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Trauma best practice

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https://www.readbyqxmd.com/read/29147813/noninvasive-induction-of-angiogenesis-in-tissues-by-external-suction-sequential-optimization-for-use-in-reconstructive-surgery
#1
G Giatsidis, L Cheng, A Haddad, K Ji, J Succar, L Lancerotto, J Lujan-Hernandez, P Fiorina, H Matsumine, D P Orgill
In reconstructive surgery, tissues are routinely transferred to repair a defect caused by trauma, cancer, chronic diseases, or congenital malformations; surgical transfer intrinsically impairs metabolic supply to tissues placing a risk of ischemia-related complications such as necrosis, impaired healing, or infection. Pre-surgical induction of angiogenesis in tissues (preconditioning) can limit postsurgical ischemic complications and improve outcomes, but very few preconditioning strategies have successfully been translated to clinical practice due to the invasiveness of most proposed approaches, their suboptimal effects, and their challenging regulatory approval...
November 17, 2017: Angiogenesis
https://www.readbyqxmd.com/read/29092054/characteristics-of-knowledge-content-in-a-curated-online-evidence-library
#2
Sowmya Varada, Ronilda Lacson, Ali S Raja, Ivan K Ip, Louise Schneider, David Osterbur, Paul Bain, Nicole Vetrano, Jacqueline Cellini, Carol Mita, Margaret Coletti, Julia Whelan, Ramin Khorasani
Objective: To describe types of recommendations represented in a curated online evidence library, report on the quality of evidence-based recommendations pertaining to diagnostic imaging exams, and assess underlying knowledge representation. Materials and Methods: The evidence library is populated with clinical decision rules, professional society guidelines, and locally developed best practice guidelines. Individual recommendations were graded based on a standard methodology and compared using chi-square test...
October 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29063214/geisinger-high-risk-osteoporosis-clinic-hiroc-2013-2015-fls-performance-analysis
#3
P Dunn, D Webb, T P Olenginski
Geisinger Health System (GHS) high-risk osteoporosis clinic (HiROC), which treats patients with low-trauma, fragility fractures, reports their 2013-2015 performance measures in secondary fracture prevention. This fracture liaison service (FLS) pathway treats 75% of high-risk, drug eligible patients, compared to 13.8% in GHS primary care. This performance points to the need for more FLS programs throughout the world. INTRODUCTION: The purpose of this study is to analyze and report ongoing performance measures in outpatient and inpatient high-risk osteoporosis clinic (HiROC) program designed for patients with low-trauma, fragility fractures...
October 23, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29054690/removable-rigid-dressings-for-postoperative-management-of-transtibial-amputations-a-review-of-published-evidence
#4
REVIEW
James P Reichmann, Phillip M Stevens, John Rheinstein, Christopher D Kreulen
Forty years of clinical experience and peer reviewed research studies support the use of non-weight bearing removable rigid dressings (RRD) as an effective means of post-operative management of transtibial amputations. We reviewed the published medical evidence regarding the use of RRDs as a postoperative management strategy, culminating in an evidence-based practice recommendation. Published peer reviewed literature on the topic was searched and classified by level of evidence based on the research design utilizing the scale recommended by the PM&R Journal (level I through V)...
October 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29046084/penetrating-neck-injuries-a-guide-to-evaluation-and-management
#5
J L Nowicki, B Stew, E Ooi
Introduction Penetrating neck injury is a relatively uncommon trauma presentation with the potential for significant morbidity and possible mortality. There are no international consensus guidelines on penetrating neck injury management and published reviews tend to focus on traditional zonal approaches. Recent improvements in imaging modalities have altered the way in which penetrating neck injuries are now best approached with a more conservative stance. A literature review was completed to provide clinicians with a current practice guideline for evaluation and management of penetrating neck injuries...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#6
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29019383/the-dentist-and-the-athletic-trainer-a-winning-team-for-oral-health-care
#7
Anthony Breitbach, Paul Nativi
Oral health is a key concern for student athletes. The dentist is the primary oral health care provider. Athletic trainers (ATs) are health professionals who have a primary care role for the student athlete. They are often the first to respond when dental trauma occurs in athletics. This paper informs dentists and ATs about each other and includes best practice in the care of athletes, which can be improved through interprofessional collaboration between dentists and ATs.
June 22, 2017: Journal of the California Dental Association
https://www.readbyqxmd.com/read/28990878/polyvictimization-in-later-life-trauma-informed-best-practices
#8
Holly Ramsey-Klawsnik, Erin Miller
This article provides a summary of salient trauma findings and conveys the dearth of research pertaining specifically to the trauma of elder abuse. This material, in conjunction with information contained in other articles composing this special issue, lays the foundation for advancing a trauma-informed approach to assisting older adults who have experienced polyvictimization. Informed by the findings presented and their extensive clinical experience with victims of violence, the authors suggest steps for providing a trauma-informed and victim-centered response to older adults who have suffered polyvictimization...
October 9, 2017: Journal of Elder Abuse & Neglect
https://www.readbyqxmd.com/read/28923035/comparison-of-volar-flexion-ulnar-deviation-and-functional-position-cast-immobilization-in-the-non-operative-treatment-of-distal-radius-fracture-in-elderly-patients-a-pragmatic-randomized-controlled-trial-study-protocol
#9
Lauri Raittio, Antti Launonen, Teemu Hevonkorpi, Toni Luokkala, Juha Kukkonen, Aleksi Reito, Bakir Sumrein, Minna Laitinen, Ville M Mattila
BACKGROUND: Distal radius fractures (DRFs) are the second most common fractures, after hip fractures, seen in clinical practice. The high incidence of low-energy trauma DRFs in elderly patients raises questions about the best treatment method in terms of function, pain, and quality of life. Although the majority of these fractures are treated non-operatively with cast immobilization, valid scientific evidence of the optimal cast immobilization is lacking. In addition, several publications, including Cochrane review have outlined the need for more evidence to determine the most appropriate method of cast immobilization...
September 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28883195/mapping-equivalence-of-german-emergency-department-medical-record-concepts-with-snomed-ct-after-implementation-with-hl7-cda
#10
Dominik Brammen, Heike Dewenter, Kai U Heitmann, Volker Thiemann, Raphael W Majeed, Felix Walcher, Rainer Röhrig, Sylvia Thun
INTRODUCTION: The German Emergency Department Medical Record (GEDMR) was created by medical domain experts and healthcare providers providing a dataset as well as a form. The trauma module of GEDMR was syntactically standardized using HL7 CDA and semantically standardized using different terminologies including SNOMED CT, LOINC and proprietary coding systems. This study depicts the mapping accuracy with aforementioned syntactical and semantical standards in general and especially the content coverage of SNOMED CT...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28865642/adapting-the-patient-centered-medical-home-to-address-psychosocial-adversity-results-of-a-qualitative-study
#11
Cecilia Vu, Emily Rothman, Caroline J Kistin, Kelly Barton, Barb Bulman, Ann Budzak-Garza, Denyse Olson-Dorff, Megan H Bair-Merritt
OBJECTIVE: The patient-centered medical home (PCMH) seeks to improve population health. However, PCMH models often focus on improving treatment of chronic diseases rather than on addressing psychosocial adversity. We sought to gather key stakeholder input about how PCMHs might feasibly and sustainably address psychosocial adversity within their patient populations. METHODS: We conducted 25 semistructured interviews with key stakeholders, such as physicians, nurses, medical assistants, and patients...
September 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28861369/microsurgical-dissection-of-facial-nerve-in-parotidectomy-a-discussion-of-techniques-and-long-term-results
#12
Fabio Nicoli, Christopher D'Ambrosia, Davide Lazzeri, Georgios Orfaniotis, Pedro Ciudad, Michele Maruccia, Li Tzong Shiun, Bulent Sacak, Shih-Heng Chen, Hung-Chi Chen
BACKGROUND: Parotidectomy has well-documented post-operative complications. Dissection of the facial nerve branches can be challenging even under loupe magnification, and partial, or complete injury of the nerve branches can occur during surgery. To reduce this risk and the associated complications, we propose a number of microsurgical best practices, which can be performed during parotidectomy. METHODS: A retrospective survey was conducted on 109 patients (45 males and 64 females, average age 46...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28846895/massive-transfusion-practice-in-non-trauma-related-hemorrhagic-shock
#13
Nauman Farooq, Panagis Galiatsatos, Jasmine K Aulakh, Christopher Higgins, Anthony Martinez
PURPOSE: Evidence suggests that trauma patients with hemorrhagic shock requiring massive transfusion have improved outcomes if resuscitated with a prescribed massive transfusion protocol (MTP). However, there is limited data regarding the efficacy of MTP in non-trauma patients. METHODS: This was a retrospective observational study of all patients who received a massive transfusion protocol for non-traumatic hemorrhagic shock over a four-year period. The primary outcome was in-patient hospital survival...
August 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28836924/preputial-mucosal-graft-for-urethral-repair
#14
Kasonde Bowa, Eliakim Manda
Urethral stricture disease is the commonest cause of morbidity in urology practice in sub-Saharan Africa. In contrast, prostate disease is commonly cited as the leading cause of urological disease in most urology practices in developed countries. In Africa, the aetiology of urethral stricture disease is compounded by a high prevalence of sexually transmitted infections (STIs), increasing levels of urethral trauma and over-stretched urological services. Thus, patients with prostate disease are treated with long-stay urethral catheters for periods often up to two years...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28836750/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update-digest
#15
Whitney K Bryant, Sanjay Shewakramani, Milana Zaurova
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28835511/retrospective-analysis-of-four-year-injury-data-from-the-infantry-training-centre-catterick
#16
Robert Heagerty, J Sharma, J Cayton, N Goodwin
INTRODUCTION: Musculoskeletal injury (MSKI) represents a considerable threat to the effectiveness and productivity of military organisations globally. The impact on the medical chain, occupational disposal with associated loss of working days and associated financial burden have far-reaching consequence. The moral and legal responsibility to reduce avoidable injuries through risk assessment and prevention strategies is fundamental to governance and a key component of best practice. METHODS: A retrospective observational analysis was performed of 4101 MSKIs presenting from a total inflow of 10 498 British Army Infantry recruits recorded over four consecutive training years between 2012 and 2016...
August 22, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28835239/prospective-comparison-of-the-anterior-and-lateral-approach-in-hemiarthroplasty-for-hip-fractures-a-study-protocol
#17
Max P L van der Sijp, Inger B Schipper, Stefan B Keizer, Pieta Krijnen, Arthur H P Niggebrugge
BACKGROUND: The Direct Anterior Approach (DAA) is an alternative approach to the currently most used Lateral Approach (LA) for hip replacement in femoral neck fracture patients. Compared to the LA, the DAA minimizes soft tissue damage. Sparing muscle tissue may facilitate early and improved postoperative mobility. It may also be associated with fewer complications, increased quality of life and lower 1-year mortality. The aim of this study is to compare postoperative complications, hip function and patient mobility after hemiarthroplasty via the anterior or lateral approach following a displaced femoral neck fracture...
August 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28822391/the-impact-of-hemodynamic-transesophageal-echocardiography-on-the-use-of-continuous-renal-replacement-therapy-in-trauma
#18
Madison Griffin, Brett Howard, Sam Devictor, Josh Ferenczy, Frances Cobb, D Benjamin Christie
Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28816873/the-need-of-validated-disease-specific-outcome-instruments-for-spine-trauma
#19
Cumhur Oner, Said Sadiqi, Anne Mechteld Lehr, Gregory D Schroeder, Alexander R Vaccaro
This article focuses on patient-reported and clinician-reported outcome measures in spine trauma care. The measurement of the quality of care and functional and health-related quality of life outcomes of spine trauma patients has become increasingly important. However, no outcome instrument is specifically designed, validated, or universally adapted for this specific patient population. Issues specific to spinal trauma patients may not be adequately addressed by the instruments that are currently used in the literature and the daily clinical practice...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28808951/what-is-the-diagnostic-accuracy-of-the-duck-walk-test-in-detecting-meniscal-tears
#20
COMPARATIVE STUDY
A Van der Post, J C A Noorduyn, V A B Scholtes, E L A R Mutsaerts
BACKGROUND: Clinical weightbearing provocation tests, like the duck walk test, may be of value in diagnosing or screening for medial meniscal tears. However, evidence of the diagnostic accuracy of the duck walk test is lacking. QUESTIONS/PURPOSES: (1) To determine the sensitivity and specificity of the duck walk test in diagnosing medial meniscal tears. (2) To determine whether tear location, tear cause (traumatic versus degenerative), and ACL insufficiency were associated with differences in the sensitivity and specificity of the test...
December 2017: Clinical Orthopaedics and related Research
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