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County Trauma/Burn Stars

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27 papers 25 to 100 followers Publications by members of Cook County Trauma Unit
John David Cull, Lauren M Sakai, Imran Sabir, Brent Johnson, Andrew Tully, Kimberly Nagy, Andrew Dennis, Frederic L Starr, Kimberly Joseph, Dorion Wiley, Henry R Moore, Uretz J Oliphant, Faran Bokhari
An increasing number of patients are presenting to trauma units with head injuries on antiplatelet therapy (APT). The influence of APT on these patients is poorly defined. This study examines the outcomes of patients on APT presenting to the hospital with blunt head trauma (BHT). Registries of two Level I trauma centers were reviewed for patients older than 40 years of age from January 2008 to December 2011 with BHT. Patients on APT were compared with control subjects. Primary outcome measures were in-hospital mortality, intracranial hemorrhage (ICH), and need for neurosurgical intervention (NI)...
February 2015: American Surgeon
Brett E Skolnick, Andrew I Maas, Raj K Narayan, Roland Gerritsen van der Hoop, Thomas MacAllister, John D Ward, Neta R Nelson, Nino Stocchetti
BACKGROUND: Progesterone has been associated with robust positive effects in animal models of traumatic brain injury (TBI) and with clinical benefits in two phase 2 randomized, controlled trials. We investigated the efficacy and safety of progesterone in a large, prospective, phase 3 randomized clinical trial. METHODS: We conducted a multinational placebo-controlled trial, in which 1195 patients, 16 to 70 years of age, with severe TBI (Glasgow Coma Scale score, ≤8 [on a scale of 3 to 15, with lower scores indicating a reduced level of consciousness] and at least one reactive pupil) were randomly assigned to receive progesterone or placebo...
December 25, 2014: New England Journal of Medicine
Nicole Fox, Diane Schwartz, Jose H Salazar, Elliott R Haut, Philipp Dahm, James H Black, Scott C Brakenridge, John J Como, Kimberly Hendershot, David R King, Adrian A Maung, Matthew L Moorman, Kimberly Nagy, Laura B Petrey, Ronald Tesoriero, Thomas M Scalea, Timothy C Fabian
BACKGROUND: Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000. Since that time, there have been advances in the management of BTAI. As a result, the EAST guidelines committee decided to develop updated guidelines for this topic using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework recently adopted by EAST...
January 2015: Journal of Trauma and Acute Care Surgery
Stathis Poulakidas, Areta Kowal-Vern
Third degree burns require skin grafting. In most instances, if the graft becomes infected, it requires debridement of the site and re-grafting. The purpose of this report is to illustrate the successful healing of a skin graft using negative pressure wound therapy with silver impregnated foam and soft silicone wound contact layer in a 4% total body surface area burn of a lower extremity skin graft infected with Pseudomonas aerugenosa without regrafting. A 27-year-old Hispanic male sustained a gasoline flame burn and presented 72 hours postincident with right lower extremity cellulitis...
July 2008: Journal of Burn Care & Research: Official Publication of the American Burn Association
Thomas Gast, Areta Kowal-Vern, Gary An, Marella L Hanumadass
Purpura fulminans is a rare complication of a coagulopathy or an infection. Haemophilus influenzae infection, which has decreased since the haemophilus influenzae type B vaccine was initiated, is an unusual initiating cause of purpura fulminans. This case is the first reported in the literature of an adult who developed purpura fulminans after Haemophilus influenzae sepsis. Her elevated beta2 glycoprotein 1 ratio may have contributed to the severity of her disease. Although rare, Haemophilus influenzae may precipitate purpura fulminans...
January 2006: Journal of Burn Care & Research: Official Publication of the American Burn Association
Tamara Z Vern, Areta Kowal-Vern, Barbara A Latenser, Alan Chakrin
Due to a successful Haemophilus Influenzae (HIF) vaccination program, this pathogen is no longer a major contributor to childhood morbidity and mortality. The effect on adult acquisition of HIF is unknown. The purpose of this study was to determine HIF infection frequency in severely burned patients. In a 62-month period, there were 1486 admissions. Twenty-four of 1,486 (1.6%) burn patients had HIF pneumonia: 16 (1%) within 72 h after injury; 8 (0.5%) patients developed it after the seventh day of hospitalization; 74 of 1,486 (5...
June 2006: Burns: Journal of the International Society for Burn Injuries
Wei F Chen, Stathis J Poulakidas, Areta Kowal-Vern, Robert C Villare
BACKGROUND: Distal lower and upper extremity wounds with bone and tendon exposure present unique challenges to reconstructive surgeons. The limitations of the local anatomy usually make simpler reconstructive modalities such as primary closure and skin grafting difficult. As a result, wounds in this area, especially ones with bone or tendon exposures, are classically treated with free tissue transfer. METHODS: Limb preservation using the combination of bone trephination and subatmospheric pressure therapy is described...
December 2010: Journal of Trauma
Heidi Memmel, Areta Kowal-Vern, Barbara A Latenser
OBJECTIVE: Diabetic burn patients comprise a significant population in burn centers. The purpose of the study was to determine the demographic characteristics of diabetic burn patients and their rate of community-acquired and nosocomial infections. RESEARCH DESIGN AND METHODS: This was a 46-month retrospective chart and patient registry review comparing diabetic with nondiabetic burn patients. Statistical analysis consisted of means +/- SD, descriptive statistics, one-way ANOVA, and chi(2) tests...
January 2004: Diabetes Care
Mona Gandhi, Areta Kowal-Vern, Gary An, Marella Hanumadass
Toxic epidermal necrolysis (TEN) is a rare life-threatening disease mostly related to drug ingestion. Apoptotic keratinocytes lead to separation of the epidermis from dermis and widespread blistering of the skin. This case is a pediatric patient with a seizure disorder who developed TEN after starting carbamezepine. Blister fluid was analyzed for protein, chemical, and mineral content. The TEN blister fluid composition was similar to burn blister, except that the burn blister fluid has a 3-fold increase in albumin and protein...
July 2008: Journal of Burn Care & Research: Official Publication of the American Burn Association
Stathis Poulakidas, Areta Kowal-Vern
BACKGROUND: Component separation technique has been used successfully in ventral hernia repair occurring after damage control surgery. Abdominal compartment syndrome, seen in severely injured burn patients, frequently requires decompressive laparotomy. The patient is at risk during this time not only for burn injury complications but also for those from an open abdomen. METHODS: This report presents the successful application of the component separation technique for early closure of decompressive laparotomies in patients with >75% total body surface area burn, which included the abdominal wall...
December 2009: Journal of Trauma
Andrew Dennis, Thomas A Vizinas, Kimberly Joseph, Samuel Kingsley, Faran Bokhari, Frederic Starr, Stathis Poulakidas, Dorion Wiley, Thomas Messer, Kimberly Nagy
BACKGROUND: Damage-control laparotomy (DCL) has revolutionized the surgery of injury. However, this has led to the dilemma of the nonclosable abdomen. Subsequently, there exists a subgroup of patients who after resuscitation and diuresis, remain nonclosable. Before the adoption of our open abdomen protocol (OAP) and use of transabdominal wall traction (TAWT), these patients required skin grafting and a planned ventral hernia. We hypothesize that our OAP and TAWT device, which use full abdominal wall thickness sutures to dynamically distribute midline traction, achieve an improved method of fascial reapproximation...
June 2013: Journal of Trauma and Acute Care Surgery
Carol Reese, Tabitha Pederson, Susan Avila, Kimberly Joseph, Kimberly Nagy, Andrew Dennis, Dorion Wiley, Frederic Starr, Faran Bokhari
OBJECTIVE: This study piloted the use of the Primary Care PTSD (PC-PTSD) screening tool in an outpatient setting to determine its utility for broader use and to gather data on traumatic stress symptoms among direct (patients) and indirect (families) survivors of traumatic injuries. METHODS: Using the PC-PTSD plus one question exploring openness to seeking help, participants were screened for PTSD in the outpatient clinic of an urban Level 1 trauma center. The survey was distributed during a 23-week period from April to September 2011...
August 2012: Journal of Trauma and Acute Care Surgery
Daniel J Valentino, Robert J Walter, Andrew J Dennis, Bosko Margeta, Frederic Starr, Kimberly K Nagy, Faran Bokhari, Dorion E Wiley, Kimberly T Joseph, Roxanne R Roberts
BACKGROUND: Data from our previous studies indicate that Taser X26 stun devices can acutely alter cardiac function in swine. We hypothesized that most transcardiac discharge vectors would capture ventricular rhythm, but that other vectors, not traversing the heart, would fail to capture the ventricular rhythm. METHODS: Using an Institutional Animal Care and Use Committee (IACUC) approved protocol, four Yorkshire pigs (25-36 kg) were anesthetized, paralyzed with succinylcholine (2 mg/kg), and then exposed to 10 second discharges from a police-issue Taser X26...
December 2008: Journal of Trauma
Robert J Walter, Andrew J Dennis, Daniel J Valentino, Bosko Margeta, Kimberly K Nagy, Faran Bokhari, Dorion E Wiley, Kimberly T Joseph, Roxanne R Roberts
OBJECTIVES: Data from the authors and others suggest that TASER X26 stun devices can acutely alter cardiac function in swine. The authors hypothesized that TASER discharges degrade cardiac performance through a mechanism not involving concurrent acidosis. METHODS: Using an Institutional Animal Care and Use Committee (IACUC)-approved protocol, Yorkshire pigs (25-71 kg) were anesthetized, paralyzed with succinylcholine (SCh; 2 mg/kg), and then exposed to two 40-second discharges from a TASER X26 with a transcardiac vector...
January 2008: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Andrew J Dennis, Daniel J Valentino, Robert J Walter, Kimberly K Nagy, Jerry Winners, Faran Bokhari, Dorion E Wiley, Kimberly T Joseph, Roxanne R Roberts
BACKGROUND: Very little objective laboratory data are available describing the physiologic effects of stun guns or electromuscular incapacitation devices (EIDs). Unfortunately, there have been several hundred in-custody deaths, which have been temporally associated with the deployment of these devices. Most of the deaths have been attributed to specific cardiac and metabolic effects. We hypothesized that prolonged EID exposure in a model animal system would induce clinically significant metabolic acidosis and cardiovascular disturbances...
September 2007: Journal of Trauma
Riyad Karmy-Jones, Gregory J Jurkovich, George C Velmahos, Thomas Burdick, Konstantinos Spaniolas, Samuel R Todd, Michael McNally, Robert C Jacoby, Daniel Link, Randy J Janczyk, Felicia A Ivascu, Michael McCann, Farouck Obeid, William S Hoff, Nathaniel McQuay, Brandon H Tieu, Martin A Schreiber, Ram Nirula, Karen Brasel, Julie A Dunn, Debbie Gambrell, Roger Huckfeldt, Jayna Harper, Kathryn B Schaffer, Gail T Tominaga, Fausto Y Vinces, David Sperling, David Hoyt, Raul Coimbra, Mathew R Rosengart, Raquel Forsythe, Clay Cothren, Ernest E Moore, Elliott R Haut, Awori J Hayanga, Linda Hird, Christopher White, Jodi Grossman, Kimberly Nagy, West Livaudais, Rhonda Wood, Imme Zengerink, John B Kortbeek
BACKGROUND: The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS: A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve. RESULTS: Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology...
January 2007: Journal of Trauma
Robert A Maxwell, Donald J Campbell, Timothy C Fabian, Martin A Croce, Fred A Luchette, Andrew J Kerwin, Kimberly A Davis, Kimberly Nagy, Samuel Tisherman
OBJECTIVE: To determine whether presumptive antibiotics reduce the risk of empyema or pneumonia following tube thoracostomy for traumatic hemopneumothorax. METHODS: A prospective, randomized, double-blind trial was performed comparing the use of cefazolin for duration of tube thoracostomy placement (Group A) versus 24 hours (Group B) versus placebo (Group C). RESULTS: A total of 224 patients received 229 tube thoracostomies. Logistic regression analysis revealed that duration of tube placement and thoracic acute injury score were predictive of empyema (p <0...
October 2004: Journal of Trauma
Scott C Brakenridge, Kimberly K Nagy, Kimberly T Joseph, Gary C An, Faran Bokhari, John Barrett
BACKGROUND: The utility of diagnostic peritoneal lavage (DPL) as a diagnostic tool specifically for shotgun wound to the abdomen (SGWA) is unknown. This prospective study was undertaken to determine the sensitivity, specificity, and accuracy of DPL for the detection of intra-abdominal injuries following SGWA. METHODS: DPL was performed on all patients sustaining SGWA who lacked a clear indication for laparotomy. Patients exceeding 10,000 red blood cells (RBC)/mm were taken for exploratory laparotomy...
February 2003: Journal of Trauma
William S Hoff, Michelle Holevar, Kimberly K Nagy, Lisa Patterson, Jeffrey S Young, Abenamar Arrillaga, Michael P Najarian, Carl P Valenziano
No abstract text is available yet for this article.
September 2002: Journal of Trauma
J A Asensio, S Chahwan, W Forno, R MacKersie, M Wall, J Lake, G Minard, O Kirton, K Nagy, R Karmy-Jones, S Brundage, D Hoyt, R Winchell, K Kralovich, M Shapiro, R Falcone, E McGuire, R Ivatury, M Stoner, J Yelon, A Ledgerwood, F Luchette, C W Schwab, H Frankel, B Chang, R Coscia, K Maull, D Wang, E Hirsch, J Cue, D Schmacht, E Dunn, F Miller, M Powell, J Sherck, B Enderson, L Rue, R Warren, J Rodriquez, M West, L Weireter, L D Britt, D Dries, C M Dunham, M Malangoni, W Fallon, R Simon, R Bell, D Hanpeter, E Gambaro, J Ceballos, J Torcal, K Alo, E Ramicone, L Chan
OBJECTIVE: The purpose of this study was to define the period of time after which delays in management incurred by investigations cause increased morbidity and mortality. The outcome study is intended to correlate time with death from esophageal causes, overall complications, esophageal related complications, and surgical intensive care unit length of stay. METHODS: This was a retrospective multicenter study involving 34 trauma centers in the United States, under the auspices of the American Association for the Surgery of Trauma Multi-institutional Trials Committee over a span of 10...
February 2001: Journal of Trauma
2014-10-02 04:02:47
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