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Trauma patients

Thaís Flôr da Rocha, Juliana Gibbon Neves, Karin Viegas
Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48...
September 2016: Revista Brasileira de Enfermagem
Babette Bais, Wouter A Karst, Bela Kubat, Robert M Verdijk
Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5-month-old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation...
October 26, 2016: Journal of Forensic Sciences
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
October 25, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Alan Bleakley
Inequalities in society are reflected in patterns of disease and access to health care, where the disadvantaged suffer most. Traditionally, doctors have kept politics out of their work, even though politics often shape medicine. What political responsibilities, then, should doctors have as they facilitate the learning of medical students? The article in this issue by Kumagai, Jackson, and Razack goes straight to the heart of this question. These authors ask whether educators should be wary of "cutting close to the bone" in discussing issues that may restimulate trauma in some medical students...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Verónica Vitriol, Alfredo Cancino, Marcelo Leiva-Bianchi, Carlos Serrano, Soledad Ballesteros, Andrea Asenjo, Cristian Cáceres, Soledad Potthoff, Carolina Salgado, Francisca Orellana, Marcela Ormazábal
: Childhood trauma is associated with different psychiatric disorders during adulthood. These disorders are often presented in comorbidity with depression. OBJECTIVE: To establish the relationship between psychiatric comorbidities and childhood traumatic events in patients with depression in Chile. METHODS: Three hundred and ninety-four patients with major depression were assessed using the MINI International Neuropsychiatric Interview and a screening for childhood trauma...
October 26, 2016: Journal of Trauma & Dissociation
R Claeys, M Walsdorff, S Pargov, R Matasa, R Duttmann, M Cannie
Non-traumatic wrist pain remains a diagnostic challenge. An accurate diagnosis is crucial in order to choose the appropriate treatment. We report the case of a 23-year-old female with a four-month history of mainly nocturnal wrist pain. There was no history of trauma or prior surgery. Radiographs and CT scans showed a lytic lesion with central nidus and sclerotic margins in the pisiform bone. Bone scan showed increased uptake in the pisiform bone. The diagnosis of osteoid osteoma was confirmed by histopathological analysis after complete surgical resection...
September 2016: Hand Surgery and Rehabilitation
M Arnal, A Cambon, P-S Marcheix, Z Belkhayar
Consensus opinion is that active movement of the elbow is a priority in the surgical treatment of total brachial plexus injuries. But the indications and neurotization techniques used to restore motor function of the hand are the subject of discussion. The aim of this retrospective study was to evaluate, in adult patients with complete post-traumatic paralysis of the brachial plexus, the functional results of neurotization of four intercostal nerves on the musculocutaneous nerve and grafting of the C5 root by one strand on the nerve to the long head of triceps and three strands on the medial component of the median nerve...
September 2016: Hand Surgery and Rehabilitation
S Honecker, J J Hidalgo Diaz, K Naito, E Pire, G Prunières, S Facca, P Liverneaux
As an alternative to amputation of the little finger, we report here seven cases of shortening arthrodesis carried out by resecting the middle phalanx and proximodistal interphalangeal (PDIP) arthrodesis. Our cohort consisted of 6 males and 1 female (58years average age), with a stiff little finger secondary to Dupuytren's disease or trauma. All fingers were approached dorsally; after resection of the middle phalanx and decortication of the subchondral bone, fusion of the remaining phalanges was performed using an intramedullary self-breaking screw-pin...
September 2016: Hand Surgery and Rehabilitation
Weerasak Singhatanadgige, Worawat Limthongkul, Frank Valone, Wicharn Yingsakmongkol, K Daniel Riew
Study Design Systematic review. Objective To compare laminoplasty versus laminectomy and fusion in patients with cervical myelopathy caused by OPLL. Methods A systematic review was conducted using PubMed/Medline, Cochrane database, and Google scholar of articles. Only comparative studies in humans were included. Studies involving cervical trauma/fracture, infection, and tumor were excluded. Results Of 157 citations initially analyzed, 4 studies ultimately met our inclusion criteria: one class of evidence (CoE) II prospective cohort study and three CoE III retrospective cohort studies...
November 2016: Global Spine Journal
Gregory Grabowski, Ryan N Robertson, Blair M Barton, Mark A Cairns, Sharon W Webb
Study Design Retrospective comparative study. Objective To compare strict Biffl criteria to more-liberal criteria for computed tomography angiography (CTA) when screening for blunt cerebrovascular injury (BCVI). Methods All CTAs performed for blunt injury between 2009 and 2011 at our institution were reviewed. All patients with cervical spine fractures who were evaluated with CTA were included; patients with penetrating trauma and atraumatic reasons for imaging were excluded. We then categorized the patients' fractures based on the indications for CTA as either within or outside Biffl criteria...
November 2016: Global Spine Journal
Hammouda Hamdy Ghoraba, Mohamed Amin Heikal, Hosam Osman Mansour, Haithem Mamon Abdelfattah, Emad Mohamed Elgemai, Adel Galal Zaky
The aim of this study is to report the difference in either anatomical or functional outcome of vitreoretinal intervention in cases of gunshot perforating eye injury if done 2-4 weeks or after the 4th week after the original trauma. Patients were treated with pars plana vitrectomy and silicon oil. Surgeries were performed in the period from February 2011 until the end of December 2014. 253 eyes of 237 patients were reviewed. 46 eyes were excluded. 207 eyes of 197 patients were analyzed. The included eyes were classified based on the timing of vitrectomy in relation to the initial trauma into two groups: 149 eyes (the first group) operated on between the 3rd and the 4th week and 58 eyes (the second group) operated on after the 4th week after the trauma...
2016: Journal of Ophthalmology
Dimitrios G Balatsouras, George Koukoutsis, Andreas Aspris, Alexandros Fassolis, Antonis Moukos, Nicolas C Economou, Michael Katotomichelakis
OBJECTIVES: We studied the clinical characteristics, nystagmographic findings, and treatment outcome of a group of patients with benign paroxysmal positional vertigo (BPPV) secondary to mild head trauma and compared them with a group of patients with idiopathic BPPV. METHODS: The medical records of 33 patients with BPPV associated with mild head trauma were reviewed. Data of a complete otolaryngological, audiological, neurotologic, and imaging evaluation were available for all patients...
October 25, 2016: Annals of Otology, Rhinology, and Laryngology
Kaila A Holtz, Rachel Lipson, Vanessa K Noonan, Brian K Kwon, Patricia B Mills
OBJECTIVE: To evaluate the prevalence and impact of spasticity following traumatic spinal cord injury (SCI). DESIGN: Prospective cohort study of the Rick Hansen Spinal Cord Injury Registry (RHSCIR) and retrospective review of inpatient medical charts. SETTING: Quaternary trauma centre, rehabilitation centre, and community settings in British Columbia, Canada. PARTICIPANTS: Individuals with a traumatic SCI between 2005 and 2014 prospectively enrolled in the Vancouver site RHSCIR were eligible for inclusion...
October 22, 2016: Archives of Physical Medicine and Rehabilitation
Michael P O'Leary, Jessica A Keeley, Arthur Yule, Caitlyn Suruki, David S Plurad, Ashkan Moazzez, Angela L Neville, Brant A Putnam, Dennis Y Kim
BACKGROUND: The objectives of this study were to examine the incidence and severity of early acute respiratory distress syndrome (ARDS) according to the Berlin Definition and to identify risk factors associated with the development of early post-traumatic ARDS. METHODS: A 2.5-year retrospective database of adult trauma patients who required mechanical ventilation for greater than 48 hours at a level 1 trauma center was analyzed for variables predictive of early (<48 hours after injury), mild, moderate, and severe ARDS and in-hospital mortality...
September 30, 2016: American Journal of Surgery
Kuan-Ho Lin, Chien-Liang Liu, Wei-Wen Kuo, Catherine Reena Paul, Wei-Kung Chen, Su-Ying Wen, Cecilia Hsuan Day, Hsi-Chin Wu, Vijaya Padma Viswanadha, Chih-Yang Huang
Cardiac trauma has been recognized as a complication associated with blunt chest trauma involving coronary artery injury, myocardium contusion and myocardial rupture. Secondary cardiac injuries after trauma supposed to be a critical factor in trauma patients, but the mechanism is not fully explored. Overproduction of TNF-alpha had been reported in multiple trauma animals, this induces oxidative stress resulting in cardiac apoptosis. Apoptosis gradually increases after trauma and reaches to a maximum level in 12 h time...
2016: PloS One
Marek Krawczyk, Michał Grąt, Rene Adam, Wojciech G Polak, Jurgen Klempnauer, Antonio Pinna, Fabrizio Di Benedetto, Franco Filipponi, Norbert Senninger, Aksel Foss, Sebastian Rufián-Peña, William Bennet, Johann Pratschke, Andreas Paul, Utz Settmacher, Giorgio Rossi, Mauro Salizzoni, Carlos Fernandez-Selles, Santiago T Martínez de Rituerto, Miguel A Gómez-Bravo, Jacques Pirenne, Olivier Detry, Pietro E Majno, Petr Nemec, Wolf O Bechstein, Michael Bartels, Silvio Nadalin, Francois R Pruvot, Darius F Mirza, Luigi Lupo, Michele Colledan, Giuseppe Tisone, Jan Ringers, Jorge Daniel, Ramón Charco Torra, Enrique Moreno González, Rafael Bañares Cañizares, Valentin Cuervas-Mons Martinez, Fernando San Juan Rodríguez, Sezai Yilmaz, Piotr Remiszewski
BACKGROUND: Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. METHODS: This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013...
November 2016: Transplantation
Tanya Anand, Rajesh Ramnanan, Ruby Skinner, Maureen Martin
Blood transfusions cause altered immunity and the duration of storage is contributory. In the era of massive transfusion protocols (MTPs) this impact is unclear, particularly as it relates to balanced transfusions. Trauma patients requiring our MTP after admission to our Level II trauma center were studied. The average age of blood transfused was calculated; old blood was a storage time of ≥14 days versus new blood <14 days. Blood to plasma ratios of 1:1 were compared with ratios >1:1. Infections, organ dysfunction multiorgan injury (MOI), and death were compared based on ratios and blood storage times...
October 2016: American Surgeon
Karen E Burtt, Alexis D Rounds, Hyuma A Leland, Ram K Alluri, Ketan M Patel, Joseph N Carey
Infections in the traumatized lower extremity are a significant source of morbidity and expense. Outcomes after vascularized soft tissue reconstruction were analyzed to determine impact on infection rates. A retrospective review of a prospectively maintained database was performed, including 114 trauma patients requiring soft tissue reconstruction of lower extremity injuries at an urban Level I tertiary referral center from 2008 to 2015. Patient characteristics and perioperative outcomes were analyzed. After trauma, 39 (34...
October 2016: American Surgeon
Kyle Mock, Jessica Keeley, Ashkan Moazzez, David S Plurad, Brant Putnam, Dennis Y Kim
The population of the United States is predicted to age dramatically over the next few decades; as such older patients will comprise an increasing proportion of the injured populations. Due to multiple comorbidities and frailty, the old and very old are at greater risk for mortality than younger patients. To identify predictors of inhospital mortality in these patients, we performed a retrospective cohort study at our Level 1 trauma center. Between April 2009 and October 2014, we identified 193 trauma patients aged 80 years and older admitted to the intensive care unit...
October 2016: American Surgeon
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
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