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polytrauma patients

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https://www.readbyqxmd.com/read/28291522/fractures-and-dislocations-of-the-hand-in-polytrauma-patients-incidence-injury-pattern-and-functional-outcome
#1
Steven Ferree, Quirine M J van der Vliet, Mark van Heijl, Roderick M Houwert, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. METHODS: A single centre retrospective cohort study was performed at a level 1 trauma centre...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#2
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28277439/role-of-laparoscopy-in-patients-with-abdominal-trauma-at-level-i-trauma-center
#3
Purushottam Parajuli, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Biplab Mishra, Maneesh Singhal, Atin Kumar, Shivanand Gamangatti, Babita Gupta, Chhavi Sawhney, Mahesh C Misra
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi...
March 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28262279/major-influence-of-interobserver-reliability-on-polytrauma-identification-with-the-injury-severity-score-iss-time-for-a-centralised-coding-in-trauma-registries
#4
Roman Maduz, Patrick Kugelmeier, Severin Meili, Robert Döring, Christoph Meier, Peter Wahl
OBJECTIVE: The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. METHODS: Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers...
February 21, 2017: Injury
https://www.readbyqxmd.com/read/28252351/patellar-reconstruction-following-previous-patellectomy-a-review-of-the-literature-and-a-case-series-using-distal-femoral-autograft-during-total-knee-arthroplasty
#5
D A George, A Dosani, R Morgan-Jones
During total knee arthroplasty, the reconstruction of the patella following a previous patellectomy is challenging, and is undertaken to improve functional outcomes and patient satisfaction. In this case series, we have reconstructed the patella using a femoral condyle resected during total knee arthroplasty. The resected femoral condyle with best available bone stock is selected and secured to the extensor mechanism. We reviewed the preoperative indications and postoperative outcomes of two patients who underwent the above procedure at our Institute, and compared this to the literature...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28246625/endovascular-management-of-a-combined-subclavian-and-vertebral-artery-injury-in-an-unstable-polytrauma-patient-case-report-and-literature-review
#6
Christian David Weber, Philipp Kobbe, Christian Herren, Andreas H Mahnken, Frank Hildebrand, Hans-Christoph Pape
While blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. While patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (BCVI) can present asymptomatic, but complications like basilar territory infarction, cortical blindness and death may occur. We report the life- and limb-saving management in a 57-year-old hemodynamically unstable trauma patient...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28243715/volume-replacement-during-trauma-resuscitation-a-brief-synopsis-of-current-guidelines-and-recommendations
#7
REVIEW
M Maegele, M Fröhlich, M Caspers, S Kaske
INTRODUCTION: Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. METHODS: A synopsis of best current knowledge with reference to the following guidelines and recommendations is presented: (1) The European Guideline on Management of Major Bleeding and Coagulopathy following Trauma (fourth edition), (2) S3 Guideline on Treatment of Patients with Severe and Multiple Injuries [English Version of the German Guideline S3 Leitlinie Polytrauma/Schwerverletzten-Behandlung/AWMF Register-Nr...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#8
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28217583/profile-of-trauma-patients-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#9
Kundavaram Paul Prabhakar Abhilash, Nilanchal Chakraborthy, Gautham Raja Pandian, Vineet Subodh Dhanawade, Thomas Kurien Bhanu, Krishna Priya
BACKGROUND: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28195897/base-of-skull-blocks-for-open-reduction-and-internal-fixation-of-faciomaxillary-fractures
#10
Sandeep Mehrotra, Sunil Anand
INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#11
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187475/concomitant-sternal-fracture-in-flail-chest-an-analysis-of-21-741-polytrauma-patients-from-the-traumaregister-dgu%C3%A2
#12
Stefan Schulz-Drost, Sebastian Krinner, Andreas Langenbach, Pascal Oppel, Rolf Lefering, Dominic Taylor, Friedrich F Hennig, Andreas Mauerer
Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear. Methods A retrospective analysis of the TraumaRegister DGU(®) was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively. Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16...
February 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28164622/using-the-expression-of-mirnas-as-biomarkers-for-the-evaluation-acute-respiratory-distress-syndrome-in-the-critically-ill-polytrauma-patient
#13
REVIEW
Marius Papurica, Alexandru F Rogobete, Carmen A Cradigati, Mirela Sarandan, Raluca Dumache, Lavinia M Bratu, Sonia E Popovici, Dorel Sandesc, Corina Vernic, Ovidiu H Bedreag
BACKGROUND: A high percentage of critically ill polytrauma patients develop acute respiratory distress syndrome (ARDS), both because of the primary traumatic injuries and because of the secondary post-traumatic injuries. For adequate management of these patients, new complex evaluation and monitoring methods are needed, methods that could answer as many questions as possible regarding the pathophysiological changes associated with ARDS. Currently, a series of clinical and biochemical markers are being used which unfortunately do not respond to the needs of an intensive care clinician...
August 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164614/using-circulating-mirnas-as-biomarkers-for-the-evaluation-and-monitoring-of-the-mitochondrial-damage-in-the-critically-ill-polytrauma-patients
#14
REVIEW
Ovidiu H Bedreag, Marius Papurica, Alexandru F Rogobete, Dorel Sandesc, Raluca Dumache, Carmen A Cradigati, Mirela Sarandan, Lavinia M Bratu, Sonia E Popovici, Laurentiu V Sima
BACKGROUND: The multiple-traumatic critical patient presents a variety of pathophysiological, cellular, and molecular dysfunctions. One of the most important is represented by mitochondrial damage which afterwards is responsible for the augmentation and worsening of a series of pathologies that lead to the worsening of the clinical status of the patient. The severe inflammatory response, sepsis, and the redox imbalance are other pathologies that together with the multiple traumas are responsible for the mitochondrial dysfunctions...
August 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164593/modulation-of-the-redox-expression-and-inflammation-response-in-the-critically-ill-polytrauma-patient-with-thoracic-injury-statistical-correlations-between-antioxidant-therapy
#15
Ovidiu H Bedreag, Alexandru F Rogobete, Dorel Sandesc, Carmen A Cradigati, Mirela Sarandan, Sonia E Popovici, Raluca Dumache, Florin G Horhat, Corina Vernic, Laurentiu V Sima, Loredana Luca, Marius Papurica
BACKGROUND: One of the major causes of mortality in the world is represented by multiple traumas. Thoracic trauma is commonly associated with polytraumas. A series of physiopathological complications follow polytraumas, leading to a significant decrease in the survival rate. As a result of injuries, significant quantities of free radicals (FR) are produced, responsible for oxidative stress (OS). To minimize the effects of OS, we recommend the administration of antioxidant substances. In this study we want to highlight statistically significant correlations between antioxidant therapy and a series of clinical variables...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164582/the-use-of-lipid-peroxidation-expression-as-a-biomarker-for-the-molecular-damage-in-the-critically-ill-polytrauma-patient
#16
REVIEW
Florin G Horhat, Alexandru F Rogobete, Marius Papurica, Dorel Sandesc, Sonia Tanasescu, Victor Dumitrascu, Monica Licker, Razvan Nitu, Carmen A Cradigati, Mirela Sarandan, Ovidiu Boruga, Ciprian D Crisan, Emil Ungureanu, Daniela M Popa, Sonia E Popovici, Ovidiu H Bedreag
BACKGROUND: The critically ill polytrauma patient, apart from the primary, traumatic injuries and the secondary, port-traumatic injuries, presents with a series of molecular disasters. Dysfunctions of the biochemical pathways and molecular damage add to the worsening of the clinical status of these patients, one of the most well-known molecular phenomena being oxidative stress (OS), responsible for an escalation of the inflammatory status, multiple infections, and multiple organ dysfunction syndrome (MODS)...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164531/literature-research-regarding-mirnas-expression-in-the-assessment-and-evaluation-of-the-critically-ill-polytrauma-patient-with-traumatic-brain-and-spinal-cord-injury
#17
Lavinia M Bratu, Alexandru F Rogobete, Marius Papurica, Dorel Sandesc, Carmen A Cradigati, Mirela Sarandan, Raluca Dumache, Sonia E Popovici, Dan C Crisan, Horia Stanca, Sonia Tanasescu, Ovidiu H Bedreag
BACKGROUND: One of the most severe conditions specific to the critically ill polytrauma patient is traumatic brain injury and traumatic spinal cord injury. The mortality rate is high in the case of these patients, both because of the direct traumatic lesions, and because of the pathophysiological imbalances associated with trauma. Amongst the most common pathologies associated with the critically ill polytrauma patients responsible for a lower survival rate, are redox imbalance, systemic inflammatory response, infections, and multiple organ dysfunction syndrome...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164521/using-the-expression-of-damage-associated-molecular-pattern-damp-for-the-evaluation-and-monitoring-of-the-critically-ill-polytrauma-patient
#18
REVIEW
Marius Papurica, Alexandru F Rogobete, Dorel Sandesc, Carmen A Cradigati, Mirela Sarandan, Raluca Dumache, Florin G Horhat, Lavinia M Bratu, Razvan Nitu, Dan C Crisan, Delia I Horhat, Elena S Popovici, Sonia Tanasescu, Vlad Daliborca, Ovidiu Boruga, Ovidiu H Bedreag
BACKGROUND: The critically ill polytrauma patient continues to be one of the most complex cases in the intensive care unit (ICU). The molecular damage is closely connected with the severe, specific pathophysiological imbalances, such as severe inflammation, infections, hypermetabolism, oxidative stress, and ultimately multiple organ dysfunction syndrome (MODS). METHODS: The literature available on PubMed and Scopus was analysed for this study. The key words used in the search were "biomarkers in critically ill patients", "molecular damage", "sepsis biomarkers", "miRNAs biomarkers", and "oxidative stress"...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28155826/comprehensive-treatment-of-the-multiply-injured-patient-a-case-study
#19
Piotr Piekarczyk, Krzysztof Kwiatkowski, Konrad Borcz, Krzysztof Piątkowski, Robert Skowronek
BACKGROUND: We describe the case of a 35-year-old man who suffered multiple organ injuries following a traffic accident. CASE REPORT: A total of 47 fractures were diagnosed in that patient. He was treated in stages according to the principles of Damage Control Orthopedics. He underwent 6 sessions of surgery with 23 surgical approaches. A follow-up examination at 12 months post injury found bone union of all fractures. The clinical and functional outcome of treatment was good as joint mobility was similar to the pre-accident status and the patient returned to work...
March 23, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28149854/from-static-to-dynamic-a-sepsis-specific-dynamic-model-from-clinical-criteria-in-polytrauma-patients
#20
EDITORIAL
Rami A Namas, Yoram Vodovotz
No abstract text is available yet for this article.
December 2016: Annals of Translational Medicine
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