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Blunt trauma

Lauren H Mangum, Joshua J Avila, Brady J Hurtgen, Alicia L Lofgren, Joseph C Wenke
BACKGROUND: Singular traumatic insults, such as bone fracture, typically initiate an appropriate immune response necessary to restore the host to pre-insult homeostasis with limited damage to self. However, multiple concurrent insults, such as a combination of fracture, blunt force trauma, and burns (polytrauma), are clinically perceived to result in abnormal immune response leading to inadequate healing and resolution. To investigate this phenomenon, we created a model rat model of polytrauma...
February 19, 2019: Journal of Orthopaedic Surgery and Research
J Kosola, T Brinck, A Leppäniemi, L Handolin
BACKGROUND AND AIMS: Blunt abdominal trauma can lead to substantial organ injury and hemorrhage necessitating open abdominal surgery. Currently, the trend in surgeon training is shifting away from general surgery and the surgical treatment of blunt abdominal trauma patients is often done by sub-specialized surgeons. The aim of this study was to identify what emergency procedures are needed after blunt abdominal trauma and whether they can be performed with the skill set of a general surgeon...
February 20, 2019: Scandinavian Journal of Surgery: SJS
Corrado Tagliati, Giulio Argalia, Gian Marco Giuseppetti
AIMS: To assess contrast enhanced ultrasound (CEUS) performance in the prediction of non-operatively managed blunt spleen injuries requiring only observation and monitoring during follow-up and to evaluate if CEUS accuracy was higher than conventional ultrasound (US) in this field. MATERIAL AND METHODS: In 112 hemodynamic stable blunt spleen trauma patients, CEUS was performed for follow-up after computed tomography evaluation in the emergency department. CEUS and US performance were assessed considering as true negative cases patients that had not underwent interventional or surgical treatment during follow-up and were assessed as negative for splenic complications respectively by CEUS or US examinations...
February 17, 2019: Medical Ultrasonography
Shahzeb Hassan, Bahram Rahmani, Jeffrey C Rastatter, Alok I Jaju, Sudhi P Kurup
Pott's puffy tumor is a significant complication of frontal sinusitis that leads to frontal bone osteomyelitis and can be associated with frontal swelling, subperiosteal abscess, and intracranial abscess. It may be associated with antecedent trauma and typically presents in adolescents. Orbital involvement is rarely reported. We describe the case of a 15-year-old male who presented after blunt facial trauma with orbital hematoma and developed Pott's puffy tumor with orbital cellulitis and subperiosteal abscess...
February 18, 2019: Orbit
Brit Long, Michael D April
No abstract text is available yet for this article.
February 14, 2019: Annals of Emergency Medicine
Robert A Tessler, Janessa M Graves, Monica S Vavilala, Adam Goldin, Frederick P Rivara
BACKGROUND/PURPOSE: Our objective was to evaluate hospital factors, including children's hospital status, associated with higher costs for blunt solid organ pediatric abdominal trauma. METHODS: We queried the 2012 Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for patients 18 years or younger with low-grade and high-grade blunt abdominal trauma. We calculated total hospital costs and adjusted cost ratios (CR) controlling for patient and hospital-level characteristics...
January 22, 2019: Journal of Pediatric Surgery
Robert L Gates, Mitchell Price, Danielle B Cameron, Stig Somme, Robert Ricca, Tolulope A Oyetunji, Yigit S Guner, Ankush Gosain, Robert Baird, Dave R Lal, Tim Jancelewicz, Julia Shelton, Karen A Diefenbach, Julia Grabowski, Akemi Kawaguchi, Roshni Dasgupta, Cynthia Downard, Adam Goldin, John K Petty, Steven Stylianos, Regan Williams
PURPOSE: The American Pediatric Surgical Association (APSA) guidelines for the treatment of isolated solid organ injury (SOI) in children were published in 2000 and have been widely adopted. The aim of this systematic review by the APSA Outcomes and Evidence Based Practice Committee was to evaluate the published evidence regarding treatment of solid organ injuries in children. METHODS: A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were utilized to identify, review, and report salient articles...
January 31, 2019: Journal of Pediatric Surgery
M Dimitriadis, R H S van den Brink, H C Comijs, R C Oude Voshaar
BACKGROUND: Brain-derived neurotrophic factor (BDNF) levels decline during depression and normalise after remission, although studies in older patient samples are inconsistent. Whether BDNF serum levels predict depression remission is unclear. We hypothesize that the predictive value of serum BDNF levels in late-life depression is moderated by selective serotonin reuptake inhibitors (SSRI) usage and early traumatization. METHODS: Our study sample was a subset of the Netherlands Study of Depression in Older persons (NESDO), a prospective cohort study...
February 7, 2019: Psychoneuroendocrinology
Gustavo Parra-Romero, Gabriel Contreras-Cantero, Diego Orozco-Guibaldo, Andrea Domínguez-Estrada, José de Jesús Mercado-Martín Del Campo, Luis Bravo-Cuéllar
Introduction: Trauma is a leading cause of morbimortality in the world. Intraabdominal compartment is the third most affected anatomical region and bleeding from this origin is difficult to identify, therefore the importance to predict possible lesions to the abdominal cavity. Objective: To describe and analyze the sociodemographic profile and injuries found in patients with abdominal trauma in a western hospital in Mexico. Method: Consecutive patients included in the local registry GDL-SHOT were analyzed...
2019: Cirugia y Cirujanos
Danny Lascano, Patrice Anderson, Rifat Latifi
No abstract text is available yet for this article.
January 1, 2019: American Surgeon
Danny Lascano, Patrice Anderson, Rifat Latifi
No abstract text is available yet for this article.
January 1, 2019: American Surgeon
Nick Nash, Charles W Kimbrough, Michael Mackowski, Matthew V Benns, Jason W Smith, Brian G Harbrecht, Matthew Bozeman
The incidence of obesity has been increasing in the United States, and the medical care of obese patients after injury is complex. Obesity has been linked to increased morbidity after blunt trauma. Whether increased girth protects abdominal organs from penetrating injury or complicates management from obesity-associated medical comorbidities after penetrating injury has not been well defined. All patients admitted with penetrating injury between January 1, 2010, and December 31, 2013, at a university-affiliated Level I center trauma center were reviewed...
January 1, 2019: American Surgeon
M Pape, G F Giannakópoulos, W P Zuidema, E S M de Lange-Klerk, E J Toor, M J R Edwards, M H J Verhofstad, T N Tromp, E M M van Lieshout, F W Bloemers, L M G Geeraedts
INTRODUCTION: Little evidence suggest that female gender is associated with a lower risk of mortality in severely injured patients, especially in premenopausal women. Previous clinical studies have shown contradictory results regarding protective effects of gender on outcome after severe trauma. The objective of this study was to determine the association between gender and outcome (mortality and Intensive Care Unit (ICU) admission) among severely injured patients in the Netherlands. METHODS: A retrospective multicentre study was performed including all polytrauma patients (Injury Severity Score (ISS) ≥16) admitted to the ED of three level 1 trauma centres, between January 1st, 2006 and December 31st, 2014...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Frank V Bensch, Elina A Varjonen, Tuomo T Pyhältö, Seppo K Koskinen
PURPOSE: BCVI may lead to ischemic stroke, disability, and death, while being often initially clinically silent. Screening criteria for BCVI based on clinical findings and trauma mechanism have improved detection, with Denver criteria being most common. Up to 30% of patients do not meet BCVI screening criteria. The aim of this study was to analyze the effect of augmented Denver criteria on detection, and to determine the relative risk for ischemic stroke. METHODS: Denver screening criteria were augmented by any high-energy trauma of the cervical spine, thorax, abdomen, or pelvis...
February 12, 2019: Emergency Radiology
David Leo Jolley, Bryan Upham, Lynne Fullerton, Robert D Annett
OBJECTIVE: The objective of this study was to evaluate the effect of the Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma guidelines and implementation of urgent neurology follow-up (UNF) appointments on an observed decline in head computed tomography (CT) use for pediatric emergency department (PED) patients presenting with headache, seizure, and trauma. METHODS: Patients ages 0 to 18 years presenting to and discharged from an urban tertiary care PED with chief complaint of trauma, headache, and seizure between 2007 and 2013 were retrospectively included...
February 8, 2019: Pediatric Emergency Care
Tanya Anand, Santa Ponce, Andrea Pakula, Cindy Norville, David Kallish, Maureen Martin, Ruby Skinner
Ventilator-associated pneumonia (VAP) is linked to increased morbidity and mortality and clinical protocols (VAP bundles) have evolved to minimize VAP. In 2009, a quality improvement project was implemented at our institution to decrease VAP rates in adult trauma patients. A VAP prevention committee was developed, and formal evidence-based education for the nursing and physician staff was introduced. During the study period (2009-2016), 2380 patients required ICU admission to our Level II trauma center. The mean Injury Severity Score was 33 + 12, and there were 17 per cent penetrating and 83 per cent blunt injuries...
October 1, 2018: American Surgeon
Sunu Philip, Dimitrios Apostolou
No abstract text is available yet for this article.
November 1, 2018: American Surgeon
Sean P Geary, Maria R Brown, Christopher Decker, Lisa M Angotti, Ashar Ata, Carl Rosati
Trauma patients admitted to the intensive care unit are a unique population with high mortality. This study aims to identify characteristics predicting the likelihood of progressing to palliative management often referred to as comfort care measures, thus enabling the trauma team to broach end-of-life decisions earlier in these patients' care. This is a retrospective analysis of the prospectively collected New York State Trauma Registry database for a single Level I trauma center for patients admitted from 2008 to 2015...
November 1, 2018: American Surgeon
Jennifer M Leonard, Stephanie F Polites, Niels D Martin, Amy E Glasgow, Elizabeth B Habermann, Lewis J Kaplan
INTRODUCTION: Many injured patients or their families make the difficult decision to withdraw life-sustaining therapies (WLST) following severe injury. While this population has been studied in the setting of severe traumatic brain injury (TBI), little is known about patients who undergo WLST without TBI. We sought to describe patients who may benefit from early involvement of end-of-life resources. METHODS: Trauma Quality Improvement Program (2013-2014) patients who underwent WLST were identified...
January 14, 2019: Injury
Mohammed Alshareef, Gibson Klapthor, Ahmed Alshareef, Zayed Almadidy, Zachary Wright, Libby Infinger, Ramin Eskandari
Cranial fasciitis is a rare benign mass that typically presents in pediatric patients from 3 weeks to 6 years of age. It is classified as a subset of nodular fasciitis that was first described in the literature in 1980. We describe the case of a 13-month-old female with a history of accidental head trauma 7 months prior to presentation and the case of a 5-month-old female with an expansile skull lesion. A systematic review of the literature on cranial fasciitis is also reported including a total of 57 published articles with 80 unique cases...
February 8, 2019: World Neurosurgery
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