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https://www.readbyqxmd.com/read/29332187/human-bite-injuries-to-the-head-and-neck-current-trends-and-management-protocols-in-england-and-wales
#1
Glyndwr W Jenkins, Robert Isaac, Shakir Mustafa
INTRODUCTION: Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper. MATERIALS AND METHOD: A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate...
January 14, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29332000/how-good-are-doctors-at-introducing-themselves-hellomynameis
#2
Peter Gillen, Sue Faye Sharifuddin, Muireann O'Sullivan, Alison Gordon, Eva M Doherty
BACKGROUND: This explorative study was triggered by the '#hellomynameis' campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction. METHOD: A patient 'exit' survey was undertaken following doctor-patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics)...
January 13, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29324371/multiple-synchronous-adenocarcinomas-of-the-small-bowel-in-a-young-patient-a-case-report
#3
Cristián Cavalla, Federico Oppliger, Giancarlo Schiappacasse, Rodrigo Valderrama, Adriana Castiblanco, Sonia Margarit
INTRODUCTION: Adenocarcinoma of the small bowel is a rare neoplasm presented usually in elder patients as a single tumor. Its presentation as multiple tumors and in young patients is exceptional and there aren't any guidelines to orient its therapy. PRESENTATION OF CASE: We present the rare case of a sixteen-year-old woman that presents to the emergency department with an intussusception due to a small bowel tumor. The resected specimen showed multiple adenocarcinomas...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29323836/segmental-arterial-mediolysis-an-unusual-case-mistaken-to-be-a-strangulated-hernia
#4
Russell D Japikse, James E Sevenson, Perry J Pickhardt, Michael D Repplinger
INTRODUCTION: Segmental arterial mediolysis (SAM) is a rare nonatherosclerotic, noninflammatory vasculopathy causing arterial wall necrosis that leads to strictures, dissections, and aneurysms, particularly in medium-sized abdominal arteries. Awareness of SAM is important because, unlike vasculitides, immunosuppressive treatment may worsen the disease process. CASE: A 58-year-old man with multiple medical comorbidities presented with acute epigastric pain and a right incarcerated inguinal hernia that was interpreted as showing bowel strangulation on computed tomography...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322942/purulent-pericarditis-an-unusual-complication-of-pneumococcal-pneumonia-a-case-report
#5
Ghizlane Zoulati, Ramatou Yèya Maïga, Rachid Kerzaz, Ghita Yahyaoui, Mustapha Harandou, Mustapha Mahmoud
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid...
January 11, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29321112/the-evaluation-and-management-of-urolithiasis-in-the-emergency-department-a-review-of-the-literature
#6
REVIEW
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Urolithiasis is a common condition in the U.S. Patients frequently present to the emergency department (ED) for care, including analgesia and treatments to facilitate stone passage. OBJECTIVE: With the new evidence concerning the evaluation and treatment of urolithiasis, this review summarizes current literature regarding the ED management of urolithiasis. DISCUSSION: Urolithiasis occurs primarily through supersaturation of urine and commonly presents with flank pain, hematuria, and nausea/vomiting...
January 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29321106/segway%C3%A2-personal-transporter-related-injuries-a-systematic-literature-review-and-implications-for-acute-and-emergency-care
#7
Ali Pourmand, Jen Liao, Jesse M Pines, Maryann Mazer-Amirshahi
BACKGROUND: The Segway® Personal Transporter™ (SPT) is used widely as a means of transport for city sightseeing tours, law enforcement, and professionals working in large facilities and factories. METHODS: We conducted a systematic review of the literature to assess SPT-related injuries. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, we queried PubMed from 1990 to 2017. The search terms Segway, personal transporter, and injury were used...
January 8, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319649/decreasing-radiation-exposure-in-pediatric-trauma-related-to-cervical-spine-clearance-a-quality-improvement-project
#8
Valerie Ann Waddell, Susan Connelly
STUDY DESIGN: Quality improvement project. OBJECTIVES: Reduce the amount of radiation exposure in the pediatric trauma population 5 years of age and older in relation to cervical spine clearance. BACKGROUND: The evaluation of pediatric cervical spine injuries must be accurate and timely to avoid missed injuries. The difficult clinical examination in pediatric trauma patients necessitates the use of radiologic examinations to avoid missing catastrophic injuries...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29306971/trauma-care-in-german-speaking-countries-have-changes-in-the-curricula-led-to-changes-in-practice-after-10%C3%A2-years
#9
Sarah Kuhn-Régnier, Michael Stickel, Björn-Christian Link, Henning Fischer, Reto Babst, Frank J P Beeres
PURPOSE: Traditionally, in the German-speaking countries, trauma patients are treated by general surgeons specialized in trauma surgery known as the Unfallchirurg. Over the last decade, a trend towards a lower influence of surgeons and a higher influence of subspecialties in the emergency department has been noted. With additional transformations in the health care system towards highly specialized medicine and the arising of new (sub-) specialties, diversification in the management of the trauma patient appears to occur...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#10
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29305684/an-extraaxially-localized-intrasellar-giant-hydatid-cyst-with-hypophyseal-insufficiency
#11
Gökhan Çavuş, Vedat Açik, Yeliz Çavuş, Emre Bilgin, Yurdal Gezercan, Ali Ihsan Ökten
PURPOSE: A hydatid cyst is a parasitic illness that is caused by the larvae of Echinococcus granulosus. Hydatid cysts occur in the liver in 75% and in the lungs in 15% of cases. Central nervous system involvement is rare (perhaps as low as 1%), and the majority of such cases are observed in children. Headache and vomiting are the most frequently observed symptoms. In patients diagnosed with a hydatid cyst, imaging methods and serologic tests are very important for identifying cranial involvement...
January 5, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29301176/sudden-paraplegia-caused-by-nontraumatic-cervical-disc-rupture-a-case-report
#12
Sung Min Kim, Byeong Sam Choi, Sungjoon Lee
A 38-year-old man visited our Emergency Department for sudden onset paraplegia that occurred 1 hour ago. He felt a piercing pain in the posterior neck and became paraplegic while he was watching television, lying down on a sofa. Neurological examination showed motor power grades II-III in both arms and grade 0 in both legs. His cervical magnetic resonance imaging (MRI) showed a large ruptured disc at the C5-6 level, severely compressing the spinal cord. Emergency anterior cervical discectomy and fusion at C5-6 were performed...
December 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29299700/emergent-spinal-mri-in-ivdu-patients-presenting-with-back-pain-do-we-need-an-mri-in-every-case
#13
Charles G Colip, Mina Lotfi, Karen Buch, Nagaraj Holalkere, Bindu N Setty
PURPOSE: Spinal MRI is the exam of choice for the workup of patients with suspected spinal infection. In this retrospective study, we assess the value of obtaining contrast-enhanced spinal MRI for patients presenting to the emergency department (ED) with acute back pain and a history of intravenous drug use (IVDU). METHODS: A retrospective IRB-approved, HIPAA compliant review of the imaging findings, reports and electronic charts of 167 consecutive IV drug-using patients (M/F = 96:71, mean age = 40 years) that presented to the ED with acute back pain over a 55-month period and underwent contrast-enhanced spinal MRI within 24 h...
January 3, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29296770/osteonecrosis-of-the-femoral-head-in-sickle-cell-disease-prevalence-comorbidities-and-surgical-outcomes-in-california
#14
Oyebimpe Adesina, Ann Brunson, Theresa H M Keegan, Ted Wun
Osteonecrosis of the femoral head (ONFH) is a prevalent complication of sickle cell disease (SCD) that has not been well described in population-based cohort studies. Using California's Office of Statewide Planning and Development discharge databases (1991-2013), we estimated the cumulative incidence of ONFH after accounting for the competing risk of death and used a multivariable Cox proportional hazards regression to identify factors associated with ONFH diagnosis. We also calculated rates of readmissions to the hospital or emergency department within 30 to 90 days of hip replacement surgery...
July 11, 2017: Blood Advances
https://www.readbyqxmd.com/read/29291540/open-splenectomy-for-varicella-zoster-induced-spontaneous-splenic-rupture
#15
Mark Christopher Sykes, Bilal Azhar, Laurence John, Salman Bokhari
INTRODUCTION: Here we present a case of atraumatic splenic rupture secondary to varicella infection requiring emergency splenectomy. The presentation was as would be expected for epstein barr virus (EBV) related splenic injury, which is well documented in the literature. Dermatological findings however suggested varicella zoster, and viral serology subsequently confirmed the diagnosis. PRESENTATION OF CASE: A young Romanian male presented to the emergency department with peritonism without preceding trauma...
December 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29290247/can-we-do-that-here-establishing-the-scope-of-surgical-practice-at-a-new-safety-net-community-hospital-through-a-transparent-collaborative-review-of-physician-privileges
#16
Sean M O'Neill, Sarah Seresinghe, Arun Sharma, Tara A Russell, L'Orangerie Crawford, Stanley K Frencher
PROBLEM DEFINITION: Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms...
January 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29287880/revisits-after-pediatric-tracheotomy-airway-concerns-result-in-returns
#17
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES: Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy. METHODS: Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29276539/triceps-tendon-rupture-repair-and-rehabilitation
#18
Cezary Kocialkowski, Rebecca Carter, Chris Peach
Triceps tendon ruptures are rare injuries and are frequently missed on initial presentation to the emergency department. In cases of complete rupture, surgical repair is recommended but no guidelines exist on the optimum reconstructive technique or rehabilitation. We present a surgical technique and rehabilitation programme for the management of these injuries. A midline posterior incision is performed, the ruptured triceps tendon is identified and mobilized, and the tendon footprint is prepared. The tendon is then repaired using bone suture anchors, with a parachute technique, and held in 40° of flexion...
January 2018: Shoulder & Elbow
https://www.readbyqxmd.com/read/29274694/acute-type-a-aortic-dissection-causing-collapse-of-previous-stent-graft
#19
Ha-Eun Kim, Hyun-Chel Joo
A 69-year old man presented to the emergency department with back pain and paraplegia. Computed tomography showed acute type A aortic dissection with primary tear right below the origin of the left subclavian artery. He had undergone endovascular aneurysm repair (EVAR) 13 months earlier, and the previously inserted EVAR graft totally collapsed. Total arch replacement covering primary entry tear was performed. Femoral pulse was undetected prior to surgery, but was monitored post-surgically after cardiopulmonary bypass weaning...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29260131/is-it-possible-to-reduce-the-surgical-mortality-and-morbidity-of-peptic-ulcer-perforations
#20
Adnan Hut, Cihad Tatar, Doğan Yıldırım, Turgut Dönmez, Akın Ünal, Ahmet Kocakuşak, Muzaffer Akıncı
Objective: Peptic ulcer perforation is a life-threatening situation requiring urgent surgical treatment. A novel vision in peptic ulcer perforation is necessary to fill the gaps created by antiulcer medication, aging of the patients, and presentation of resistant cases in our era. In this study, we aimed to share our findings regarding the effects of various risk factors and operative techniques on the mortality and morbidity of patients with peptic ulcer perforation. Material and Methods: Data from 112 patients presenting at our Training and Research Hospital Emergency Surgery Department between January 2010 and December 2015 who were diagnosed with PUP through physical examination and laboratory and radiological tests and operated at the hospital have been retrospectively analyzed...
2017: Turkish Journal of Surgery
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