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Trauma patient

Chase Samsel, Sara Tapsak, Katherine Thomson, Kristine McKenna, Kerry McGregor, Peter Forbes, Patricia Ibeziako
INTRODUCTION: This study describes psychotropic medication use in a pediatric and young adult solid organ transplant population. METHODS: We conducted a retrospective review of the lifetime incidence of psychotropic medication use and associated characteristics in patients seen over a 6-year period at a large pediatric transplant center utilizing univariate and multivariate statistical analyses. RESULTS: The lifetime incidence of psychotropic medication use was 36...
February 20, 2019: Pediatric Transplantation
Jane Rutty, Mike Biggs, Deborah Dowsett, Ant Kitchener, Natalie Coltman, Guy Rutty
BACKGROUND: There is significant change throughout the world regarding Post Mortem Computed Tomography (PMCT) as an adjunct or a replacement to the traditional invasive autopsy. Of interest, is the ability to demonstrate visually two and three dimensional normal soft tissue, organ and skeletal anatomy, as well as natural disease and trauma pathology. OBJECTIVES: The objective was to compare formal traditional methods of teaching anatomy and pathology (pictures and diagrams) to pre-registration student nurses with supplementary PMCT 2/3D generated images, videos and printed anatomical models...
February 10, 2019: Nurse Education Today
Shira Maguen, Yongmei Li, Erin Madden, Karen H Seal, Thomas C Neylan, Olga V Patterson, Scott L DuVall, Callan Lujan, Brian Shiner
Little is known about predictors of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD), with most data coming from small cohort studies and post-hoc analyses of clinical trials. We examined patient and treatment factors associated with initiation and completion of EBP for PTSD in a large longitudinal cohort. We conducted a national, retrospective cohort study of all Iraq and Afghanistan War veterans who had a post-deployment PTSD diagnosis from 10/01-9/15 at a Veterans Health Administration facility and had at least one coded post-deployment psychotherapy visit...
February 11, 2019: Psychiatry Research
Craig French
Erythropoietin (EPO) is a 34kD pleiotropic cytokine that was first identified as being essential for red blood cell (RBC) production. It is now recognized however that EPO is produced by many tissues. It plays a key role in the modulation of the response to injury, inflammation, and tissue hypoxia via the inhibition of apoptosis. Large clinical trials in the critically ill failed to demonstrate a role for EPO as an RBC transfusion sparing agent; however, improved clinical outcomes, attributable to EPO role in tissue protection are observed in critically ill trauma patients...
April 2019: Critical Care Clinics
Karim Asehnoune, Mickael Vourc'h, Antoine Roquilly
Low-dose hydrocortisone reduces the dose of vasopressors and hospital length of stay; it may also decrease the rate of hospital-acquired pneumonia and time on ventilator. No major side effect was reported, but glycemia and natremia should be monitored. Progesterone did not enhance outcome of trauma patients. A meta-analysis suggested that oxandrolone was associated with shorter length of stay and reduced weight loss. Erythropoietin did not enhance neurologic outcome of traumatic brain-injured patients; such treatment, however, could reduce the mortality in subgroups of patients...
April 2019: Critical Care Clinics
Ji-Yao Jiang, Guo-Yi Gao, Jun-Feng Feng, Qing Mao, Li-Gang Chen, Xiao-Feng Yang, Jin-Fang Liu, Yu-Hai Wang, Bing-Hui Qiu, Xian-Jian Huang
China has more patients with traumatic brain injury (TBI) than most other countries in the world, making this condition a major public health concern. Population-based mortality of TBI in China is estimated to be approximately 13 cases per 100 000 people, which is similar to the rates reported in other countries. The implementation of various measures, such as safety legislation for road traffic, establishment of specialised neurosurgical intensive care units, and the development of evidence-based guidelines, have contributed to advancing prevention and care of patients with TBI in China...
March 2019: Lancet Neurology
Alexander E St John, Jason C Newton, Erika J Martin, Bassem M Mohammed, Daniel Contaifer, Jessica L Saunders, Gretchen M Brophy, Bruce D Spiess, Kevin R Ward, Donald F Brophy, José A López, Nathan J White
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common and deadly bleeding disorder. Platelet dysfunction is present during TIC, but its mechanisms remain unclear. Platelets are currently thought to become "exhausted", a state in which they have released their granule contents and can no longer aggregate or contract. METHODS: This prospective observational cohort study tested the hypothesis that platelet exhaustion is present during TIC and characterized the early time course of platelet dysfunction...
February 19, 2019: Journal of Thrombosis and Haemostasis: JTH
Jumpei Takamatsu
BACKGROUND: Simple pericardial injuries are asymptomatic in many cases and usually do not cause bleeding that leads to cardiac tamponade. In this study, however, we report a case involving a patient with pericardial injury, in whom extravasation in the pericardium was identified using contrast-enhanced computed tomography (CT). CASE PRESENTATION: A 67-year-old man fell from a 3-m-high ladder and was injured and transported to our hospital. No pericardial effusion was observed on focused assessment with sonography for trauma (FAST) or plain CT on arrival, but pericardial effusion was detected on follow-up observation...
February 19, 2019: Surgical Case Reports
Minouk Esmée van Steijn, Karel Willem Frank Scheepstra, Gulfidan Yasar, Miranda Olff, Martine Charlotte de Vries, Maria Gabriel van Pampus
The objective of this study was to study mental health, coping, and support after work-related adverse events among pediatricians. Physicians are frequently exposed to adverse events. It makes them at risk for posttraumatic stress disorder (PTSD), depression, and anxiety disorders. Besides the personal impact, physicians could pose a threat towards patients, as mental health problems are associated with medical errors. A questionnaire was sent to all members of the Pediatric Association of The Netherlands in October 2016...
February 19, 2019: European Journal of Pediatrics
Jan Oliver Voß, Nadine Thieme, Sven Märdian, Christian Doll, Stefan Hartwig, Max Heiland, Jan-Dirk Raguse, Nicolai Adolphs
INTRODUCTION: The treatment of facial fractures is an integral part of the oral and maxillofacial surgical treatment spectrum. In the case of complex fractures that involve multiple levels of the facial skeleton associated with severe concomitant injuries, an individual and interdisciplinary treatment approach is needed, which requires the infrastructure of a national trauma center. OBJECTIVE: The aim of this study was to analyze the incidence and management of patients with complex facial fractures and considering the concomitant injury pattern...
February 19, 2019: Der Unfallchirurg
Kalaiarasi Raja, Sithananda-Kumar Venkatesan, Sivaraman Ganesan, Arun Alexander
Introduction:  Penetration injury to the neck constitutes 5-10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management. Case Report: A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site...
January 2019: Iranian Journal of Otorhinolaryngology
Kunal Shah, Akshay Gadiya, Abhay Nene
Neglected cervical spine trauma is rare with very few case series reported in literature. There are no clear guidelines for its treatment. If operative treatment is sought, the role of skull traction, type of approach (anterior only, posterior only, or combined), sequence of surgery, type of instrumentation, etc., have to be considered. Hence, the treatment is challenging. Autostabilization has been described in the natural history of degenerative lumbar spondylolisthesis. As a result, many patients are treated nonoperatively, obviating need of surgery...
October 2018: Journal of Craniovertebral Junction and Spine
Tjark Tassemeier, Marcel Haversath, Moritz Schutzbach, Marcus Jäger
Purpose: Osteoporotc fractures with posterior wall injury are commonly treated with a pedicle srcrew instrumentation (PSI) or a ballonkyphoplasty (BKP). A predictor for complications for these patients is the American Society of Anesthesiologists (ASA) class. Clinical results in ASA II/III patients who underwent BKP and PSI due to OF were evaluated to find the optimal treatment regimen. Materials and Methods: In a retrospective study design, ASA Class II and III patients with OF type OF 2 and OF 3 according to the German Society of Orthopedics and Trauma Surgery classification who underwent surgery between 2011 and 2016 were enrolled...
October 2018: Journal of Craniovertebral Junction and Spine
Toru Yamada, Yasuaki Motomura, Eiji Hiraoka, Aki Miyagaki, Juichi Sato
BACKGROUND Intramural hematoma of the esophagus (IHE), a rare manifestation of acute mucosal injuries of the esophagus, can be caused by trauma such as endoscopic surgeries. Coagulation disorders increase the risk of IHE. The most common location of IHE is in the distal esophagus. The characteristic clinical triad of manifestations comprises acute retrosternal pain, odynophagia or dysphagia, and hematemesis. It is important to distinguish IHE from other acute conditions such as acute coronary syndrome, aortic dissection, and pulmonary embolism...
February 20, 2019: American Journal of Case Reports
Omar Bekdache, Tiffany Paradis, Yu Bai He Shen, Aly Elbahrawy, Jeremy Grushka, Dan L Deckelbaum, Kosar Khwaja, Paola Fata, Tarek Razek, Andrew Beckett
INTRODUCTION: Haemorrhage remains the leading cause of preventable death in trauma. Damage control measures applied to patients in extremis in order to control exsanguinating bleeding from non-compressible torso injuries use different techniques to limit blood flow from the aorta to the rest of the body. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining momentum recently as an adjunct measure that can provide the same results using less invasive approaches...
February 19, 2019: BMJ Open
Tjitte Verbeek, Hans Arentsen, Evert Jan Breet, Machiel M Kuipers, Pieter H W Lubbert, Huibert Burger
INTRODUCTION: Diagnosis and treatment of fractures and dislocations are mostly performed in hospital settings. However, equal care for patients with non--complex fractures or dislocations ('minor trauma care') may be provided in general practice. While substitution of care from secondary to primary care settings is stimulated by governments and insurers, it is unknown what the effects are on patient satisfaction level. Therefore, our primary objective is to determine the effect of minor trauma care delivered in a general practice as compared with a hospital on patient satisfaction...
February 19, 2019: BMJ Open
Kasim L Qureshi, Rachel Upthegrove, Emma Toman, Vijay Sawlani, David James Davies, Antonio Belli
OBJECTIVES: To estimate the prevalence of post-traumatic stress disorder (PTSD) in a large civilian population with traumatic brain injury (TBI), and to assess whether brain injury severity is correlated with PTSD symptoms. DESIGN: Observational, cross-sectional study. SETTING AND PARTICIPANTS: Outpatient clinic in a major UK trauma centre and secondary care hospital. Estimates of PTSD prevalence are based on 171 sampled individuals attending TBI clinic within an 18-month period...
February 19, 2019: BMJ Open
Ameeta Retzer, Grace M Turner, Anita Slade, Derek Kyte, Christel McMullan, Laura Jones, Antonio Belli, Melanie Calvert
INTRODUCTION: Traumatic brain injury (TBI) represents a major health and socioeconomic problem internationally. The expansive nature of injuries results in a heterogeneous population. The degree and type of long-term impacts following TBI and improvement following injury are highly variable. The use of electronic Patient Reported Outcomes Measures (ePROMs) could help identify residual impacts of TBI and support patient management and care. The Patient Reported Outcomes Research in Trauma study is a qualitative study exploring the long-term symptoms and impacts that are experienced by those with TBI and the potential utility of an ePROM platform to collect real-time information on patient symptoms and quality of life to inform treatment and identify support needs...
January 25, 2019: BMJ Open
Elizabeth D E Papathanassoglou, Yoanna Skrobik, Kathleen Hegadoren, Patrica Thompson, Henry Thomas Stelfox, Colleen Norris, Louise Rose, Sean M Bagshaw, Michael Meier, Cheryl LoCicero, Rhonda Ashmore, Tiffany Sparrow Brulotte, Imran Hassan, Tanya Park, Demetrios J Kutsogiannis
INTRODUCTION: Delirium is a common complication of critical illness, associated with negative patient outcomes. Preventive or therapeutic interventions are mostly ineffective. Although relaxation-inducing approaches may benefit critically ill patients, no well-designed studies target delirium prevention as a primary outcome. The objective of this study is to assess feasibility and treatment effect estimates of a multimodal integrative intervention incorporating relaxation, guided imagery and moderate pressure touch massage for prevention of critical illness delirium and for related outcomes...
January 15, 2019: BMJ Open
Germa Catherina Maria Nass, Leon Willem van Rens, Boukje Arnolda Gerdina Dijkstra
BACKGROUND: Posttraumatic Stress Disorder (PTSD) is more common in patients with Substance Use Disorder (SUD) than in the general population. Although international guidelines recommend integrated treatment clinicians are still hesitant in offering integrated treatment and more concrete recommendations are needed. This study aims to contribute to a practice-based guideline through the exploration of practice-based decision criteria to determine the indication and treatment of SUD and PTSD...
February 19, 2019: Substance Abuse Treatment, Prevention, and Policy
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