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https://www.readbyqxmd.com/read/29341938/increased-serum-concentrations-of-soluble-st2-are-associated-with-pulmonary-complications-and-mortality-in-polytraumatized-patients
#1
Thomas Haider, Elisabeth Simader, Philipp Hacker, Hendrik J Ankersmit, Thomas Heinz, Stefan Hajdu, Lukas L Negrin
BACKGROUND: We sought to evaluate the role of soluble ST2 (suppression of tumorigenicity) serum concentrations in polytraumatized patients and its potential role as biomarker for pulmonary complications. METHODS: We included severely injured patients (injury severity score≥16) admitted to our level I trauma center and analyzed serum samples obtained on the day of admission and on day 2. Furthermore, patients with isolated thoracic injury and healthy probands were included and served as control groups...
January 17, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29340725/decision-making-in-management-of-the-complex-trauma-patient-changing-the-mindset-of-the-non-trauma-surgeon
#2
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#3
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29329171/nonhuman-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-polytraumatic-hemorrhagic-shock
#4
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, Ruth Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable nonhuman primate (NHP) models of severe polytraumatic hemorrhagic shock. METHODS: NHPs were randomized into five severe pressure-targeted hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF), and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24 h...
February 2018: Shock
https://www.readbyqxmd.com/read/29323086/a-rare-case-of-shewanella-putrefaciens-bacteremia-in-a-patient-of-road-traffic-accident
#5
Ritesh Ranjan, Priti Chowdhary
Shewanella putrefaciens rarely causes human infection. These are mostly found in environment and food stuffs. Shewanella are often found in mixed culture. It has been implicated in cellulitis, otitis media, and septicemia. It may be found in respiratory tract, urine, feces, and pleural fluid. There is no definite guideline for therapeutic option. In general, these are susceptible to various antimicrobial agents but are often resistant to penicillin and cephalothin. We report a rare case of bacteremia by S. putrefaciens in a patient of head injury with polytrauma after a road traffic accident...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#6
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#7
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29306971/trauma-care-in-german-speaking-countries-have-changes-in-the-curricula-led-to-changes-in-practice-after-10%C3%A2-years
#8
Sarah Kuhn-Régnier, Michael Stickel, Björn-Christian Link, Henning Fischer, Reto Babst, Frank J P Beeres
PURPOSE: Traditionally, in the German-speaking countries, trauma patients are treated by general surgeons specialized in trauma surgery known as the Unfallchirurg. Over the last decade, a trend towards a lower influence of surgeons and a higher influence of subspecialties in the emergency department has been noted. With additional transformations in the health care system towards highly specialized medicine and the arising of new (sub-) specialties, diversification in the management of the trauma patient appears to occur...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29304054/injury-mechanisms-patterns-and-outcomes-of-older-polytrauma-patients-an-analysis-of-the-dutch-trauma-registry
#9
Rob de Vries, Inge H F Reininga, Oliver Pieske, Rolf Lefering, Mostafa El Moumni, Klaus Wendt
BACKGROUND: Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. METHODS: Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18-59) and older (Group B: ages ≥60) polytrauma patients were compared...
2018: PloS One
https://www.readbyqxmd.com/read/29276840/serum-albumin-predicts-long-term-neurological-outcomes-after-acute-spinal-cord-injury
#10
Bobo Tong, Catherine R Jutzeler, Jacquelyn J Cragg, Lukas Grassner, Jan M Schwab, Steve Casha, Fred Geisler, John L K Kramer
BACKGROUND: There is a need to identify reliable biomarkers of spinal cord injury recovery for clinical practice and clinical trials. OBJECTIVE: Our objective was to correlate serum albumin levels with spinal cord injury neurological outcomes. METHODS: We performed a secondary analysis of patients with traumatic spinal cord injury (n = 591) participating in the Sygen clinical trial. Serum albumin concentrations were obtained as part of routine blood chemistry analysis, at trial entry (24-72 hours), 1, 2, and 4 weeks after injury...
December 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29276713/participation-in-recreational-athletics-after-operative-fixation-of-tibial-plateau-fractures-predictors-and-functional-outcomes-of-those-getting-back-in-the-game
#11
David N Kugelman, Abdullah M Qatu, Jack M Haglin, Sanjit R Konda, Kenneth A Egol
Background: Tibial plateau fractures can be devastating traumatic injuries to the knee, particularly in active athletes. Purpose/Hypothesis: The purpose of this study was to report on the return to participation in recreational athletics after operatively managed tibial plateau fractures. In addition, this study assessed factors associated with the ability to return to participation in recreational athletics after tibial plateau fractures treated with open reduction internal fixation and compared final outcomes between patients who were able to return to recreational athletics and those who could not...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29258783/air-versus-ground-transportation-in-isolated-severe-head-trauma-a-national-trauma-data-bank-study
#12
Alberto Aiolfi, Elizabeth Benjamin, Gustavo Recinos, Alejandro De Leon Castro, Kenji Inaba, Demetrios Demetriades
BACKGROUND: The effect of prehospital helicopter emergency medical services (HEMS) on mortality has been analyzed previously in polytrauma patients with discordant results. OBJECTIVE: Our aim was to compare outcomes in patients with isolated severe blunt traumatic brain injuries (TBIs) transported by HEMS or ground emergency medical services (GEMS). METHODS: We conducted a National Trauma Data Bank study (2007-2014). All adult patients (≥16 years old) who sustained an isolated severe blunt TBI and were transported by HEMS or GEMS were included in the study...
December 16, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29258687/analysis-of-mortality-and-fixation-failure-in-geriatric-fractures-using-quantitative-computed-tomography
#13
Tyler S Pidgeon, Joey P Johnson, Matthew E Deren, Andrew R Evans, Roman A Hayda
OBJECTIVES: While osteoporosis has been shown to be a contributing factor in low energy fractures in the elderly, limited data exists regarding the correlation of bone mineral density (BMD) and T-Scores to mortality and failure of fracture fixation. This study seeks to determine the relationship between femoral neck BMD in elderly patients with typical geriatric fractures and mortality and fracture fixation failure using Quantitative Computed Tomography (QCT). MATERIALS AND METHODS: Patients over the age of 65 who sustained fractures of the proximal humerus, distal radius, pelvic ring, acetabulum, hip, proximal tibia, and ankle who also underwent a CT scan that included an uninjured femoral neck were retrospectively reviewed...
December 15, 2017: Injury
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#14
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29234837/injury-severity-in-polytrauma-patients-is-underestimated-using-the-injury-severity-score-a-single-center-correlation-study-in-air-rescue
#15
C Schröter, F Urbanek, C Frömke, M Winkelmann, P Mommsen, C Krettek, C Zeckey
PURPOSE: Prehospital estimation of injury severity is essential for prehospital therapy, deciding on the destination hospital and the associated emergency room care. The aim of this study was to compare prehospital estimates of the abbreviated injury scale (AIS) and the Injury Severity Score (ISS) by emergency physicians with the values of AIS and ISS of injury severity determined at the conclusion of diagnostics. METHODS: In this prospective study, the ISS was determined prehospital by emergency physicians...
December 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29230943/clinical-information-seeking-in-traumatic-brain-injury-a-survey-of-veterans-health-administration-polytrauma-care-team-members
#16
Timothy Hogan, Rachael Martinez, Charlesnika Evans, Karen Saban, Eric Proescher, Monica Steiner, Bridget Smith
BACKGROUND: The polytraumatic nature of traumatic brain injury (TBI) makes diagnosis and treatment difficult. OBJECTIVES: To (1) characterise information needs among Veterans Health Administration (VHA) polytrauma care team members engaged in the diagnosis and treatment of TBI; (2) identify sources used for TBI related information; and (3) identify barriers to accessing TBI related information. METHODS: Cross-sectional online survey of 236 VHA polytrauma care team members...
December 12, 2017: Health Information and Libraries Journal
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#17
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
December 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29221655/interleukin-6-and-interleukin-10-plasma-levels-and-mrna-expression-in-polytrauma-patients
#18
Heber B Sapan, Idrus Paturusi, Andi Asadul Islam, Irawan Yusuf, Ilhamjaya Patellongi, Muhammmad Nasrum Massi, Aryono D Pusponegoro, Syafrie K Arief, Ibrahim Labeda, Leo Rendy, Mochammad Hatta
PURPOSE: Host response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patient's outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 (IL-6) and interleukin-10 (IL-10). Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients. METHODS: This prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score (ISS) ≥ 16]...
December 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29218392/unusual-circumstances-to-diagnose-cervical-pott-s-disease
#19
Mohamed Ali Kedous, Ahmed Msakni, Wael Chebbi, Mourad Zaraa, Mohsen Trabelsi
Tuberculous spondylodiscitis usually affects the dorso-lumbar spine, and its cervical location is a rare condition that can mimic other diseases and consequently cause treatment delays. We report a case of tuberculous spondylodiscitis of the lower cervical spine discovered under unusual circumstances in a patient with severe polytrauma involving a cranio-cerebral trauma, a non-displaced fracture of the two laminæ and the spinous process of the C6 vertebrae as well as fibular and tibial shaft fractures. The patient underwent static tibial nailing, and a collar with occipital and chin supports was applied...
December 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29211186/epidemiology-of-acute-kidney-injury-and-chronic-kidney-disease-in-the-intensive-care-unit
#20
Darwin Tejera, Fernanda Varela, Daniela Acosta, Stephanie Figueroa, Sebastián Benencio, Cristina Verdaguer, Mauricio Bertullo, Federico Verga, Mario Cancela
OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis...
November 30, 2017: Revista Brasileira de Terapia Intensiva
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