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https://www.readbyqxmd.com/read/29475171/intrahepatic-splenosis-mimicking-hepatic-neoplasia
#1
Gabriel Neves Saad Teles, Paulo Eduardo Zerati Monteiro, Raphael Raphe
INTRODUCTION: Splenosis is defined as the heterotopic autoimplantation of splenic tissue following trauma to or surgery on the spleen. CLINICAL CASE: We present a case of an asymptomatic 73-year-old male in whom hypervascular lesions were detected during routine exams. The patient reported a history of carotid artery surgery and cholecystectomy; he had a laparotomy incision from childhood but was unaware of the reason for it. The patient exhibited slightly elevated carcinoembryonic antigen (CEA) levels...
February 17, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#2
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
February 22, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29473832/motocross-injuries-in-pediatric-and-adolescent-patients
#3
Amy L McIntosh, Christy M Christophersen
Motocross is a popular sport in which participants ride a two-wheeled, motorized vehicle on an uneven 2-km track with natural or human-made obstacles. Participants compete at high rates of speed, and children as young as age 4 years compete in age-appropriate groups. Motocross is recognized as a strenuous sport with a high accident rate. Most injuries are musculoskeletal in nature. The most commonly injured areas are the forearm, clavicle, femur, and tibia. Many injuries require surgical treatment. Some patients sustain head trauma with loss of consciousness...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29473476/challenges-of-combining-perspectives
#4
Maria Sundvall, David Titelman, Sofie Bäärnhielm
BACKGROUND: Asylum seekers have increased risk of suicide and suicidal behavior, with differences related to origin, gender, and age. There are barriers to communication in clinical encounters between asylum seekers and clinicians. There is insufficient knowledge about how communication in the clinical encounter affects the suicide risk in female asylum seekers. AIMS: To explore the documented communication between female asylum-seeking suicide attempters and clinicians and how it affects treatment...
February 23, 2018: Crisis
https://www.readbyqxmd.com/read/29473013/high-risk-repair-of-traumatic-mitral-valve-rupture-in-the-setting-of-polytrauma
#5
Michael John Paisley, Zachary Deboard, Donald Thomas
Background  The rare complication of mitral valve rupture from blunt trauma is certainly not at the top of the differential of shock. Case Description  We report the case of a 56-year-old woman who sustained numerous injuries after a 30-m fall with cardiogenic shock secondary to mitral valve rupture causing severe mitral valve regurgitation. Management included successful primary leaflet repair, annuloplasty, and single vessel coronary artery bypass. Conclusion  Valvular repair in the setting of polytrauma is a complex decision that requires careful balance of risks and benefits relative to patient stability...
January 2018: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/29472972/bone-health-improvement-protocol
#6
Nathan K Wool, Shannon Wilson, Alexander Cm Chong, Bradley R Dart
Introduction: Metabolic bone disease is a malady that causes significant morbidity and mortality to a patient who has sustained a fragility fracture. There is currently no protocol to prevent secondary fragility fracture at our institution. The objective of this study was to create an appropriate protocol for implementing clinical pathways for physicians to diagnose and treat osteoporosis and fragility fractures by educating patients. Methods: A multidisciplinary team created an appropriate protocol that could be implemented in an inpatient setting...
August 2017: Kansas Journal of Medicine
https://www.readbyqxmd.com/read/29472964/functional-outcomes-of-thoracolumbar-junction-spine-fractures
#7
Bradford A Wall, Alan Moskowitz, M Camden Whitaker, Teresa L Jones, Ryan M Stuckey, Catherine L Carr-Maben, Alexander Cm Chong
Introduction: Few studies have evaluated the functional outcomes of traumatic thoracic and lumbar vertebral body fractures. This study evaluated the functional and clinical outcomes of patients, who sustained a fracture to the thoracolumbar area of the spine (T10 to L2 region), with ≥ 25° kyphosis versus those with less kyphotic curvature. Methods: The trauma registry records of two level 1 trauma centers using ICD-9 codes for fracture to the thoracolumbar juncture (T10 to L2 region) were reviewed...
May 2017: Kansas Journal of Medicine
https://www.readbyqxmd.com/read/29472928/immunothrombotic-activity-of-damage-associated-molecular-patterns-and-extracellular-vesicles-in-secondary-organ-failure-induced-by-trauma-and-sterile-insults
#8
REVIEW
John Eppensteiner, Robert Patrick Davis, Andrew S Barbas, Jean Kwun, Jaewoo Lee
Despite significant improvements in injury prevention and emergency response, injury-related death and morbidity continues to increase in the US and worldwide. Patients with trauma, invasive operations, anti-cancer treatment, and organ transplantation produce a host of danger signals and high levels of pro-inflammatory and pro-thrombotic mediators, such as damage-associated molecular patterns (DAMPs) and extracellular vesicles (EVs). DAMPs (e.g., nucleic acids, histone, high-mobility group box 1 protein, and S100) are molecules released from injured, stressed, or activated cells that act as endogenous ligands of innate immune receptors, whereas EVs (e...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29472891/a-review-of-traumatic-axonal-injury-following-whiplash-injury-as-demonstrated-by-diffusion-tensor-tractography
#9
REVIEW
Sung Ho Jang, Young Hyeon Kwon
Whiplash is a bony or soft tissue injury resulting from an acceleration-deceleration energy transfer in the neck. Although patients with whiplash injury often complain of cerebral symptoms, and previous studies have reported evidence indicating brain injury, such an association has not been clearly elucidated. Traumatic axonal injury (TAI) is tearing of axons due to indirect shearing forces during acceleration, deceleration, and rotation of the brain or to direct head trauma. Diffusion tensor imaging (DTI) has a unique advantage to detect TAI in patients whose conventional brain CT or magnetic resonance imaging (MRI) results were negative following head trauma...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29472753/autopsy-proven-mirtazapine-withdrawal-induced-mania-hypomania-associated-with-sudden-death
#10
Rena Pombo, Etta Johnson, Alejandra Gamboa, Bennet Omalu
Manic episodes induced by antidepressant withdrawal are rarely reported. Mirtazapine is a tetracyclic, piperazinoazepine compound and is a noradrenergic, adrenergic, serotonergic, histaminergic, and muscarinic-antagonist antidepressant that is used for the treatment of major depression and other psychiatric illnesses. There are several reported cases of manic/hypomanic episodes induced by mirtazapine withdrawal based on suspected clinical symptoms that were not confirmed by autopsy and toxicology. We present the first reported case of mirtazapine withdrawal-induced mania/hypomania associated with sudden death and confirmed by autopsy and toxicology...
October 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/29472311/cancer-diagnosis-a-trauma-for-patients-and-doctors-alike
#11
Frank Gieseler, Lynn Gaertner, Elske Thaden, Werner Theobald
No abstract text is available yet for this article.
February 22, 2018: Oncologist
https://www.readbyqxmd.com/read/29471855/phase-based-treatment-versus-immediate-trauma-focused-treatment-in-patients-with-childhood-trauma-related-posttraumatic-stress-disorder-study-protocol-for-a-randomized-controlled-trial
#12
Noortje I van Vliet, Rafaele J C Huntjens, Maarten K van Dijk, Ad de Jongh
BACKGROUND: The treatment of posttraumatic stress disorder (PTSD) related to a history of sexual and/or physical abuse in childhood is the subject of international debate, with some favouring a phase-based approach as their preferred treatment, while others argue for immediate trauma-focused treatment. A history of (chronic) traumatisation during childhood has been linked to the development of distinct symptoms that are often labelled as symptoms of complex PTSD. Many therapists associate the presence of symptoms of complex PTSD with a less favourable treatment prognosis...
February 22, 2018: Trials
https://www.readbyqxmd.com/read/29471849/implementing-alcohol-misuse-sbirt-in-a-national-cohort-of-pediatric-trauma-centers-a-type-iii-hybrid-effectiveness-implementation-trial
#13
Michael J Mello, Sara J Becker, Julie Bromberg, Janette Baird, Mark R Zonfrillo, Anthony Spirito
BACKGROUND: The American College of Surgeons mandates universal screening for alcohol misuse and delivery of an intervention for those screening positive as a requirement for certification as a level 1 trauma center. Though this requirement has been mandated for over a decade, its implementation has been challenging. Our research team completed an implementation study supporting seven pediatric trauma centers' compliance with the requirement by developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) policy for adolescent trauma patients...
February 22, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29470527/value-of-diagnostic-and-therapeutic-laparoscopy-for-patients-with-blunt-abdominal-trauma-a-10-year-medical-center-experience
#14
Heng-Fu Lin, Ying-Da Chen, Shyr-Chyr Chen
Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006-2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B...
2018: PloS One
https://www.readbyqxmd.com/read/29470474/monitoring-pre-hospital-transport-of-severely-injured-patients-in-the-midland-region-of-new-zealand
#15
Jesse Whitehead, Matt Roskruge, Colin Tan, Alistair Smith, Grant Christey
AIM: Pre-hospital triage strategies aim to identify the type and extent of patient injuries and ensure that they are transferred to the most appropriate trauma centres. Despite the importance of appropriate pre-hospital transport, there is little evidence base to assist medical staff on optimal destination policy for emergent pre-hospital transport. This paper explores the spatial relationship of patient transfers prior to the implementation of the Midland Pre-Hospital Trauma Destination Matrix in New Zealand, and is a retrospective view of practice against a destination policy that was applied after the study period...
February 23, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29470319/splenic-rupture-in-children-with-portal-hypertension
#16
Orith Waisbourd-Zinman, Amit Shah, Henry C Lin, Elizabeth B Rand
INTRODUCTION: Massive splenomegaly from portal hypertension (PHTN) in children raises the specter of splenic rupture; however, the incidence, etiology, and risk of rupture have not been studied, nor have existing practices to reduce risk. We therefore performed an international survey to describe the splenic rupture cases in PHTN and to describe the existing empirical practice among hepatologists. METHODS: A questionnaire was constructed to elicit cases of splenic rupture and collect hepatologists' common practices for prevention of splenic rupture...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29470190/blood-transfusion-management-in-the-severely-bleeding-military-patient
#17
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
February 22, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29469764/focal-linear-elastosis-in-a-patient-with-joint-hypermobility-syndrome
#18
Barak C Clement, Christopher Forster, Nicholas Logemann
Focal linear elastosis (FLE) is a benign skin findingcharacterized by hypertrophic linear plaques withabnormal elastic fibers on histology. We present aunique case in which focal linear elastosis occurredin the setting of joint hypermobility syndrome(JHS). Our patient, a 20-year-old man with a medicalhistory significant for symptoms consistent with JHS,had been followed by the rheumatology clinic formany months. He was referred to the dermatologydepartment for further evaluation of asymptomaticlongitudinal bands on his back that had been presentfor many years...
January 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29469668/review-of-de-novo-cerebral-arteriovenous-malformation-haemorrhage-risk-treatment-approaches-and-outcomes
#19
Xianli Lv, Guihuai Wang
Objective A small number of patients has been reported to develop a completely new or de novo arteriovenous malformation (AVM) after brain surgery, haemorrhage, head trauma or ischaemic stroke. The natural history of these lesions is unknown. In this review, both ruptured and unruptured de novo AVMs and their treatments were reviewed. Methods Published literature in the PubMed database citing 'de novo cerebral arteriovenous malformation' was reviewed. Additional studies were identified through reference searches in each reviewed article...
January 1, 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#20
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
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