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Trauma, emergency surgery

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https://www.readbyqxmd.com/read/28441281/incarcerated-medial-epicondyle-fractures-with-elbow-dislocation-risk-factors-associated-with-morbidity
#1
Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28434082/senior-general-surgery-residents-can-be-trained-to-perform-focused-assessment-with-sonography-for-trauma-patients-accurately
#2
Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan, Jyh-Cherng Yu
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28427782/prospective-study-of-a-non-restrictive-decision-rule-for-acute-aortic-syndrome
#3
Judah Goldschmiedt, Jeffrey M Levsky, Eran Y Bellin, Esther Mizrachi, David Esses, Linda B Haramati
OBJECTIVES: To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). METHODS: We prospectively assessed the performance of a previously described, collaboratively designed, non-restrictive clinical decision rule for AAS. Emergency Department patients with suspected AAS were stratified into low and high-risk groups based on decision rule results, from July 2013-August 2014...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#4
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28423132/repair-of-penetrating-pericardial-and-diaphragmatic-injury-with-cormatrix%C3%A2-patch-in-a-case-of-suicide-attempt
#5
Federica Jiritano, Carlo Garrasi, Lucia Cristodoro, Egidio Bevacqua, Pasquale Mastroroberto
The authors report the case of a suicide attempt. A 59-year-old man with self-inflicted penetrating chest trauma underwent emergency cardiothoracic surgery. Pre-operative computed tomography scan showed critical proximity between the blade and the right ventricle. Intraoperative findings showed a pericardial laceration and a huge diaphragmatic lesion with heart and abdominal organs integrity. The diaphragm muscle was repaired with a CorMatrix® patch, an acceptable alternative to the traditional synthetic mesh avoiding infection and repeated herniation...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#6
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#7
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28404521/diabetic-complications-in-the-cornea
#8
Alexander V Ljubimov
Diabetic corneal alterations, such as delayed epithelial wound healing, edema, recurrent erosions, neuropathy/loss of sensitivity, and tear film changes are frequent but underdiagnosed complications of both type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus. The disease affects corneal epithelium, corneal nerves, tear film, and to a lesser extent, endothelium, and also conjunctiva. These abnormalities may appear or become exacerbated following trauma, as well as various surgeries including retinal, cataract or refractive...
April 9, 2017: Vision Research
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#9
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28387108/-highflow-priapism-diagnostic-evaluation-contribution-of-ultrasound-and-recommendations
#10
O Lavergne, A Thomas, R Andrianne, D Waltrégny, L Coppens
The high flow priapism (HFP) is a very rare pathology. It must be distinguished from the low flow which is a real urologic emergency. The diagnosis of HFP (most often post-trauma) remains clinical, but penile color Doppler ultrasound can confirm, identify and track the evolution of the lesion. Conservative treatment is effective and remains the first line treatment. However the different therapeutic modalities (selective embolisation, surgery) should be explained to the patient and be considered case by case...
November 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28379911/treatment-of-pregnant-patients-with-orthopaedic-trauma
#11
Nirmal Tejwani, Kevin Klifto, Christopher Looze, Christopher Scott Klifto
Fracture management in pregnant patients is challenging. Anatomic and physiologic changes in pregnancy increase the complexity of treatment. Maternal trauma increases the risk of fetal loss, preterm birth, placental abruption, cesarean delivery, and maternal death. Initial resuscitation and treatment in a facility equipped to handle the orthopaedic injury and preterm births are paramount. Pelvic and acetabular injuries are potentially life threatening. The benefits and risks of surgical treatment must be carefully considered...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28370979/cohort-study-on-emergency-general-surgery-patients-and-an-observation-unit
#12
Marilla Dickfos, Hany Ibrahim, Andrew Evans, Robert Franz
BACKGROUND: Medium-sized, non-trauma hospitals experience many of the same difficulties as tertiary centres do when it comes to managing emergency general surgery patients. However, acute surgical units are not a financially viable option in these hospitals. To improve the care of emergency general surgery patients at one such hospital, a Rapid Assessment Medical Surgical (RAMS) unit was developed to decrease the time to review and increase the efficiency in caring for these patients...
March 30, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28369494/emergency-video-assisted-thoracoscopic-surgery-for-haemopneumothorax-and-diaphragm-repair-after-stabbing-performed-through-pre-existing-wounds
#13
Aman Coonar, Laurence Orchard
Video of video-assisted thoracoscopic surgery (VATS) on a 16-year old who had been stabbed. The knife penetrated the diaphragm, lung and intercostal pedicle causing a haemopneumothorax. A chest drain was inserted by the trauma team. VATS was performed entirely through the stab and chest drain pre-existing wounds without extension.
March 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28368128/minimally-invasive-surgery-in-periodontal-regeneration-a-review-of-the-literature
#14
John C Tunnell, Stephen K Harrel
New techniques have emerged to achieve periodontal regeneration without the drawbacks associated with conventional flap surgery. Minimally invasive surgery (MIS) is a method of surgical access that minimizes flap reflection and tissue trauma, resulting in maintenance of critical blood supply, stability of the blood clot within the wound site, and less postoperative recession over time. As advancements in materials and techniques are made, MIS in periodontal regeneration continues to evolve. The emergence of a videoscope for use during MIS (VMIS) has improved visual access to surgical sites, facilitating improved defect debridement and root planing...
April 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#15
Laura C Lamb, Stephanie C Montgomery, Brian Wong Won, Siobhan Harder, Jeffrey Meter, James M Feeney
BACKGROUND: Fragility fractures have become a worldwide epidemic associated with significant morbidity and mortality. As the world population ages, the number of patients that experience these fractures is also expected to rise. A multidisciplinary team was assembled that was coordinated by the Acute Inpatient Medical Service and included orthopedic surgeons, geriatricians, anesthesiologists, cardiologists, nurses, trauma surgeons, emergency medicine physicians, physiatrists, and physical therapists...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28361365/acute-non-traumatic-idiopathic-spinal-subdural-hematoma-radiographic-findings-and-surgical-results-with-a-literature-review
#16
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro
PURPOSE: Intraspinal hematoma is a serious condition, and early diagnosis is necessary to permit emergency treatment. Among such hematomas, non-traumatic spinal subdural hematoma is a rare occurrence. We have experienced three patients with surgically proven subdural spinal hematoma, and here we report these cases with a review of their clinical and imaging characteristics. METHODS: All three cases were idiopathic with no history of disease, no coagulopathy, and no trauma...
March 30, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28356323/bacterial-and-fungal-endophthalmitis
#17
REVIEW
Marlene L Durand
Endophthalmitis is a severe eye infection that may result in permanent loss of useful vision in the affected eye. Most cases are exogenous and occur as a complication of cataract surgery, an intravitreal injection, or penetrating ocular trauma. Endogenous endophthalmitis results from hematogenous seeding of the eye by bacteria or fungi, but bacteremia or fungemia may be transient and patients may present without symptoms of systemic infection. Nearly all endophthalmitis patients present with decreased vision, and some also have eye pain...
July 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#18
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350943/controversies-in-spinal-trauma-and-evolution-of-care
#19
James S Harrop, George N Rymarczuk, Alexander R Vaccaro, Michael P Steinmetz, Lindsay A Tetreault, Michael G Fehlings
Management of spinal trauma is a complex and rapidly evolving field. To optimize patient treatment algorithms, an understanding of and appreciation for current controversies and advancing technologies in the field of spinal trauma is necessary. Therefore, members of the AOSpine Knowledge Forum Trauma initiative used a modified Delphi method to compile a list of controversial issues and emerging technologies in the field of spinal trauma, and a list of the 14 most relevant topics was generated. A total of 45 440 manuscripts covering the breadth of spine and spinal trauma were initially identified...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28341511/open-and-endovascular-abdominal-aortic-injury-repair-outcomes-in-polytrauma-patients
#20
Anand Dayama, Aksim Rivera, Odunayo Olorunfemi, Ahmed Mahmoud, Catherine A Fontecha, John McNelis
INTRODUCTION: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care although it is associated with high mortality. In past few years, endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings. The objective of this study was to compare outcomes after open repair versus endovascular repair of AAI in polytrauma patients. METHODS: The National Trauma Data Bank, from 2008 to 2012, was queried to identify trauma patients undergoing open and endovascular repair of AAI using International Classification of Diseases, ninth Edition, and Clinical Modification codes...
March 21, 2017: Annals of Vascular Surgery
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