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https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#1
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28650199/an-initial-application-of-a-biopsychosocial-framework-to-predict-posttraumatic-stress-following-pediatric-injury
#2
Meghan L Marsac, Nancy Kassam-Adams, Douglas L Delahanty, Jeffrey Ciesla, Danielle Weiss, Keith F Widaman, Lamia P Barakat
OBJECTIVE: Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association...
June 26, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28649302/differential-predictors-of-dsm-5-ptsd-and-icd-11-complex-ptsd-among-african-american-women
#3
Abigail Powers, Negar Fani, Sierra Carter, Dorthie Cross, Marylene Cloitre, Bekh Bradley
Background: Complex posttraumatic stress disorder (CPTSD) is proposed for inclusion in the ICD-11 as a diagnosis distinct from posttraumatic stress disorder (PTSD), reflecting deficits in affective, self-concept, and relational domains. There remains significant controversy over whether CPTSD provides useful diagnostic information beyond PTSD and other comorbid conditions, such as depression or substance use disorders. Objective: The present study examined differences in psychiatric presentation for three groups: traumatized controls, DSM-5 PTSD subjects, and ICD-11 CPTSD subjects...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28647848/the-utilization-of-round-window-membrane-surface-tension-in-facilitating-slim-electrodes-insertion-during-cochlear-implantation
#4
Ihab Nada, Ahmed Nabil Abdelhamid, Ahmed Negm
This is a prospective randomized study aimed to evaluate the round window membrane (RWM) surface tension in facilitating slim electrodes insertion during cochlear implantation. A total number of (118) children were included in this study (118 implantations). Mean age was 36.72 months (range from 18 to 60 months). This study was conducted from January 2015 to September 2016 at a cochlear implant centre in a tertiary referral hospital. Slit incision in the anterosuperior quadrant of the RWM was done in 70 cases, While RWM cruciate incision was done in 48 cases...
June 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28647160/a-clinical-decision-rule-to-predict-zygomatico-maxillary-fractures
#5
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/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#6
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#7
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
June 21, 2017: Surgery
https://www.readbyqxmd.com/read/28645946/risk-factors-for-admission-at-three-urban-emergency-departments-in-england-a-cross-sectional-analysis-of-attendances-over-1-month
#8
Sharif A Ismail, Ian Pope, Benjamin Bloom, Raquel Catalao, Emilie Green, Rebecca E Longbottom, Gwyneth Jansen, David McCoy, Tim Harris
OBJECTIVE: To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England. DESIGN AND SETTING: Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645672/percutaneous-pedicle-screw-placement-under-single-dimensional-fluoroscopy-with-a-designed-pedicle-finder-a-technical-note-and-case-series
#9
Fon-Yih Tsuang, Chia-Hsien Chen, Yi-Jie Kuo, Wei-Lung Tseng, Yuan-Shen Chen, Chin-Jung Lin, Chun-Jen Liao, Feng-Huei Lin, Chang-Jung Chiang
BACKGROUND CONTEXT: Minimally invasive spine surgery has become increasingly popular in clinical practice, and it offers patients the potential benefits of reduced blood loss, wound pain, and infection risk and also diminishes the loss of working time and length of hospital stay. However, surgeons require more intraoperative fluoroscopy and ionizing radiation exposure during minimally invasive spine surgery for localization, especially for guidance in instrumentation placement. In addition, computer navigation is not accessible in some facility-limited institutions...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28645215/upper-extremity-trauma-resulting-from-agricultural-accidents-mechanism-and-severity-for-patients-with-and-without-upper-extremity-injury
#10
Louis C Grandizio, Benjamin Wagner, Jove Graham, Joel C Klena
BACKGROUND: Farming remains the most dangerous occupation in the United States and upper extremity (UE) injuries occur frequently in agricultural accidents. The purpose of this study is to describe the injury mechanisms, severity, and health care costs of UE injuries resulting from agricultural accidents and to compare patients with and without injuries to the UE. METHODS: We performed a 6-year retrospective review of our level I trauma center registry from January 2006 to May 2013, identifying all patients injured in an agricultural accident...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644586/medical-record-weight-mrw-a-new-reliable-predictor-of-hospital-stay-morbidity-and-mortality-in-the-hip-fracture-population
#11
P Calpin, K Taheny, J F Baker, J Green, J P McCabe
We sought to compare the weight of patient's medical records (MRW) to that of standardised surgical risk scoring systems in predicting postoperative hospital stay, morbidity, and mortality in patients with hip fracture. Patients admitted for surgical treatment of a newly diagnosed hip fracture over a 3-month period were enrolled. Patients with documented morbidity or mortality had significantly heavier medical records. The MRW was equivalent to the age-adjusted Charlson co-morbidity index and better than the American Society of Anaesthesiologists physical status score (ASA), the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM,) and Portsmouth-POSSUM score (P-POSSUM) in correlation with length of hospital admission, p = ...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#12
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643096/-results-of-the-pilot-phase-of-the-age-trauma-registry-dgu%C3%A2
#13
Benjamin Bücking, Erich Hartwig, Ulrike Nienaber, Ulla Krause, Thomas Friess, Ulrich Liener, Maria Hevia, Christopher Bliemel, Matthias Knobe
BACKGROUND: Since 2014, hospitals with ortho-geriatric fracture centres could be certified as AltersTraumaZentrum DGU® in Germany. To measure the quality of treatment in these centres, a geriatric trauma registry (AltersTraumaRegister DGU®) was established. OBJECTIVES: The aim of this work was to report the results of the pilot phase of the AltersTraumaRegister DGU® from the year 2015. MATERIALS AND METHODS: Included were 118 patients >70 years with hip fracture or implant-related femoral fractures...
June 22, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28642650/epidemiological-study-on-lisfranc-injuries
#14
Marcel Faraco Sobrado, Guilherme Honda Saito, Marcos Hideyo Sakaki, Pedro Augusto Pontin, Alexandre Leme Godoy Dos Santos, Túlio Diniz Fernandes
OBJECTIVE: To analyze the characteristics of patients with Lisfranc injuries and their associated fractures . METHODS: This is a retrospective analysis on 42 patients with Lisfranc injuries hospitalized at Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, between 2006 and 2010. Parameters on patient profile, risk factors, fracture characteristics, data on treatment and acute complications were analyzed ...
January 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28641984/bi-objective-approach-for-placing-ground-and-air-ambulance-base-and-helipad-locations-in-order-to-optimize-ems-response
#15
Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28641392/alcohol-is-not-protective-against-mortality-following-traumatic-brain-injury
#16
Jennifer S Albrecht, Majid Afshar, Deborah M Stein, Gordon S Smith
Alcohol exposure results in reduced mortality following traumatic brain injury (TBI) in animal models, yet clinical studies reported conflicting results and clinical trials based on proposed mechanisms have been disappointing. Methodological issues common to many of the clinical studies may have contributed to spurious results. Our objective was to evaluate the association between blood alcohol concentration (BAC) and in-hospital mortality following TBI, overcoming methodological problems of prior studies. We conducted a retrospective cohort study on individuals treated for isolated TBI at the R Adams Cowley Shock Trauma Center between 1997-2012 (n = 1,084)...
June 21, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28641385/development-of-an-electronic-medical-record-based-child-physical-abuse-alert-system
#17
Rachel P Berger, Richard A Saladino, Janet Fromkin, Emily Heineman, Srinivasan Suresh, Tom McGinn
Objective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes. Methods: Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center...
June 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28641304/hyperemesis-gravidarum-a-review-of-recent-literature
#18
Viktoriya London, Stephanie Grube, David M Sherer, Ovadia Abulafia
BACKGROUND: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown...
June 23, 2017: Pharmacology
https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#19
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28640776/early-fever-after-trauma-does-it-matter
#20
Holly E Hinson, Susan Rowell, Cynthia Morris, Amber L Lin, Martin A Schreiber
BACKGROUND: Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury, and associated with inflammation. METHODS: We prospectively enrolled patients with major trauma with and without TBI from a busy level I trauma center ICU. Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores (HAIS): Polytrauma: Head AIS score >2, one other region>2, Isolated Head: Head AIS score>2, all other regions <3, Isolated Body: One region >2, excluding Head/Face, Minor Injury: No region with AIS>2...
June 20, 2017: Journal of Trauma and Acute Care Surgery
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