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trauma haemorrhage

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https://www.readbyqxmd.com/read/29162534/nano-and-micro-materials-in-the-treatment-of-internal-bleeding-and-uncontrolled-haemorrhage
#1
REVIEW
Elizabeth Gaston, John F Fraser, Zhi Ping Xu, Hang T Ta
Internal bleeding is defined as the loss of blood that occurs inside of a body cavity. After a traumatic injury, haemorrhage accounts for over 35% of pre-hospital deaths and 40% of deaths within the first 24hours. Coagulopathy, a disorder in which the blood is not able to properly form clots, typically develops after traumatic injury and results in a higher rate of mortality. The current methods to treat internal bleeding and coagulopathy are inadequate due to the requirement of extensive medical equipment that is typically not available at the site of injury...
November 18, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#2
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160091/probabilistic-description-of-infant-head-kinematics-in-abusive-head-trauma
#3
T O Lintern, M P Nash, P Kelly, F H Bloomfield, A J Taberner, P M F Nielsen
Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions...
November 21, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29150890/suspended-animation-the-past-present-and-future-of-major-cardiothoracic-trauma
#4
REVIEW
Syed Mohiyaddin, Prakash Nanjaiah, Ahmed O Saad, Metesh N Acharya, Tanveer A Khan, Rhodri H Davies, Saeed Ashraf
About 50% of the trauma victims die at the scene mostly because of exsanguinating haemorrhage. Most trials of resuscitation fail in face of the ongoing bleeding. Ongoing research/studies to save these victims by inducing rapid hypothermia using cardiopulmonary bypass as an emergency initial measure along with delayed resuscitation show improved outcomes. A comprehensive review of this research and analysis of studies showed that rapid induction of hypothermia within 5 min of cardiac arrest is associated with better survival and improved neurological outcome...
November 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29126600/effect-of-treatment-delay-on-the-effectiveness-and-safety-of-antifibrinolytics-in-acute-severe-haemorrhage-a-meta-analysis-of-individual-patient-level-data-from-40%C3%A2-138-bleeding-patients
#5
Angèle Gayet-Ageron, David Prieto-Merino, Katharine Ker, Haleema Shakur, François-Xavier Ageron, Ian Roberts
BACKGROUND: Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. METHODS: We did an individual patient-level data meta-analysis of randomised trials done with more than 1000 patients that assessed antifibrinolytics in acute severe bleeding. We identified trials done between Jan 1, 1946, and April 7, 2017, from MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, Popline, and the WHO International Clinical Trials Registry Platform...
November 7, 2017: Lancet
https://www.readbyqxmd.com/read/29112977/initial-clinical-experience-with-dual-layer-detector-spectral-ct-in-patients-with-acute-intracerebral-haemorrhage-a-single-centre-pilot-study
#6
Soo Buem Cho, Hye Jin Baek, Kyeong Hwa Ryu, Jin Il Moon, Bo Hwa Choi, Sung Eun Park, Kyungsoo Bae, Kyung Nyeo Jeon, Dong Wook Kim
PURPOSE: The purpose of this study was to investigate the clinical feasibility of spectral analyses using dual-layer detector spectral computed tomography (CT) in acute intracerebral haemorrhage (ICH). MATERIAL AND METHODS: We retrospectively reviewed patients with acute ICH who underwent CT angiography on a dual-layer detector spectral CT scanner. A spectral data analysis was performed to detect contrast enhancement in or adjacent to acute ICH by using spectral image reconstructions including monoenergetic (MonoE), virtual noncontrast (VNC), and iodine overlay fusion images...
2017: PloS One
https://www.readbyqxmd.com/read/29110753/a-multicentre-randomised-controlled-trial-of-position-during-the-late-stages-of-labour-in-nulliparous-women-with-an-epidural-clinical-effectiveness-and-an-economic-evaluation-bumpes
#7
Debra Bick, Annette Briley, Peter Brocklehurst, Pollyanna Hardy, Edmund Juszczak, Lynn Lynch, Christine MacArthur, Phillip Moore, Mary Nolan, Oliver Rivero-Arias, Julia Sanders, Andrew Shennan, Matt Wilson
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an 'upright position' throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a 'lying-down' position? DESIGN: Two-arm randomised controlled trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29102964/oral-injuries-and-occult-harm-in-children-evaluated-for-abuse
#8
Molly V Dorfman, James B Metz, Kenneth W Feldman, Reid Farris, Daniel M Lindberg
OBJECTIVE: To determine the frequency of occult trauma in children with oral injury evaluated for physical abuse. DESIGN: This was a retrospectively planned secondary analysis of a prospective, observational study. SETTING: Emergency departments supported by 20 US child abuse teams in the Examining Siblings to Recognize Abuse (ExSTRA) network. PATIENTS: Children <120 months old evaluated for physical abuse. INTERVENTIONS: Analysis of index children with oral injury on initial examination...
November 4, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29091255/spontaneous-intracystic-haemorrhage-of-an-arachnoid-cyst-associated-with-a-subacute-subdural-hematoma-a-case-report-and-literature-review
#9
Evren Aydogmus, Tufan Hicdonmez
Arachnoid cysts (ACs) are congenital malformations that may develop anywhere in the subarachnoid space along the cerebrospinal axis but are mostly observed in the temporal fossa and Sylvian fissure, predominantly in the left side. ACs account for 1% of all intracranial space-occupying lesions. ACs are a potential risk factor for subdural haematoma in all age groups following a traumatic head injury. Although an intracystic haemorrhage of AC without evidence of a head trauma is very rare, it may particularly develop in children and young adults who spend much more time engaged in games and forced physical exercise...
September 20, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29079917/permissive-hypotensive-resuscitation-in-adult-patients-with-traumatic-haemorrhagic-shock-a-systematic-review
#10
REVIEW
Mohammed Albreiki, David Voegeli
BACKGROUND: Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation whilst treating severely injured patients, and its effectiveness on the survival rate remains unexplored. This detailed systematic review aims to critically evaluate the available literature that investigates the effects of PHR on survival rate. METHODS: A systematic review design searched for comparative and non-comparative studies using EMBASE, MEDLINE, PubMed, Web-of-Science and CENTRAL...
October 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29075919/a-systematic-autopsy-survey-of-human-infant-bridging-veins
#11
Emma C Cheshire, Roger D G Malcomson, Peng Sun, Evgeny M Mirkes, Jasmin M Amoroso, Guy N Rutty
In the first years of life, subdural haemorrhage (SDH) within the cranial cavity can occur through accidental and non-accidental mechanisms as well as from birth-related injury. This type of bleeding is the most common finding in victims of abusive head trauma (AHT). Historically, the most frequent cause of SDHs in infancy is suggested to be traumatic damage to bridging veins traversing from the brain to the dural membrane. However, several alternative hypotheses have been suggested for the cause and origin of subdural bleeding...
October 26, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29072635/a-systematic-review-of-neuroprotective-strategies-during-hypovolemia-and-hemorrhagic-shock
#12
REVIEW
Marius Nistor, Wilhelm Behringer, Martin Schmidt, René Schiffner
Severe trauma constitutes a major cause of death and disability, especially in younger patients. The cerebral autoregulatory capacity only protects the brain to a certain extent in states of hypovolemia; thereafter, neurological deficits and apoptosis occurs. We therefore set out to investigate neuroprotective strategies during haemorrhagic shock. This review was performed in accordance to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Before the start of the search, a review protocol was entered into the PROSPERO database...
October 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29066647/buttock-wounds-beware-what-lies-beneath
#13
Stephanie Clark, Suzanne Westley, Alexander Coupland, Mohamad Hamady, Alun H Davies
A 25-year-old man presented to a major trauma centre with multiple stab wounds, most significantly to the right buttock. Triple-phase CT revealed no acute bleeding and his wounds were closed. In the month following injury, he re-presented seven times to the emergency department (ED) complaining of bleeding and wound breakdown. After his seventh ED attendance, he was examined under general anaesthesia. Intraoperatively, profuse arterial bleeding was encountered and the local major haemorrhage protocol was activated...
October 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29059118/early-haemorrhage-control-and-management-of-trauma-induced-coagulopathy-the-importance-of-goal-directed-therapy
#14
Jakob Stensballe, Hanne H Henriksen, Pär I Johansson
PURPOSE OF REVIEW: The aim of this study was to discuss the recent developments in trauma-induced coagulopathy and the evolvement of goal-directed therapy. RECENT FINDINGS: Mortality from major trauma continues to be a worldwide problem, and massive haemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25-35% of the patients further increasing trauma mortality. The pathophysiology of coagulopathy in trauma reflects at least two distinct mechanisms: Acute traumatic coagulopathy, consisting of endogenous heparinization, activation of the protein C pathway, hyperfibrinolysis and platelet dysfunction, and resuscitation associated coagulopathy...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#15
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29022794/an-assessment-of-pelvic-binder-placement-at-a-uk-major-trauma-centre
#16
H Naseem, P D Nesbitt, D C Sprott, A Clayson
Introduction Pelvic binders are used to reduce the haemorrhage associated with pelvic ring injuries. Application at the level of the greater trochanters is required. We assessed the frequency of their use in patients with pelvic ring injuries and their positioning in patients presenting to a single major trauma centre. Methods A retrospective review of our trauma database was performed to randomly select 1000 patients for study from April 2012 to December 2016. Patients with a pelvic binder or a pelvic ring injury defined by the Young and Burgess classification were included...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28993912/the-utility-of-magnetic-resonance-imaging-in-addition-to-computed-tomography-scans-in-the-evaluation-of-cervical-spine-injuries-a-study-of-obtunded-blunt-trauma-patients
#17
Bernard Puang Huh Lau, Hwee Weng Dennis Hey, Eugene Tze-Chun Lau, Pei Yi Nee, Kimberly-Anne Tan, Wah Tze Tan
PURPOSE: Evidence guiding the use of CT and MRI scans in blunt trauma patients who are obtunded remains controversial. This study aims to determine and predict if computed tomography (CT) scans alone can be performed without risking oversight of substantial injuries found on follow-up magnetic resonance imaging (MRI). METHODS: This is a retrospective cohort study of 63 blunt trauma patients with a Glasgow Coma Scale of < 8. Data were collated from electronic medical records and included patient demographics, premorbid mobility, mechanism of injury, suspected level of injury and neurological examination findings...
October 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28993489/civilian-and-military-doctors-knowledge-of-tranexamic-acid-txa-use-in-major-trauma-a-comparison-study
#18
Jonathan Blair Thomas Herron, R French, A D Gilliam
INTRODUCTION: Tranexamic acid (TXA) administration within the recommended time of 3 hours has been demonstrated to improve outcomes following trauma. The aim of this study was to identify potential knowledge gaps in the administration of TXA in order to target further educational training in those doctors responsible for the management of acute trauma. METHODS: 104 military and 852 civilian doctors were invited to complete a four-item web-based questionnaire pertaining to the indications, dose, side effects and evidence base for TXA administration in trauma...
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28992845/-correct-diagnostic-of-traumatic-renal-trauma-is-important-for-the-treatment
#19
EDITORIAL
Sophia Liff Maibom, Susanne Christiansen Frevert, Mette Lind Holm
Renal trauma is injury to the kidney because of either blunt or penetrating trauma. The condition must be diagnosed quickly and correctly in order to preserve kidney function. This article describes classification, diagnostics, treatment and follow-up. It is important to do a CT-urography to classify the injury properly. The majority of the patients with renal injury can be managed conservatively. Surgical exploration is primarily for the control of haemorrhage. Complications may require additional imaging or inter-ventions...
October 2, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#20
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
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