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https://www.readbyqxmd.com/read/27933158/development-and-implementation-of-a-standardized-pathway-in-the-pediatric-intensive-care-unit-for-children-with-severe-traumatic-brain-injuries
#1
Lauren Rakes, Mary King, Brian Johnston, Randall Chesnut, Rosemary Grant, Monica Vavilala
Severe traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. In 2003 and 2012, the Brain Trauma Foundation established and refined evidence-based guidelines for management of severe TBI in children. A recent multicenter study demonstrated an association between TBI guideline adherence and improved discharge survival. However, this study also showed large variation in adherence to pediatric TBI management at our level 1 pediatric trauma center, where overall adherence to fourteen pediatric intensive care unit (PICU) TBI clinical indicators was 64%...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932859/central-corneal-thickness-of-iraqi-population-in-relation-to-age-gender-refractive-errors-and-corneal-curvature-a-hospital-based-cross-sectional-study
#2
Yasir Jawad Kadhim, Qasim K Farhood
BACKGROUND: Central corneal thickness (CCT) is an important indicator of corneal status. Its measurement provides valid information about corneal physiological condition and possible changes associated with diseases, traumas, and hypoxia. It is an integral part for interpretation of intraocular pressure and glaucoma patient management and in prerefractive procedure assessment. OBJECTIVE: The aim of this study is to determine the mean CCT among a normal Iraqi population and to correlate between CCT and age, gender, refraction, and corneal curvature...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27932436/multifactorial-pathological-hip-subluxation-in-neurofibromatosis-type-1-nf1-due-to-intra-articular-plexiform-neurofibroma-lumbar-radiculopathy-and-neurofibromatous-polyneuropathy
#3
Waqar Waheed, Diego F Diego F Lemos, Nelms Nathaniel Nelms, Rup Tandan
Neurofibromatosis type-1 (NF1) is a multisystem disorder with very rare descriptions of hip instability. We report a case of a 37-year-old man with known NF1 and childhood-onset of left foot drop, who developed persistent left hip pain following a minor trauma. Physical examination revealed left-sided mild foot drop, hip abductor weakness, bilateral sensory loss in feet and an antalgic gait. Work-up revealed anterolateral subluxation of the left femoral head along with left hip plexiform neurofibroma (PN), dysplastic and degenerative changes, neurofibromatous neuropathy and chronic left L5 radiculopathy...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27932078/the-utility-of-vacuum-assisted-closure-therapy-for-skin-necrosis-secondary-to-cervical-abscess-in-the-elderly
#4
Tadataka Tsuji, Koichi Satoh, Emi Okuno, Akiko Sobue, Yoshiya Nishide, Susumu Tanaka, Mikihiko Kogo
Vacuum-assisted closure (VAC) systems have been used as negative-pressure dressings in various fields, including decubitus ulcer, trauma, and wound dehiscence. To the best of our knowledge, few reports have examined the utility of VAC therapy for neck abscess in an oldest-old patient. We present here a rare case of neck abscess secondary to parotid abscess, resulting in extensive skin necrosis. Successful management included emergency drainage following epithelial induction through a VAC system without using skin grafting...
December 5, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/27930461/odontogenic-orofacial-infections
#5
Dario Bertossi, Antonio Barone, Antonio Iurlaro, Simone Marconcini, Daniele De Santis, Marco Finotti, Pasquale Procacci
Acute dental abscess is a frequent and sometimes underestimated disease of the oral cavity. The acute dental abscess usually occurs secondary to caries, trauma, or failed endodontic treatment. After the intact pulp chamber is opened, colonization of the root canals takes place with a variable set of anaerobic bacteria, which colonize the walls of the necrotic root canals forming a specialized mixed anaerobic biofilm. Asymptomatic necrosis is common. However, abscess formation occurs when these bacteria and their toxic products breach into the periapical tissues through the apical foramen and induce acute inflammation and pus formation...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27930279/use-of-a-novel-accounting-and-grouping-method-for-major-trunk-injuryanalysis-of-data-from-a-statewide-trauma-financial-survey
#6
Kyla D Joubert, Charles D Mabry, Kyle J Kalkwarf, Richard D Betzold, Horace J Spencer, Kara M Spinks, Austin Porter, Saleema Karim, Ronald D Robertson, Michael J Sutherland, Robert T Maxson
Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#7
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27929716/posttraumatic-endophthalmitis-in-children-epidemiology-diagnosis-management-and-prognosis
#8
Pooja Bansal, Pradeep Venkatesh, Yograj Sharma
Pediatric posttraumatic endophthalmitis presents with great complexities and challenges arising due to delayed presentation, difficulty in eliciting an accurate history, or trauma with unusual and highly contaminated objects. The possibility of initial misdiagnosis as panuveitis, metastatic endophthalmitis, and masquerade syndrome is also very high, which results not only in several unwarranted investigations being performed, but also a delay in the initiation of treatment. The standard treatment remains primary repair of the wound, intravitreal therapy with broad spectrum antibiotics, and parsplana vitrectomy...
December 8, 2016: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/27929693/use-of-recycled-external-fixators-in-management-of-compound-injuries
#9
Swagat Mahapatra, Nandakumar Rengarajan
BACKGROUND: Compound fractures form a bulk of Orthopaedic Trauma cases in a developing country like India. External Fixation devices are the mainstays of treatment of these open fractures. They are generally used as a one use disposable device and add a great burden to the health care costs, especially in a developing country. In our study we evaluated the efficacy and complication rate of recycled external fixators with that of new external fixators. MATERIALS AND METHODS: This was a prospective randomised interventional study conducted in a tertiary care teaching hospital of a developing country...
December 8, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27928592/radiation-induced-complex-anterior-urinary-fistulation-for-prostate-cancer-a-retrospective-multicenter-study-from-the-trauma-and-urologic-reconstruction-network-of-surgeons-turns
#10
E Charles Osterberg, Alex J Vanni, Thomas W Gaither, Mohannad A Awad, Joshua A Broghammer, Scott C Pate, Hadley Wyre, Jeremy B Myers, Sean P Elliott, Suprita Krishna, Lee C Zhao, Christopher McClung, Bradley A Erickson, Benjamin N Breyer
PURPOSE: To characterize anterior urinary fistulae following radiotherapy for prostate cancer. METHODS: Over 10 years, 31 men were identified to have an anterior urinary fistula. A retrospective database was created to evaluate patient demographics, presentation, diagnostic procedures, operative interventions, outcomes, and complications. Comparisons between men who underwent cystectomy versus bladder-sparing surgeries were performed. RESULTS: At a median age of 73 (interquartile range (IQR) 68...
December 7, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27927257/unusual-diagnosis-in-a-patient-with-minor-ankle-trauma
#11
Zoë Piggott, Donna Clark
We present the case of a 23 year-old male who sustained an anterior tibial artery pseudoaneurysm after an apparently innocuous soccer injury. The patient presented with sudden onset severe pain and swelling one week after the injury. The diagnosis was made using duplex ultrasound, and confirmed with CT angiography. Definitive management consisted of endovascular platinum microcoiling. One year later, the patient is asymptomatic and remains active. A review of the epidemiology, diagnosis, and treatment of arterial pseudoaneurysm is presented...
December 8, 2016: CJEM
https://www.readbyqxmd.com/read/27924759/sudden-cardiac-death-in-south-india-incidence-risk-factors-and-pathology
#12
Uma N Srivatsa, K Swaminathan, K Sithy Athiya Munavarah, Ezra Amsterdam, K Shantaraman
BACKGROUND: Sudden cardiac death (SCD) is a major cause of mortality secondary to coronary artery disease (CAD) in the industrialized societies. Although South Asians have a high prevalence of CAD, the frequency and underlying pathology of SCD among this population are unknown. METHODS: Medical records of consecutive patients presenting with unexplained sudden death (USD) in a tertiary care center were reviewed. Patients with trauma, violent deaths, positive toxicology and non-cardiac pathology were excluded to determine sudden cardiac death (SCD)...
July 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27924366/utility-of-plain-radiographs-and-mri-in-cervical-spine-clearance-in-symptomatic-non-obtunded-pediatric-patients-without-high-impact-trauma
#13
Justin M Moore, Jonathan Hall, Michael Ditchfield, Christopher Xenos, Andrew Danks
PURPOSE: The optimal imaging modality for evaluating cervical spine trauma and optimizing management in the pediatric population is controversial. In pediatric populations, there are no well-established guidelines for cervical spine trauma evaluation and treatment. Currently, there is virtually no literature regarding imaging and management of symptomatic pediatric patients who present with cervical spine trauma without high-impact mechanism. This study aims to establish an optimal imaging strategy for this subgroup of trauma patients...
December 6, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-post-traumatic-giant-internal-carotid-artery-aneurysm
#14
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery (ICA). However, for the ipsilateral post-traumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high flow direct CCF would be better for the prevention of hyper-perfusion syndrome and the intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy was suffered from severe head trauma caused by being hit by a car...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#15
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
December 3, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27922966/local-coverage-for-acute-severely-herniated-brain-using-scalp-and-forehead-flaps-in-a-pediatric-patient-with-head-trauma
#16
Matthew Brown, Navid Pourtaheri, Kristopher Katira, Sunil Manjila, Ali S Totonchi
A 4-year-old-boy required emergent craniectomy and drainage of a large right-sided acute subdural hematoma after head trauma, during which massive sinus hemorrhage with brain swelling occurred. Acute intraoperative management entailed dural cover using synthetic dural membrane substitute and scalp coverage over the herniated brain using acellular dermal matrix. After intensive monitoring and control of raised intracranial pressure over the next few days, the exposed brain was then covered by scalp and forehead flaps with cadaveric skin grafting to the donor site...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27921017/factors-impacting-mortality-in-the-pre-hospital-period-after-road-traffic-accidents-in-urban-india
#17
Ananthnarayan Chandrasekharan, Aditya J Nanavati, Sandhya Prabhakar, Subramaniam Prabhakar
BACKGROUND: India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. OBJECTIVES: We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. PATIENTS AND METHODS: A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27920244/are-the-registry-data-reliable-an-audit-of-a-regional-trauma-registry-in-the-netherlands
#18
E E Horton, P Krijnen, H M Molenaar, I B Schipper
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27919768/proximal-femoral-fractures-in-centenarians-a-retrospective-analysis-of-39-patients
#19
A Morice, N Reina, G Gracia, P Bonnevialle, J-M Laffosse, K Wytrykowski, E Cavaignac, N Bonnevialle
BACKGROUND: A corollary of the current population ageing in France is an increase in proximal femoral fractures (PFFs), particularly among centenarians. The outcomes of PFF in centenarians in France are unknown. We therefore conducted a retrospective study of centenarians with PFFs both to assess: 1) assess clinical outcomes according to geriatric and trauma scores, 2) and to determine whether routine surgery is warranted. HYPOTHESIS: Morbidity and mortality in a single-centre cohort of centenarians with surgically treated PFFs are consistent with previous reports...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919714/initial-testing-of-a-behavioural-pain-assessment-tool-within-trauma-units
#20
Julie Gregory
Pain is common in trauma patients who may be older and also may have cognitive impairment leading to reduced communication about their pain. A number of observational pain assessment tools are available and have been found to have limited clinical usefulness. The Bolton Pain Assessment Tool (BPAT) was developed following a trial of three established tools and includes a section to involve family and/or close carers in the pain assessment process. The aim of this paper is to present the findings of initial testing of BPAT...
September 7, 2016: International Journal of Orthopaedic and Trauma Nursing
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