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https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#1
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29298242/contemporary-management-of-high-grade-renal-trauma-results-from-the-american-association-for-the-surgery-of-trauma-aast-genitourinary-trauma-study
#2
Sorena Keihani, Yizhe Xu, Angela P Presson, James M Hotaling, Raminder Nirula, Joshua Piotrowski, Christopher M Dodgion, Cullen M Black, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Brian P Smith, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Peter B Thomsen, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brandi Miller, Richard A Santucci, Matthew M Carrick, Timothy Hewitt, Frank N Burks, Jurek F Kocik, Reza Askari, Jeremy B Myers
BACKGROUND: The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted towards a non-operative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. METHODS: From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma [AAST] grades III-V) were collected from 14 participating Level-1 trauma centers...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283969/development-of-a-trauma-system-and-optimal-placement-of-trauma-centers-using-geospatial-mapping
#3
Michael A Horst, Shreya Jammula, Brian W Gross, Eric H Bradburn, Alan D Cook, Juliet Altenburg, Madison Morgan, Danielle Von Nieda, Frederick B Rogers
BACKGROUND: The care of patients at individual trauma centers (TCs) has been carefully optimized, but not the placement of TCs within the trauma systems. We sought to objectively determine the optimal placement of trauma centers in Pennsylvania using geospatial mapping. METHODS: We used the Pennsylvania Trauma Systems Foundation (PTSF) and Pennsylvania Health Care Cost Containment Council (PHC4) registries for adult (age ≥15) trauma between 2003-2015 (n=377,540 and n=255,263)...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283966/under-triage-in-trauma-does-an-organized-trauma-network-capture-the-major-trauma-victim-a-statewide-analysis
#4
Michael A Horst, Shreya Jammula, Brian W Gross, Alan D Cook, Eric H Bradburn, Juliet Altenburg, Danielle Von Nieda, Madison Morgan, Frederick B Rogers
BACKGROUND: Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-trauma centers (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29259248/aav-vector-meditated-expression-of-hla-g-reduces-injury-induced-corneal-vascularization-immune-cell-infiltration-and-fibrosis
#5
Matthew L Hirsch, Laura M Conatser, Sara M Smith, Jacklyn H Salmon, Jerry Wu, Nicholas E Buglak, Rich Davis, Brian C Gilger
Over 1.5 million individuals suffer from cornea vascularization due to genetic and/or environmental factors, compromising visual acuity and often resulting in blindness. Current treatments of corneal vascularization are limited in efficacy and elicit undesirable effects including, ironically, vision loss. To develop a safe and effective therapy for corneal vascularization, adeno-associated virus (AAV) gene therapy, exploiting a natural immune tolerance mechanism induced by human leukocyte antigen G (HLA-G), was investigated...
December 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29251706/valproic-acid-induces-pro-survival-transcriptomic-changes-in-swine-subjected-to-traumatic-injury-and-hemorrhagic-shock
#6
Patrick E Georgoff, Vahagn C Nikolian, Gerald Higgins, Kiril Chtraklin, Hassan Eidy, Mohamed H Ghandour, Aaron Williams, Brian Athey, Hasan B Alam
BACKGROUND: Valproic acid (VPA) is a histone deacetylase inhibitor that improves outcomes in large animal models of trauma. However, its protective mechanism of action is not completely understood. We sought to characterize the genetic changes induced by VPA treatment following traumatic injuries. METHODS: Six female Yorkshire swine were subjected to traumatic brain injury (TBI, controlled cortical impact), polytrauma (liver and splenic laceration, rib fracture, rectus crush), and hemorrhagic shock (HS, 40% total blood volume)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#7
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29250339/does-duration-of-symptoms-affect-clinical-outcome-after-hip-arthroscopy-for-labral-tears-analysis-of-prospectively-collected-outcomes-with-minimum-2-year-follow-up
#8
Brian D Dierckman, Jake Ni, Eric A Hohn, Benjamin G Domb
Limited research exists on the possible association between duration of symptoms and clinical outcomes following hip arthroscopy for labral tears. The purpose of this study was to evaluate whether duration of symptoms affected clinical and patient-reported outcome (PRO) scores following hip arthroscopy for labral tears. From 2008 to 2011, data were collected prospectively on all patients undergoing primary hip arthroscopy for labral tears. Workers' compensation cases, dysplasia cases and patients with previous ipsilateral hip surgeries were excluded...
December 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/29239798/retrobulbar-hematoma-a-systematic-review-of-factors-related-to-outcomes
#9
Brian Christie, Lisa Block, Yue Ma, Alexandra Wick, Ahmed Afifi
INTRODUCTION: Retrobulbar hematoma (RBH), a rare but serious condition, can result in permanent vision loss. Although it is a known complication following trauma or facial fracture reduction, sinus surgery, or blepharoplasty, factors related to patient outcomes are not well-defined. A systematic review was performed to determine the relation of patient/treatment factors to outcomes. METHODS: Articles retrieved from a PubMed search (1989-2017) were reviewed. Demographic information, etiology, symptoms, and final vision outcomes were analyzed using Fisher's exact tests, single and multiple predictor logistic regression...
November 24, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29226380/acute-severe-mitral-regurgitation-after-blunt-chest-trauma
#10
Petar Saric, Benjamin D Ravaee, Toral R Patel, Brian D Hoit
Myocardial contusion and aortic injury are well-known cardiac complications of blunt chest trauma, but valvular injury is rare. Traumatic valve injuries most commonly involve the aortic valve, with isolated mitral valve injury being quite rare. We report a case of acute severe mitral regurgitation due to ruptured chordae tendineae requiring surgical repair following a motor vehicle accident.
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29215498/postoperative-deep-vein-thrombosis-pulmonary-embolism-and-myocardial-infarction-complications-after-therapeutic-anticoagulation-in-the-patient-with-spine-trauma
#11
Brian Shiu, Elizabeth Le, Ehsan Jazini, Tristan B Weir, Timothy Costales, Nicholas Caffes, Ebrahim Paryavi, Nathan O'Hara, Daniel E Gelb, Eugene Y Koh, Steven C Ludwig
STUDY DESIGN: A retrospective review (2001-2014) was conducted using prospectively collected data at a level I trauma center. OBJECTIVE: We sought to determine the incidence and characteristics of complications occurring secondary to therapeutic anticoagulation in adult spine trauma patients. SUMMARY OF BACKGROUND DATA: Numerous studies have assessed prophylactic anticoagulation after spine surgery, but none has investigated the risks of therapeutic doses of anticoagulation for treatment of postoperative thromboembolic events...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29195236/management-of-malocclusion-after-maxillofacial-trauma
#12
Ashish P Sharma, Brian Hondorp, Andrey Gaiduchik, Nadim Z Baba, Jayini Thakker, Jared C Inman
No abstract text is available yet for this article.
December 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/29194491/healthcare-providers-perceptions-of-a-situational-awareness-display-for-emergency-department-resuscitation-a-simulation-qualitative-study
#13
Lisa A Calder, Abhi Bhandari, George Mastoras, Kathleen Day, Kathryn Momtahan, Matthew Falconer, Brian Weitzman, Benjamin Sohmer, A Adam Cwinn, Stanley J Hamstra, Avi Parush
Importance: Emergency resuscitation of critically ill patients can challenge team communication and situational awareness. Tools facilitating team performance may enhance patient safety. Objectives: To determine resuscitation team members' perceptions of the Situational Awareness Display's utility. Design: We conducted focus groups with healthcare providers during Situational Awareness Display development. After simulations assessing the display, we conducted debriefs with participants...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29194317/gut-epithelial-cell-derived-exosomes-trigger-post-trauma-immune-dysfunction
#14
Mitsuaki Kojima, Todd W Costantini, Brian P Eliceiri, Theresa W Chan, Andrew Baird, Raul Coimbra
INTRODUCTION: Exosomes are extracellular vesicles that act as endogenous mediators of the immune response. We have previously shown that exosomes released into mesenteric lymph (ML) following trauma/hemorrhagic shock (T/HS) induce pro-inflammatory cytokine production in macrophages and are involved in the pathogenesis of post-shock acute lung injury. However, the cellular origin of ML exosomes and their role in the post-trauma immune response remains unclear. We hypothesized that exosomes released from damaged-intestinal epithelial cells (IECs) contribute to post-trauma immune dysfunction by altering the function of dendritic cells (DCs), key regulators of the adaptive immunity...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29194314/preliminary-results-of-a-novel-hay-hole-fall-prevention-initiative
#15
Erich K Batra, Brian W Gross, Shreya Jammula, Eric H Bradburn, Ronald D Baier, Michael J Reihart, Dennis Murphy, Kay Moyer, Joseph Hess, Susan Lackmann, Jo Ann Miller
BACKGROUND: Hay-hole falls are a prevalent source of trauma among Anabaptists-particularly Anabaptist youth. We sought to decrease hay-hole falls in South Central Pennsylvania through the development and distribution of all-weather hay-hole covers to members of the at-risk Anabaptist community. METHODS: Following the creation of a rural trauma prevention syndicate, hay-hole cover prototypes co-designed and endorsed by the Pennsylvania Amish Safety Committee (PASC) were developed and distributed throughout South Central Pennsylvania...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29191099/an-assessment-of-frailty-as-a-tool-for-risk-stratification-in-adult-spinal-deformity-surgery
#16
Emily K Miller, Brian J Neuman, Amit Jain, Alan H Daniels, Tamir Ailon, Daniel M Sciubba, Khaled M Kebaish, Virginie Lafage, Justin K Scheer, Justin S Smith, Shay Bess, Christopher I Shaffrey, Christopher P Ames
OBJECTIVE The goal of this study was to analyze the value of an adult spinal deformity frailty index (ASD-FI) in preoperative risk stratification. Preoperative risk assessment is imperative before procedures known to have high complication rates, such as ASD surgery. Frailty has been associated with risk of complications in trauma surgery, and preoperative frailty assessments could improve the accuracy of risk stratification by providing a comprehensive analysis of patient factors that contribute to an increased risk of complications...
December 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29186416/a-randomized-dose-ranging-study-of-neuropeptide-y-in-patients-with-posttraumatic-stress-disorder
#17
Sehrish Sayed, Nicholas T Van Dam, Sarah R Horn, Marin M Kautz, Michael Parides, Sara Costi, Katherine A Collins, Brian Iacoviello, Dan V Iosifescu, Aleksander A Mathé, Steven M Southwick, Adriana Feder, Dennis S Charney, James W Murrough
Background: Anxiety and trauma-related disorders are among the most prevalent and disabling medical conditions in the U.S., and posttraumatic stress disorder (PTSD) in particular exacts a tremendous public health toll. We examined the tolerability and anxiolytic efficacy of neuropeptide Y (NPY) administered via an intranasal route in patients with PTSD. Methods: Twenty-six individuals were randomized in a cross-over, single ascending dose study into one of five cohorts: 1...
November 23, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29183536/a-preliminary-analysis-of-compassion-fatigue-in-a-surgeon-population-are-female-surgeons-at-heightened-risk
#18
COMPARATIVE STUDY
Daniel Wu, Brian Gross, Katelyn Rittenhouse, Carissa Harnish, Claire Mooney, Frederick B Rogers
Compassion fatigue (CF), a state of physical/emotional distress caused by repeatedly caring for those experiencing traumatic episodes, is a prevalent issue for today's healthcare provider. We sought to characterize levels of CF within a surgeon population, particularly comparing trauma surgery with other surgical specialties. A survey containing the Professional Quality of Life Scale (ProQOL), a validated tool assessing compassion satisfaction (CS), CF, and burnout (BO) was distributed via electronic newsletter to members of the American College of Surgeons...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29183526/do-transferred-patients-increase-the-risk-of-venous-thromboembolism-in-trauma-centers
#19
Brian K Yorkgitis, Olubode A Olufajo, David Metcalfe, Gally Reznor, Joaquim M Havens, Zara Cooper, Ali Salim
Trauma patients often require initial stabilization followed by transfer for ongoing trauma care. Thus, the administration of VTE prophylaxis is often delayed until admission to the receiving hospital. It is unclear if transfer status is a risk factor for VTE. The National Trauma Database v6.2 was used to identify patients admitted to Level I and II trauma centers. Exclusions included patients on anticoagulation, <18 years, known VTE before trauma, or pregnant. Patients transferred were compared with nontransferred patients...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29174671/human-igf-i-propeptide-a-promotes-articular-chondrocyte-biosynthesis-and-employs-glycosylation-dependent-heparin-binding
#20
Shuiliang Shi, Brian J Kelly, Congrong Wang, Ken Klingler, Albert Chan, George J Eckert, Stephen B Trippel
BACKGROUND: Insulin-like growth factor I (IGF-I) is a key regulator of chondrogenesis, but its therapeutic application to articular cartilage damage is limited by rapid elimination from the repair site. The human IGF-I gene gives rise to three IGF-I propeptides (proIGF-IA, proIGF-IB and proIGF-IC) that are cleaved to create mature IGF-I. In this study, we elucidate the processing of IGF-I precursors by articular chondrocytes, and test the hypotheses that proIGF-I isoforms bind to heparin and regulate articular chondrocyte biosynthesis...
November 21, 2017: Biochimica et Biophysica Acta
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