-rule-for-identifying-children-at-very-low-risk-for-intra-abdominal-injury-following-blunt-abdominal-trauma
#5
Chase A Arbra, Adam M Vogel, Leah Plumblee, Jingwen Zhang, Patrick D Mauldin, Melvin S Dassinger, Robert T Russell, Martin L Blakely, Christian J Streck
BACKGROUND: A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans following blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS: The public use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29657727/preoperative-fluid-restriction-for-trauma-patients-with-hemorrhagic-shock-decreases-ventilator-days
#6
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29652296/validation-of-the-aast-egs-grade-for-skin-and-soft-tissue-infection
#7
Mohamed D Ray-Zack, Matthew C Hernandez, Moustafa Younis, Wyatt B Hoch, Dylan S Soukup, Nadeem Haddad, Martin D Zielinski
INTRODUCTION: Skin and soft tissue infections (SSTI) present with variable severity. The American Association for the Surgery of Trauma (AAST) developed an emergency general surgery (EGS) grading system for several diseases. We aimed to determine whether the AAST EGS grade corresponds with key clinical outcomes. METHODS: Single institution retrospective review of patients (≥18 years) admitted with SSTI during 2012-2016 was performed. Patients with surgical site infections or <18 years were excluded...
February 27, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29650015/inclusion-and-exclusion-criteria-used-in-non-specific-low-back-pain-trials-a-review-of-randomised-controlled-trials-published-between-2006-and-2012
#8
Pål André Amundsen, David W Evans, Dévan Rajendran, Philip Bright, Tom Bjørkli, Sandra Eldridge, Rachelle Buchbinder, Martin Underwood, Robert Froud
BACKGROUND: Low back pain is a common health complaint resulting in substantial economic burden. Each year, upwards of 20 randomised controlled trials (RCTs) evaluating interventions for non-specific low back pain are published. Use of the term non-specific low back pain has been criticised on the grounds of encouraging heterogeneity and hampering interpretation of findings due to possible heterogeneous causes, challenging meta-analyses. We explored selection criteria used in trials of treatments for nsLBP...
April 12, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#9
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29618191/delayed-massive-hemothorax-requiring-surgery-after-blunt-thoracic-trauma-over-a-5-year-period-complicating-rib-fracture-with-sharp-edge-associated-with-diaphragm-injury
#10
Sung Wook Chang, Kyoung Min Ryu, Jae-Wook Ryu
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#11
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29615194/comments-on-tele-mentored-emergency-trauma-surgery-a-feasibility-study-using-live-tissue-models
#12
Camilo Rosales
No abstract text is available yet for this article.
March 22, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#13
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29609952/rethinking-the-pgy-1-basic-clinical-year-a-canadian-national-survey-of-its-educational-value-for-diagnostic-radiology-residents
#14
Kathryn E Darras, Abigail A Arnold, Colin Mar, Bruce B Forster, Linda Probyn, Silvia D Chang
RATIONALE AND OBJECTIVES: Recently, the relevance of the postgraduate year 1 (PGY-1) Basic Clinical Year for radiology residents has been questioned. The purpose of this study was to determine the attitude of radiologists and trainees toward this year and which clinical rotations they perceived as most valuable to clinical practice. MATERIALS AND METHODS: Following institutional review board approval, an anonymous online survey was administered to Canadian radiologists and radiology trainees...
March 30, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29608545/adherence-to-20-emergency-general-surgery-best-practices-results-of-a-national-survey
#15
Angela M Ingraham, M Didem Ayturk, Catarina I Kiefe, Heena P Santry
OBJECTIVE: To examine national adherence to emergency general surgery (EGS) best practices. BACKGROUND: There is a national crisis in access to high-quality care for general surgery emergencies. Acute care surgery (ACS), a specialty leveraging strengths of trauma systems, may ameliorate this crisis. A critical component of trauma care is adherence to clinical guidelines. We previously established best practices for EGS using RAND Appropriateness Methodology and pilot data...
March 30, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29606410/disparities-in-pediatric-gonadal-torsion-does-gender-race-and-insurance-status-affect-outcomes
#16
Jessica L Buicko, Shevonne S Satahoo, Krishnamurti A Rao, Juan E Sola, Holly L Neville
PURPOSE: Ovarian and testicular torsions are emergencies requiring prompt surgical treatment to preserve gonadal function. However, diagnosis in females is often delayed owing to nonspecific symptoms. We sought to assess disparities in management and outcomes between males and females with torsion. METHODS: The National Inpatient Sample was queried for pediatric patients with "emergent", "urgent", or "trauma center" admission and ICD-9 codes for ovarian torsion and testicular torsion...
February 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29589502/comparison-between-a-multicentre-collaborative-closed-loop-audit-assessing-management-of-supracondylar-fractures-and-the-british-orthopaedic-association-standard-for-trauma-11-boast-11-guidelines
#17
MULTICENTER STUDY
R Goodall, H Claireaux, J Hill, E Wilson, F Monsell, Boast Collaborative, P Tarassoli
Aims Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29587748/regulation-of-alveolar-macrophage-death-in-acute-lung-inflammation
#18
REVIEW
Erica K Y Fan, Jie Fan
Acute lung injury (ALI) and its severe form, known as acute respiratory distress syndrome (ARDS), are caused by direct pulmonary insults and indirect systemic inflammatory responses that result from conditions such as sepsis, trauma, and major surgery. The reciprocal influences between pulmonary and systemic inflammation augments the inflammatory process in the lung and promotes the development of ALI. Emerging evidence has revealed that alveolar macrophage (AM) death plays important roles in the progression of lung inflammation through its influence on other immune cell populations in the lung...
March 27, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29572673/laparoscopic-anatomical-liver-resection-after-complex-blunt-liver-trauma-a-case-report
#19
Arpad Ivanecz, Vid Pivec, Bojan Ilijevec, Saša Rudolf, Stojan Potrč
BACKGROUND: Various minimally invasive therapies are important adjuncts to management of hepatic injuries. However, there is a certain subset of patients who will benefit from liver resection, but there are no reports in the literature on laparoscopic anatomical liver resection for the management of complications after blunt liver trauma. CASE PRESENTATION: A 20-year-old male was admitted to the Emergency Unit of a tertiary referral center following a car accident...
March 23, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29568223/acquired-von-willebrand-syndrome-complicating-nephrotic-syndrome-a-case-of-a-patient-with-membranous-nephropathy
#20
Taro Sugase, Tetsu Akimoto, Takaaki Kimura, Takashi Yagisawa, Eiji Kusano, Daisuke Nagata
Acquired von Willebrand syndrome (AVWS) is a rare clinical entity presenting with heterogeneous hemorrhagic manifestations, although some subsets of patients with AVWS may be asymptomatic until they are exposed to major trauma, an invasive procedure, or surgery. We herein report one such case in a 73-year-old male patient with nephrotic syndrome with a prolonged active partial thromboplastin time. We initially did not deal with this distinct abnormal clotting profile seriously, but persistent bleeding after a retroperitoneoscopic-assisted renal biopsy that allowed us to ascribe his nephrotic syndrome to membranous nephropathy fortuitously led to the discovery of concurrent AVWS...
2018: Clinical Medicine Insights. Case Reports
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