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https://www.readbyqxmd.com/read/28724601/focused-assessment-with-sonography-for-trauma-fast-identifies-liver-injury-following-cardiopulmonary-resuscitation
#1
Hiroshi Nashiki, Yoshiharu Miyate, Yousuke Terui, Masayuki Otani
Liver trauma is a recognised rare complication of cardiopulmonary resuscitation (CPR) and may be difficult to detect. We report a case of intraperitoneal haemorrhage due to liver injury following CPR in a 50-year-old man admitted to the intensive care unit. The haemorrhage was diagnosed with focused assessment with sonography for trauma (FAST). FAST can rapidly and easily diagnose liver injury. FAST is recommended for excluding haemoperitoneum in patients who are haemodynamically unstable after resuscitation...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#2
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28700414/evaluation-of-gut-blood-barrier-gbb-dysfunction-in-various-models-of-trauma-haemorrhagic-shock-and-burn-injury
#3
Lisa Wrba, Annette Palmer, Christian Karl Braun, Markus Huber-Lang
Dysfunction of the gut-blood barrier (GBB) plays a pivotal role in various diseases, including trauma, haemorrhagic shock (HS) and burn injury, as well as inflammatory bowel diseases (IBD). Whereas GBB disruption significantly contributes to IBD, the exact extent and consequences of GBB failure and its reliable determination in the clinical course following trauma remain rather unclear. A compromised GBB function seems to contribute to remote organ injury after trauma by generation of inflammatory mediators and biologically active lymph, which in turn augments the inflammatory response...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28698750/the-relationship-between-risk-factors-of-head-trauma-with-ct-scan-findings-in-children-with-minor-head-trauma-admitted-to-hospital
#4
Babak Masoumi, Farhad Heydari, Hamidreza Hatamabadi, Reza Azizkhani, Zahra Yoosefian, Majid Zamani
BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan. AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional. METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28692445/normal-cerebral-vascular-pulsations-in-humans-changes-with-age-and-implications-for-microvascular-disease
#5
Mi O Kim, Yan Li, Fangfei Wei, Jiguang Wang, Michael F O'Rourke, Audrey Adji, Alberto P Avolio
BACKGROUND: Cerebral syndromes in older humans, secondary stroke in younger persons following trauma, and sickle cell anaemia in children, are linked by unexplained microvascular damage and high cerebral pressure or flow pulsations. The aim of this study was to characterize age-related pressure and flow waveforms patterns entering the brain, to explain these in terms of disturbed physiological function, and to consider clinical implications. METHOD: Blood flow velocity waves were measured in four cerebral vascular territories by transcranial Doppler of 1020 apparently normal patients (497 men, 21-78 years)...
July 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28692173/perinatal-and-maternal-morbidity-and-mortality-among-term-singletons-following-midcavity-operative-vaginal-delivery-versus-caesarean-delivery
#6
Giulia M Muraca, Amanda Skoll, Sarka Lisonkova, Yasser Sabr, Rollin Brant, Geoffrey W Cundiff, K S Joseph
OBJECTIVE: To quantify severe perinatal and maternal morbidity/mortality associated with midcavity operative vaginal delivery compared with caesarean delivery. DESIGN: Population-based, retrospective cohort study. SETTING: British Columbia, Canada. POPULATION: Term, singleton deliveries (2004-2014) by attempted midcavity operative vaginal delivery or caesarean delivery in the second stage of labour, stratified by indication for operative delivery (n=10,901 deliveries; 5,057 indicated for dystocia, 5,844 for fetal distress)...
July 10, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28688890/any-changes-in-recent-massive-transfusion-practices-in-a-tertiary-level-institution
#7
Romi Sinha, David Roxby
BACKGROUND & OBJECTIVES: A previous review of transfusion practices in our institution between 1998 and 2008 showed a trend of high ratios of red cells (RC) to plasma (FFP) and platelets to RC towards the later years of review period. The aim of the study was to further evaluate transfusion practices in the form of blood product usage and outcomes following massive transfusion (MT) METHODS: All adult patients with critical bleeding who received a MT (defined as ≥10 units of RC in 24h) in 2008 and between January 2010 and December 2014 were identified...
June 8, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28684079/a-comparison-of-base-deficit-and-vital-signs-in-the-early-assessment-of-patients-with-penetrating-trauma-in-a-high-burden-setting
#8
Mark Peter Dunham, Benn Sartorius, Grant Llewellyn Laing, John Lambert Bruce, Damian Luiz Clarke
INTRODUCTION: An assessment of physiological status is a key step in the early assessment of trauma patients with implications for triage, investigation and management. This has traditionally been done using vital signs. Previous work from large European trauma datasets has suggested that base deficit (BD) predicts clinically important outcomes better than vital signs (VS). A BD derived classification of haemorrhagic shock appeared superior to one based on VS derived from ATLS criteria in a population of predominantly blunt trauma patients...
June 20, 2017: Injury
https://www.readbyqxmd.com/read/28681229/late-reconstruction-of-severe-open-book-deformities-of-the-pelvis-tips-and-tricks
#9
Christian Fang, Hatem Alabdulrahman, Roman Pfeifer, Ivan S Tarkin, Hans-Christoph Pape
BACKGROUND: The primary goal of treatment for open book pelvic injuries after high-energy trauma is to control haemorrhage and to close the pelvic ring anatomically. Less commonly, patients may present late with malunion or non-union. METHODS: We reviewed five operatively treated patients with delayed severe open book deformities who had a diastasis of more than 6 cm. We describe the pre-operative workup, surgical strategy and challenges experienced. They specifically include: extensive scar and contracture formation, malunion, urogenital prolapse and difficult reduction of vertical shear element...
July 5, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28661856/the-use-of-fibrinogen-concentrate-for-the-management-of-trauma-related-bleeding-a-systematic-review-and-meta-analysis
#10
REVIEW
Carlo Mengoli, Massimo Franchini, Giuseppe Marano, Simonetta Pupella, Stefania Vaglio, Marco Marietta, Giancarlo M Liumbruno
Haemorrhage following injury is associated with significant morbidity and mortality. The role of fibrinogen concentrate in trauma-induced coagulopathy has been the object of intense research in the last 10 years and has been systematically analysed in this review. A systematic search of the literature identified six retrospective studies and one prospective one, involving 1,650 trauma patients. There were no randomised trials. Meta-analysis showed that fibrinogen concentrate has no effect on overall mortality (risk ratio: 1...
July 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28647160/a-clinical-decision-rule-to-predict-zygomatico-maxillary-fractures
#11
Simon Haworth, Anthony Bates, Andrea Beech, Greg Knepil
Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation...
May 25, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#12
Sara Denham, Tracy Humphrey, Ruth Taylor
BACKGROUND: Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model...
June 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28634651/focus-issue-european-journal-of-trauma-and-emergency-surgery-on-volume-resuscitation-and-coagulation-focus-on-volume-resuscitation-and-coagulation-to-improve-outcomes-in-acute-trauma-haemorrhage
#13
EDITORIAL
M Maegele, T Lustenberger
No abstract text is available yet for this article.
June 20, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28632435/relative-effects-of-plasma-fibrinogen-concentrate-and-factor-xiii-on-rotem-coagulation-profiles-in-an-in-vitro-model-of-massive-transfusion-in-trauma
#14
David E Schmidt, Märit Halmin, Agneta Wikman, Anders Östlund, Anna Ågren
Massive traumatic haemorrhage is aggravated through the development of trauma-induced coagulopathy, which is managed by plasma transfusion and/or fibrinogen concentrate administration. It is yet unclear whether these treatments are equally potent in ensuring adequate haemostasis, and whether additional factor XIII (FXIII) administration provides further benefits. In this study, we compared ROTEM whole blood coagulation profiles after experimental massive transfusion with different transfusion regimens in an in vitro model of dilution- and transfusion-related coagulopathy...
June 20, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28631430/internal-cyclopexy-for-complicated-traumatic-cyclodialysis-cleft
#15
Cong Wang, Xiao-Yan Peng, Qi-Sheng You, Yi Liu, Xiu-Qin Pang, Peng-Fei Zheng, Jost B Jonas
PURPOSE: To assess the surgical and functional outcome of internal direct cyclopexy as therapy of complicated traumatic cyclodialysis. METHODS: The single-centre interventional case-series study included eyes with traumatic cyclodialysis who had consecutively been treated. Internal cyclopexy was performed using double-armed sutures introduced into the eye through the pars plana opposite to the cyclodialysis cleft and which were laid parallel to limbus. Additional procedures included cataract surgery, and pars plana vitrectomy...
June 20, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28627763/suspected-methadone-toxicity-from-hospital-to-autopsy-bed
#16
Jaber Gharehdaghi, Asieh Takalloo-Bakhtiari, Hossein Hassanian-Moghaddam, Nasim Zamani, Mohammad-Javad Hedayatshode
High mortality rates have been reported for methadone in both adults and children. We aimed to determine the pattern of toxicity, possible underlying diseases and treatment challenges in patients referred to our center with early diagnosis of methadone toxicity and who later died. Medical files of all methadone-poisoned patients who had been admitted to a referral center of toxicology between March 2011 and March 2016, died during the hospital stay and sent for autopsy to Legal Medicine Organization were retrospectively evaluated...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28601210/tranexamic-acid-use-in-prehospital-uncontrolled-hemorrhage
#17
REVIEW
Benjamin R Huebner, Warren C Dorlac, Chris Cribari
The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28558815/pathophysiology-of-chronic-subdural-haematoma-inflammation-angiogenesis-and-implications-for-pharmacotherapy
#18
REVIEW
Ellie Edlmann, Susan Giorgi-Coll, Peter C Whitfield, Keri L H Carpenter, Peter J Hutchinson
Chronic subdural haematoma (CSDH) is an encapsulated collection of blood and fluid on the surface of the brain. Historically considered a result of head trauma, recent evidence suggests there are more complex processes involved. Trauma may be absent or very minor and does not explain the progressive, chronic course of the condition. This review focuses on several key processes involved in CSDH development: angiogenesis, fibrinolysis and inflammation. The characteristic membrane surrounding the CSDH has been identified as a source of fluid exudation and haemorrhage...
May 30, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28551075/diagnostic-accuracy-of-post-mortem-ct-with-targeted-coronary-angiography-versus-autopsy-for-coroner-requested-post-mortem-investigations-a-prospective-masked-comparison-study
#19
Guy N Rutty, Bruno Morgan, Claire Robinson, Vimal Raj, Mini Pakkal, Jasmin Amoroso, Theresa Visser, Sarah Saunders, Mike Biggs, Frances Hollingbury, Angus McGregor, Kevin West, Cathy Richards, Laurence Brown, Rebecca Harrison, Roger Hew
BACKGROUND: England and Wales have one of the highest frequencies of autopsy in the world. Implementation of post-mortem CT (PMCT), enhanced with targeted coronary angiography (PMCTA), in adults to avoid invasive autopsy would have cultural, religious, and potential economic benefits. We aimed to assess the diagnostic accuracy of PMCTA as a first-line technique in post-mortem investigations. METHODS: In this single-centre (Leicester, UK), prospective, controlled study, we selected cases of natural and non-suspicious unnatural death referred to Her Majesty's (HM) Coroners...
July 8, 2017: Lancet
https://www.readbyqxmd.com/read/28549445/fibrinogen-early-in-severe-trauma-study-feisty-study-protocol-for-a-randomised-controlled-trial
#20
James Winearls, Martin Wullschleger, Elizabeth Wake, Catherine Hurn, Jeremy Furyk, Glenn Ryan, Melita Trout, James Walsham, Anthony Holley, Jeremy Cohen, Megan Shuttleworth, Wayne Dyer, Gerben Keijzers, John F Fraser, Jeffrey Presneill, Don Campbell
BACKGROUND: Haemorrhage is a leading cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage. Early fibrinogen replacement is recommended by several international trauma guidelines using either fibrinogen concentrate (FC) or cryoprecipitate (Cryo). There is limited evidence to support one product over the other with widespread geographic and institutional variation in practice. This pilot trial is the first randomised controlled trial comparing FC to Cryo in traumatic haemorrhage...
May 26, 2017: Trials
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