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https://www.readbyqxmd.com/read/29786898/adults-with-comorbid-posttraumatic-stress-disorder-alcohol-use-disorder-and-opioid-use-disorder-the-effectiveness-of-modified-prolonged-exposure
#1
Kelly R Peck, Julie A Schumacher, Paul R Stasiewicz, Scott F Coffey
Opioid use disorders (OUDs) are a growing problem in the United States. When OUDs co-occur with problematic drinking and posttraumatic stress disorder (PTSD), negative drug-related mental and physical health outcomes may be exacerbated. Thus, it is important to establish whether PTSD treatments with established efficacy for dually diagnosed individuals also demonstrate efficacy in individuals who engage in problematic drinking and concurrent opioid misuse. Adults who met DSM-IV-TR criteria for PTSD and alcohol dependence were recruited from a substance use treatment facility and were randomly assigned to receive either modified prolonged exposure (mPE) therapy for PTSD or a non-trauma-focused comparison treatment...
May 22, 2018: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29786886/predictors-of-treatment-completion-for-families-referred-to-trauma-focused-cognitive-behavioral-therapy-after-child-abuse
#2
Marianne Celano, Amanda NeMoyer, Anna Stagg, Nikia Scott
Despite advances in the dissemination of evidence-based therapy for abuse-related traumatic stress, many referred children fail to complete treatment. Using archival data from a sample of children participating in trauma-focused cognitive behavioral therapy (TF-CBT) at a hospital-based child advocacy center, analyses explored the impact of baseline child traumatic stress symptoms, a second (nonprimary) caregiver's treatment attendance, and the number of assessment sessions on treatment completion while controlling for demographic variables...
May 22, 2018: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29786821/cardiac-findings-of-sternal-fractures-due-to-thoracic-trauma-a-five-year-retrospective-study
#3
Ahmet Uluşan, Özgür Karakurt
BACKGROUND: This study mainly aimed to determine the frequency of sternal fractures in thoracic trauma patients and to assess the differences in surgical need, cardiac findings, and treatment processes between patients with fracture on different sternal zones and displaced and non-displaced sternal fractures. METHODS: We analyzed the data of patients with sternal fracture due to thoracic trauma admitted to a state hospital between January 2011 and December 2015...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786819/evaluation-of-pterygoid-plate-fractures-unrelated-to-le-fort-fractures-using-maxillofacial-computed-tomography
#4
Serra Özbal Güneş, Yeliz Aktürk, Esra Soyer Güldoğan
BACKGROUND: This study aims to describe the major pterygoid plate fractures (PPFs) patterns unrelated to Le Fort fractures (LFFs) using maxillofacial computed tomography (CT). METHODS: After obtaining our hospital ethics committee approval (37-05), data for PPF were acquired from the medical records of all the trauma patients who were diagnosed using CT at our hospital from April 2014 to April 2017. RESULTS: Of the 178 patients, 135 (male/female = 86/49; mean age = 37...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786818/management-of-traumatic-arteriovenous-fistulas-a-tertiary-academic-center-experience
#5
Mazlum Şahin, Cihan Yücel, Eyüp Murat Kanber, Fatma Tuba İlal Mert, Burcu Bıçakhan
BACKGROUND: To present the surgical experience at a tertiary academic center of treating patients with traumatic arteriovenous fistulas (AVFs) who in whom endovascular treatment was contraindicated or in whom unsuccessful endovascular treatment had been performed. METHODS: A total of 27 patients with traumatic AVFs who underwent surgery between September 2014 and May 2016 were included. The site of injury, timing of surgery, and the surgical methods utilized were analyzed retrospectively...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#6
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786037/preliminary-outcome-of-individualized-abdominoperineal-excision-for-locally-advanced-low-rectal-cancer
#7
Yi Zheng, Jia-Gang Han, Zhen-Jun Wang, Zhi-Gang Gao, Guang-Hui Wei, Zhi-Wei Zhai, Bao-Cheng Zhao
Background: The introduction of individualized abdominoperineal excision (APE) may minimize operative trauma and reduce the rate of complications. The purpose of this study was to evaluate the safety and efficacy of individualized APE for low rectal cancer. Methods: Fifty-six patients who underwent individualized APE from June 2011 to June 2015 were evaluated retrospectively in Beijing Chaoyang Hospital, Capital Medical University. The main outcome measures were circumferential resection margin (CRM) involvement, intraoperative perforation, postoperative complications, and local recurrence...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#8
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785695/differences-in-characteristics-and-outcome-of-patients-with-penetrating-injuries-in-the-usa-and-the-netherlands-a-multi-institutional-comparison
#9
Suzan Dijkink, Pieta Krijnen, Aglaia Hage, Gwendolyn M Van der Wilden, George Kasotakis, Dennis den Hartog, Ali Salim, J Carel Goslings, Frank W Bloemers, Steven J Rhemrev, David R King, George C Velmahos, Inger B Schipper
INTRODUCTION: The incidence and nature of penetrating injuries differ between countries. The aim of this study was to analyze characteristics and clinical outcomes of patients with penetrating injuries treated at urban Level-1 trauma centers in the USA (USTC) and the Netherlands (NLTC). METHODS: In this retrospective cohort study, 1331 adult patients (470 from five NLTC and 861 from three USTC) with truncal penetrating injuries admitted between July 2011 and December 2014 were included...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29785655/early-results-after-operatively-versus-non-operatively-treated-flail-chest-a-retrospective-study-focusing-on-outcome-and-complications
#10
Mathieu M E Wijffels, Tjebbe Hagenaars, Diba Latifi, Esther M M Van Lieshout, Michael H J Verhofstad
PURPOSE: Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29785654/a-systematic-review-and-meta-analysis-of-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-management-of-major-exsanguination
#11
REVIEW
B L S Borger van der Burg, Thijs T C F van Dongen, J J Morrison, P P A Hedeman Joosten, J J DuBose, T M Hörer, R Hoencamp
BACKGROUND: Circulatory collapse is a leading cause of mortality among traumatic major exsanguination and in ruptured aortic aneurysm patients. Approximately 40% of patients die before hemorrhage control is achieved. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive surgical or endovascular repair. A systematic review was conducted for the current clinical use of REBOA in patients with hemodynamic instability and to discuss its potential role in improving prehospital and in-hospital outcome...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29785378/delayed-presentation-of-grade-iv-renal-injury-post-blunt-trauma
#12
J Teh, M Khan, D Liu, J Roberts-Thomson
High-grade renal injuries are relatively uncommon in blunt trauma. They typically occur in the context of multisystem injuries. When present, these renal injuries are usually identified at the time of hospital presentation. Here, we present a case of delayed presentation of American Association for the Surgery of Trauma (AAST) grade-IV renal injury in a 61-year-old female who sustained multisystem injuries during a high-speed motor vehicle accident. To our knowledge, this is the first report case of delayed presentation of grade-IV renal injury...
May 2018: Urology Case Reports
https://www.readbyqxmd.com/read/29784656/lessons-identified-from-the-2017-manchester-and-london-terrorism-incidents-part-two-the-reception-and-definitive-care-hospital-phases
#13
REVIEW
Paul Hunt
The provision of medical care during the reception and definitive care phases of a terrorist incident will likely take place in designated receiving hospitals such as Major Trauma Centres. There is a need for an enhanced capability in such units to receive, initially manage and hold casualties with more serious injuries. Also, even less severely injured casualties may require significant time and clinical input such as risk management in potential bloodborne viruses.The distribution of casualties from the incident scene requires advance consideration of the injury pattern and regional network organisation of specialist services, such as maxillofacial, neurosurgery or severe burns care...
May 21, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29784591/accuracy-and-outcome-of-rapid-ultrasound-in-shock-and-hypotension-rush-in-egyptian-polytrauma-patients
#14
Adel Hamed Elbaih, Ahmed Mohamed Housseini, Mohamed E M Khalifa
PURPOSE: "Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes...
March 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29784284/routine-surveillance-imaging-following-mild-traumatic-brain-injury-with-intracranial-hemorrhage-may-not-be-necessary
#15
Smruti K Patel, Yair M Gozal, Bryan M Krueger, James C Bayley, Suzanne Moody, Norberto Andaluz, Richard A Falcone, Karin S Bierbrauer
BACKGROUND: Mild traumatic brain injury (mTBI) comprises the majority of pediatric traumatic brain injury. Children with mTBI even with traumatic intracranial hemorrhage (tICH) rarely experience a clinically significant neurologic decline (CSND). The utility of routine surveillance imaging in the pediatric population also remains controversial, especially owing to concerns about the risks of radiation exposure at a young age. This study aims to identify demographic or injury-related characteristics that may facilitate recognition of children at risk of progression with mTBI...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29783252/the-analytical-prognosis-of-the-susceptibility-to-aminoglycosides-and-doxycycline-inacinetobacter-baumanniiisoolated-from-burns-of-intensive-care-unit-patients
#16
Vasyl I Nahaichuk, Oleksandr A Nazarchuk, Neonila I Osadchuk, Dmytro V Dmytriiev, Halyna H Nazarchuk
OBJECTIVE: Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29781945/appropriateness-of-pediatric-orthopaedic-transfers-to-a-level-1-hospital
#17
Jaclyn McKenna, David Novikov, Amanda Pawlak, Jihye Park, Jie Yang, Hariharan Iyer, James Barsi
OBJECTIVE: The purpose of this study was to compare a cohort of transferred pediatric orthopaedic patients with orthopaedic patients who primarily presented to a Level 1 pediatric emergency department to identify risk factors for transfer. DESIGN: Retrospective cohort study. SETTING: This study was performed at a level one trauma center in New York. PATIENTS: The cohort consisted of patients under age 18 who presented to one level 1 pediatric trauma center between January 1, 2013 - December 31, 2013 with an orthopaedic fracture diagnosis code (ICD-9 805...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29781925/osteo-odonto-keratoprosthesis-in-severe-thermal-and-chemical-injuries
#18
Alfonso Vasquez-Perez, Mehran Zarei-Ghanavati, Venkata Avadhanam, Christopher Liu
PURPOSE: To report the results of osteo-odonto-keratoprosthesis (OOKP) surgery in patients who sustained severe chemical and thermal injuries. METHODS: This is a noncomparative retrospective case series of 14 patients who underwent OOKP surgery between 2001 and 2016 at the Sussex Eye Hospital, Brighton, UK, because of severe chemical and thermal injuries RESULTS:: OOKP surgery was performed in 14 eyes of 14 patients. Eight patients (57%) sustained thermal injuries and 6 patients (43%) chemical injuries...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29780829/the-effect-of-c-arm-mobility-and-field-of-vision-on-radiation-exposure-in-the-treatment-of-proximal-femoral-fractures-a-randomized-clinical-trial
#19
Mahmut Kalem, Kerem Başarır, Hakan Kocaoğlu, Ercan Şahin, Hakan Kınık
Objectives: To examine the effect of fluoroscopy devices with different sizes of image intensifier and C-arm maneuverability on operating time, fluoroscopy time, radiation dose and reduction, and fixation quality at intertrochanteric femoral fractures. Design: Single-center, randomized, prospective study. Setting: Academic Level I trauma hospital. Patients and Intervention: 34 patients treated with cephalomedullary nailing for a stable, intertrochanteric proximal femur fracture (OTA A1)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29779843/sociodemographic-determinants-of-non-accidental-traumatic-injuries-in-children
#20
Omar Nunez Lopez, Byron D Hughes, Deepak Adhikari, Kari Williams, Ravi S Radhakrishnan, Kanika A Bowen-Jallow
BACKGROUND: Traumatic injuries account for 18% of child abuse cases and 1680 children die from abuse annually. We set out to determine the impact of sociodemographic characteristics on resource utilization and outcomes in nonaccidental trauma (NAT). METHODS: We used the Kid's Inpatient Database to identify children with two main subgroups of child abuse diagnoses: NAT and other forms of child abuse. Income was represented by quartiles. Statistical analysis included descriptive statistics and regression analyses...
May 12, 2018: American Journal of Surgery
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