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Michael T Yim, Huy D Tran, Binoy M Chandy
OBJECTIVES/HYPOTHESIS: To determine the epidemiology of incidental thyroglossal duct cysts (TGDC) discovered on imaging studies obtained in the head and neck area in children and to discuss subsequent management. METHODS: A retrospective chart review was performed at Texas Children's Hospital of all computed tomography (CT) and magnetic resonance (MR) imaging studies obtained in the head and neck region between July 2011 and July 2014. Images obtained for the purpose of evaluating a neck or lingual mass were excluded from the study, as were patients with previously known TGDCs...
October 2016: International Journal of Pediatric Otorhinolaryngology
B Hylton, S Lidder, A Armitage, S James
UNLABELLED: PURPOSE OF THE STUDY The aim of this pilot study was to develop The Eastbourne Miami-J Protocol for care of cervical injuries within the community. Led by orthopaedic senior practitioners, a multidisciplinary approach was developed to provide education and collar care for patients on a weekly basis. MATERIALS AND METHODS A total of 51 patients (17 male and 33 female), mean age 74 years (21 to 95) with CT confirmed cervical injuries during November 2010 and May 2014 followed the Eastbourne Miami-J Protocol...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
Kenji Inaba, Saskya Byerly, Lisa D Bush, Mathew J Martin, David Martin, Kimberly A Peck, Galinos Barmparas, Matthew J Bradley, Joshua P Hazelton, Raul Coimbra, Asad J Choudhry, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Bellal Joseph, Julie Dunn, Christian T Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades
BACKGROUND: For blunt trauma patients who have failed the NEXUS low-risk criteria, the adequacy of CT as the definitive imaging modality for clearance remains controversial. The purpose of this study was to prospectively evaluate the accuracy of CT for the detection of clinically significant C-spine injury. METHODS: Prospective multicenter observational study (09/2013-03/2015), at 18 North American Trauma Centers. All adult (≥18yo) blunt trauma patients underwent a structured clinical examination...
July 20, 2016: Journal of Trauma and Acute Care Surgery
Guoyun Bu, Feng Shuang, Gang Liu, Ye Wu, Shuxun Hou, Dongfeng Ren, Weilin Shang
OBJECTIVES: We designed a novel surgical strategy named one-stage selective discectomy combined with expansive hemilaminectomy (OSDEHL) which might theoretically reduce the postoperative complications of Cervical Spondylotic Myelopathy (CSM). The objectives of this study is to evaluate its efficacy and safety. METHODS: 62 patients with CSM were enrolled in this study. The procedure includes selective discectomy with fusion at 1 or 2 segments of maximal cord compression and expansive hemilaminectomy on the symptomatic or severe side of the body...
June 20, 2016: World Neurosurgery
John Tran, Donald Jeanmonod, Darin Agresti, Khalief Hamden, Rebecca K Jeanmonod
INTRODUCTION: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation...
May 2016: Western Journal of Emergency Medicine
Therese M Duane, Andrew J Young, Poornima Vanguri, Luke G Wolfe, Judith Katzen, Jinfeng Han, Julie Mayglothling, James F Whelan, Michel B Aboutanos, Rao R Ivatury, Ajai K Malhotra
BACKGROUND: Variability exists in the approach to cervical spine (c-spine) clearance after significant trauma. Using concurrently gathered data on more than 9,000 such patients, the current study develops an evidence-based and readily adoptable algorithm for c-spine clearance aimed at timely removal of collar, optimal use of imaging, and appropriate spine consultations. METHODS: Prospective study of adult blunt trauma team alert (TTA) patients presenting at a Level I trauma center who underwent screening computed tomography (CT) to diagnose/rule out c-spine injury (January 2008 to May 2014)...
September 2016: Journal of Trauma and Acute Care Surgery
J Davies, S Cross, J Evanson
AIM: To determine the potential effect of changes to the National Institute for Health and Care Excellence (NICE) guidelines to the use of computed tomography (CT) in the assessment of suspected paediatric cervical spine (c-spine) injury. MATERIAL AND METHODS: A 5 year retrospective study was conducted of c-spine imaging in paediatric (<10 years) patients presenting following blunt trauma at a Level 1 trauma centre in London. All patients under the age of 10 years who underwent any imaging of the c-spine following blunt trauma were included...
September 2016: Clinical Radiology
Bruno Tirotti Saragiotto, Zoe A Michaleff
No abstract text is available yet for this article.
July 2016: Journal of Physiotherapy
Ikrormi Rungsung, Amutha Ramaswamy
LKB1, the tumour suppressor, is found mutated in Peutz-Jeghers syndrome. The LKB1 is a serine-threonine kinase protein that is allosterically activated by the binding of STRADα and MO25α without phosphorylating the Thr212 present at activation loop. The present study aims to highlight the structural dynamics and complexation mechanism during the allosteric activation of LKB1 by these co-activators using molecular dynamics simulations. The all atom simulations performed on the complexes of LKB1 with ATP, STRADα and MO25α for a period of 30 ns reveal that binding of STRADα and MO25α significantly stabilizes the highly flexible regions of LKB1 such as ATP binding region (β1- β2 loop), catalytic & activation loop segments and αG helix...
May 9, 2016: Journal of Biomolecular Structure & Dynamics
Katherine D Wysham, Sara G Murray, Nancy Hills, Edward Yelin, Lianne S Gensler
OBJECTIVE: Little data exist regarding mortality in Ankylosing Spondylitis (AS). We assessed diagnoses associated with in-hospital mortality in AS using a population-based inpatient dataset. METHODS: Data were abstracted from the Healthcare Cost and Utilization Project- Nationwide Inpatient Sample (HCUP-NIS) between 2007-2011. We identified AS admissions using International Classification of Diseases-9 Clinical Modification (ICD9-CM) code 720.0. In-hospital mortality was the primary outcome...
May 9, 2016: Arthritis Care & Research
Manuel Ribeiro da Silva, Daniela Linhares, Pedro Cacho Rodrigues, Eurico Lisboa Monteiro, Manuel Santos Carvalho, Pedro Negrão, Rui Peixoto Pinto, Nuno Neves
PURPOSE: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. METHODS: Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. RESULTS: Seventy-five cases of C-spine injuries (nine SCIWORA) were identified...
June 2016: International Orthopaedics
Christopher R Connelly, John D Yonge, Lynn E Eastes, Pamela E Bilyeu, Phillip M Kemp Bohan, Martin A Schreiber, Kenneth S Azarow, Jennifer M Watters, Mubeen A Jafri
BACKGROUND: Morbidity and mortality of cervical spine (C-spine) injury in pediatric trauma patients are high, necessitating quick and accurate diagnosis. Best practices emphasize minimizing radiation exposure through decreased reliance on computed tomography (CT), instead using clinical assessment, physical examination, and alternate imaging techniques. We implemented an institutional performance improvement and patient safety (PIPS) program initiative for C-spine clearance in 2010 because of high rates of CT scans among pediatric trauma patients...
August 2016: Journal of Trauma and Acute Care Surgery
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: CT of the cervical spine is routinely ordered for low-risk mechanisms of injury, including ground level fall (GLF). Two commonly employed clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I ED who received C-spine CT scans were obtained over a six month period...
March 30, 2016: Journal of Trauma and Acute Care Surgery
Nikita Chopra, Thomas E Wales, Raji E Joseph, Scott E Boyken, John R Engen, Robert L Jernigan, Amy H Andreotti
Bruton's tyrosine kinase (Btk) is a Tec family non-receptor tyrosine kinase that plays a critical role in immune signaling and is associated with the immunological disorder X-linked agammaglobulinemia (XLA). Our previous findings showed that the Tec kinases are allosterically activated by the adjacent N-terminal linker. A single tryptophan residue in the N-terminal 17-residue linker mediates allosteric activation, and its mutation to alanine leads to the complete loss of activity. Guided by hydrogen/deuterium exchange mass spectrometry results, we have employed Molecular Dynamics simulations, Principal Component Analysis, Community Analysis and measures of node centrality to understand the details of how a single tryptophan mediates allostery in Btk...
March 2016: PLoS Computational Biology
Michael D O'Sullivan, Robert Piggot, Mutaz Jaddan, John P McCabe
The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5 facetal subluxation with no obvious fractures; however, the MR imaging of the C-Spine revealed a non-contiguous and occult injury to C6/C7 disc with a posterior annular tear and associated disc extrusion...
2016: Journal of Surgical Case Reports
Tanya L Zakrison, Brian H Williams
BACKGROUND: Cervical spine injuries causing spinal cord trauma are rare in blunt trauma yet lead to devastating morbidity and mortality when they occur. There exists considerable debate in the literature about the best way for clinicians to proceed in ruling out cervical spine injuries in alert or obtunded blunt trauma patients. METHODS: We reviewed the current literature and practice management guidelines to generate clinical recommendations for the detection and clearance of cervical spine injuries in the blunt trauma patient...
January 28, 2016: International Journal of Surgery
Tomasz Kwiatkowski
Head trauma is leading cause of mortality after injuries related with skiing and snowboarding. Wearing a helmet is considered to be a primary method to prevent traumatic brain injuries (TBI) among alpine sports participants. This article, based on literature review, determines the efficacy of helmets and safety of their use. It also presents practical principles of proper helmet fitting. A well proven reduction in the risk of TBI connected with helmet use is reported in the literature, ranging from 22 to 60%...
2015: Przegla̧d Lekarski
Jong Tae Kim, Ho Jin Lee, Doo Yong Choi, Myoung Hoon Shin, Jae Taek Hong
PURPOSE: The cervical spine has a linear chain of correlation or reciprocal relationship regionally (within the cervical spine) and globally (head to whole spine). The purpose of this study was to assess the sequential alignment change of the regional and global cervical spine after two-level anterior cervical discectomy and fusion (ACDF) performed on the lower cervical spine. METHODS: This study included 61 patients (mean age 56 ± 8.6 years; range 35-70 years) who underwent ACDF at C5-6-7 with a plate-cage construct and whose C-spine neutral lateral radiographs showed an identical degree of horizontal gaze (occipital slope) peri-operatively...
July 2016: European Spine Journal
C Schöneberg, B Schweiger, B Hussmann, M D Kauther, S Lendemans, C Waydhas
OBJECTIVE: The objective of this systematic review was to discuss current knowledge of the diagnostic management of cervical spine (c-spine) injuries in children. METHODS: Studies dealing with this topic were collected from the following sources: MEDLINE via PubMed, Embase, and Cochrane. Where possible, a meta-analysis was performed. Furthermore, the level of evidence for all the included publications was assigned. RESULTS: The incidence of cervical spine injury (CSI) in children is rare (1...
December 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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