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https://www.readbyqxmd.com/read/29140953/contemporary-management-of-rectal-injuries-at-level-i-trauma-centers-the-results-of-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#1
Carlos V R Brown, Pedro G Teixeira, Elisa Furay, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael S Truitt, Clay C Burlew, Morgan Schellenberg, Jack Sava, John VanHorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercruysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
INTRODUCTION: Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and pre-sacral drainage in the management of extraperitoneal injuries are not beneficial. METHODS: This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004-2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140560/negative-posttrauma-cognitions-mediate-the-association-between-morally-injurious-events-and-trauma-related-psychopathology-in-treatment-seeking-veterans
#2
Philip Held, Brian J Klassen, Denise S Zou, Blake S Schroedter, Niranjan S Karnik, Mark H Pollack, Alyson K Zalta
Exposure to potentially morally injurious events has been shown to be associated with posttraumatic stress disorder (PTSD) and depression symptoms in military personnel. Few studies have examined factors that help to explain how potentially morally injurious events may contribute to the development of trauma-related psychopathology. Negative posttrauma cognitions are thought to play a role in the etiology of PTSD and depression following trauma; however, it is unclear whether more global beliefs about the self, others, and world play a role in the development of PTSD and depression due to morally injurious events...
November 15, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#3
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29132578/major-trauma-outside-a-trauma-center-prehospital-emergency-department-and-retrieval-considerations
#4
REVIEW
Preston J Fedor, Brian Burns, Michael Lauria, Clare Richmond
Care of the critically injured begins well before the patient arrives at a large academic trauma center. It is important to understand the continuum of care from the point of injury in the prehospital environment, through the local hospital and retrieval, until arrival at a trauma center capable of definitive care. This article highlights the important aspects of trauma assessment and management outside of tertiary or quaternary care hospitals. Key elements of each phase of care are reviewed, including management pearls and institutional strategies to facilitate effective and efficient treatment of trauma patients from the point of injury forward...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29130872/a-retrospective-comparative-analysis-of-the-use-of-implantable-bone-stimulators-in-nonunions
#5
J Ryan Martin, George Vestermark, Brian Mullis, Jeffrey Anglen
This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29117058/the-effect-of-time-to-international-normalized-ratio-reversal-on-intracranial-hemorrhage-evolution-in-patients-with-traumatic-brain-injury
#6
Hans Andrews, Katelyn Rittenhouse, Brian Gross, Frederick B Rogers
The incidence of geriatric traumatic brain injury (TBI) is increasing throughout the United States, with many of these patients taking anticoagulation (AC) medication. The purpose of this investigation was to determine the effect of time to international normalized ratio (INR) reversal on intracranial hemorrhage evolution in TBI patients taking prehospital AC medication. We hypothesized that rapid reversal of INR improves outcomes of head-injured patients taking AC medication. Admissions to a Level II trauma center between February 2011 and December 2013 were reviewed...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29117051/analysis-of-patient-follow-up-at-a-level-i-trauma-center-in-ohio
#7
Brian Fletcher, Tami Meyers, Michelle Guilliams, Teresa Poliseno, Josh Burton, Michael Lieber, Ed Buggie, M Shay OʼMara
Trauma patients report being unprepared for hospital discharge. The purpose of this study was to identify follow-up compliance rates at our trauma clinic and identify factors associated with trauma patients' adherence to follow-up appointment. We recruited patients 15 years and older who were discharged from the trauma service between December 2014 and August 2015. Demographic information and injury-related variables were obtained from the trauma registry for patients who attended their follow-up and those who did not attend...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29108845/validation-of-the-age-adjusted-shock-index-using-pediatric-trauma-quality-improvement-program-data
#8
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Shannon Acker, Denis Bensard, Brian Kenney
PURPOSE: In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. METHODS: We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29090266/a-cross-sectional-survey-of-anaesthesia-related-expectations-amongst-patients-awaiting-upper-limb-trauma-surgery
#9
Brian Declan O'Donnell, Gabriella Iohom
BACKGROUND AND AIMS: Little is known regarding patients' anaesthesia-related expectations when presenting for upper limb trauma surgery. METHODS: We conducted a prospective cross-sectional survey exploring prior anaesthetic experience, anaesthesia-related knowledge, anaesthesia expectations, the preoperative visit and factors likely to influence anaesthesia choice. The survey was completed by 192 patients. RESULTS: Anaesthetists were identified as doctors by 52%; 53% were unaware of their planned anaesthesia; 58% indicated likely acceptance of regional anaesthesia...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29082055/quadriceps-tendon-rupture-in-an-adolescent-athlete
#10
William A Zuke, Beatrice Go, Alexander E Weber, Brian Forsythe
Quadriceps tendon rupture is an uncommon injury that usually occurs in middle-aged and elderly men with a history of chronic illnesses. We report the case of a 17-year-old healthy adolescent male baseball player who sustained this injury as a result of sudden deceleration in his left knee. He initially reported to the emergency department and then presented to our practice, where he was diagnosed with a quadriceps tendon tear. Preoperatively, he was unable to perform a single straight-leg raise. During surgical repair, the free edge of the quadriceps tendon was mobilized and anchored into the superior pole of the patella, followed by sutures to ensure reinforcement of the quadriceps footprint...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29065041/publication-rate-of-podium-presentations-at-the-orthopaedic-trauma-association-annual-meetings-2008-2012
#11
Benjamin R Williams, Lauren M MacCormick, Dylan L McCreary, Anthonly J Dugarte, Brian P Cunningham
OBJECTIVE: To determine journal publication rates of podium presentations from the OTA Annual Meetings between 2008 and 2012. METHODS: Podium presentations from the 2008 to 2012 OTA annual meeting were compiled from the Annual Meeting archives. During December 2016, PubMed searches were performed using individual keywords in the abstract title and content. The results were reviewed for matches to the meeting abstracts with regards to title, authors, and abstract content...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29050687/comparison-of-adverse-events-and-postoperative-mobilization-following-knee-extensor-mechanism-rupture-repair-a-systematic-review-and-network-meta-analysis
#12
Joseph Serino, Amin Mohamadi, Sebastian Orman, Brian McCormick, Philip Hanna, Michael J Weaver, Mitchel B Harris, Ara Nazarian, Arvind von Keudell
BACKGROUND: Extensor mechanism rupture (EMR) of the knee is a rare but potentially debilitating injury that often occurs due to trauma. While a wide variety of surgical treatments have been reported, there is currently no consensus on the most successful treatment method. The timing of post-operative joint mobilization is also critical for successful recovery after EMR repair. Despite the traditional method of complete immobilization for 6 weeks, there is an increasing trend towards early post-operative knee mobilization...
October 16, 2017: Injury
https://www.readbyqxmd.com/read/29029779/redefining-the-abdominal-seatbelt-sign-enhanced-ct-imaging-metrics-improve-injury-prediction
#13
Michael C Johnson, Brian J Eastridge
INTRODUCTION: The abdominal seatbelt sign (ASBS) has an established association with abdominal injury, yet its definition remains ill-defined. We hypothesize specific imaging characteristics associated with the ASBS such as location above the pelvic brim and depth of abdominal wall contusion would better predict underlying injury and need for operative intervention. METHODS: We performed a retrospective chart review of subjects suffering from restrained motor vehicle collisions (MVC) evaluated at a level one trauma facility from 2010 to 2015...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29019796/monitoring-modalities-and-assessment-of-fluid-status-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-east
#14
David S Plurad, William Chiu, Ali S Raja, Samuel M Galvagno, Uzer Khan, Dennis Y Kim, Samuel A Tisherman, Jeremy Ward, Mark E Hamill, Vicki Bennett, Brian Williams, Bryce Robinson
BACKGROUND: Fluid administration in critically ill surgical patients must be closely monitored to avoid complications. Resuscitation guided by invasive methods are not consistently associated with improved outcomes. As such, there has been increased use of Focused Ultrasound and Arterial Pulse Waveform Analysis (APWA) to monitor and aid resuscitation. An assessment of these methods using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework is presented...
October 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28982020/streptococcus-phocae-in-marine-mammals-of-northeastern-pacific-and-arctic-canada-a-retrospective-analysis-of-85-postmortem-investigations
#15
Nicole D Taurisano, Brian P Butler, Diana Stone, Harry Hariharan, Paul J Fields, Hugh W Ferguson, Martin Haulena, Paul Cotrell, Ole Nielsen, Stephen Raverty
Streptococcus phocae is a pathogen of marine mammals, although its pathogenicity remains poorly understood. Recovery of this bacterium from asymptomatic carriers suggests that it is an opportunistic pathogen. We investigated the role of S. phocae in naturally occurring disease and its significance as a pathogen based on postmortem investigations. Between 2007 and 2012, 1,696 whole carcasses, tissue samples, or both were submitted from the northeastern Pacific and Arctic Canada for diagnostic testing. Streptococcus phocae was cultured from phocids (n=66), otariids (n=12), harbor porpoises (Phocoena phocoena; n=5), and sea otters (Enhydra lutris; n=2)...
October 5, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28981324/detailed-analysis-of-insulin-absorption-variability-and-the-tissue-response-to-continuous-subcutaneous-insulin-infusion-catheter-implantation-in-swine
#16
Jasmin R Hauzenberger, Brian R Hipszer, Channy Loeum, Peter A McCue, Mark DeStefano, Marc C Torjman, Mahmut T Kaner, Alek R Dinesen, Inna Chervoneva, Thomas R Pieber, Jeffrey I Joseph
BACKGROUND: Worldwide, ∼1 million people manage their type 1 diabetes with an insulin pump and a continuous subcutaneous insulin infusion (CSII) catheter. Patients routinely insert a new catheter every 2-3 days due to increasing variability of insulin absorption over time. Catheter insertion and maintenance damage capillaries, lymphatics, cells, and connective tissue leading to an acute inflammatory response. METHODS: We compared an investigational CSII catheter (IC) and a commercial CSII catheter (CC) regarding insulin absorption pharmacokinetics (PK) and tissue inflammation...
November 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28979663/finger-pad-squamous-cell-carcinoma-report-of-squamous-cell-carcinoma-of-the-distal-palmar-digit-and-review-of-associated-risk-factors-mimickers-and-treatment-of-squamous-cell-carcinoma-of-ventral-hand-digits
#17
Philip R Cohen, S Brian Jiang
BACKGROUND: Squamous cell carcinoma of the palmar digits is rare. PURPOSE: The authors describe a man with squamous cell carcinoma of the pulp of his left fourth finger, and review the risk factors that may be associated with squamous cell carcinoma development on the ventral digits of the hand. the authors also summarize the clinical differential diagnoses and treatment of squamous cell carcinoma at this location. METHODS: the authors retrospectively reviewed the literature using PubMed and searched for the following terms: squamous cell carcinoma, squamous cell carcinoma in situ, finger, thumb, palmar, and ventral...
August 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/28964957/dsm-5-based-latent-ptsd-models-assessing-structural-relations-with-gad-in-filipino-post-relocatees
#18
Imelu G Mordeno, Brian J Hall
An increasing number of studies investigated the latent factor structure of posttraumatic stress disorder (PTSD) symptomatology following the new fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To date, there is no consensus on the best representation of PTSD. This study examined six latent PTSD models in a sample of Filipino post-disaster relocatees (N = 523). Further investigation on the relationship of the best-fitting model to generalized anxiety disorder (GAD) in the latent level was conducted...
December 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28958366/trauma-systems-origins-evolution-and-current-challenges
#19
REVIEW
Danielle A Pigneri, Brian Beldowicz, Gregory J Jurkovich
Trauma is the leading cause of death among patients 46 years or younger, and having a system in place for the care of the injured is of paramount importance to the health of a community. The growth and development of civilian trauma systems has not been an easy process. The concept of regionalized health care that the trauma system models has been emulated by other specialized and time-sensitive areas of medicine, notably stroke and acute cardiac events. Continued process improvement, public education, support and involvement, a sound infrastructure, and integrated technology should remain our focus...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958283/guideline-driven-care-improves-outcomes-in-patients-with-traumatic-rib-fractures
#20
Kathleen Flarity, Whitney C Rhodes, Andrew J Berson, Brian E Leininger, Paul E Reckard, Keyan D Riley, Charles P Shahan, Thomas J Schroeppel
There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation...
September 1, 2017: American Surgeon
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