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https://www.readbyqxmd.com/read/29784570/research-gaps-in-wilderness-medicine
#1
Daniel Tritz, Kody Dormire, Travis Brachtenbach, Joshua Gordon, Donald Sanders, David Gearheart, Julia Crawford, Matt Vassar
INTRODUCTION: Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. METHODS: We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations...
May 18, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29735231/comparing-the-efficacy-of-methods-for-immobilizing-the-thoracic-lumbar-spine
#2
Salam Rahmatalla, Jonathan DeShaw, Joshua Stilley, Gerene Denning, Charles Jennissen
OBJECTIVE: The purpose of this study was to compare the relative efficacy of immobilization systems in limiting thoracic-lumbar movements. METHODS: A dynamic simulation system was used to reproduce transport-related shocks and vibration, and involuntary movements of the thoracic-lumbar region were measured using 3 immobilization configurations. RESULTS: The vacuum mattress and the long spine board were generally more effective than the cot alone in reducing thoracic-lumbar rotation and flexion/extension...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29729811/a-multicenter-program-to-implement-the-canadian-c-spine-rule-by-emergency-department-triage-nurses
#3
Ian G Stiell, Catherine M Clement, Maureen Lowe, Connor Sheehan, Jacqueline Miller, Sherry Armstrong, Brenda Bailey, Kerry Posselwhite, Jannick Langlais, Karin Ruddy, Susan Thorne, Alison Armstrong, Catherine Dain, Jeffrey J Perry, Christian Vaillancourt
STUDY OBJECTIVE: The Canadian C-Spine Rule has been widely applied by emergency physicians to safely reduce use of cervical spine imaging. Our objective is to evaluate the clinical effect and safety of real-time Canadian C-Spine Rule implementation by emergency department (ED) triage nurses to remove cervical spine immobilization. METHODS: We conducted this multicenter, 2-phase, prospective cohort program at 9 hospital EDs and included alert trauma patients presenting with neck pain or with cervical spine immobilization...
May 2, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29729467/the-efficacy-of-thoracolumbar-bracing-on-spinal-immobilization-a-precise-assessment-of-gross-intersegmental-and-segmental-spinal-motion-restriction-by-a-3d-kinematic-system
#4
Gernot Lang, Anja Hirschmüller, Stefanie Patermann, Patric Eichelberger, Peter Strohm, Heiner Baur, Norbert P Südkamp, Georg W Herget
BACKGROUND: Various diseases of the spine are treated by immobilization via orthoses, although detailed evidence on the efficiency of orthotic bracing remains elusive. The present study sought to investigate the impact of three different orthoses on spinal immobilization utilizing three dimensional (3D) kinematic measurements. METHODS: Twelve healthy volunteers performed different motion tasks such as trunk flexion/extension and bilateral trunk bending, respectively...
May 2, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29705652/nonoperative-management-of-c-2-dens-fractures-single-center-experience-and-review-of-the-literature
#5
Oliver Gembruch, Elias Lemonas, Yahya Ahmadipour, Ulrich Sure, Nicolai El Hindy, Oliver Müller
OBJECTIVE: The demographic change in the population leads to a rising number of patients presenting with fractures of the cervical spine, especially C-2, due to falls. With an increase of co-morbidities in these elder patients, the risk for intra- and postoperative complications is increased likewise. Thus, an alternative strategy instead of operative management of these fractures should be taken into account whenever possible. Conservative management of dens fractures in the elderly is still a subject of great controversy despite numerous studies on this topic...
April 22, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29687674/intubation-through-2-supraglottic-airway-device-in-cervical-spine-immobilization-a-randomized-trial-of-residents-use-of-the-intubating-laryngeal-mask-airway-and-the-intubating-laryngeal-tube-in-manikins
#6
Dawid Aleksandrowicz, Tomasz Gaszyński
OBJECTIVES: The aim of this study was to compare the intubating laryngeal mask (iLM) airway and the new intubating laryngeal tube (iLTS-D) in use by residents with minimal previous intubation experience during simulated conditions of reduced cervical spine mobility. MATERIAL AND METHODS: Thirty first-year residents in anesthesiology participated in the study (18 women). All participants had minimal intubation experience (fewer than 10 previously performed intubations) and were novices in the specialty...
June 2018: Emergencias: revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29656152/occipital-condyle-fractures-and-concomitant-cervical-spine-fractures-implications-for-management
#7
James L West, Atilio E Palma, Lukas Vilella, Kyle M Fargen, Charles L Branch, Stacey Q Wolfe
INTRODUCTION: Occipital condyle fractures (OCFs) have previously been described based upon anatomic characteristics; however, recent literature has proposed management based on biomechanical stability and neural element compression. The treatment of biomechanically stable fractures varies between observation and cervical immobilization. Prior to determining best management, understanding of concomitant cervical spine fractures in the presence of OCFs is prudent. The primary aim of this pilot study was to determine the rate of occurrence of biomechanically significant cervical spine fractures with OCFs...
April 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29624623/motion-and-dural-sac-compression-in-the-upper-cervical-spine-during-the-application-of-a-cervical-collar-in-case-of-unstable-craniocervical-junction-a-study-in-two-new-cadaveric-trauma-models
#8
Shiyao Liao, Niko R E Schneider, Petra Hüttlin, Paul A Grützner, Frank Weilbacher, Stefan Matschke, Erik Popp, Michael Kreinest
BACKGROUND: Unstable conditions of the craniocervical junction such as atlanto-occipital dislocation (AOD) or atlanto-axial instability (AAI) are severe injuries with a high risk of tetraplegia or death. Immobilization by a cervical collar to protect the patient from secondary damage is a standard procedure in trauma patients. If the application of a cervical collar to a patient with an unstable craniocervical condition may cause segmental motion and secondary injury to the spinal cord is unknown...
2018: PloS One
https://www.readbyqxmd.com/read/29613899/traumatic-spinal-cord-injury
#9
Alejandro A Rabinstein
PURPOSE OF REVIEW: This article provides an update on the acute and subacute management and prognostication of patients with traumatic spinal cord injury. RECENT FINDINGS: Immobilization of the spine and spine clearance should be individualized depending on the ability to perform a reliable neurologic examination, the presence of neck pain, and the imaging findings. Early surgery (within 24 hours) to achieve definitive cord decompression and spine stabilization may be beneficial...
April 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29608449/conservative-treatment-of-hangman-variant-fractures
#10
Thomas E Niemeier, Sakthevil R Manoharan, Amrita Mukherjee, Steven M Theiss
STUDY DESIGN: This is retrospective cohort study. OBJECTIVE: Investigate the stability of patients with hangman variant fractures and outcomes of treatment with external immobilization. SUMMARY OF BACKGROUND DATA: Traumatic spondylolisthesis of the axis (C2) with the fracture extending into the vertebral body has been incompletely characterized. Small case series have showed high rates of neurological injury and cite difficulty treating closed due to greater instability secondary to extensive ligamentous injury...
March 31, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29603079/effects-of-breast-and-prostate-cancer-metastases-on-lumbar-spine-biomechanics-rapid-in-silico-evaluation
#11
J Lorkowski, O Grzegorowska, M S Kozień, I Kotela
Metastases to distant organs are a frequent occurrence in cancer diseases. The skeletal system, especially the spine, is one such organ. The objective of this study was to apply a numerical modeling, using a finite element method (FEM), for the evaluation of deformation and stress in lumbar spine in bone metastases to the spine. We investigated 20 patients (10 women and 10 men) aged 38-81 years. In women, osteolytic lesions in lumbar spine accompanied breast cancer, in men it was prostate cancer. Geometry of FEM models were built based on CT scans of metastatic lumbar spine...
March 31, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29580891/repeated-social-stress-leads-to-contrasting-patterns-of-structural-plasticity-in-the-amygdala-and-hippocampus
#12
D Patel, S Anilkumar, S Chattarji, B Buwalda
Previous studies have demonstrated that repeated immobilization and restraint stress cause contrasting patterns of dendritic reorganization as well as alterations in spine density in amygdalar and hippocampal neurons. Whether social and ethologically relevant stressors can induce similar patterns of morphological plasticity remains largely unexplored. Hence, we assessed the effects of repeated social defeat stress on neuronal morphology in basolateral amygdala (BLA), hippocampal CA1 and infralimbic medial prefrontal cortex (mPFC)...
March 23, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29535875/posttraumatic-spinal-cord-injury-without-radiographic-abnormality
#13
REVIEW
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
https://www.readbyqxmd.com/read/29528997/lack-of-consensus-in-physician-recommendations-regarding-return-to-driving-after-cervical-spine-surgery
#14
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
https://www.readbyqxmd.com/read/29528600/-74-year-old-man-with-a-complex-acromio-clavicular-disjunction
#15
J Juanos Cabanas, H Jennart, G Leclercq, D Zorman
Acromioclavicular dislocation is a frequent pathology commonly encountered in traumatology. Therefore, its management is generally standardized, guided by clinical and radiological evaluation. This can range from conservative treatment by limb immobilization and functional rehabilitation, to surgical treatment by using minimally invasive techniques. We present the particular case of a 74-year-old patient with an acromioclavicular dislocation associated with a non-displaced fracture of the coracoid process as well as of the spine of the scapula...
2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/29505977/external-fixation-and-surgical-fusion-for-pediatric-cervical-spine-injuries-short-term-outcomes
#16
Taylor E Purvis, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, C Rory Goodwin, Mari L Groves, Michael C Ain, Daniel M Sciubba
OBJECTIVE: To compare in-hospital complication rates in pediatric patients with atlantoaxial and subaxial injuries undergoing either external fixation or surgical fusion. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2002-2011 Nationwide Inpatient Sample (NIS) for patients under the age of 18 with a diagnosis of cervical spine fracture without spinal cord injury or cervical spine subluxation. Patients who underwent external immobilization or internal fixation were included for analysis...
May 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29505854/clinical-features-and-treatment-outcomes-of-langerhans-cell-histiocytosis-of-the-spine
#17
XiangYu Xu, SongBo Han, Liang Jiang, ShaoMin Yang, XiaoGuang Liu, HuiShu Yuan, Feng Wei, FengLiang Wu, Lei Dang, Hua Zhou, Hua Zhang, ZhongJun Liu
BACKGROUND CONTEXT: Langerhans cell histiocytosis (LCH) of the spine is a relatively rare condition with unknown etiology. The diagnosis and treatment protocols for spine LCH remain controversial. PURPOSE: In this study, we evaluated the efficacy and safety of our proposed diagnosis and treatment protocol introduced in 2009. STUDY DESIGN: This is a retrospective study. PATIENT SAMPLE: A total of 110 patients with spine LCH who had been diagnosed and treated in our hospital from October 1997 to November 2015 were included in this study...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29462728/treatment-of-lumbar-discitis-using-silicon-nitride-spinal-spacers-a-case-series-and-literature-review
#18
William M Rambo
INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29452031/prehospital-cervical-spine-motion-immobilization-versus-spine-motion-restriction
#19
Erik E Swartz, W Steven Tucker, Matthew Nowak, Jason Roberto, Amy Hollingworth, Laura C Decoster, Thomas W Trimarco, Jason P Mihalik
OBJECTIVE: This study aims to evaluate the efficacy of two different spinal immobilization techniques on cervical spine movement in a simulated prehospital ground transport setting. METHODS: A counterbalanced crossover design was used to evaluate two different spinal immobilization techniques in a standardized environment. Twenty healthy male volunteers (age = 20.9 ± 2.2 yr) underwent ambulance transport from a simulated scene to a simulated emergency department setting in two separate conditions: utilizing traditional spinal immobilization (TSI) and spinal motion restriction (SMR)...
February 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29447489/compulsory-use-of-the-backboard-is-associated-with-increased-frequency-of-thoracolumbar-imaging
#20
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
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