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https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#1
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28102533/hospital-incident-command-first-responders-or-receiving-centers
#2
Brian Fletcher, Amanda Knight, Brandy Pockrus, Matthew J Wain, Kathy Lehman-Huskamp
OBJECTIVES: (1) Propose a conceptual model of an alternative hospital incident management system (HIMS) that integrates concepts used by emergency operations centers (EOCs). (2) Compare HIMS to the standard hospital incident command system (HICS) model. DESIGN: A quasi-experimental study was performed. Two identical tabletop incident scenarios were presented, one utilizing HICS and one using HIMS. Participants completed postexercise surveys for each tabletop. Surveys contained both knowledge and satisfaction questions...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28099379/systemic-intraoperative-anticoagulation-during-arterial-injury-repair-implications-for-patency-and-bleeding
#3
Zoё Maher, Brian Frank, Noelle Saillant, Anna Goldenberg, Elizabeth Dauer, Joshua P Hazelton, Andrea Lubitz, Huaqing Zhao, Jeremy W Cannon, Mark J Seamon
BACKGROUND: The role of systemic intraoperative anticoagulation (SIAC) during surgical repair of major arterial injuries is controversial. Any potential improvement in arterial patency must be weighed against the risk of hemorrhage in these critically injured patients. We hypothesized that SIAC would increase arterial patency without increasing bleeding complications. METHODS: We conducted a multi-institution, retrospective cohort study of trauma patients with major vascular injury from 2005-2013 in 3 level I centers...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28088301/methocarbamol-use-is-associated-with-decreased-hospital-length-of-stay-in-trauma-patients-with-closed-rib-fractures
#4
Asad E Patanwala, Ohoud Aljuhani, Brian J Kopp, Brian L Erstad
BACKGROUND: The objective of this study was to evaluate the effect of methocarbamol on hospital length of stay in patients with closed rib fracture injuries. METHODS: This was a retrospective cohort study conducted in an academic medical center in the United States. Adult trauma patients, who sustained closed rib fractures, were included. Patients were categorized based on whether they received methocarbamol or not during admission. The primary outcome of interest was time to hospital discharge in days (i...
January 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28087346/patterns-of-retinal-hemorrhage-associated-with-pediatric-cerebral-sinovenous-thrombosis
#5
Gil Binenbaum, Julia E Reid, David L Rogers, Anne Jensen, Lori L Billinghurst, Brian J Forbes
BACKGROUND: Cerebral sinovenous thrombosis (CSVT) has been proposed as an alternative cause of retinal hemorrhage (RH) in children being evaluated for abusive head trauma. This study investigated the prevalence and characteristics of RH in children with CSVT. METHODS: The medical records of children >6 weeks of age with newly diagnosed CSVT and fundus examination by an ophthalmologist were examined retrospectively. Primary outcomes were presence and patterns of RH...
January 10, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#6
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28072503/posttraumatic-stress-disorder-symptoms-and-cognitive-function-in-a-large-cohort-of-middle-aged-women
#7
Jennifer A Sumner, Kaitlin Hagan, Fran Grodstein, Andrea L Roberts, Brian Harel, Karestan C Koenen
BACKGROUND: Posttraumatic stress disorder (PTSD) has been linked to cognitive decline, but research in women is generally lacking. We examined whether trauma and elevated PTSD symptoms were associated with worse cognitive function in middle-aged civilian women. A secondary objective was to investigate the possible role of depression in the relation of PTSD symptoms to cognitive function. METHODS: The sample comprised 14,029 middle-aged women in the Nurses' Health Study II...
January 10, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28062099/the-trauma-registry-compared-to-all-patient-refined-diagnosis-groups-apr-drg
#8
Jodi Hackworth, Johanna Askegard-Giesmann, Thomas Rouse, Brian Benneyworth
BACKGROUND: Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. METHODS: Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children's hospital...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#9
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28039008/risk-factors-for-severe-complications-of-operative-mandibular-fractures
#10
Brian J Christensen, Donald E Mercante, John P Neary, Brett J King
PURPOSE: The purpose of the present study was to identify the risk factors for major complications developing during the operative treatment of mandibular fractures. PATIENTS AND METHODS: We conducted a retrospective medical record review of patients who had undergone open reduction, internal fixation of mandibular fractures from August 1, 2012 to December 31, 2014 at a large, urban teaching hospital and level 1 trauma center. The outcome variable of interest was major complications, defined as the occurrence of any one of the following events: hospital readmission, return to the operating room, and a prolonged, unexpected postoperative stay...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28033139/air-medical-administration-of-tranexamic-acid
#11
Brian Cornelius
Traumatic injury is a significant cause of morbidity and mortality in the United States. Massive hemorrhage is responsible for the vast majority of deaths. Evolution in trauma treatment has resulted in major improvements to emergency care. Tranexamic acid (TXA), an antifibrinolytic agent, is synthetically derived from amino acids. The CRASH-2 study demonstrated that the early administration of TXA results in significant decreases in morbidity and mortality. Experiences by coalition forces in Southwest Asia found a substantial increase in survival of trauma patients with early TXA administration...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28033135/omega-3-fatty-acid-supplementation-and-warfarin-a-lethal-combination-in-traumatic-brain-injury
#12
Brian W Gross, Maria Gillio, Cole D Rinehart, Caitlin A Lynch, Frederick B Rogers
Polyunsaturated fatty acids such as omega-3 eicosapentaenoic acid and omega-6 docosahexaenoic acid, found in over-the-counter fish oil supplements, are often consumed for their beneficial, prophylactic, anti-inflammatory effects. Although the mechanisms of action are not fully known, a diet rich in polyunsaturated fats may reduce the risk of hyperlipidemia, atherosclerosis, high low-density lipoprotein cholesterol levels, hypertension, and inflammatory diseases. Masked by its many benefits, the risks of omega-3 fatty acid supplementation are often underappreciated, particularly its ability to inhibit platelet aggregation and promote bleeding in patients taking anticoagulant medications...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28030496/temporary-arterial-shunts-in-damage-control-experience-and-outcomes
#13
Sarah Matthew, Brian P Smith, Jeremy W Cannon, Patrick M Reilly, C William Schwab, Mark J Seamon
BACKGROUND: Arterial shunting is a well-described method to control hemorrhage and rapidly re-establish flow, but optimal shunt dwell times remain controversial. We hypothesized that prolonged shunt dwell times of >6 hours are related to adverse outcomes after major arterial injury. METHODS: A review (2005-2013) of all patients with arterial shunts placed after traumatic injury at our urban Level-I trauma center was undertaken. Patients who expired prior to shunt removal (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28018427/successful-nonoperative-management-of-high-grade-blunt-renal-injuries
#14
Allison M May, Oussama Darwish, Brian Dang, John J Monda, Prajakta Adsul, Johar Syed, Sameer A Siddiqui
Current management of high-grade blunt renal trauma favors a nonoperative approach when possible. We performed a retrospective study of high grade blunt renal injuries at our level I trauma center to determine the indications and success of nonoperative management (NOM). 47 patients with blunt grade IV or V injuries were identified between October 2004 and December 2013. Immediate operative patients (IO) were compared to nonoperatively managed (NOM). Of the 47 patients, 3 (6.4%) were IO and 44 (95.6%) NOM. IO patients had a higher heart rate on admission, 133 versus 100 in NOM (P = 0...
2016: Advances in Urology
https://www.readbyqxmd.com/read/27990119/oral-administration-of-sitagliptin-activates-creb-and-is-neuroprotective-in-murine-model-of-brain-trauma
#15
Brian DellaValle, Gitte S Brix, Birgitte Brock, Michael Gejl, Jørgen Rungby, Agnete Larsen
Introduction: Traumatic brain injury is a major cause of mortality and morbidity. We have previously shown that the injectable glucagon-like peptide-1 (GLP-1) analog, liraglutide, significantly improved the outcome in mice after severe traumatic brain injury (TBI). In this study we are interested in the effects of oral treatment of a different class of GLP-1 based therapy, dipeptidyl peptidase IV (DPP-IV) inhibition on mice after TBI. DPP-IV inhibitors reduce the degradation of endogenous GLP-1 and extend circulation of this protective peptide in the bloodstream...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27989140/enolate-forming-compounds-as-a-novel-approach-to-cytoprotection
#16
Richard M LoPachin, Brian C Geohagen, Lars Ulrik Nordstrøm, Terrence Gavin
Evidence from laboratory studies and clinical trials suggests that plant-derived polyphenolic compounds such as curcumin, resveratrol, or phloretin might be useful in the treatment of certain diseases (e.g., Alzheimer's disease) and acute tissue injury states (e.g., spinal cord trauma). However, despite this potential, the corresponding chemical instability, toxic potential, and low bioavailability of these compounds could limit their ultimate clinical relevance. We have shown that pharmacophores of curcumin (e...
December 19, 2016: Chemical Research in Toxicology
https://www.readbyqxmd.com/read/27974867/elevated-admission-base-deficit-is-associated-with-a-complex-dynamic-network-of-systemic-inflammation-which-drives-clinical-trajectories-in-blunt-trauma-patients
#17
Othman Abdul-Malak, Yoram Vodovotz, Akram Zaaqoq, Jesse Guardado, Khalid Almahmoud, Jinling Yin, Brian Zuckerbraun, Andrew B Peitzman, Jason Sperry, Timothy R Billiar, Rami A Namas
We hypothesized that elevated base deficit (BD) ≥ 4 mEq/L upon admission could be associated with an altered inflammatory response, which in turn may impact differential clinical trajectories. Using clinical and biobank data from 472 blunt trauma survivors, 154 patients were identified after excluding patients who received prehospital IV fluids or had alcohol intoxication. From this subcohort, 84 patients had a BD ≥ 4 mEq/L and 70 patients with BD < 4 mEq/L. Three samples within the first 24 h were obtained from all patients and then daily up to day 7 after injury...
2016: Mediators of Inflammation
https://www.readbyqxmd.com/read/27940901/structured-trauma-focused-cbt-and-unstructured-play-experiential-techniques-in-the-treatment-of-sexually-abused-children-a-field-study-with-practicing-clinicians
#18
Brian Allen, Natalie Armstrong Hoskowitz
Structured, trauma-focused cognitive-behavioral therapy (CBT) techniques are widely considered an effective intervention for children who experienced sexual abuse. However, unstructured (i.e., nondirective) play/experiential techniques have a longer history of widespread promotion and are preferred by many practicing clinicians. No evidence is available, however, to determine how the integration of these techniques impacts treatment outcome. In this study, community-based clinicians who received training in a structured, trauma-focused cognitive-behavioral intervention administered pretreatment and posttreatment evaluations to 260 sexually abused children presenting with elevated posttraumatic stress...
December 9, 2016: Child Maltreatment
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
#19
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/27916579/distal-patellar-tendon-avulsion-in-association-with-high-energy-knee-trauma-a-case-series-and-review-of-the-literature
#20
Brian Capogna, Eric Strauss, Sanjit Konda, Alan Dayan, Michael Alaia
BACKGROUND: Patellar tendon rupture is rare in the general population. Typically, failure occurs proximally or at the mid-substance. Distal avulsion from the tibial tubercle in adults is rare and not well described in the orthopedic literature. METHODS: We present the largest series of patients with distal patellar tendon injury with associated multi-ligamentous disruption of the knee. A series of six patients with distal patellar tendon avulsion were identified at a single institution...
December 1, 2016: Knee
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