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https://www.readbyqxmd.com/read/28721596/central-adrenal-insufficiency-following-traumatic-brain-injury-a-missed-diagnosis-in-the-critically-injured
#1
Eileen Fan, Peter W Skippen, Michael A Sargent, David D Cochrane, Jean-Pierre Chanoine
BACKGROUND: High-dose steroid administration is no longer recommended in the treatment of acute traumatic brain injury (TBI) as it failed to prove beneficial in improving patients' outcome. However, a masked benefit of steroid administration in TBI management was that it provided corticosteroid replacement therapy in patients with TBI-related central adrenal insufficiency. CASE PRESENTATION: We report the case of a 12-year-old boy who suffered a severe TBI from a motor vehicle accident that resulted in complete deficiency of anterior pituitary function...
July 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28718319/medical-modeling-for-precision-ulna-reconstruction-using-a-microvascular-fibula-free-flap
#2
Michael Alperovich, Jonathan M Bekisz, Vishal D Thanik
BACKGROUND: Despite the growing use of medical modeling in other surgical specialties, its utilization in extremity reconstruction has remained limited. METHODS: We present the application of medical modeling for ulna reconstruction using a microvascular fibula free flap. RESULTS: Following a motor vehicle accident, the patient suffered segmental loss of the right radius and ulna with concomitant forearm soft tissue and muscle loss. Using medical modeling, imaging from the unaffected contralateral forearm and lower extremity was used to plan a reconstruction that restored the anatomic length and orientation of the ulna...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28705744/the-relationship-between-ocular-trauma-and-substance-abuse-in-emergency-department-patients
#3
Sylvia L Chang, Vaama Patel, John Giltner, Richard Lee, Catherine A Marco
INTRODUCTION: Eye injury is the second most common cause of visual impairment and a leading cause of monocular blindness in the United States. There are approximately 6 million ED visits related to drug use annually, including misuse or abuse of pharmaceuticals and illicit drug use. The purpose of this study was to assess the relationship between ocular trauma and substance abuse among emergency department patients and to assess that relationship with demographic factors, including age and gender...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28702266/papillary-thyroid-carcinoma-ectopic-malignancy-versus-metastatic-disease
#4
Yanery's Agosto-Vargas, Madeleine Gutiérrez, José Hernán Martínez, Michelle Mangual-Garcia, Coromoto Palermo, Sharon Vélez-Maymi, Luis Hernández-Vázquez, Samayra Miranda-Rodríguez, Alex González-Bossolo, Ernesto Solá-Sánchez, Marianne Hernández-Negrón
Papillary thyroid carcinoma frequently metastasizes to regional lymph nodes. However, cervical lymph node metastasis as a sole manifestation of occult papillary thyroid carcinoma is rarely observed. Ectopic thyroid is an uncommon condition defined as the presence of thyroid tissue at a site other than pretracheal area. Approximately 1-3% of all ectopic thyroid tissue is located in the lateral neck. This entity may represent the only functional thyroid tissue in the body. Malignant transformation of ectopic thyroid is uncommon; but even rarer is the development of papillary carcinoma on it...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28694600/long-term-resolution-of-delayed-onset-hypoglossal-nerve-palsy-following-occipital-condyle-fracture-case-report-and-review-of-the-literature
#5
Sudhakar Vadivelu, Zihan Masood, Bryan Krueger, Rudy Marciano, David Chen, Cliff Houseman, Salvatore Insinga
The authors present the case of a patient that demonstrates resolution of delayed onset hypoglossal nerve palsy (HNP) subsequent to occipital condyle fracture following a motor vehicle accident. Decompression of the hypoglossal nerve and craniocervical fixation led to satisfactory long-term (>5 years) outcome. There is a scarcity of literature in recognizing HNPs following trauma and a lack of pathophysiological understanding to both a delayed presentation and to resolution versus persistence. This is the first report demonstrating long-term resolution of hypoglossal nerve injury following trauma to the craniocervical junction...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28694217/the-magnitude-of-angular-and-translational-displacement-of-dens-fractures-is-dependent-on-the-sagittal-alignment-of-the-cervical-spine-rather-than-the-force-of-injury
#6
Sabina R Blizzard, Bala Krishnamoorthy, Matthew Shinseki, Marcel Betsch, Jung Yoo
BACKGROUND CONTEXT: Although it is generally believed that the magnitude of dens fracture displacement is proportional to the amount of force applied to the cervical spine during injury, the factors responsible for displacement have not been studied. PURPOSE: Our aim was to determine factors which contribute to horizontal and angular displacement of dens fractures. STUDY DESIGN/SETTING: We conducted a retrospective review of adult patients who were admitted to our level one trauma center between 1/1/2008 and 12/31/2013...
July 7, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28692627/emotional-intelligence-and-the-occurrence-of-accidents-in-motorcycle-drivers-in-kashan-iran
#7
Fatemeh Sadat Asgarian, Mohammad Aghajani, Negin Masoudi Alavi
There is an inherent risk of death and injury for motorcyclists. Some factors such as personality and psychological characteristics may be contributors of motor vehicle accidents/crashes. This study aimed to determine the relationship between emotional intelligence and its related components and the occurrence of accidents/crashes in motorcycle drivers. In this case-control study, 280 motorcycle drivers with and without a history of motorcycle-related accidents or crashes in Kashan, Iran, were selected for convenience sampling...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28688797/burden-of-traffic-accidents-among-pedestrians-of-fars-province-southern-iran-estimate-of-years-of-life-lost-in-a-sample-of-iranian-population-from-2009-to-2013
#8
Yaser Sarikhani, Seyed Taghi Heydari, Saeed Gholamzadeh, Maryam Mazloom, Payam Peymani, Kamran Bagheri Lankarani, Ahmad Kalateh Sadati, Reza Tabrizi, Maryam Akbari
PURPOSE: Traffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach. METHODS: The data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents...
June 19, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28685017/traumatic-diaphragmatic-rupture-with-underlying-lung-laceration-and-tension-pneumoperitoneum
#9
Zexi Allan, Calvin Peng, Raaj Chandra
Tension pneumoperitoneum is commonly caused by gastrointestinal perforation and pulmonary causes are extremely rare. We present a case of a 47-year-old male post motor vehicle accident with a suspected left-sided haemopneumothorax on initial chest x-ray. CT of the chest post chest tube insertion showed a left-sided diaphragmatic rupture and an extensive diaphragmatic hernia. While en-route to the operating theatre, the intubated patient developed tension pneumoperitoneum with positive pressure ventilation and required immediate surgical intervention and repair...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28673696/appendicitis-following-blunt-abdominal-trauma
#10
Travis Cobb
Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28670409/traumatic-spinal-cord-injury-long-term-motor-sensory-and-urinary-outcomes
#11
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#12
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28664351/would-brief-alcohol-intervention-be-helpful-in-facial-trauma-patients-a-narrative-review
#13
REVIEW
Kai H Lee, Andrew Hughes
Facial trauma is commonly associated with excessive consumption of alcohol and is often associated with interpersonal violence or motor vehicle accidents. Alcohol-related trauma presentation to hospitals causes a major service burden, and there have been efforts to reduce such trauma load with educational programs and social support. Brief alcohol intervention (BAI) in an acute setting (emergency department or trauma centre) has been shown as an effective means to reduce future alcohol intake and the incidence of future alcohol-related injuries, especially in the period immediately following injuries...
June 30, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28663775/a-single-center-review-of-palatal-fractures-etiology-patterns-concomitant-injuries-and-management
#14
Ian C Hoppe, Jordan N Halsey, Frank S Ciminello, Edward S Lee, Mark S Granick
Introduction: Palatal fractures are frequently associated with facial trauma and Le Fort fractures. The complex anatomy of the midfacial skeleton makes diagnosing and treating these injuries a challenge. The goal of this study was to report our experience with the presentation, concomitant injuries, and management of palatal fractures at a level I trauma center in an urban environment. Methods: Data were collected for all palatal fractures diagnosed between January 2000 and December 2012 at the University Hospital in Newark, NJ...
2017: Eplasty
https://www.readbyqxmd.com/read/28659680/isolated-double-gastric-perforation-in-blunt-abdominal-trauma-a-case-report
#15
Husain M Gheewala, Snehajit Wagh, Surajsinh A Chauhan, Sonam M Devlekar, Shruti Bhave, Dharmesh J Balsarkar
Blunt abdominal trauma mostly results from motor vehicle accidents, recreational accidents, falls or assaults with commonly injured internal organs being the spleen, liver, retroperitoneum, small bowel, kidneys, bladder, colorectal, diaphragm and pancreas. Gastric rupture is quite uncommon. Isolated gastric perforations following blunt trauma to the abdomen are mostly seen in paediatric patients. It is uncommon in adult patients and even rarer is the occurrence of double gastric perforations. We report here with a case of isolated double gastric perforation in a 24-year-old male patient following vehicular accident...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28647501/driving-simulators-in-the-clinical-assessment-of-fitness-to-drive-in-sleepy-individuals-a-systematic-review
#16
REVIEW
David R Schreier, Christina Banks, Johannes Mathis
Road traffic injuries are projected to be the leading cause of death for those aged between 15 and 29 years by the year 2030, and sleepiness is estimated to be the underlying cause in up to 15-20% of all motor vehicle accidents. Sleepiness at the wheel is most often caused by socially induced sleep deprivation or poor sleep hygiene in otherwise healthy individuals, medical disorders, or the intake of drugs. Validated methods for objectifying sleepiness are urgently sought, particularly in the context of driving...
May 4, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28645549/staged-treatment-of-infected-tibiotalar-fusion-using-a-combination-antibiotic-spacer-and-antibiotic-coated-intramedullary-nail
#17
Justin Miller, Victor Hoang, Richard S Yoon, Frank A Liporace
Pilon fractures are notoriously difficult injuries to treat. The current published data on salvage procedures after failed pilon fractures includes both total ankle arthroplasty (TAA) and tibiotalar fusion, each with its own specific indications. However, no acceptable treatment algorithm addressing the complications of these limb salvage procedures is available. We present the case of a 23-year-old patient, who sustained a complex pilon fracture after a motor vehicle accident. The patient was referred to our institution after an initial fixation attempt, followed by subsequent failed TAA, which was complicated by an infected fusion attempt...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28630829/are-we-justified-doing-salvage-or-amputation-procedure-based-on-mangled-extremity-severity-score-in-mangled-upper-extremity-injury
#18
R Siva Kumar, Prahalad Kumar Singhi, M Chidambaram
INTRODUCTION: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system. MATERIALS AND METHODS: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28624897/corrosion-of-harrington-rod-in-idiopathic-scoliosis-long-term-effects
#19
Beth Sherman, Tanya Crowell
PURPOSE: Metal implants have been used to treat adolescent idiopathic scoliosis since the 1960s. Only recently, however, it has the issue of metal-bone breakdown secondary to metal corrosion in situ come to light, raising concerns of possible long-term complications from the resulting metallosis and inflammation of spinal tissues. We present a case of a patient with neurological deficit, pain, and disability with Harrington rod in place for over 30 years, to bring attention to the issue of bio-corrosion of metal implants and its effect on human tissue...
June 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28622590/can-evolutionary-theory-explain-the-slow-development-of-knowledge-about-the-level-of-safety-built-into-roads
#20
Rune Elvik
In several papers, Hauer (1988, 1989, 2000a, 2000b, 2016) has argued that the level of safety built into roads is unpremeditated, i.e. not the result of decisions based on knowledge of the safety impacts of design standards. Hauer has pointed out that the development of knowledge about the level of safety built into roads has been slow and remains incomplete even today. Based on these observations, this paper asks whether evolutionary theory can contribute to explaining the slow development of knowledge. A key proposition of evolutionary theory is that knowledge is discovered through a process of learning-by-doing; it is not necessarily produced intentionally by means of research or development...
June 13, 2017: Accident; Analysis and Prevention
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