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Trauma management

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https://www.readbyqxmd.com/read/29775632/controlled-delivery-of-a-focal-adhesion-kinase-inhibitor-results-in-accelerated-wound-closure-with-decreased-scar-formation
#1
Kun Ma, Sun Hyung Kwon, Jagannath Padmanabhan, Dominik Duscher, Artem A Trotsyuk, Yixiao Dong, Mohammed Inayathullah, Jayakumar Rajadas, Geoffrey C Gurtner
Formation of scars following wounding or trauma represents a significant healthcare burden costing the economy billions of dollars every year. Activation of focal adhesion kinase (FAK) has been shown to play a pivotal role in transducing mechanical signals to elicit fibrotic responses and scar formation during wound repair. We have previously shown that inhibition of FAK using local injections of a small molecule FAK inhibitor (FAKI) can attenuate scar development in a hypertrophic scar model. Clinical translation of FAKI therapy has been challenging, however, due to the lack of an effective drug delivery system for extensive burn injuries, blast injuries, and large excisional injuries...
May 15, 2018: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/29775090/evaluation-of-management-and-guideline-adherence-in-children-with-mild-traumatic-brain-injury
#2
Merel C Broers, Jikke-Mien F Niermeijer, Irene A W Kotsopoulos, Hester F Lingsma, Jos F M Bruinenberg, Coriene E Catsman-Berrevoets
AIM: To evaluate the management and guideline adherence in children with mild traumatic brain injury (MTBI) in emergency departments (ED) in the Netherlands. METHODS: A multicentre cohort study was conducted, including children younger than 18 years with MTBI who presented within 24 hours after trauma in the ED of hospitals in the southwest region of the Netherlands, in 2014. Primary outcome measures for management were percentages of performed computed tomography (CT) scans and hospital admissions...
May 18, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29774197/paraplegia-following-spinal-cord-contusion-from-an-indirect-gunshot-injury
#3
Khuram Khan, Beatrice Dieudonne, Saqib Saeed, Sara Alothman, Yasir Saeed, Sanjiv Gray
Spinal cord injuries are debilitating and life threatening. Paraplegia due to direct traumatic gunshot injury to the spinal cord is common. The most common cause of spinal cord injury is road traffic accidents. This is followed by spinal cord injury due to a fall from a height. Most of the spinal cord injuries due to gunshot wounds occur as a result of direct traumatic effects. We present a rare case of a 49-year-old male with trauma. He developed paraplegia after a gunshot wound injury to the neck and contusion to the spinal cord, with no direct trauma...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774191/traumatic-optic-neuropathy
#4
REVIEW
Sun Young Jang
Traumatic optic neuropathy (TON) refers to optic nerve injury resulting from direct and indirect head and facial trauma. The pathogenesis of indirect TON has not been fully elucidated, and the management of TON remains controversial. In this review article, I review the recent literature regarding TON and discuss how to manage indirect TON.
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773764/degloving-lower-leg-injury-the-importance-of-additional-treatment-negative-pressure-and-hyperbaric-oxygen-therapy
#5
Piotr Stabryła, Joanna Kulińska, Łukasz Warchoł, Anna Kasielska-Trojan, Wojciech Gaszyński, Bogusław Antoszewski
Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss. In this article, we present the management and therapeutic outcomes of a patient admitted due to the degloving injury of the lower extremity caused by workplace accident. We described the complexity of treatment including surgical intervention as well as additional treatment, which combined brought good esthetic outcome...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29773455/inferior-vena-cava-filter-strut-penetration-into-the-vertebral-column-a-case-of-10-year-clinical-follow-up
#6
David A Petrov, Aakash Chauhan, Sean Fitzpatrick, Daniel T Altman, Bethany Casagranda
BACKGROUND: The rate of vena cava (IVC) filter placement has increased over the past decade, especially in the orthopaedic trauma patient population. With the increasing use of IVC filters, radiologists and referring clinicians must be familiar with potential complications. CLINICAL CASE: This case report presents an 18-year-old polytraumatized patient who had an IVC filter placed and required T8-L2 posterior spinal fusion. At 4.5 years of follow-up, a computed tomography (CT) scan for painful spinal hardware incidentally found that the IVC filter had migrated into the L3 vertebral body...
April 18, 2018: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29772995/bilateral-spontaneous-quadriceps-tendon-ruptures-after-staged-bilateral-total-knee-arthroplasties-a-case-report
#7
Marine Coste, Jared M Newman, Neil V Shah, Ahmed M Eldib, Preston W Grieco, Aditya V Maheshwari
Quadriceps tendon ruptures are rare complications of total knee arthroplasty (TKA) and may be associated with preexisting tendon degeneration, vascular injuries during surgery, damage to the quadriceps tendon with over resection of the patella, or incomplete healing after a particular surgical approach. Moreover, postoperative causes include tissue necrosis due to component malalignment, trauma, and infection. Patient factors such as chronic systemic diseases, medications, increased body weight, and sedentary lifestyle could also be responsible...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29772885/geographical-distribution-and-spatio-temporal-patterns-of-hospitalization-due-to-dengue-infection-at-a-leading-specialist-hospital-in-malaysia
#8
Gary K K Low, Panayoti Papapreponis, Ridzuan M Isa, Seng Chiew Gan, Hui Yee Chee, Kian Keong Te, Nadia M Hatta
Increasing numbers of dengue infection worldwide have led to a rise in deaths due to complications caused by this disease. We present here a cross-sectional study of dengue patients who attended the Emergency and Trauma Department of Ampang Hospital, one of Malaysia's leading specialist hospitals. The objective was to search for potential clustering of severe dengue, in space and/or time, among the annual admissions with the secondary objective to describe the spatio-temporal pattern of all dengue cases admitted to this hospital...
May 7, 2018: Geospatial Health
https://www.readbyqxmd.com/read/29771484/management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#9
Andria Tatem, Rupa Kapoor
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29770872/application-of-the-aast-egs-grade-for-adhesive-small-bowel-obstruction-to-a-multi-national-patient-population
#10
Matthew C Hernandez, Arianna Birindelli, John L Bruce, Johannes J P Buitendag, Victory Y Kong, Mircea Beuran, Johnathon M Aho, Ionut Negoi, Damian L Clarke, Salomone Di Saverio, Martin D Zielinski
BACKGROUND: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) has demonstrated to be a valid tool in North American patient populations. Using a multi-national patient cohort, we retrospectively assessed the validity the AAST ASBO grading system and estimated disease severity in a global population in order to correlate with several key clinical outcomes. METHODS: Multicenter retrospective review during 2012-2016 from four centers, Minnesota USA, Bologna Italy, Pietermaritzburg South Africa, and Bucharest Romania, was performed...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29770222/recurrent-vertebral-fractures-in-a-young-adult-a-closer-look-at-bone-health-in-type-1-diabetes-mellitus
#11
Eleanor P Thong, Sarah Catford, Julie Fletcher, Phillip Wong, Peter J Fuller, Helena Teede, Frances Milat
The association between type 1 diabetes mellitus (T1DM) and bone health has garnered interest over the years. Fracture risk is known to be increased in individuals with T1DM, although bone health assessment is not often performed in the clinical setting. We describe the case of a 21-year-old male with longstanding T1DM with multilevel vertebral fractures on imaging, after presenting with acute back pain without apparent trauma. Dual-energy X-ray absorptiometry (DXA) revealed significantly reduced bone mineral density at the lumbar spine and femoral neck...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29769371/how-are-we-currently-training-and-maintaining-clinical-readiness-of-us-and-uk-military-surgeons-responsible-for-managing-head-face-and-neck-wounds-on-deployment
#12
John Breeze, J G Combes, J DuBose, D B Powers
INTRODUCTION: The conflicts in Iraq and Afghanistan provided military surgeons from the USA and the UK with extensive experience into the management of injuries to the head, face and neck (HFN) from high energy bullets and explosive weaponry. The challenge is now to maintain the expertise in managing such injuries for future military deployments. METHODS: The manner in which each country approaches four parameters required for a surgeon to competently treat HFN wounds in deployed military environments was compared...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29769368/the-reconstructive-trauma-surgery-interface-fellowship-and-its-applicability-to-military-and-civilian-trainees
#13
EDITORIAL
Douglas Hammond, J Breeze, D Evriviades
The Reconstructive Trauma Surgery Fellowship is a based at the Queen Elizabeth Hospital, Birmingham, and focuses on the multidisciplinary management of major trauma from presentation to discharge. It is unique to the UK in that it provides both management and leadership experience as well as operative surgical skills particularly in terms of reconstruction on complex trauma patients including those from the military. This paper describes the relevance of fellowships in modern surgical training, composition of the reconstructive trauma fellowship and the relevance for both civilian and military trainees...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29769109/valproate-induced-hyperammonemia-uncovering-an-underlying-inherited-metabolic-disorder-a-case-report
#14
Shaine Mehta, Sarrah Tayabali, Robin Lachmann
BACKGROUND: Sodium valproate is a commonly used anticonvulsant. It is widely recognized that valproate can cause hyperammonemia, particularly in people with underlying liver disease. Patients with urea cycle disorders are genetically predisposed to this adverse event and can develop severe hyperammonemia if given valproate. This can occur even if liver functions tests and plasma concentration of valproate are normal, highlighting the importance of checking ammonia levels in any patient presenting with encephalopathy...
May 17, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#15
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29767853/nicorandil-induced-ulcerations-a-10-year-observational-study-of-all-cases-spontaneously-reported-to-the-french-pharmacovigilance-network
#16
Valérie Babic, Nadine Petitpain, Claire Guy, Philippe Trechot, Anne Claire Bursztejn, Jean Luc Faillie, Thierry Vial, Jean Luc Schmutz, Pierre Gillet
Nicorandil-induced ulcers remain often poorly recognised, with a late diagnosis and an inadequate management. We aimed to provide a clinical overview of the 148 spontaneously reported cases of nicorandil-induced ulcers to the French pharmacovigilance network between 2005 and 2014 and to complete this picture with worldwide published cases over the same period. Spontaneously reported nicorandil-induced ulcers were mainly mucosal (oral and anal) with a previous trauma in 23·0% of patients, revealed by a severe complication in 12·8% of cases...
May 16, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29766572/multiple-superficial-oral-mucoceles-after-mycoplasma-induced-mucositis
#17
Meggie Morand, Afshin Hatami
Oral mucoceles are lesions arising mainly from the minor salivary glands and are thought to occur after excretory duct trauma. We report a case of multiple superficial oral mucoceles on a child's labial mucosa after Mycoplasma pneumoniae mucositis. Mucoceles can mimic persistent or recurrent stomatitis and lead to potential errors in management.
May 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29766414/oral-health-and-oral-health-risk-behaviour-in-children-with-and-without-externalising-behaviour-problems
#18
M Staberg, J G Norén, L Gahnberg, A Ghaderi, C Kadesjö, A Robertson
AIM: This was to study children with early detected externalising behaviour problems compared to matched controls regarding oral health, oral health risk behaviour and the parental evaluation of the child's oral health and dental care. METHODS: Children aged 10-13 years and with externalising behaviour problems, were compared to matched controls. Behavioural characteristics were based on the Strength and Difficulties Questionnaire. The children and their parents completed questionnaires regarding dental fear, tooth brushing, dietary habits and evaluation of oral health and dental care...
May 15, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29766137/after-the-embo-predicting-non-hemorrhagic-indications-for-splenectomy-after-angioembolization-in-patients-with-blunt-trauma
#19
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Background: Successful non-operative management (NOM) of blunt splenic trauma is enhanced with splenic angioembolization (SAE). Patients may still require splenectomy post-SAE for splenic infarction/necrosis. Prior studies have used white blood cell count (WBC), platelet count (PLT), and PLT:WBC ratio after splenectomy to predict complications, but none have evaluated these findings prior to splenectomy in patients who have undergone SAE. Changes in these values may indicate clinically significant splenic infarction, facilitating management of these patients...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766131/does-intracranial-pressure-management-hurt-more-than-it-helps-in-traumatic-brain-injury
#20
Charles A Adams, Deborah M Stein, Jonathan J Morrison, Thomas M Scalea
Traumatic brain injury (TBI) is the leading cause of death after traumatic injury. Raised intracranial pressure (ICP) is particularly associated with poor TBI outcomes, prompting clinicians to monitor this parameter, using it to guide therapies aimed at reducing pressures. Despite this approach being recommended by several bodies such as the Brain Trauma Foundation and the American College of Surgeons, the evidence demonstrating that ICP-guided therapy improves outcome is limited. The topic was debated at the 36th Annual Point/Counterpoint Acute Care Surgery Conference and the following article summarizes the discussants points of view along with a summary of the evidence...
2018: Trauma surgery & acute care open
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