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https://www.readbyqxmd.com/read/29787558/a-new-weighted-injury-severity-scoring-system-better-predictive-power-for-pediatric-trauma-mortality
#1
Junxin Shi, Jiabin Shen, Sarah Caupp, Angela Wang, Kathryn E Nuss, Brian Kenney, Krista K Wheeler, Bo Lu, Henry Xiang
BACKGROUND: An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. METHODS: Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS...
May 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787556/unrealized-potential-of-the-us-military-battlefield-trauma-system-dow-rate-is-higher-in-iraq-and-afghanistan-than-in-vietnam-but-cfr-and-kia-rate-are-lower
#2
Shawn C Nessen, Jennifer Gurney, Todd E Rasmussen, Andrew P Cap, Elizabeth Mann-Salinas, Tuan D Le, Stacy Shackelford, Kyle N Remick, Kevin Akers, Brian Eastridge, Donald Jenkins, Zsolt Stockinger, Clinton K Murray, Kirby Gross, Jason Seery, Robert Mabry, John B Holcomb
Level IV/Observational/Retrospective/Historic Controls.
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786884/bone-morbidity-and-recovery-in-children-with-acute-lymphoblastic-leukemia-results-of-a-six-year-prospective-cohort-study
#3
Leanne M Ward, Jinhui Ma, Bianca Lang, Josephine Ho, Nathalie Alos, Mary Ann Matzinger, Nazih Shenouda, Brian Lentle, Jacob L Jaremko, Beverly Wilson, David Stephure, Robert Stein, Anne Marie Sbrocchi, Celia Rodd, Victor Lewis, Sara Israels, Ronald M Grant, Conrad V Fernandez, David B Dix, Elizabeth A Cummings, Robert Couch, Elizabeth Cairney, Ronald Barr, Sharon Abish, Stephanie A Atkinson, John Hay, Frank Rauch, David Moher, Kerry Siminoski, Jacqueline Halton
Osteoporotic fractures are a significant cause of morbidity in acute lymphoblastic leukemia (ALL). Our objective was to determine the incidence and predictors of fractures and recovery from osteoporosis in pediatric ALL over 6 years following glucocorticoid initiation. Vertebral fractures (VF) and vertebral body reshaping were assessed on annual spine radiographs, low-trauma non-VF were recorded at regular intervals and spine bone mineral density (BMD) was captured every 6 months for 4 years and then annually...
May 22, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29780028/induced-endometrial-trauma-endometrial-scratch-in-the-mid-luteal-menstrual-cycle-phase-preceding-first-cycle-ivf-icsi-versus-usual-ivf-icsi-therapy-study-protocol-for-a-randomised-controlled-trial
#4
Clare Pye, Robin Chatters, Judith Cohen, Kate Brian, Ying C Cheong, Susan Laird, Lamiya Mohiyiddeen, Jonathan Skull, Stephen Walters, Tracey Young, Mostafa Metwally
INTRODUCTION: Endometrial trauma commonly known as endometrial scratch (ES) has been shown to improve pregnancy rates in women with a history of repeated implantation failure undergoing in vitro fertilisation (IVF), with or without intracytoplasmic sperm injection (ICSI). However, the procedure has not yet been fully explored in women having IVF/ICSI for the first time. This study aims to examine the effect of performing an ES in the mid-luteal phase prior to a first-time IVF/ICSI cycle on the chances of achieving a clinical pregnancy and live birth...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29778523/local-immunomodulation-with-anti-inflammatory-cytokine-encoding-lentivirus-enhances-functional-recovery-after-spinal-cord-injury
#5
Jonghyuck Park, Joseph T Decker, Daniel J Margul, Dominique R Smith, Brian J Cummings, Aileen J Anderson, Lonnie D Shea
Trauma to the spinal cord and associated secondary inflammation can lead to permanent loss of sensory and motor function below the injury level, with the resulting environment serving as a barrier that limits regeneration. In this study, we investigate the localized expression of anti-inflammatory cytokines IL-10 and IL-4 via lentiviral transduction in multichannel bridges. Porous multichannel bridges provide physical guidance for axonal outgrowth with the cytokines hypothesized to modulate the neuroinflammatory microenvironment and enhance axonal regeneration...
April 27, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/29774231/semaphorin3a-signaling-is-dispensable-for-motor-axon-reinnervation-of-the-adult-neuromuscular-junction
#6
Jennifer L Shadrach, Brian A Pierchala
The neuromuscular junction (NMJ) is a specialized synapse that is formed by motor axon innervation of skeletal muscle fibers. The maintenance of motor-muscle connectivity is critical for the preservation of muscle tone and generation of movement. Injury can induce a robust regenerative response in motor axons, but severe trauma or chronic denervation resulting from neurodegenerative disease typically leads to inefficient repair and poor functional recovery. The axon guidance molecule Semaphorin3A (Sema3A) has been implicated as a negative regulator of motor innervation...
May 2018: ENeuro
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#7
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#8
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29741715/forward-surgical-team-experience-fste-is-associated-with-increased-confidence-with-combat-surgeon-trauma-skills
#9
D Joshua Mancini, Brian P Smith, Travis M Polk, C William Schwab
Introduction: Little is known regarding the confidence of military surgeons prior to combat zone deployment. Military surgeons are frequently deployed without peers experienced in combat surgery. We hypothesized that forward surgical team experience (FSTE) increases surgeon confidence with critical skill sets. Methods: We conducted a national survey of military affiliated personnel. We used a novel survey instrument that was piloted and validated by experienced military surgeons to collect demographics, education, practice patterns, and confidence parameters for trauma and surgical critical care skills...
May 8, 2018: Military Medicine
https://www.readbyqxmd.com/read/29735658/osmotic-stabilization-prevents-cochlear-synaptopathy-after-blast-trauma
#10
Jinkyung Kim, Anping Xia, Nicolas Grillet, Brian E Applegate, John S Oghalai
Traumatic noise causes hearing loss by damaging sensory hair cells and their auditory synapses. There are no treatments. Here, we investigated mice exposed to a blast wave approximating a roadside bomb. In vivo cochlear imaging revealed an increase in the volume of endolymph, the fluid within scala media, termed endolymphatic hydrops. Endolymphatic hydrops, hair cell loss, and cochlear synaptopathy were initiated by trauma to the mechanosensitive hair cell stereocilia and were K+ -dependent. Increasing the osmolality of the adjacent perilymph treated endolymphatic hydrops and prevented synaptopathy, but did not prevent hair cell loss...
May 7, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29729771/in-harm-s-way-unintentional-firearm-injuries-in-young-children
#11
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Brian Kenney
PURPOSE: Firearm-related trauma represents a major source of preventable injury and death. Many firearm injuries in young children are unintentional, and the true incidence may be underestimated. We sought to characterize the morbidity of unintentional firearm injuries. METHODS: National Trauma Data Bank data from 2007 to 2014 was obtained for patients aged 0-14 sustaining gunshot wounds (GSW). We analyzed demographics, injury severity score, hospital and ICU length of stay (LOS), ventilator days, discharge to rehab, and mortality...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29723025/gender-differences-in-associations-between-dsm-5-posttraumatic-stress-disorder-symptom-clusters-and-functional-impairment-in-war-veterans
#12
Eric C Meyer, Brian Konecky, Nathan A Kimbrel, Bryann B DeBeer, Brian P Marx, Jeremiah Schumm, Walter E Penk, Suzy Bird Gulliver, Sandra B Morissette
Understanding the links between posttraumatic stress disorder (PTSD) symptoms and functional impairment is essential for assisting veterans in transitioning to civilian life. Moreover, there may be differences between men and women in the relationships between PTSD symptoms and functional impairment. However, no prior studies have examined the links between functional impairment and the revised symptom clusters as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5; American Psychiatric Association, 2013) or whether the associations between PTSD symptom clusters and functional impairment differ by gender...
May 2018: Psychological Services
https://www.readbyqxmd.com/read/29719851/an-unforeseeable-complication-posterior-ischemic-optic-neuropathy-after-penetrating-injury-to-the-heart
#13
Joseph J Eid, Brian C Cronin, Susan Seman
Trauma surgeons are currently encountering unusual adverse events after traumatic injuries. Ischemic optic neuropathy is a rare complication that may occur in trauma and burn patients that present in extremis and require massive resuscitation. A 29-year-old male patient sustains a penetrating injury to the heart that required primary repair. He remained hemodynamically stable and required a limited amount of resuscitative fluids and products. Postoperatively, the patient develops acute painless bilateral loss of vision...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29712534/a-scoping-review-on-health-economics-in-neurosurgery-for-acute-spine-trauma
#14
Brian C F Chan, B Catharine Craven, Julio C Furlan
OBJECTIVE Acute spine trauma (AST) has a relatively low incidence, but it often results in substantial individual impairments and societal economic burden resulting from the associated disability. Given the key role of neurosurgeons in the decision-making regarding operative management of individuals with AST, the authors performed a systematic search with scoping synthesis of relevant literature to review current knowledge regarding the economic burden of AST. METHODS This systematic review with scoping synthesis included original articles reporting cost-effectiveness, cost-utility, cost-benefit, cost-minimization, cost-comparison, and economic analyses related to surgical management of AST, whereby AST is defined as trauma to the spine that may result in spinal cord injury with motor, sensory, and/or autonomic impairment...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29710329/chronic-meningitis-investigated-via-metagenomic-next-generation-sequencing
#15
Michael R Wilson, Brian D O'Donovan, Jeffrey M Gelfand, Hannah A Sample, Felicia C Chow, John P Betjemann, Maulik P Shah, Megan B Richie, Mark P Gorman, Rula A Hajj-Ali, Leonard H Calabrese, Kelsey C Zorn, Eric D Chow, John E Greenlee, Jonathan H Blum, Gary Green, Lillian M Khan, Debarko Banerji, Charles Langelier, Chloe Bryson-Cahn, Whitney Harrington, Jairam R Lingappa, Niraj M Shanbhag, Ari J Green, Bruce J Brew, Ariane Soldatos, Luke Strnad, Sarah B Doernberg, Cheryl A Jay, Vanja Douglas, S Andrew Josephson, Joseph L DeRisi
Importance: Identifying infectious causes of subacute or chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed. Objective: To present a case series of patients with diagnostically challenging subacute or chronic meningitis using metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) supported by a statistical framework generated from mNGS of control samples from the environment and from patients who were noninfectious...
April 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29681707/pediatric-proximal-femur-fractures
#16
REVIEW
Brian L Dial, Robert K Lark
Pediatric proximal femur fractures are rare injuries resulting from high-energy trauma. The Delbet classification is used when describing these injuries, and associates fracture type to the development of avascular necrosis. Historically, casting was utilized in the treatment of these injuries, but high complication rates following this approach have changed the treatment modality to early and anatomic fixation. Complications associated with these injuries including avascular necrosis, non-union, coxa-vara, and premature physeal fusion...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29672440/the-epidemiology-of-emergency-department-thoracotomy-in-a-statewide-trauma-system-does-center-volume-matter
#17
Ryan P Dumas, Mark J Seamon, Brian P Smith, Wei Yang, Jeremy W Cannon, C William Schwab, Patrick M Reilly, Daniel N Holena
INTRODUCTION: The relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions...
April 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29667171/mental-health-service-utilization-before-and-after-receipt-of-a-service-connected-disability-award-for-ptsd-findings-from-a-national-sample
#18
Rebecca K Sripada, Claire M Hannemann, Paula P Schnurr, Brian P Marx, Stacey J Pollack, John F McCarthy
OBJECTIVE: To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). DATA SOURCES: A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). STUDY DESIGN: We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership...
April 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29666739/prosopagnosia-as-a-type-of-conversion-disorder
#19
Clodagh Power, Oisin Hannigan, Robert Coen, Irene Bruce, Matthew Gibb, Marie McCarthy, David Robinson, Brian A Lawlor
Background: Conversion disorder is a common and debilitating condition that remains poorly understood. We present a previously undescribed form of conversion disorder to highlight the complexity of the condition and consider the interplay of factors that produce conversion symptoms. Case: A 50-year-old male presented with acquired prosopagnosia and language impairment. Neuropsychological testing indicated right temporal lobe dysfunction. Extensive work-up outruled an organic aetiology...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29659106/individual-treatment-selection-for-patients-with-posttraumatic-stress-disorder
#20
Anne-Katharina Deisenhofer, Jaime Delgadillo, Julian A Rubel, Jan R Böhnke, Dirk Zimmermann, Brian Schwartz, Wolfgang Lutz
BACKGROUND: Trauma-focused cognitive behavioral therapy (Tf-CBT) and eye movement desensitization and reprocessing (EMDR) are two highly effective treatment options for posttraumatic stress disorder (PTSD). Yet, on an individual level, PTSD patients vary substantially in treatment response. The aim of the paper is to test the application of a treatment selection method based on a personalized advantage index (PAI). METHOD: The study used clinical data for patients accessing treatment for PTSD in a primary care mental health service in the north of England...
April 16, 2018: Depression and Anxiety
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