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https://www.readbyqxmd.com/read/29775977/-rehabilitation-after-traumatic-fracture-of-thoracic-and-lumbar-spine
#1
Hartmut Bork, Stefan Simmel, Eckhardt Böhle, Ulrich Ernst, Klaus Fischer, Bernd Fromm, Jean-Jacques Glaesener, Bernhard Greitemann, P Krause, S Panning, V Pullwitt, J Schmidt, Andreas Veihelmann, Lutz Vogt
On the basis of the S2-k guideline "Rehabilitation after traumatic fractures of the thoracic und lumbar spine without neurologic disorder", this article gives an overview of target-oriented rehabilitation of patients with minor fractures or those with column stability and unstable spinal fractures which are stabilised by surgery. To obtain early social and job related reintegration, outpatient or inpatient rehabilitation has to start immediately after treatment in hospital. Rehabilitation must be orientated towards the biopsychosocial model of ICF and has to be adapted for the patient...
May 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29766126/factor-viia-administration-in-traumatic-brain-injury-an-aast-mitc-propensity-score-analysis
#2
Sarah Lombardo, D Millar, Gregory J Jurkovich, Raul Coimbra, Ram Nirula
Background: Recombinant factor VIIa (rFVIIa) has been used off-label as an adjunct in the reversal of warfarin therapy and management of hemorrhage after trauma. Only a handful of these reports are rigorous studies, from which results regarding safety and effectiveness have been mixed. There remains no clear consensus as to the role of rFVIIa in traumatic brain injury (TBI). Methods: Eleven level 1 trauma centers provided clinical data and head CT scans of patients with a Glasgow Coma Scale (GCS) score of ≤13 and radiographic evidence of TBI...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764673/comparison-between-thromboelastography-and-conventional-coagulation-test-should-we-abandon-conventional-coagulation-tests-in-polytrauma-patients
#3
Jaume Tur Martínez, Patrizio Petrone, Alexander Axelrad, Corrado P Marini
INTRODUCTION: TEG provides an in-vivo assessment of viscoelastic clot strength in whole blood compared with CCT, which may not reflect the influence of platelets. The aim of this study was to compare TEG vs. CCT in trauma patients stratified by mechanism of injury (MOI) and pre-existing coagulation status. METHODS: A retrospective, observational study of 230 polytrauma patients admitted to a University Hospital Level 1 Trauma Center, with TEG and CCT on admission stratified by MOI: multiple trauma (MT), isolated traumatic brain injury (TBI) or MT+TBI...
May 12, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29744242/non-invasive-mechanical-ventilation-in-critically-ill-trauma-patients-a-systematic-review
#4
REVIEW
Annia Schreiber, Fatma Yıldırım, Giovanni Ferrari, Andrea Antonelli, Pablo Bayoumy Delis, Murat Gündüz, Marcin Karcz, Peter Papadakos, Roberto Cosentini, Yalım Dikmen, Antonio M Esquinas
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29739062/new-molecular-and-epigenetic-expressions-as-novel-biomarkers-in-critically-ill-polytrauma-patients-with-acute-kidney-injury-aki
#5
REVIEW
Mihaela V Ivan, Alexandru F Rogobete, Ovidiu H Bedreag, Marius Papurica, Sonia E Popovici, Anca Dinu, Mihai Sandesc, Andrei Beceanu, Lavinia M Bratu, Calin M Popoiu, Dorel Sandesc, Ovidiu Boruga, Lazar Fulger
BACKGROUND: A high percentage of the critically ill polytrauma patients develop acute kidney injury (AKI) secondary to trauma and are therefore prone to high morbidity and mortality rates. One of the main objectives in these cases is the fast detection of the condition and continuous rigorous monitoring of the patients. Currently the panel of biomarkers available for monitoring and for the prognosis of AKI is limited. Numerous studies have proven the importance of microRNAs in this field...
May 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29736752/interventions-that-support-or-involve-caregivers-or-families-of-patients-with-traumatic-injury-a-systematic-review
#6
Megan E Shepherd-Banigan, Abigail Shapiro, Jennifer R McDuffie, Mira Brancu, Nina R Sperber, Courtney H Van Houtven, Andrzej S Kosinski, Neha N Mehta, Avishek Nagi, John W Williams
BACKGROUND: Almost 40 million family caregivers care for a loved one with severe physical or cognitive impairments. The purpose of this review is to summarize evidence about the benefits of interventions to support or involve family members/caregivers of patients with trauma-related injury on caregiver, patient, and household outcomes. METHODS: English-language peer-reviewed publications in MEDLINE, CINAHL, and PsycINFO from 1995 through December 2016 were identified...
May 7, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29729228/the-impact-of-stigma-on-community-reintegration-of-veterans-with-traumatic-brain-injury-and-the-well-being-of-their-caregivers
#7
Sean M Phelan, Lauren R Bangerter, Greta Friedemann-Sanchez, Kandace A Lackore, Megan A Morris, Courtney H Van Houtven, Kathleen F Carlson, Michelle van Ryn, Kristin J Harden, Joan M Griffin
OBJECTIVE: To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration. DESIGN: A cross-sectional survey study of 564 informal caregivers of Veterans of US wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT). SETTING: Care settings of community dwelling former inpatients of any US Veterans Polytrauma Rehabilitation Center...
May 2, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29704955/comparison-of-plate-osteosynthesis-versus-non-operative-management-for-mid-shaft-clavicle-fractures-a-prospective-study
#8
Akshay Bhardwaj, Gaurav Sharma, Ashok Patil, Vaijnath Rahate
INTRODUCTION: Treatment for mid-shaft clavicle fractures has recently seen a paradigm shift towards surgical management. The aim of the study was to compare clinical and functional outcome between plate osteosynthesis and conservative line of management in middle-third clavicle fractures. MATERIAL AND METHODS: A prospective randomized study was conducted on 69 patients with closed displaced clavicle fractures between May 2014 and May 2016. Patients with medial or lateral third clavicle fractures, polytrauma and compound fractures were excluded from the study...
April 17, 2018: Injury
https://www.readbyqxmd.com/read/29703875/mesenteric-bones-intra-abdominal-heterotopic-ossification
#9
A Michael, S Narasimman, N Jasjit Singh
Intra-abdominal heterotopic ossification usually develops after abdominal surgery and can cause complications such as bowel obstruction and even intestinal perforation. Bisphosphonates, NSAIDs and even local radiation is used as prophylaxis or treatment. Surgeons must consider heterotopic ossification and its complications as a differential when managing complex polytrauma patients with suspicious radiographic densities.
April 2018: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29703240/temporal-phenotyping-of-circulating-microparticles-after-trauma-a-prospective-cohort-study
#10
Matthias Fröhlich, Nadine Schäfer, Michael Caspers, Julia K Böhm, Ewa K Stürmer, Bertil Bouillon, Marc Maegele
BACKGROUND: After severe polytrauma the dynamic process of coagulation may deteriorate towards a trauma-induced coagulopathy (TIC) promoting a dramatic increase in morbidity and mortality. Recent evidence suggests that microparticles (MPs) play a pivotal role at the interface between cellular and plasmatic coagulation systems. However, the impact of MPs on functional coagulation has not been clarified yet in the setting of traumatic injuries. We assessed the temporal patterns of circulating MP concentrations including their cellular origin in the context of clinical presentation and global coagulation assays...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29691042/foot-fractures-in-polytrauma-patients-injury-characteristics-and-timing-of-diagnosis
#11
Quirine M J van der Vliet, Robert C Lucas, George Velmahos, Roderick M Houwert, Luke P H Leenen, Falco Hietbrink, Marilyn Heng
BACKGROUND: Due to prioritizing care and concomitant injuries, foot fractures in polytrauma patients often receive limited attention initially. However, as foot function is important, treatment and diagnosis of these fractures should be accurate. The aims of this study were to assess the incidence and distribution of foot fractures in polytrauma patients and to examine possible risk factors for delayed diagnosis of foot fractures. METHODS: This was a retrospective study on all adult (≥18 years) polytrauma (ISS ≥16) patients admitted to a single level 1 trauma center between 2006 and 2016...
April 17, 2018: Injury
https://www.readbyqxmd.com/read/29682027/decompressive-craniectomy-in-diffuse-traumatic-brain-injury-an-industrial-hospital-study
#12
Niraj Kumar Choudhary, Rinku Bhargava
Context: High intracranial pressure is the most frequent cause of mortality and disability after severe traumatic brain injury (TBI) which is treated by first-line therapeutic measures. When these measures fail, second-line therapies are started. Among second-line therapies, decompressive craniectomy (DC) has been used. It improves the functional outcome in these patients. Aim: This study aims to analyze the clinicoradiological factors associated with the prognosis of severe TBI in patients undergoing DC...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682003/differentiation-in-an-inclusive-trauma-system-allocation-of-lower-extremity-fractures
#13
F S Würdemann, D P J Smeeing, S Ferree, F Nawijn, E J M M Verleisdonk, L P H Leenen, R M Houwert, F Hietbrink
Background: Implementation of an inclusive trauma system leads to reduced mortality rates, specifically in polytrauma patients. Field triage is essential in this mortality reduction. Triage systems are developed to identify patients with life-threatening injuries, and trauma mechanisms are important for triaging. Although complex extremity fractures are mostly non-lethal, these injuries are frequently the result of a high-energy trauma mechanism. The aim of this study is to compare injury and patient characteristics, as well as resource demands, of lower extremity fractures between a level (L)1 and level (L)2 trauma centre in a mature inclusive trauma system...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29681051/voluminous-urethral-stone-a-very-rare-complication-after-male-suburethral-sling-surgery-as-a-result-of-sling-erosion-into-proximal-urethra
#14
Ioan Scarneciu, Cristian Andrei, Camelia Scarneciu, Aura Mihaela Lupu, Ovidiu Gabriel Bratu, Sorin Lupu
Male sling for urinary incontinence is usually accompanied by very good results, with a small number of complications,but, when appear, they may be redundant. Voluminous urethral stone developed on suburethral sling as a result of sling erosion into the proximal urethra is an extremely rare complication (following the analysis of cases published on the internet, the authors of this article no longer identified another similar case). We present the case of a patient who presented in our clinic for severe and permanent urinary incontinence, perineal discomfortand pain that was influenced by position...
April 21, 2018: Urology Journal
https://www.readbyqxmd.com/read/29680410/influence-of-entrapment-on-prehospital-management-and-the-hospital-course-in-polytrauma-patients-a-retrospective-analysis-in-air-rescue
#15
Christian Macke, Marika Sarakintsis, Marcel Winkelmann, Philipp Mommsen, Mohamed Omar, Christian Schröter, Christian Krettek, Christian Zeckey
BACKGROUND: Entrapment is a challenging and crucial factor in the prehospital setting. Few studies have addressed whether entrapment has an influence on on-scene treatment or on the following hospital course. OBJECTIVES: Here we aimed to investigate the influence of entrapment on prehospital management and on the hospital course of polytrauma patients. METHODS: We performed a retrospective analysis of consecutive patients with an Injury Severity Score ≥16 and aged 16-65 years that were admitted between 2005 and 2013 to a Level I trauma center...
April 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29679584/remember-the-vessels-craniofacial-fracture-predicts-risk-for-blunt-cerebrovascular-injury
#16
Elina Varjonen, Frank Bensch, Tuomo Pyhältö, Mika Koivikko, Johanna Snäll
PURPOSE: The risk factors for blunt cerebrovascular injuries (BCVIs) are currently under intensive research, yet it is still controversial who should be screened. This study aimed to determine whether craniofacial fractures are associated with BCVI. PATIENTS AND METHODS: This retrospective cohort study focused on patients with suspected polytrauma after whole-body computed tomographic angiography of the cervical arteries. Patients were reviewed for BCVI and craniofacial fractures...
March 28, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29666944/macrophages-play-an-essential-role-in-trauma-induced-sterile-inflammation-and-tissue-repair
#17
REVIEW
Moritz Peiseler, Paul Kubes
Severe trauma is accompanied by a profound activation of the immune system. Patients with polytrauma develop systemic inflammatory response syndrome (SIRS) and often sepsis, which contributes substantially to high mortality of this condition. On a cellular level, necrosis and loss of plasma membrane integrity lead to the release of endogenous "damage-associated molecular patterns" (DAMPs) as danger signals, which in turn activate innate immune cells. Inflammation that occurs in the absence of invading pathogens has been termed sterile inflammation and trauma with tissue damage represents an acute form of sterile inflammation...
April 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29664881/tibial-fracture-nonunion-and-time-to-healing-following-reamed-intramedullary-nailing-risk-factors-based-on-a-single-centre-review-of-1003-patients
#18
Hannah L Dailey, Katherine A Wu, Ping-Shi Wu, Margaret M McQueen, Charles M Court-Brown
OBJECTIVE: To determine factors associated with nonunion of adult tibial fractures. DESIGN: Retrospective review with data collection for logistic regression and survival analysis. SETTING: Scottish Level I trauma centre, 1985 to 2007. PATIENTS: During this period, 1,590 adult tibial fractures were treated by reamed nailing and 1,003 met all inclusion criteria for the chosen analysis. INTERVENTION: Reamed intramedullary nailing...
April 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29661098/predicting-emergence-from-a-disorder-of-consciousness-using-the-coma-recovery-scale-revised
#19
Janette A Hamilton, Paul B Perrin, Thomas A Campbell, Steven J Danish, Alissa L Goldstein
This study explored the utility of the Coma Recovery Scale-Revised (CRS-R) in predicting emergence from a disorder of consciousness, using a sample of veterans who were treated at one of the five Veterans Affairs (VA) polytrauma rehabilitation centre sites in an Emerging Consciousness programme. Participants (N = 70) included both combat and non-combat active duty military personnel and veterans who sustained either a severe traumatic brain injury, or anoxic brain injury and were considered to have a disorder of consciousness at the time of admission...
April 16, 2018: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/29660743/-rehabilitation-after-multiple-trauma
#20
Stefan Simmel
Many polytrauma patients report significant long-term impairments to their physical and mental health, resulting in a reduction of their quality of life. In addition to the obvious physical accident sequences, psychological influences and the individual context factors pose special challenges to the rehabilitation team and the infrastructure of the facility. Professional reintegration and chronic pain are particularly common problems in the trauma rehabilitation. The central task of rehabilitation after accidents is the restoration or substantial improvement of the functional health and thus the reintegration into the social and professional environment...
April 2018: Die Rehabilitation
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