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https://www.readbyqxmd.com/read/28719647/morbidity-outcomes-and-cost-benefit-analysis-of-wildlife-rehabilitation-in-catalonia-spain
#1
Rafael Angel Molina-López, Santi Mañosa, Alex Torres-Riera, Manel Pomarol, Laila Darwich
BACKGROUND: There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs...
2017: PloS One
https://www.readbyqxmd.com/read/28719428/blood-product-utilization-among-trauma-and-nontrauma-massive-transfusion-protocols-at-an-urban-academic-medical-center
#2
Eshan U Patel, Paul M Ness, Christi E Marshall, Thomas Gniadek, David T Efron, Peter M Miller, Joseph A Zeitouni, Karen E King, Evan M Bloch, Aaron A R Tobian
BACKGROUND: Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a large, urban academic medical center. METHODS: A retrospective study of blood product utilization was conducted in patients who required an MTP activation between January 2011 and December 2015 at an urban academic medical center...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#3
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28717977/-challenges-of-implementing-a-geriatric-trauma-network-a-regional-structure
#4
Carsten Schoeneberg, Bjoern Hussmann, Thomas Wesemann, Ludger Pientka, Marie-Christin Vollmar, Christine Bienek, Markus Steinmann, Benjamin Buecking, Sven Lendemans
BACKGROUND: At present, there is a high percentage and increasing tendency of patients presenting with orthogeriatric injuries. Moreover, significant comorbidities often exist, requiring increased interdisciplinary treatment. These developments have led the German Society of Trauma Surgery, in cooperation with the German Society of Geriatrics, to establish geriatric trauma centers. METHODS: As a conglomerate hospital at two locations, we are cooperating with two external geriatric clinics...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28716291/similarities-between-large-animal-related-and-motor-vehicle-crash-related-injuries
#5
Abigail M Tremelling, Robert A Marley, Mackenzie B Marley, Christina M Woofter, Courtney Docherty, Ann E Salvator, Farid F Muakkassa
OBJECTIVE: Many Americans sustain large animal-related injuries (LARIs) from blunt trauma. We compare the injuries and management of LARI in our region of the United States with those of motor vehicle crashes (MVCs). METHODS: A 15-year retrospective study of trauma patients with LARI matched to MVC controls by Injury Severity Score (ISS), age, and sex was conducted. Values were statistically compared, and differences were considered statistically significant at P < ...
July 14, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#6
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#7
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#8
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28713032/psychosocial-rehabilitation-after-war-trauma-with-adaptive-disclosure-design-and-rationale-of-a-comparative-efficacy-trial
#9
Julie D Yeterian, Danielle S Berke, Brett T Litz
BACKGROUND: Posttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD...
July 13, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28712672/noise-induced-cochlear-synaptopathy-in-rhesus-monkeys-macaca-mulatta
#10
M D Valero, J A Burton, S N Hauser, T A Hackett, R Ramachandran, M C Liberman
Cochlear synaptopathy can result from various insults, including acoustic trauma, aging, ototoxicity, or chronic conductive hearing loss. For example, moderate noise exposure in mice can destroy up to ∼50% of synapses between auditory nerve fibers (ANFs) and inner hair cells (IHCs) without affecting outer hair cells (OHCs) or thresholds, because the synaptopathy occurs first in high-threshold ANFs. However, the fiber loss likely impairs temporal processing and hearing-in-noise, a classic complaint of those with sensorineural hearing loss...
July 8, 2017: Hearing Research
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#11
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28712090/does-prior-traumatization-affect-the-treatment-outcome-of-cbt-for-panic-disorder-the-potential-role-of-the-maoa-gene-and-depression-symptoms
#12
Sebastian Trautmann, Jan Richter, Markus Muehlhan, Michael Höfler, Hans-Ulrich Wittchen, Katharina Domschke, Andreas Ströhle, Alfons O Hamm, Heike Weber, Tilo Kircher, Volker Arolt, Alexander L Gerlach, Georg W Alpers, Thomas Fydrich, Thomas Lang, Andreas Reif
Although cognitive behavioral therapy (CBT) is highly effective in the treatment of anxiety disorders, many patients still do not benefit. This study investigates whether a history of traumatic event experience is negatively associated with outcomes of CBT for panic disorder. The moderating role of the monoamine oxidase A (MAOA) gene and depression symptoms as well as the association between trauma history and fear reactivity as a potential mechanism are further analyzed. We conducted a post-hoc analysis of 172 male and 60 female patients with panic disorder treated with CBT in a multi-center study...
July 15, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28711170/early-selenium-treatment-for-traumatic-brain-injury-does-it-improve-survival-and-functional-outcome
#13
Hosseinali Khalili, Rebecka Ahl, Yang Cao, Shahram Paydar, Gabriel Sjölin, Amin Niakan, Gholamreza Dabiri, Shahin Mohseni
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and debility following trauma. The initial brain tissue insult is worsened by secondary reactive responses including oxidative stress reactions, inflammatory changes and subsequent permanent neurologic deficits. Effective agents to improve functional outcome and survival following TBI are scarce. Selenium is an antioxidant which has shown to reduce oxidative stress. This study examines the effect of intravenous selenium (Selenase(®)) treatment in patients with severe TBI on functional outcome and survival in a prospective study design...
July 8, 2017: Injury
https://www.readbyqxmd.com/read/28710975/paternal-history-of-mental-illness-associated-with-posttraumatic-stress-disorder-among-veterans
#14
Megan Shepherd-Banigan, Michelle L Kelley, Jodie G Katon, John F Curry, Karen M Goldstein, Mira Brancu, H Ryan Wagner, Teresa E Fecteau, Courtney H Van Houtven
This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) study (n = 3191), an ongoing multi-site cohort study of US Afghanistan and Iraq conflict era veterans. Participants who recalled a father history of PTSD had a 26-percentage point higher likelihood of meeting criteria for PTSD; while participants reporting any family history of PTSD had a 15-percentage point higher probability of endorsing symptoms consistent with PTSD...
June 17, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28709458/markers-of-nitric-oxide-are-associated-with-sepsis-severity-an-observational-study
#15
Martin Sebastian Winkler, Stefan Kluge, Maximilian Holzmann, Eileen Moritz, Linda Robbe, Antonia Bauer, Corinne Zahrte, Marion Priefler, Edzard Schwedhelm, Rainer H Böger, Alwin E Goetz, Axel Nierhaus, Christian Zoellner
BACKGROUND: Nitric oxide (NO) regulates processes involved in sepsis progression, including vascular function and pathogen defense. Direct NO measurement in patients is unfeasible because of its short half-life. Surrogate markers for NO bioavailability are substrates of NO generating synthase (NOS): L-arginine (lArg) and homoarginine (hArg) together with the inhibitory competitive substrate asymmetric dimethylarginine (ADMA). In immune cells ADMA is cleaved by dimethylarginine-dimethylaminohydrolase-2 (DDAH2)...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#16
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708777/intraoperative-topical-antibiotics-for-infection-prophylaxis-in-pelvic-and-acetabular-surgery
#17
Matthew T Owen, Emily M Keener, Zane B Hyde, Reaves M Crabtree, Parke W Hudson, Russell L Griffin, Jason A Lowe
OBJECTIVES: Determine if topical vancomycin and tobramycin powder reduces the incidence of surgical site infection (SSI) following pelvic ring and acetabulum fracture surgery. DESIGN: Retrospective cohort study SETTING:: University of Alabama at Birmingham, Academic Level I Trauma Center PATIENTS/PARTICIPANTS:: 219 patients (140 meeting inclusion criteria) with pelvic and acetabular fractures who underwent open reduction and internal fixation (ORIF) from March 2012 to November 2013...
June 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28707273/team-communication-patterns-in-emergency-resuscitation-a-mixed-methods-qualitative-analysis
#18
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#19
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28706393/cotrimoxazole-a-wonder-drug-in-the-era-of-multiresistance-case-report-and-review-of-literature
#20
Priyam Batra, Vishant Deo, Purva Mathur, Amit Kumar Gupta
Antimicrobial resistance is one of the greatest threats to human health worldwide. The rate of development of newer antibiotics is much slower than the rate of development of antibiotic resistance. A survey reported that it takes 15 years and US$800 million (including preclinical and clinical costs) to bring a single drug to the market, whereas the reuse of the older drugs for antimicrobial use takes $17 million, thereby circumventing 40% of the overall cost. The first case is a patient with nosocomial pyrexia of unknown origin who was given treatment with tigecycline and cefepime/tazobactam but failed to respond to the same...
July 2017: Journal of Laboratory Physicians
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