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https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#1
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28815160/the-burden-of-spine-fractures-in-india-a-prospective-multicenter-study
#2
Ilyas S Aleem, Dylan DeMarco, Brian Drew, Parag Sancheti, Vijay Shetty, Mandeep Dhillon, Clary J Foote, Mohit Bhandari
STUDY DESIGN: Prospective cohort study. OBJECTIVES: The objectives of this study were (1) to determine the characteristics of patients sustaining spinal trauma in India and (2) to explore the association between patient or injury characteristics and outcomes after spinal trauma. METHODS: In affiliation with the ongoing INternational ORthopaedic MUlticentre Study (INORMUS), 192 patients with spinal injuries were recruited during an 8-week period (November 2011 to June 2012) from 14 hospitals in India and followed for 30-days...
June 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#3
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#4
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28810653/surgical-trauma-and-low-dose-methylprednisolone-modulate-the-severity-of-the-acute-phase-response-induced-by-zoledronic-acid-infusion
#5
Jian Chen, Lipeng Yu, Lixin Chen, Xuan Wu, Pengyu Tang, Jian Yin, Tao Jiang, Guoyong Yin, Jin Fan
The aim of the present study was to investigate risk factors for the development of an acute-phase response (APR) associated with the initial zoledronic acid (ZA) infusion in patients undergoing surgery, and to assess whether its onset may be reduced by post-dose administration of low-dose methylprednisolone (MP) or acetaminophen. A retrospective study of patients with osteoporosis who attended the departments of orthopedics and endocrinology of a single hospital and received 5 mg ZA was conducted; the patients included surgical and non-surgical cases...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#6
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28806284/is-extracorporeal-cardiopulmonary-resuscitation-practical-in-severe-chest-trauma-a-systematic-review-in-single-center-of-developing-country
#7
Up Huh, Seunghwan Song, Sung Woon Chung, Sang-Pil Kim, Chung Won Lee, Hyo Young Ahn, Miju Bae, Seon Hee Kim
BACKGROUND: We report our experience with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with rupture of heart and major vessels caused by severe chest trauma. METHODS: From April 2015 to May 2016, 10 patients with suspected injuries to the heart and major vessels following focused assessment with sonography in trauma or computed tomography were selected from patients admitted at a level I trauma centre presenting with cardiac tamponade and tension haemothorax due to severe chest trauma...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#8
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28804877/validation-of-a-geriatric-trauma-prognosis-calculator-a-p-a-l-li-a-t-e-consortium-study
#9
Allyson C Cook, Bellal Joseph, M Jane Mohler, Kenji Inaba, Brandon R Bruns, Paul A Nakonezny, Jeff D Kerby, Karen J Brasel, Steven E Wolf, Joseph Cuschieri, M Elizabeth Paulk, Ramona L Rhodes, Scott C Brakenridge, A Peter Ekeh, Herb A Phelan
BACKGROUND/OBJECTIVES: The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. DESIGN: Retrospective cohort...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28797932/when-social-support-is-not-enough-trauma-and-ptsd-symptoms-in-a-risk-sample-of-adolescents
#10
Ricardo J Pinto, Diogo Morgado, Sara Reis, Rita Monteiro, Alytia Levendosky, Inês Jongenelen
Social support can mitigate the severity of posttraumatic stress disorder (PTSD) in children and adults following traumatic events. However, little is known about the role of social support in high-risk samples of adolescents from the community. The present study examined the relationship between social support and PTSD symptoms in adolescents exposed to traumatic events and childhood adversity, after adjusting for the effects of potential covariates, including sociodemographic factors, previous childhood adversity, level of exposure, comorbid anxiety, depression symptoms, and substance abuse, and coping strategies...
August 7, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28795328/severe-hemorrhagic-shock-leads-to-a-delayed-fracture-healing-and-decreased-bone-callus-strength-in-a-mouse-model
#11
Katrin Bundkirchen, Christian Macke, Janin Reifenrath, Luisa Marilena Schäck, Sandra Noack, Borna Relja, Philipp Naber, Bastian Welke, Michael Fehr, Christian Krettek, Claudia Neunaber
BACKGROUND: Multiple trauma is frequently associated with hemorrhagic shock and fractures of the extremities. Clinically, the rate of impaired fracture healing (delayed healing and nonunion) seems to be increased in patients with multiple injuries compared with patients with isolated fractures. As the underlying pathogenesis remains poorly understood, we aimed to analyze the biomechanical properties during fracture healing in a murine model. QUESTIONS: The aim of this study was to determine whether fracture healing after severe hemorrhagic shock results in (1) delayed bridging as determined by macroscopic and radiographic assessment, (2) altered conditions of callus components as determined by µCT, and (3) decreased maximum bending moment measured by a three-point-bending test compared with ordinary fracture healing...
August 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28768663/effects-of-multiple-simulated-birth-traumas-on-urethral-continence-function-in-rats
#12
Satoru Yoshikawa, Yasuhiro Sumino, Joonbeom Kwon, Takahisa Suzuki, Takeya Kitta, Minoru Miyazato, Naoki Yoshimura
Multiple vaginal parities have been reported to be an important risk factor for stress urinary incontinence (SUI). Simulated birth trauma with single vaginal distention (VD) has been used to induce the SUI condition in animals; however, the effect of multiple simulated birth traumas on the urethral continence function has not been well characterized. Therefore, we examined the effects of multiple VDs on urethral functions in vivo and the changes in gene expressions of several molecules in the urethra using female SD rats, which were divided into 3 groups; sham, VD-1 (single VD), and VD-3 groups (3 times of VDs every 2 weeks)...
August 2, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28768467/challenges-experienced-during-rehabilitation-after-traumatic-multiple-rib-fractures-a-qualitative-study
#13
Jacqueline Claydon, Gregory Maniatopoulos, Lisa Robinson, Paul Fearon
BACKGROUND: People with multiple rib fractures rarely receive rehabilitation aimed specifically at their chest wall injuries. This research explores patient perceptions of rehabilitation and recovery. MATERIALS AND METHODS: A qualitative study exploring how a purposive sample of 15 people with traumatic multiple rib fractures at a Major Trauma Centre in the United Kingdom make sense of their recovery. Data collected during one-to-one interviews 4 to 9 months after injury...
August 2, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28759327/factors-of-pelvic-infection-and-death-in-patients-with-open-pelvic-fractures-and-rectal-injuries
#14
Wenhao Song, Dongsheng Zhou, Weicheng Xu, Guoming Zhang, Chunhui Wang, Daodi Qiu, Jinlei Dong
BACKGROUND: Open pelvic fractures associated with rectal injuries are uncommon. They often cause serious pelvic infection, even death. This combination of injuries has been reviewed infrequently. Herein, we report factors associated with pelvic infection and death in a group of patients with open pelvic fractures and concurrent rectal injuries. METHODS: We retrospectively reviewed the records of patients with open pelvic fractures and rectal injuries who were treated at our institution from January 2010-April 2014...
July 31, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28757696/can-pneumocephalus-present-as-flashes-of-light-a-rare-case-report
#15
Santanu Ghosh, Menon P Jayasree, Mathew Biju, Basu Snehanshu
Orbital emphysema and associated pneumocephalus usually result from trauma to orbital bones or due to sinus disease, allowing air to travel from paranasal sinus into orbit and brain. However, it is extremely rare to have orbital emphysema and pneumocephalus in the absence of orbital wall fracture. In our case, a young male was admitted with severe eye pain, diminution of vision due to sudden exposure of compressed air gun. Examination revealed proptosed, emphysematous right eye with conjunctival laceration...
May 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28756035/role-of-clinical-suspicion-in-pediatric-blunt-trauma-patients-with-severe-mechanisms-of-injury
#16
Carolinna M Garcia, Sandra J Cunningham
OBJECTIVES: In adult patients with blunt trauma, severe mechanism of injury leads to routine pan-computed tomography (CT). Due to concerns about the risk of radiation, we sought to determine whether clinical suspicion could identify children requiring radiographic imaging. METHODS: A prospective study was conducted in a pediatric emergency department of a Level 1 trauma center. Patients ≤14years presenting with blunt trauma due to predefined severe mechanisms were eligible...
July 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28755602/the-mediator-effect-of-personality-traits-on-the-relationship-between-childhood-abuse-and-depressive-symptoms-in-schizophrenia
#17
Ryo Okubo, Takeshi Inoue, Naoki Hashimoto, Akio Suzukawa, Hajime Tanabe, Matsuhiko Oka, Hisashi Narita, Koki Ito, Yuki Kako, Ichiro Kusumi
Previous studies indicated that personality traits have a mediator effect on the relationship between childhood abuse and depressive symptoms in major depressive disorder and nonclinical general adult subjects. In the present study, we aimed to test the hypothesis that personality traits mediate the relationship between childhood abuse and depressive symptoms in schizophrenia. We used the following questionnaires to evaluate 255 outpatients with schizophrenia: the Child Abuse and Trauma Scale, temperament and character inventory, and Patients Health Questionnire-9...
June 13, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28750214/childhood-trauma-is-not-a-confounder-of-the-overlap-between-autistic-and-schizotypal-traits-a-study-in-a-non-clinical-adult-sample
#18
Jing-Bo Gong, Ya Wang, Simon S Y Lui, Eric F C Cheung, Raymond C K Chan
Childhood trauma has been shown to be a robust risk factor for mental disorders, and may exacerbate schizotypal traits or contribute to autistic trait severity. However, little is known whether childhood trauma confounds the overlap between schizotypal traits and autistic traits. This study examined whether childhood trauma acts as a confounding variable in the overlap between autistic and schizotypal traits in a large non-clinical adult sample. A total of 2469 participants completed the Autism Spectrum Quotient (AQ), the Schizotypal Personality Questionnaire (SPQ), and the Childhood Trauma Questionnaire-Short Form...
July 17, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28747716/burn-induced-muscle-metabolic-derangements-and-mitochondrial-dysfunction-are-associated-with-activation-of-hif-1%C3%AE-and-mtorc1-role-of-protein-farnesylation
#19
Harumasa Nakazawa, Kazuhiro Ikeda, Shohei Shinozaki, Masayuki Kobayashi, Yuichi Ikegami, Ming Fu, Tomoyuki Nakamura, Shingo Yasuhara, Yong-Ming Yu, J A Jeevendra Martyn, Ronald G Tompkins, Kentaro Shimokado, Tomoko Yorozu, Hideki Ito, Satoshi Inoue, Masao Kaneki
Metabolic derangements are a clinically significant complication of major trauma (e.g., burn injury) and include various aspects of metabolism, such as insulin resistance, muscle wasting, mitochondrial dysfunction and hyperlactatemia. Nonetheless, the molecular pathogenesis and the relation between these diverse metabolic alterations are poorly understood. We have previously shown that burn increases farnesyltransferase (FTase) expression and protein farnesylation and that FTase inhibitor (FTI) prevents burn-induced hyperlactatemia, insulin resistance, and increased proteolysis in mouse skeletal muscle...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28746303/clinical-significance-and-prognostic-implications-of-quantifying-pulmonary-contusion-volume-in-patients-with-blunt-chest-trauma
#20
Ismail Mahmood, Ayman El-Menyar, Basil Younis, Khalid Ahmed, Syed Nabir, Mohamed Nadeem Ahmed, Omer Al-Yahri, Saeed Mahmood, Rafael Consunji, Hassan Al-Thani
BACKGROUND Pulmonary contusion (PC) is the most frequent blunt chest injury which could be used to identify patients at high-risk of clinical deterioration. We aimed to investigate the clinical correlation between PC volume and outcome in patients with blunt chest trauma (BCT). MATERIAL AND METHODS BCT patients with PC were identified retrospectively from the prospectively collected trauma registry database over a 2-year period. Contusion volume was measured and expressed as percentage of total lung (CTCV) volume using three-dimensional reconstruction of thoracic CT images on admission...
July 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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