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https://www.readbyqxmd.com/read/28932982/cerebral-fat-embolism-recognition-complications-and-prognosis
#1
Daniel Agustín Godoy, Mario Di Napoli, Alejandro A Rabinstein
Fat embolism syndrome (FES) is a rare syndrome caused by embolization of fat particles into multiple organs including the brain. It typically manifests with petechial rash, deteriorating mental status, and progressive respiratory insufficiency, usually occurring within 24-48 h of trauma with long-bone fractures or an orthopedic surgery. The diagnosis of FES is based on clinical and imaging findings, but requires exclusion of alternative diagnoses. Although there is no specific treatment for FES, prompt recognition is important because it can avoid unnecessary interventions and clarify prognosis...
September 20, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28930961/impact-of-a-novel-phosphoinositol-3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#2
George Edward Black, Kyle K Sokol, Donald M Moe, Jon D Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhaylo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental phosphoinositol-3 kinase (PI3-K) inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage-associated molecular patterns (DAMPs)...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#3
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28929802/a-study-of-outcomes-of-patients-treated-at-a-uk-major-trauma-centre-for-moderate-or-severe-injuries-one-to-three-years-after-injury
#4
Stephen Spreadborough, Kate Radford, Roshan das Nair, Adam Brooks, Miriam Duffy
OBJECTIVE: To assess return to work outcomes of major trauma patients treated at a level 1 UK major trauma centre and evaluate factors associated with improved outcomes. DESIGN: Cross-sectional cohort design. SUBJECTS: In total, 99 patients at one, two or three years post-discharge from a Major Trauma Centre with an injury severity score above 9, in full-time work or education prior to injury, aged 18-70 and discharged between April 2012 and June 2015...
September 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28915647/necroptosis-as-a-potential-therapeutic-target-in-multiple-organ-dysfunction-syndrome
#5
Yao-Li Cui, Li-Hua Qiu, Shi-Yong Zhou, Lan-Fang Li, Zheng-Zi Qian, Xian-Ming Liu, Hui-Lai Zhang, Xiu-Bao Ren, Yong-Qiang Wang
PURPOSE: To investigate how necroptosisis, i.e. programmed necrosis, is involved in MODS, and to examine whether Nec-1, a specific necroptosis inhibitor, ameliorates multiorgan injury in MODS. EXPERIMENTAL DESIGN: A model of MODS was established in six-week old SD rats using fracture trauma followed by hemorrhage. Control animals received sham surgery. Cell death form and necrosome formation were measured by fluorescence-activated cell sorting and western blotting...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28913856/multiplate-and-teg-platelet-mapping-in-a-population-of-severely-injured-trauma-patients
#6
M J George, J Burchfield, B MacFarlane, Y-W W Wang, J C Cardenas, N J White, B S Gill, C E Wade
OBJECTIVES: The objectives of this study were to compare thromboelastography platelet mapping (TEG PM) with impedance aggregometry (Multiplate, MP) in a single trauma population and relate their results clinically. BACKGROUND: Platelet function as measured by thromboelastography and impedance aggregometry demonstrates significant reductions that persist for days following traumatic injury. However, no study compares these devices and the correlation between them is not known...
September 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28912021/association-between-spinal-immobilization-and-survival-at-discharge-for-on-scene-blunt-traumatic-cardiac-arrest-a-nationwide-retrospective-cohort-study
#7
Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi, Shunichi Fukuhara
INTRODUCTION: Spinal immobilization has been indicated for all blunt trauma patients suspected of having cervical spine injury. However, for traumatic cardiac arrest (TCA) patients, rapid transportation without compromising potentially reversible causes is necessary. Our objective was to investigate the temporal trend of spinal immobilization for TCA patients and to examine the association between spinal immobilization and survival. METHODS: We conducted a retrospective cohort study using the Japan Trauma Data Bank 2004-2015 registry data...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28905370/neuromodulation-and-devices-in-trigeminal-neuralgia
#8
Kevin Weber
PREMISE: Trigeminal neuralgia is a severe facial pain disorder that has been studied for decades. Classical trigeminal neuralgia (CTN) is either idiopathic or caused by neurovascular compression. The related painful trigeminal neuropathies are often secondary to other causes, such as multiple sclerosis or trauma. PROBLEM: Therapies for trigeminal neuralgia and neuropathy have often been pharmacologic or surgical. Pharmacologic therapies are not effective in some cases and often cause side effects, some substantial...
September 14, 2017: Headache
https://www.readbyqxmd.com/read/28898557/improved-survival-for-rural-trauma-patients-transported-by-helicopter-to-a-verified-trauma-center-a-propensity-score-analysis
#9
Thein Hlaing Zhu, Lisa Hollister, Dazar Opoku, Samuel M Galvagno
OBJECTIVES: Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) vs. ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting. METHODS: The ascertainment of trauma patients age ≥15 years (n=469 cases) by HT and (n=580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28893848/a-review-of-10-years-of-scapula-injuries-sustained-by-uk-military-personnel-on-operations
#10
Darren C Roberts, D M Power, S A Stapley
BACKGROUND: Scapula fractures are relatively uncommon injuries, mostly occurring due to the effects of high-energy trauma. Rates of scapula fractures are unknown in the military setting. The aim of this study is to analyse the incidence, aetiology, associated injuries, treatment and complications of these fractures occurring in deployed military personnel. METHODS: All UK military personnel returning with upper limb injuries from Afghanistan and Iraq were retrospectively reviewed using the Royal Centre for Defence Medicine database and case notes (2004-2014)...
September 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28890868/surgical-and-immune-reconstitution-murine-models-in-bone-marrow-research-potential-for-exploring-mechanisms-in-sepsis-trauma-and-allergy
#11
REVIEW
Pedro Xavier-Elsas, Renato Nunes Ferreira, Maria Ignez C Gaspar-Elsas
Bone marrow, the vital organ which maintains lifelong hemopoiesis, currently receives considerable attention, as a source of multiple cell types which may play important roles in repair at distant sites. This emerging function, distinct from, but closely related to, bone marrow roles in innate immunity and inflammation, has been characterized through a number of strategies. However, the use of surgical models in this endeavour has hitherto been limited. Surgical strategies allow the experimenter to predetermine the site, timing, severity and invasiveness of injury; to add or remove aggravating factors (such as infection and defects in immunity) in controlled ways; and to manipulate the context of repair, including reconstitution with selected immune cell subpopulations...
August 20, 2017: World Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28886492/the-dynamics-of-prehospital-hospital-care-and-modes-of-transport-during-civil-conflict-and-terrorist-incidents
#12
S Celik, R Dursun, A Aycan, H Gönüllü, C Adanaş, M Eryılmaz, E Gönüllü, M E Akyol, S Keskin, C Güloğlu
OBJECTIVE: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. STUDY DESIGN: Multicentric prospective observational study. METHOD: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers...
September 5, 2017: Public Health
https://www.readbyqxmd.com/read/28882377/lasting-impression-of-violence-retained-bullets-and-depressive-symptoms
#13
Randi N Smith, Mark J Seamon, Vinayak Kumar, Andrew Robinson, Justine Shults, Patrick M Reilly, Therese S Richmond
BACKGROUND: Over 70,000 nonfatal firearm injuries occur in the US annually, frequently leaving victims injured with retained bullets. The long-term psychological risks associated with retained bullets remains unstudied. By serving as a constant reminder of injury, we hypothesized that the presence of retained bullets after firearm injury is associated with increased PTSD and depression symptom severity. METHODS: We conducted a prospective cohort study (2013-2015) of Black male survivors of firearm injury at an urban Level I trauma center...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#14
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#15
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28870273/factors-associated-with-delay-in-trauma-team-activation-and-impact-on-patient-outcomes
#16
Rory Connolly, Michael Y Woo, Jacinthe Lampron, Jeffrey J Perry
OBJECTIVE: Trauma code activation is initiated by emergency physicians using physiological and anatomical criteria, mechanism of injury, and patient demographic factors. Our objective was to identify factors associated with delayed trauma team activation. METHODS: We assessed consecutive cases from a regional trauma database from January 2008 to March 2014. We defined a delay in trauma code activation as a time greater than 30 minutes from the time of arrival. We conducted univariate analysis for factors potentially influencing trauma team activation, and we subsequently used multiple logistic regression analysis models for delayed activation in relation to mortality, length of stay, and time to operative management...
September 5, 2017: CJEM
https://www.readbyqxmd.com/read/28869097/cbt-in-the-prevention-of-psychosis-and-other-severe-mental-disorders-in-patients-with-an-at-risk-mental-state-a-review-and-proposed-next-steps
#17
Mark van der Gaag, David van den Berg, Helga Ising
Patients with an 'At risk mental state' (ARMS) for developing psychosis can be treated successfully with CBT to postpone and prevent the transition to a first psychotic episode. A characteristic of individuals that meet ARMS criteria is that they are still open for multiple explanations for extraordinary experiences. CBT aims to normalize extraordinary experiences with education and to prevent delusional explanations. The treatment is not only effective, but also cost-saving in averting psychosis as well as in reducing disability adjusted life years at 18- and 48-month follow-up...
August 28, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28869064/multiple-correspondence-analysis-as-a-strategy-to-explore-the-association-between-categories-of-qualitative-variables-related-to-oral-maxillofacial-trauma-and-violent-crimes-at-the-community-level
#18
Í de Macedo Bernardino, L M Santos, A V P Ferreira, T L M de Almeida Lima, L M da Nóbrega, S d'Avila
The main objective of this study was to show the applicability of multiple correspondence analysis (MCA) in the detection and representation of underlying structures in large datasets used to investigate oral-maxillofacial lesions. A cross-sectional study was conducted involving the analysis of the medical-forensic and social records of 992 people who experienced oral-maxillofacial trauma resulting from non-fatal violent crimes that occurred in the community. Based on the MCA results, two distinct victim profiles were identified...
August 28, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28868232/penile-reconstruction-with-skin-grafts-and-dermal-matrices-indications-and-management
#19
Paloma Triana Junco, Mariela Dore, Vanesa Nuñez Cerezo, Javier Jimenez Gomez, Miriam Miguel Ferrero, Mercedes Díaz González, Pedro Lopez-Pereira, Juan Carlos Lopez-Gutierrez
Introduction  The penis eventually needs specific cutaneous coverage in the context of reconstructive procedures following trauma or congenital anomalies. Local flaps are the first choice but are not always available after multiple previous procedures. In these cases, skin graft and dermal matrices should be considered. Materials and Methods  This study was a retrospective review of the past 4 years of four patients with severe loss of penile shaft skin who underwent skin reconstruction. Dermal matrices and skin grafts were utilized...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28868043/metabolomics-profiling-as-a-diagnostic-tool-in-severe-traumatic-brain-injury
#20
REVIEW
Jussi P Posti, Alex M Dickens, Matej Orešič, Tuulia Hyötyläinen, Olli Tenovuo
Traumatic brain injury (TBI) is a complex disease with a multifaceted pathophysiology. Impairment of energy metabolism is a key component of secondary insults. This phenomenon is a consequence of multiple potential mechanisms including diffusion hypoxia, mitochondrial failure, and increased energy needs due to systemic trauma responses, seizures, or spreading depolarization. The degree of disturbance in brain metabolism is affected by treatment interventions and reflected in clinical patient outcome. Hence, monitoring of these secondary events in peripheral blood will provide a window into the pathophysiological course of severe TBI...
2017: Frontiers in Neurology
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