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https://www.readbyqxmd.com/read/29665031/mortality-following-surgery-for-trauma-in-an-indian-trauma-cohort
#1
M Mansourati, V Kumar, M Khajanchi, M L Saha, S Dharap, R Seger, M Gerdin Wärnberg
BACKGROUND: India accounts for 20 per cent of worldwide trauma mortality. Little is known about the quality of trauma surgery in an Indian setting. The aim of this study was to estimate the overall perioperative mortality rate, and to assess the association between type of acute surgical intervention and perioperative mortality among adult patients treated for trauma in an urban Indian setting. METHODS: Data were obtained from injured adult patients enrolled in four urban Indian hospitals during 2013-2015...
April 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29651520/-surface-modifications-of-implants-part-2-clinical-application
#2
Marcus Jäger
The chemical composition, surface structure and topography of a biomaterial have an essential influence on the effects of an implant in the human body. In orthopedic and trauma surgery they make a relevant contribution to solve the current and future challenges. Particularly high are the requirements of permanent implants in bone. Besides material aging due to oxidation, implants are subjected to cyclic loading that leads to relevant biomechanical wear and abrasion. To date significant efforts have been made to minimize adverse implant-associated immunoreactions as well as the risk of periprosthetic infections...
April 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29650475/use-of-patient-reported-outcome-measures-in-oral-and-maxillofacial-trauma-surgery-a-review
#3
REVIEW
R Ologunde, N M H McLeod
In the UK, about one person/100/year sustains a facial injury, so trauma surgery accounts for a considerable part of the caseload in oral and maxillofacial surgery (OMFS). Patient-reported outcome measures (PROM) allow for patient-centred assessment of postoperative outcomes, but to our knowledge, most research in OMFS trauma does not currently include them. To investigate their use, we searched Medline to find relevant studies that reported outcomes from inception in January 1879 to August 2016. Those not in the English language and those that did not report operations were excluded...
April 9, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29644264/laparoscopic-approach-to-the-management-of-penetrating-traumatic-diaphragmatic-injury
#4
Teo Li Tserng, Maria Benita Gatmaitan
Background: Traditionally, laparotomy/thoracotomy is the standard approach for thoracoabdominal injuries. However, it has a non-therapeutic rate of 12-40% and 40% morbidity. Laparoscopy, as a diagnostic and therapeutic modality, has evolved to be integral to general and subspecialty surgeons in the management of patients. However, its use in the field of trauma surgery has been limited. We present a case of traumatic diaphragmatic injury from a low velocity penetrating wound successfully repaired through laparoscopic approach...
August 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29615194/comments-on-tele-mentored-emergency-trauma-surgery-a-feasibility-study-using-live-tissue-models
#5
Camilo Rosales
No abstract text is available yet for this article.
March 22, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29613949/reduced-dnase-enzyme-activity-in-response-to-high-post-injury-mitochondrial-dna-concentration-provides-a-therapeutic-target-for-sirs
#6
Daniel J McIlroy, Kyra Minahan, Simon Keely, Natalie Lott, Philip Hansbro, Doug W Smith, Zsolt J Balogh
BACKGROUND: Cell free mitochondrial DNA (mtDNA) is pro-inflammatory and has been detected in high concentrations in trauma patients' plasma. Deoxyribonuclease (DNase) is the free plasma enzyme responsible for the digestion of extracellular DNA. The relationship between mtDNA and DNase after major trauma is unknown. We hypothesized that DNase activity would be elevated after injury and trauma surgery, and would be associated with high concentrations of extracellular DNA. METHODS: 2-year prospective study was performed on 103 consecutive trauma patients (Male 81%, Age: 38 IQR 30-59 years; ISS: 18 IQR 12-26) who underwent standardised major orthopaedic trauma surgical interventions...
March 22, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29589042/-hemostyptics-for-treatment-of-junctional-vascular-injuries-management-of-traumatic-vascular-injuries-at-the-transition-from-trunk-to-extremities
#7
REVIEW
D C Hinck, S Wipper, E S Debus
BACKGROUND: Uncontrolled post-traumatic bleeding is still the leading cause of death among trauma patients. In situations of mass casualty incidents (MASCAL) and military conflicts the treatment of uncontrolled critical bleeding is a challenge and associated with a worse outcome due to the austere environment; however, even under optimal treatment circumstances in situations of individual medicine the severity of vascular trauma is underestimated. As a consequence, this leads to a poorer prognosis for patients with (vascular) injuries...
March 27, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29582942/-fluoroscopic-based-navigation-in-orthopaedic-trauma-a-review-of-a-large-center-s-experience
#8
Yoram A Weil, Meir Liebergall, Rami Mosheiff, Amal Khoury
INTRODUCTION: Computer Assisted Orthopaedic Surgery (CAOS) was introduced in the late 1990's and early 2000's. Since then its application in orthopaedic trauma has been utilized mainly as augmented fluoroscopy for intraoperative navigation. From 2010 our center implemented an advanced system allowing further expansion of this technology. AIMS: The aim of this study was to describe the experience with an advanced fluoroscopic based CAOS system in our center. METHODS: The BrainLabTM Trauma 3...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29555082/non-accidental-trauma-a-national-survey-on-management
#9
Richard Sola, Valerie A Waddell, Shawn D St Peter, Pablo Aguayo, David Juang
INTRODUCTION: Non-accidental trauma (NAT) has significant societal and health care implications. Standardized care has been shown to improve outcomes. The purpose of our study was to survey trauma centers and elucidate the continued variable management of NAT. METHODS: After institutional review board approval, an email survey was sent to Level 1 and 2 ACS verified trauma centers along with general and pediatric surgery training programs. Trauma hospital characteristics and NAT management were analyzed...
March 10, 2018: Injury
https://www.readbyqxmd.com/read/29554038/trauma-surgeon-performance-of-appendectomy-in-5-10-year-old-children-is-safe-and-decreases-length-of-hospital-stay
#10
Derek B Wall, Carlos Ortega
BACKGROUND: Even in metropolitan areas, on-call pediatric surgeons may not always be immediately available for surgical care of appendicitis, potentially leading to delays in care. In 2012, the in-house trauma group at a suburban Level 1 trauma center (none with formal pediatric fellowship training) assumed surgical care of 5-10 year-old children with appendicitis, who had previously been cared for by pediatric surgeons. We propose to compare the outcomes of the trauma and pediatric surgery groups...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29542418/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-on-sodium-glucose-cotransporter-2-inhibitors-a-case-series
#11
Purva Sharma, Yash Jobanputra, Karen Lewin, Stuart Bagatell, Daniel Lichtstein
BACKGROUND: Diabetic ketoacidosis (DKA) is a serious complication of diabetes seen commonly in autoimmune Type 1 diabetes mellitus (DM), however patients with Type 2 diabetes are also at risk. Diabetic ketoacidosis may be precipitated by the catabolic stress of acute illness such as trauma, surgery, or infections. Recent studies have suggested that sodium glucose cotransporter-2 (SGLT-2) inhibitors precipitate DKA in Type 2 diabetes. We present a case series of four patients on SGLT-2 inhibitors who presented with DKA...
March 13, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29538456/a-trauma-network-with-centralized-and-local-health-care-structures-evaluating-the-effectiveness-of-the-first-certified-trauma-network-of-the-german-society-of-trauma-surgery
#12
Antonio Ernstberger, Michael Koller, Florian Zeman, Maximilian Kerschbaum, Franz Hilber, Eva Diepold, Julika Loss, Tanja Herbst, Michael Nerlich
BACKGROUND: Trauma is a global burden of disease and one of the main causes of death worldwide. Therefore, many countries around the world have implemented a wide range of different initiatives to minimize mortality rates after trauma. One of these initiatives is the bundling of treatment expertise in trauma centers and the establishment of trauma networks. Germany has a decentralized system of trauma care medical centers. Severely injured patients ought to receive adequate treatment in both level I and level II centers...
2018: PloS One
https://www.readbyqxmd.com/read/29523015/-weighting-of-orthopaedics-trauma-surgery-in-the-medical-state-examination-comparison-of-the-written-examination-with-the-national-catalogue-of-learning-objectives-in-surgery
#13
Jasmina Sterz, Vanessa Britz, Matthias Münzberg, Martina Kadmon, Iris Schleicher, Adrian Meder, Rainer Kamp, Maren Janko, Ingo Marzi, Miriam Rüsseler
BACKGROUND: The national competence-based catalogue of learning-goals in surgery (NKLC) defines competence levels for each of its 230 goals, including "competence level in 1: factual knowledge" up to "competence level 3: independent action". Aside from the cumulative examinations influencing the learning behaviour of students, those teaching targets do not affect the second state examination. This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP (central German institute for medical and pharmaceutical examinations) are congruent with the trauma-surgical and orthopaedic learning goals in the NKLC, in which this thematic focus is emphasised...
March 9, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29499817/use-of-tourniquets-in-limb-trauma-surgery
#14
REVIEW
Yelena Bogdan, David L Helfet
Although tourniquets are commonly used in patients with limb trauma patients, both in the acute and elective settings, no set protocols exist for their indications, contraindications, or proper use. This article addresses the current literature on optimal pressure, timing, cuff design, and complications of tourniquets in trauma patients. General issues are discussed, followed by those specific to upper and lower extremities. Lastly, serious complications, such as pulmonary embolism, are described.
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29484075/chronic-expanding-hematoma-of-the-left-flank-mimicking-a-soft-tissue-neoplasm
#15
Guglielmo Manenti, Armando Ugo Cavallo, Salvatore Marsico, Daniele Citraro, Erald Vasili, Adriano Lacchè, Marco Forcina, Amedeo Ferlosio, Piero Rossi, Roberto Floris
Soft-tissue hematomas are a common clinical entity often associated with trauma, surgery, and bleeding disorders. In the majority of cases, soft-tissue hematomas acutely appear and spontaneously resolve, but sometimes, they present as swellings that slowly expand and progressively increase with time. We present a case of a 70-year-old man with chronic expanding hematoma of the left flank without any history of recent trauma or other medical disease. The diagnosis could not be confirmed on imaging features alone, so the patient was taken to surgery for open biopsy and excision...
December 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/29472928/immunothrombotic-activity-of-damage-associated-molecular-patterns-and-extracellular-vesicles-in-secondary-organ-failure-induced-by-trauma-and-sterile-insults
#16
REVIEW
John Eppensteiner, Robert Patrick Davis, Andrew S Barbas, Jean Kwun, Jaewoo Lee
Despite significant improvements in injury prevention and emergency response, injury-related death and morbidity continues to increase in the US and worldwide. Patients with trauma, invasive operations, anti-cancer treatment, and organ transplantation produce a host of danger signals and high levels of pro-inflammatory and pro-thrombotic mediators, such as damage-associated molecular patterns (DAMPs) and extracellular vesicles (EVs). DAMPs (e.g., nucleic acids, histone, high-mobility group box 1 protein, and S100) are molecules released from injured, stressed, or activated cells that act as endogenous ligands of innate immune receptors, whereas EVs (e...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29461404/use-of-patient-related-outcomes-after-orthopaedic-trauma-helpful-or-not-so-much
#17
William T Obremskey, Thomas F Higgins, Janet Pryu Bettger, Mark S Vrahas, Douglas W Lundy
Over 100 years ago, the orthopaedic surgeon, Ernest Codman, recommended that surgeons and hospitals be paid by the "end result." Healthcare Reform is moving to value over volume, and patient-reported outcomes (PROs) are 1 measure of quality and outcomes that are becoming pervasive. In this study, the current status of patient-reported outcomes and their use in orthopaedic trauma was reviewed. The contributors presented the state of PRO measurements at the Basic Science Focus Forum at the OTA Annual Meeting in 2016...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29450640/incidence-of-perioperative-complications-in-total-hip-and-knee-arthroplasty-in-patients-with-parkinson-disease
#18
Tankamani Sharma, Wolfgang Hönle, René Handschu, Werner Adler, Tarun Goyal, Alexander Schuh
INTRODUCTION: The aim of this study is to evaluate the difference in perioperative complication rate in total hip, bipolar hemiarthroplasties and total knee arthroplasty in patients with Parkinson disease in trauma and elective surgery in our Musculoskeletal Center during a period of 10 years. MATERIAL AND METHOD: Between 2006 and 2016, 45 bipolar hemiarthroplasties in trauma surgery, 15 total knee and 19 total hip arthroplasties in patients with Parkinson's disease were performed...
February 15, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29433799/international-survey-among-orthopaedic-trauma-surgeons-lack-of-a-definition-of-fracture-related-infection
#19
M Morgenstern, T F Moriarty, R Kuehl, R G Richards, M A McNally, M H J Verhofstad, O Borens, C Zalavras, M Raschke, S L Kates, W J Metsemakers
INTRODUCTION: Fracture-related infection (FRI) is one of the most challenging musculoskeletal complications in orthopaedic-trauma surgery. Although the orthopaedic community has developed and adopted a consensus definition of prosthetic joint infections (PJI), it still remains unclear how the trauma surgery community defines FRI in daily clinical practice or in performing clinical research studies. The central aim of this study was to survey the opinions of a global network of trauma surgeons on the definitions and criteria they routinely use, and their opinion on the need for a unified definition of FRI...
February 6, 2018: Injury
https://www.readbyqxmd.com/read/29410701/is-case-triaging-a-useful-tool-for-emergency-surgeries-a-review-of-106-trauma-surgery-cases-at-a-level-1-trauma-center-in-south-africa
#20
Sharfuddin Chowdhury, Andrew John Nicol, Mahammed Riyaad Moydien, Pradeep Harkison Navsaria, Luis Felipe Montoya-Pelaez
Background: The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death...
2018: World Journal of Emergency Surgery: WJES
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