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Pelvic trauma

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https://www.readbyqxmd.com/read/28530617/-principles-of-urinary-tract-reconstructive-surgery
#1
Juan Gomez Rivas, Jesús Cisneros Ledo
INTRODUCTION: In the last 15 years, the role of laparoscopic surgery has progressively increased to include reconstructive procedures such as pyeloplasty and management of ureteral stricture, in addition to being a field in continuous development, this refers to the improvement of ergonomics, new instruments and new techniques. We present a review on basic features of laparoscopic reconstructive surgery in urology. ACQUISITION OF EVIDENCE: For this review, an exhaustive literature search was performed in PUBMED, MEDILNE, BioMed central and others, with the keywords: reconstructive surgery, urology, laparoscopy...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28529680/-beyond-saving-lives-current-perspectives-of-interventional-radiology-in-trauma
#2
REVIEW
Anuradha Singh, Atin Kumar, Pawan Kumar, Subodh Kumar, Shivanand Gamanagatti
Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28528722/outcomes-after-motor-vehicle-trauma-transfers-to-level-i-trauma-centers-compared-with-direct-admissions
#3
Aleksandr Rozenberg, Timothy Danish, Viktor Y Dombrovskiy, Todd R Vogel
BACKGROUND: The multilevel designation system given to U.S. trauma centers has proven useful in providing injury-level-appropriate care and guiding field triage. Despite the system, patients are often transferred to Level I trauma centers for higher-level care/specialized services. OBJECTIVES: The objective of this study is to assess whether there is a difference in outcomes of patients transferred to Level I centers compared with direct admissions. METHODS: The Nationwide Inpatient Sample was queried to identify patients involved in motor vehicle accidents, using International Classification of Diseases, Ninth Revision, Clinical Modification E-codes...
May 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#4
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#5
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28512691/complete-circumferential-osseous-extension-in-the-acetabular-rim-occurs-regardless-of-acetabular-coverage
#6
Keisuke Watarai, Fumihiko Kimura, Yuho Kadono, Yoon Taek Kim, Mamoru Niitsu, Hiromi Oda, Hirohiko Azuma
BACKGROUND: Complete circumferential osseous extension in the acetabular rim has been reported to occur in the deep hip with pincer impingement. However, this phenomenon occasionally is observed in dysplastic hips without pincer impingement, and the degree to which this finding might or might not be associated with hip pain, and how often it occurs bilaterally among patients, are not well characterized. QUESTIONS/PURPOSES: (1) To determine the proportion of patients with complete circumferential osseous extension in the acetabular rim using three-dimensional (3-D) CT in patients with and without hip pain who had CT scans obtained for various reasons...
May 16, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28506314/application-of-intraoperative-limb-length-measurement-by-a-new-osteotomy-device-in-hemiarthroplasty-for-treating-femoral-neck-fracture
#7
Zhanle Zheng, Lei Yang, Yanling Su, Xian Yu, Zhiyong Hou, Yingze Zhang
BACKGROUND: Limb length discrepancy is one of the most common complications after hip arthroplasty. We developed a device - intraoperative limb-length measurement and osteotomy device (ILMOD), and applied it to patients who were treated with hemiarthroplasty for femoral neck fracture to improve limb length discrepancy by providing an accurate osteotomy during hemi-arthroplasty. METHODS: Between April 2012 and October 2013, 65 patients were treated with hip hemiarthroplasty for femoral neck fracture at our trauma center...
May 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#8
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28490704/-establishement-for-regional-pelvic-trauma-database-in-hunan-province
#9
Liang Cheng, Yong Zhu, Haitao Long, Junxiao Yang, Buhua Sun, Kanghua Li
To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally...
April 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28479762/transurethral-resection-of-prostate-in-benign-prostatic-enlargement-with-underactive-bladder-a-retrospective-outcome-analysis
#10
Ashok Kumar Sokhal, Rahul Janak Sinha, Bimalesh Purkait, Vishwajeet Singh
PURPOSE: The purpose of this study was to evaluate the clinical outcome and efficacy of transurethral resection of the prostate in patients of benign prostatic enlargement (BPE) with underactive bladder. MATERIALS AND METHODS: Retrospective study of 174 patients, who underwent transurethral resection of prostate (TURP) between 2008 and 2015, for lower urinary tract symptoms with BPE with bladder underactivity. Clinical history, physical examination, renal function test, urinalysis, cystourethroscopy, transabdominal or transrectal ultrasonography, and urodynamic study were recorded...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28473090/acr-appropriateness-criteria-%C3%A2-suspected-physical-abuse-child
#11
Sandra L Wootton-Gorges, Bruno P Soares, Adina L Alazraki, Sudha A Anupindi, Jeffrey P Blount, Timothy N Booth, Molly E Dempsey, Richard A Falcone, Laura L Hayes, Abhaya V Kulkarni, Sonia Partap, Cynthia K Rigsby, Maura E Ryan, Nabile M Safdar, Andrew T Trout, Roger F Widmann, Boaz K Karmazyn, Susan Palasis
The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28470717/bulbomembranous-anastomotic-urethroplasty-for-strictures-of-the-proximal-bulbar-urethra-unassociated-with-pelvic-trauma
#12
Vanessa Fenner, Daniel A Benamran, Sao-Nam Tran, Giordano Venzi, Gregory J Wirth, Christophe E Iselin
No abstract text is available yet for this article.
May 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28466615/angiographic-embolization-in-pediatric-abdominal-trauma
#13
Yechiel Sweed, Jonathan Singer-Jordan, Sorin Papura, Norman Loberant, Alon Yulevich
BACKGROUND: Trauma is the leading cause of childhood morbidity and mortality. Abdominal bleeding is one of the common causes of mortality due to trauma. Angiography and embolization are well recognized as the primary treatments in certain cases of acute traumatic hemorrhage in adults; however, evidence is lacking in the pediatric population. OBJECTIVES: To assess the safety and efficacy of transcatheter arterial embolization (TAE) for blunt and penetrating abdominal and pelvic trauma in the pediatric age group...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#14
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463744/practicality-of-exchanging-transparent-3d-ct-for-radiography-for-pelvic-fractures
#15
Ryan Hutten, Laurie M Lomasney, Vasilios Vasilopoulos, Albert Song, Andrew Chiang, Mitchell Bernstein, Hobie Summers
OBJECTIVE: We assess the utility of transparent 3D reconstructed CT images for evaluation of traumatic pelvic bony injuries compared to traditional radiographs. METHODS: Radiographs and 3D reconstructed CT were anonymized and randomized before review by 4 board certified physicians using a standardized questionnaire and compared to a gold-standard axial CT by a fifth board certified physician. RESULTS: 49 patients were included. We found significant agreement (K=[0...
April 27, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28462160/giant-hydronephrotic-kidney-masquerading-as-urinoma-a-rare-presentation-with-review-of-literature
#16
Ashok Kumar Sokhal, Manav Agrawal, Durgesh Kumar Saini, Kawaljit Singh, Ashok Kumar Gupta, Satyanarayan Sankhwar, Bhupendra Pal Singh
Giant hydronephrosis (GH) is a condition in which pelvicalyceal system contains more than 1000 ml of urine. Common causes of GH are uretero-pelvic junction obstruction, renal calculus, abdominal trauma. We are reporting a case of 45 years' male, who presented with abdominal trauma and haematuria and was suspected a urinoma secondary to renal trauma. Examination revealed soft, cystic abdominal lump. Computed tomography of the abdomen revealed grossly hydronephrotic right kidney. The patient was managed by pyeloplasty after renal scan (estimated plasma renal flow- 91...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28459424/does-physician-reimbursement-correlate-to-risk-in-orthopaedic-trauma
#17
Vasanth Sathiyakumar, Rachel V Thakore, Cesar S Molina, William T Obremskey, Manish K Sethi
This study investigated whether current Medicare reimbursements for orthopaedic trauma procedures correlate with complications. A total of 18,510 patients representing 33 orthopaedic trauma procedures from 2005 to 2011 were studied. Adverse events and Medicare payments for each orthopaedic trauma procedure were collected. Linear regressions determined correlations between complications and Medicare payments for orthopaedic trauma procedures. A weak correlation between Medicare payments and complications was found for all procedures (r = ...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28458849/u-type-bilateral-sacral-fracture-with-spino-pelvic-dissociation-caused-by-epileptic-seizure
#18
Qian Wang, Ian Verrall, Rowan Walker, Kevin Tetsworth, Herwig Drobetz
Sacral fracture with spino-pelvic  dissociation is a rare and unstable injury caused by high-energy trauma, often with serious haemodynamic and neurological implications. Diagnosis is easily delayed or missed as it is often masked by severe associated injuries. Here, we present an unusual case of spino-pelvic dissociation sustained during a seizure episode in a young epileptic patient on long-term anticonvulsant therapy with previous thoracolumbar spinal arthrodesis. This unique case brings to light the need for clinicians to consider sacral fractures in patients presenting with low back pain with no preceding trauma who otherwise may have risk factors for pathological fractures...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458065/outcomes-of-lumbopelvic-fixation-in-the-treatment-of-complex-sacral-fractures-using-minimally-invasive-surgical-techniques
#19
Ehsan Jazini, Tristan Weir, Emeka Nwodim, Oliver Tannous, Comron Saifi, Nicholas Caffes, Timothy Costales, Eugene Koh, Kelley Banagan, Daniel Gelb, Steven C Ludwig
BACKGROUND CONTEXT: Complex sacral fractures with vertical and anterior pelvic ring instability treated with traditional fixation methods are associated with high rates of failure and poor clinical outcomes. Supplemental lumbopelvic fixation (LPF) has been applied for additional stability to help with fracture union. PURPOSE: To determine whether minimally invasive LPF provides reliable fracture stability and acceptable complication rates in cases of complex sacral fractures...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28456672/muscle-localization-of-heterotopic-ossification-following-spinal-cord-injury
#20
Malte Ohlmeier, Eduardo M Suero, Mirko Aach, Renate Meindl, Thomas A Schildhauer, Mustafa Citak
BACKGROUND: Heterotopic Ossification (HO) is a known complication especially in people suffering traumatic spinal cord injury (SCI). Though some risk factors have already been described, the pathophysiology of HO is still unknown. The pelvis is the most common region for HO occurrence. However, the prevalence of HO by muscle groups about the hip is not well described. PURPOSE: To analyze the prevalence of early HO in muscle groups about the hip in 267 patients with SCI...
April 26, 2017: Spine Journal: Official Journal of the North American Spine Society
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