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https://www.readbyqxmd.com/read/28933699/pyoderma-gangrenosum-an-uncommon-case-report-and-review-of-the-literature
#1
António Carlos Lemos, Debora Aveiro, Natália Santos, Vítor Marques, Luís Filipe Pinheiro
BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative condition that is diagnostically and therapeutically challenging, as debridement leads to ulcer deterioration (pathergy phenomenon); immunosuppression is considered the gold standard therapy. CASE REPORT: The authors present the case of a 42-year-old woman with PG and uncontrolled iatrogenic diabetes, secondary to a total pancreatectomy performed in another hospital in 1998 due to nesidioblastosis. In 2008, she was referred to the diabetic foot consultation at Centro Hospitalar Tondela-Viseu (Viseu, Portugal) due to an infected wound on the left leg thought to be related to a trauma from footwear, but the injury worsened despite treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28932702/emergency-ct-of-blunt-abdominal-trauma-experience-from-a-large-urban-hospital-in-southern-china
#2
REVIEW
Jingshan Gong, Dongdong Mei, Minjie Yang, Jianmin Xu, Yangyang Zhou
Trauma is one of the leading causes of death for men and women under the age of 45 years old, and abdominal injuries contribute to a large number of these deaths. Prompt diagnosis is very important for treatment decision making and can be life-saving. CT has become an essential imaging modality in emergency medicine. In this pictorial review, we present our experience of CT in blunt abdominal trauma and describe CT findings of common injuries, including hemoperitoneum, solid viscera, hollow viscera, mesenteric and diaphragmatic injuries...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28931486/caring-for-the-veteran-military-and-family-member-nursing-competencies-strategies-for-integrating-content-into-nursing-school-curricula
#3
Libba Reed McMillan, David Crumbley, Julie Freeman, Marilyn Rhodes, Michele Kane, Joy Napper
In the United States, one in every 15 persons is a Veteran (U. S. Department of Veterans Affairs, 2016; U. S. News & World Report, 2017). An estimated 27% of these Veterans receive healthcare through the Veteran's Health Administration (VHA), leaving 73% to seek care in civilian hospitals (Bagalman, 2014). Realistically, most nurses in the United States will care for military members, Veterans or family members in a variety of healthcare systems and settings. Nurse educators are positioned to lead efforts in providing nursing students with the knowledge necessary to provide competent care and serve as advocates for our nation's heroes...
September 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#4
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#5
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#6
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930951/routine-computed-tomography-after-recent-operative-exploration-for-penetrating-trauma-what-injuries-do-we-miss
#7
April E Mendoza, Christopher A Wybourn, Anthony G Charles, Andre R Campbell, Bruce A Cairns, Margaret M Knudson
BACKGROUND: Patients with penetrating trauma who cannot be stabilized undergo operative intervention without preoperative imaging. In such cases, postoperative imaging may reveal additional injuries not identified during the initial operative exploration. The purpose of this study is to explore the utility of postoperative CT imaging in the setting of penetrating trauma. METHODS: This was a retrospective analysis of patients with penetrating trauma treated at an urban Level 1 trauma center between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#8
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#9
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930944/negative-ct-can-safely-rule-out-clinically-significant-intra-abdominal-injury-in-the-asymptomatic-patient-after-blunt-trauma-prospective-evaluation-of-1193-patients
#10
Elizabeth Benjamin, Jayun Cho, Gustavo Recinos, Evren Dilektasli, Lydia Lam, John Brunner, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation following negative imaging. METHODS: A prospective analysis at a large level I trauma center was conducted from 11/2014-5/2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930926/fractures-of-the-nasal-bones-is-external-splinting-really-warranted
#11
Ourania Schoinohoriti, Dimosthenis Igoumenakis, George Rallis
BACKGROUND: It has been advocated that reduction of nasal bone fractures should be followed by internal packing and/or external splinting. Despite the ample literature concerning the advantages and limitations of various splint types, the necessity and effectiveness of external splinting has not been well documented. OBJECTIVE: To present the authors' experience and review the literature on treatment of nasal bone fractures, focusing on the indications and effectiveness of external splinting following closed reduction...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#12
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930046/canadian-benchmarks-for-acute-injury-care
#13
Lynne Moore, David Evans, Natalie L Yanchar, Jaimini Thakore, Henry Thomas Stelfox, Sayed Morad Hameed, Richard Simons, John Kortbeek, Julien Clément, François Lauzier, Alexis F Turgeon
BACKGROUND: Acute care injury outcomes vary substantially across Canadian provinces and trauma centres. Our aim was to develop Canadian benchmarks to monitor mortality and hospital length of stay (LOS) for injury admissions. METHODS: Benchmarks were derived using data from the Canadian National Trauma Registry on patients with major trauma admitted to any level I or II trauma centre in Canada and from the following patient subgroups: isolated traumatic brain injury (TBI), isolated thoracoabdominal injury, multisystem blunt injury, age 65 years or older...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#14
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929612/comparison-of-laparoscopic-toupet-and-laparoscopic-nissen-fundoplications-in-neurologically-normal-children
#15
Go Miyano, Masaya Yamoto, Hiromu Miyake, Masakatsu Kaneshiro, Keiichi Morita, Hiroshi Nouso, Mariko Koyama, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Koji Fukumoto, Atsuyuki Yamataka, Naoto Urushihara
INTRODUCTION: We compared laparoscopic Toupet fundoplication (LTF) and laparoscopic Nissen fundoplication (LNF) in neurologically normal children. METHODS: Forty neurologically normal children who were followed up for more than 3 years after LTF (n = 22) or LNF (n = 18) were reviewed retrospectively. LTF and LNF were performed between 2006 and 2012. RESULTS: There were no significant differences in gender (LTF, 15 male and 7 female patients; LNF:, 12 male and 6 female patients), mean age at surgery (LTF vs LNF: 2...
September 20, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28929307/fracture-liaison-service-report-on-the-first-successful-experience-from-the-middle-east
#16
Falah Bachour, Maroun Rizkallah, Amer Sebaaly, Angelique Barakat, Hiba Razzouk, Rawad El Hage, Riad Nasr, Mirvat El Khoury, Ghassan Maalouf
This study aims to assess for the first time in the Middle East, the clinical benefits of an FLS model established in a hospital in Beirut, Lebanon. It shows a significant 54% relative risk reduction in re-fracture incidence, confirming the patient-oriented benefit of diffusing this system in the Middle East region. PURPOSE/INTRODUCTION: Few hospitals in Lebanon applied Fracture Liaison Service (FLS) program. A type A FLS is established at Bellevue hospital in Beirut in July 2013. This study aims to assess its clinical benefits and efficacy...
September 19, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28928288/association-between-insurance-and-transfer-of-injured-children-from-emergency-departments
#17
Yunru Huang, Jamie L Kissee, Parul Dayal, Nancy Ewen Wang, Ilana S Sigal, James P Marcin
OBJECTIVES: To determine if injured children presenting to nondesignated trauma centers are more or less likely to be transferred relative to being admitted based on insurance status. METHODS: We conducted a cross-sectional study by using the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Pediatric trauma patients receiving care in emergency departments (EDs) at nontrauma centers who were either admitted locally or transferred to another hospital were included...
September 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#18
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28927775/-pasteurella-multocida-meningoencephalitis-in-a-14-year-old-child
#19
L Kuoch, F Villedieu, G Favaretto, J Toulouse, L Mignot, M Jokic
Pasteurella multocida is generally responsible for local infections through animal bites. It can be a cause of meningitis, which tends to affect people at the extreme ages of life or suffering from immunodeficiency. A 14-year-old teenager was hospitalized with typical signs of bacterial meningitis. P. multocida was evidenced in the cerebrospinal fluid. Progression was marked by a degradation on the 4th day of treatment, despite intravenous antibiotic therapy with third-generation cephalosporin, followed by a single seizure on the 7th day of treatment...
September 15, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28926849/-a-nationwide-survey-of-undergraduate-training-in-orthopaedics-and-trauma-surgery
#20
Miriam Ruesseler, Susanne Froehlich, Sigrid Ruesseler, Julian Zabel, Jasmina Sterz, Udo Obertacke
Background Musculoskeletal conditions are the most frequent cause of long-term pain and disability. Scientifically funded, structured training would be highly desirable for all medical students and of great economic relevance for the health care system. The present article portrays the status quo of undergraduate training in orthopaedics and trauma surgery, with a comparison to the status quo of 2008. Material and Methods A 51-item questionnaire was sent to all heads of the departments of orthopaedics or trauma surgery at the 37 medical faculties in Germany...
September 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
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