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https://www.readbyqxmd.com/read/27895358/paediatric-traumatic-brain-injury-presentation-prognostic-indicators-and-outcome-analysis-from-a-tertiary-care-center-in-a-developing-country
#1
Badar Ujjan, Muhammad Waqas, Muhammad Babar Khan, Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children worldwide. This study was conducted to report the presentation, management, outcomes and prognostic indicators in a large series of patients from a tertiary care centre in a developing country. It is a review of prospectively collected data of paediatric patients with TBI admitted at our centre between July 2010 and December 2013. A total of 291 patients with a mean age of 7.2±5.0 years were dichotomised into survivors and non-survivors, and variables were compared between the two groups...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27891547/severe-pelvic-injury-vascular-lesions-detected-by-ante-and-post-mortem-contrast-medium-enhanced-ct-and-associations-with-pelvic-fractures
#2
Mahmoud Hussami, Silke Grabherr, Reto A Meuli, Sabine Schmidt
OBJECTIVES: The objectives of this study were to compare arterial and venous contrast medium extravasation in severe pelvic injury detected by ante- and post-mortem multi-detector CT (MDCT) and determine whether vascular injury is associated with certain types of pelvic fracture. METHODS: We retrospectively included two different cohorts of blunt pelvic trauma with contrast medium extravasation shown by MDCT. The first group comprised 49 polytrauma patients; the second included 45 dead bodies undergoing multi-phase post-mortem CT-angiography (MPMCTA)...
November 28, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27891397/spontaneous-subdural-haematoma-developing-secondary-to-arachnoid-cyst-rupture
#3
Mehmet Onur Yüksel, Mehmet Sabri Gürbüz, Mehmet Senol, Numan Karaarslan
Arachnoid cysts are congenital, benign, non-neoplastic, extra-axial intra-arachnoidal lesions. Arachnoid cysts rarely become symptomatic, with bleeding. Intracranial haemorrhage as a complication of arachnoid cyst is a very rare condition. It is well-known that mid-cranial fossa cysts might cause intracerebral haemorrhage or subdural haematoma secondary to traumas. However, the occurrence of spontaneous subdural haematoma secondary to arachnoid cysts, developing without any trauma, is even rarer. A 17-year-old boy presenting with diplopia and headache, with no history of trauma, was diagnosed with left temporal lobe arachnoid cyst and left fronto-parietal subdural haematoma...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27878794/varicosities-of-the-lower-extremity-new-approaches-cosmetic-or-therapeutic-needs
#4
Luca Spinedi, Heiko Uthoff, Sasan Partovi, Daniel Staub
Varicose veins of the lower extremity (VVLE) are a frequently encountered vascular disorder in the general population. The general view that VVLE are a non-serious disease with primarily aesthetic impact is a common misconception, as the disease can have a significant negative impact on generic and disease-specific quality of life. Further, VVLE may be associated with potentially threatening clinical conditions, such as chronic venous ulceration, venous thromboembolism and haemorrhage from ruptured varicose veins...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27855275/epidemiology-and-aetiology-of-traumatic-cardiac-arrest-in-england-and-wales-a-retrospective-database-analysis
#5
Ed Barnard, David Yates, Antoinette Edwards, Marisol Fragoso-Iñiguez, Tom Jenks, Jason E Smith
BACKGROUND: Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. METHODS: Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data...
November 14, 2016: Resuscitation
https://www.readbyqxmd.com/read/27848415/learning-lessons-from-war-to-treat-people-with-trauma
#6
(no author information available yet)
Trauma is a leading cause of death and disability in civilian environments, and on the battlefield, and trauma-induced haemorrhage is the main cause of potentially preventable death.
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27843669/a-case-of-a-chronic-pancreatic-pseudocyst-causing-atraumatic-splenic-rupture-without-evidence-of-acute-pancreatitis
#7
P Moori, E J Nevins, T Wright, C Bromley, Y Rado
Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP), described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27842639/elevated-international-normalised-ratios-correlate-with-severity-of-injury-and-outcome
#8
M A Noorbhai, H M Cassimjee, B Sartorius, D J J Muckart
BACKGROUND: Haemorrhagic shock is the leading cause of preventable early deaths from trauma. Acute coagulopathy on admission to a trauma unit is associated with worse outcomes. The relationship of haemorrhage to early mortality remains consistent regardless of mechanism of injury. Haemorrhage and haemorrhagic shock are increasingly amenable to interventions that result in reductions in morbidity and mortality. OBJECTIVES: To assess the prevalence of coagulopathy in patients admitted to the level 1 trauma unit at Inkosi Albert Luthuli Central Hospital, Durban, South Africa, and correlate it with in-hospital mortality...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27820707/resuscitative-endovascular-balloon-occlusion-of-the-aorta-promise-practice-and-progress
#9
Zane B Perkins, Robbie A Lendrum, Karim Brohi
PURPOSE OF REVIEW: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research. RECENT FINDINGS: REBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians...
November 4, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27818370/can-diffusion-weighted-imaging-be-used-as-a-tool-to-predict-seizures-in-patients-with-pleds
#10
Jaishree Narayanan
It is unclear which patients with PLEDs will have associated seizures and therefore will need to be treated aggressively with antiepileptic medications. We present a prospective observational study of ten consecutive non-anoxic patients with PLEDs based on continuous 24-hour EEG monitoring. According to the EEG, five of the patients had seizures associated with PLEDs and five had PLEDs but no seizures. The aetiology included: neoplasm (n=1), cortical dysplasia (n=1), acute head trauma (n=1), encephalomalacia related to healed abscess (n=1), intra-parenchymal haemorrhage (n=1), and no structural lesion (n=5)...
November 4, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27816340/management-of-spontaneous-intracerebral-haemorrhages
#11
Barbara Casolla, Romain Tortuyaux, Charlotte Cordonnier
Spontaneous intracerebral haemorrhage is defined as a collection of blood in the cerebral parenchyma that is not caused by trauma. It represents roughly 10-20% of all strokes. The clinical presentation is unspecific and the diagnosis requires brain imaging. ICH is a medical emergency and ICH patients have to be admitted in an acute stroke unit. The priority is to fight against ICH expansion. The first step consists in the administration of a specific antagonist of the antithrombotic treatment when available, and in the strict control of blood pressure...
November 2, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27813214/complications-of-haemophilia-in-babies-first-two-years-of-life-a-report-from-the-centers-for-disease-control-and-prevention-universal-data-collection-system
#12
R Kulkarni, R J Presley, J M Lusher, A D Shapiro, J C Gill, M Manco-Johnson, M A Koerper, T C Abshire, D DiMichele, W K Hoots, P Mathew, D J Nugent, S Geraghty, B L Evatt, J M Soucie
AIM: To describe the prevalence and complications in babies ≤2 years with haemophilia. METHODS: We used a standardized collection tool to obtain consented data on eligible babies aged ≤2 years with haemophilia enrolled in the Centers for Disease Control and Prevention Universal Data Collection System surveillance project at US Hemophilia Treatment Centers (HTCs). RESULTS: Of 547 babies, 82% had haemophilia A, and 70% were diagnosed within one month of birth...
November 4, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27811561/haemostatic-resuscitation-in-trauma-the-next-generation
#13
Jakob Stensballe, Sisse R Ostrowski, Pär I Johansson
PURPOSE OF REVIEW: To discuss the recent developments in and evolvement of next generation haemostatic resuscitation in bleeding trauma. RECENT FINDINGS: Mortality from major trauma is a worldwide problem, and massive haemorrhage remains a major cause of potentially preventable deaths. Development of coagulopathy further increases trauma mortality emphasizing that coagulopathy is a key target in the phase of bleeding. The pathophysiology of coagulopathy in trauma reflects at least three distinct mechanisms that may be present isolated or coexist: acute traumatic coagulopathy, coagulopathy associated with the lethal triad, and consumptive coagulopathy...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27805960/resuscitative-endovascular-balloon-occlusion-of-the-aorta-promise-practice-and-progress
#14
Zane B Perkins, Robbie A Lendrum, Karim Brohi
PURPOSE OF REVIEW: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research. RECENT FINDINGS: REBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27803918/surgeon-performed-point-of-care-ultrasound-in-severe-eye-trauma-report-of-two-cases
#15
Fikri M Abu-Zidan, Korana Balac, Chetana Anand Bhatia
The indications of point-of-care ultrasound (POCUS) in the management of multiple trauma patients have been expanding. Although computed tomography (CT) scan of the orbit remains the gold standard for imaging orbital trauma, ultrasound is a quick, safe, and portable tool that can be performed bedside. Here we report two patients who had severe eye injuries with major visual impairment where surgeon-performed POCUS was very useful. One had a foreign body injury while the other had blunt trauma. POCUS was done using a linear probe under sterile conditions with minimum pressure on the eyes...
October 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27771202/-in-case-of-fetal-macrosomia-the-best-strategy-is-the-induction-of-labor-at-38%C3%A2-weeks-of-gestation
#16
REVIEW
P Rozenberg
Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia...
October 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27755116/blood-products-and-procoagulants-in-traumatic-bleeding-use-and-evidence
#17
Henna Wong, Nicola Curry, Simon J Stanworth
PURPOSE OF REVIEW: Death from uncontrolled haemorrhage is one of the leading causes of trauma-related mortality and is potentially preventable. Advances in understanding the mechanisms of trauma-induced coagulopathy (TIC) have focused attention on the role of blood products and procoagulants in mitigating the sequelae of TIC and how these therapies can be improved. RECENT FINDINGS: A host of preclinical and clinical studies have evaluated blood product availability and efficacy in trauma...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27730689/measurement-of-haemolysis-markers-following-transfusion-of-uncrossmatched-low-titer-group-o-whole-blood-in-civilian-trauma-patients-initial-experience-at-a-level-1-trauma-centre
#18
J N Seheult, D J Triulzi, L H Alarcon, J L Sperry, A Murdock, M H Yazer
BACKGROUND/OBJECTIVES: The safety of administering uncrossmatched, group O, cold-stored, whole blood (cWB) during civilian trauma resuscitation was evaluated. METHODS/MATERIALS: Male trauma patients with haemorrhage-induced hypotension who received leuko-reduced uncrossmatched group O+, low titer (<50) anti-A and -B, platelet-replete cWB during initial resuscitation were included. The biochemical markers of haemolysis (lactate dehydrogenase, total bilirubin, haptoglobin, creatinine, serum potassium) were measured on the day of cWB receipt (day 0), and over the next 2 days, reports of transfusion reactions and total blood product administration in first 24 h of admission were recorded...
October 12, 2016: Transfusion Medicine
https://www.readbyqxmd.com/read/27726304/simulation-based-team-training-for-multi-professional-obstetric-care-teams-to-improve-patient-outcome-a-multicentre-cluster-randomised-controlled-trial
#19
A F Fransen, J van de Ven, E Schuit, Aac van Tetering, B W Mol, S G Oei
OBJECTIVE: To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome. DESIGN: Multicentre, open, cluster randomised controlled trial. SETTING: Obstetric units in the Netherlands. POPULATION: Women with a singleton pregnancy beyond 24 weeks of gestation. METHODS: Random allocation of obstetric units to a 1-day, multi-professional, simulation-based team training focusing on crew resource management (CRM) in a simulation centre or to no such team training...
October 10, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27724088/advances-in-military-resuscitation
#20
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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