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Search Results: 1 - 10 of 989 matches for " traumatic "
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An Update on Traumatic Joint Dislocations in Nigeria  [PDF]
E. O. Edomwonyi, R. E. T. Enemudo
Open Journal of Orthopedics (OJO) , 2015, DOI: 10.4236/ojo.2015.57029
Abstract: Trauma has assumed a pre-eminent epidemic proportion in the hierarchy of diseases afflicting the growing populace in Nigeria. Research into traumatic dislocations is relatively small. Road traffic accident is the commonest cause of traumatic dislocation in Nigeria currently. Human factors and collapse of road infrastructures are the major reasons. Young, productive, adult males are still the most affected while the rarity among children is again highlighted. Careful and detailed evaluation of patients is advised as certain conditions can mask the presence of a dislocation. Lack of diagnostic and therapeutic facilities in most centres in Nigeria makes this difficult, with clinicians resorting to clinical evaluation only and probably supported by only plain X-rays in some cases. Most cases are amenable to closed surgical management. Identification of long term complications is a major challenge, because of the poor follow up culture of our patients. Good road design and maintenance, enforcement of road regulations, manpower development and improvements in diagnostic and therapeutic facilities in all centres will reduce the burden of traumatic dislocations on the populace.
The coast and benefits of helicopter emergency medical services instead of the ground unit in traumatic patients: A cost-effectiveness analysis  [PDF]
Amin Shams Akhtari, Naghmeh Sadat Jafari, Hamid Kariman, Afshin Amini, Vahid Monsef, Mohamad Noorizadeh, Neda Gholizadeh
Health (Health) , 2013, DOI: 10.4236/health.2013.55119

Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care; however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90; 95% confidence interval [CI] 1.60 to 2.25; P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36; 95% CI 1.18 to 1.58; P: 0001).

Blunt Traumatic Pericardial Rupture
—Case Report and Literature Review

Hongbin Wang, Min Li
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.410086

Pericardial rupture following blunt chest trauma is rare and associated with high mortality rate ranging from 30% to 64%. We review 42 cases which have been reported in the literature in last 17 years and report a case of our own. We have found that 83% of the cases were men with a mean age of 49 years. The most frequent cause was traffic accidents (79%). Preoperative diagnosis of traumatic rupture of the pericardium has been improved in recent 17 years, and the result is satisfactory. Early detection, timely treatment is the key. Pneumopericardium may be a valuable radiographic clue for diagnosis. The management of pericardial rupture is mainly to avoid the risk of cardiac strangulation or acute tamponade. If the injury is recognized timely, treatment is simple and effective.

Posterior Dislocation of the Hip in a 4-Year-Old Boy  [PDF]
Serhat Mutlu, Bulent Yucel, Tahir Mutlu Duymus, Baran K?mür, Ozgur Karaman, Harun Mutlu
Case Reports in Clinical Medicine (CRCM) , 2015, DOI: 10.4236/crcm.2015.41006
Traumatic hip dislocations occur in children below 15 years old. Just as in adults, posterior hip dislocations are 10 times more common than anterior hip dislocations. Traumatic hip dislocation in pediatric patients < 10 years of age requires much less force than that in an adult, while in children over 10 years old, We reported a 4-year-old boy with traumatic hip dislocation. Closed reduction with the Bigelow manoeuvre was applied without general anesthesia in the Emergency room. Patient was followed up for 4 weeks in a hip spica cast. There were no problems at the 6-month follow-up examination. Traumatic hip dislocation in children is not a common event and is generally caused by minor trauma.
Chronic Headache after Pediatric Brain Injury: A Systematic Review  [PDF]
Devi E. Nampiaparampil
Journal of Behavioral and Brain Science (JBBS) , 2011, DOI: 10.4236/jbbs.2011.13011
Abstract: Introduction: Chronic pain is an under-diagnosed consequence of traumatic brain injury (TBI) in subjects aged ≤16. The objective of this study was to determine its prevalence. Methods: The Ovid/Medline database was searched for articles published between 1951 and February 2008 using any combination of the terms brain injury, pain, headache, blast injury, and combat. The PubMed, MD Consult, Cochrane Collaboration, National Institutes of Health Clinical Trials Database, Meta-Register of Current Controlled Trials, and CRISP databases were searched using the keyword brain injury. 1110 articles were identified for evaluation. 258 articles were reviewed and 26 met the inclusion criteria for calculating the prevalence of chronic pain after TBI. Three cross-sectional studies met the inclusion criteria for calculating this prevalence in the population aged ≤16. Results: Twenty-six studies (18 cross-sectional, 5 prospective, and 3 retrospective) including 4468 patients with TBIs were identified. Fifteen studies assessed headache (HA) pain in 1932 patients. Of these, 1081 complained of chronic HA, yielding a prevalence of 56.0% (95%CI, 53.9% - 58.2%). Three studies furnished data on 262 patients with TBI and age ≤16. One-hundred-fifteen of these subjects experienced chronic HA suggesting prevalence of 43.9% (95%CI, 37.9% - 49.9%) in this population. We found evidence to suggest that there is an association between TBI and the development of chronic HA pain. Conclusions: Chronic pain from headache is a common complication of TBI and is common even among children with apparently minor injuries to the brain. The evidence suggests that this condition is independent of psychiatric disorders such as post-traumatic stress disorder and depression.
A review of conditions altering the permanent appearance of the vulva  [PDF]
Ian S. C. Jones
Open Journal of Obstetrics and Gynecology (OJOG) , 2012, DOI: 10.4236/ojog.2012.24078
Abstract: This article is aimed at providing information on variations in the clinical appearance of the vulva. The appearance of the vulva can be altered by reversible or permanent conditions both of which may result in minor or major changes. Reversible conditions include those associated with infections or acute trauma which results in distortion of the vulva. Some permanent changes are caused by life threatening conditions which are present at birth whereas others develop more slowly or as the result of a deliberate act either traditional female surgery or surgery performed by a registered medical practitioner. To the inexperienced practitioner changes from the normal vulvar appearance can be confusing. The aim of this article is to highlight and categorise changes that can affect the appearance of the vulva. Whatever the presentation the importance of obtaining a detailed history and performing an appropriate, sensitive and thorough examination can not be over emphasised.
Outcome following severe traumatic brain injury TBI correlates with serum S100B but not brain extracellular fluid S100B: An intracerebral microdialysis study  [PDF]
Craig D. Winter, Geraldine F. Clough, Ashley K. Pringle, Martin K. Church
World Journal of Neuroscience (WJNS) , 2013, DOI: 10.4236/wjns.2013.32013

S100B protein is released by astrocytes into the brain extracellular fluid following acute brain injury and elevated levels in CSF and serum have been shown to correlate with patient outcome following traumatic brain injury. A prospective study of brain extracellular fluid (ECF) and serum S100B levels in 12 patients with severe head injury (GCS ≤ 8) was undertaken using intracerebral microdialysis to investigate whether a correlation with ECF S100B and outcome could be confirmed. Patient outcomes were assessed at 6 months using the Glasgow Outcome Scale (GOS) and divided into two outcome groups: group A, 8 survivors with either a good recovery or moderate disability (GOS scores of 4 or 5); and group B, 4 patients who died (GOS 1). Peak serum levels of S100B were significantly greater in group B (mean 6.03 ng/ml) compared with group A (mean 0.73 ng/ml) (P = 0.009). Group A had a mean peak S100B in the extracellular compartment of 186 ng/ml compared to 150 ng/ml in group B. There was no significant difference between the mean peak brain ECF S100B concentrations for the 2 outcome groups (P = 0.932). We confirm that intracerebral microdialysis can be used to sample S100B concentrations from brain extracellular fluid and our results suggest that the ECF S100B levels were variable and that there was no significant difference between the good outcome and poor outcome groups. In contrast, the serum levels of S100B of patients with a poor outcome were significantly higher than those with a good outcome.

Current needs, the future of adolescents and young adults having sustained a moderate or severe Traumatic Brain Injury (TBI) and the potential of their social participation  [PDF]
Sirois Katia, Boucher Normand, Lepage Céline
Open Journal of Therapy and Rehabilitation (OJTR) , 2014, DOI: 10.4236/ojtr.2014.21009
Abstract: The general objective of this study is to identify the specific needs of youths who have suffered a moderate or severe traumatic brain injury (TBI) and their levels of life habit accomplishments. The secondary objective aims to identify how they view themselves in the future with regard to their life habits. Eighteen young persons with moderate or severe TBIs aged 14 to 20 completed questionnaires based on the Life-Habits questionnaire and elaborated on their current level of satisfaction and their visions of the future. Teenagers reported that maintaining good interpersonal relationships, being autonomous, fulfilling their responsibilities, warding off lone-liness, as well as being supported in their efforts to reach a satisfying response to their needs and concerns were their highest priorities. In order to increase their satisfaction related to life habits they suggest improving external factors, such as information concerning TBIs to their entourage. They see themselves as complete social participants in the future. Youths with moderate or severe TBIs identified their needs and envisioned their future to be like that of any other teenager and young adult. They hope to start a family and find a good job. They also identified strategies to improve their life habits.
Role of Xuesaitong in Amelioration of Neural Function and Alteration of Bax Expression in Rats with Brain Trauma  [PDF]
Wei Huang, Qi Yan, Jia Liu, Jintao Li, Tinghua Wang
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.69091
Abstract: Traumatic brain injury (TBI) is one of the most common diseases in clinical neurosurgery characterized with high incidence rate, mortality and many complications. Objectives: The purpose of this study is to explore the roles of Xuesaitong in the therapeutic effect of brain trauma and alteration of expression in Bax, a kind of promoting apoptosis factor. Methods: The rat traumatic brain injury models were established by using modified free falling body impact method. Thereafter, Xuesaitong was employed to be administered to TBI rats, and NSS Score Rating Scale was used to evaluate the effect of Xuesaitong. Moreover, real-time PCR was used to detect the Bax expression changes before and after the Xuesaitong administration. Results: Xuesaitong could accelerate the neurofunctional recovery of TBI rats, accompanied by NSS Scores significant decrease. Simultaneously, it also could inhibit the expression of Bax factor. Conclusions: Xusaitong could markedly ameliorate TBI restoration, in which it promotes the neurofunctional recovery, and at the same time it inhibits the expression of Bax.
Non-Traumatic Intracranial Heterotopic Ossification: A Case from Turkey  [PDF]
Mehmet Hanifi Kokacya, Hasan G?k?e, Zeynel Abidin Ta?, Dua Sümeyra Demirk?ran, Muhammet Mustafa Arslan
Forensic Medicine and Anatomy Research (FMAR) , 2016, DOI: 10.4236/fmar.2016.41003
Abstract: Heterotopic ossification (HO) is the abnormal, non-neoplastic presence of lamellar bone in soft tissue. The ectopic formation of lamellar bone in non-osseus tissues secondary to traumatic injuries of the spinal cord or the brain is defined as Neurogenic HO. The pathophysiology of HO is not clear. But several theories like overactive humoral mechanisms after fracture healing, imbalance of pro-osteoinductive and anti-osteoinductive mediators located on the soft tissues and gene mutations in such as bone morphogenetic proteins-4 (BMP-4) are proposed. Casualty factors leading to increased risk of HO include older age, blast mechanism of injury, location of injury and traumatic brain injury. The aim of this paper is to demonstrate a case of HO located in the brain without history of trauma or any other risk factors.
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