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Latest & greatest articles for trauma
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on trauma or other clinical topics then use Trip today.
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Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates Scientific Impact Paper No. 54 December 2016Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates 1. Background Implantation continues to be a rate-limiting step in the success of assisted conception treatments. For implantation to occur, a blastocyst must (...) of women. While there is, as yet, no universally accepted definition for RIF , it has been proposed as the failure to achieve a clinical pregnancy after transfer of at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. 14 Thus far, the effect of endometrial trauma on pregnancy outcome in women who have experienced recurrent miscarriage (RM) has not been evaluated. 2. Evidence for endometrial trauma and improved implantation rates
Validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk patients with blunt trauma to the neck: part 2. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Col To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury (...) in alert low-risk adult patients with blunt trauma to the neck.We searched four databases from 2005 to 2015. Pairs of independent reviewers critically appraised eligible studies using the modified QUADAS-2 and QAREL criteria. We synthesized low risk of bias studies following best evidence synthesis principles.We screened 679 citations; five had a low risk of bias and were included in our synthesis. The sensitivity of the Canadian C-spine rule ranged from 0.90 to 1.00 with negative predictive values
The influence of sex steroid hormones on the response to trauma and burn injury Trauma and related sequelae result in disturbance of homeostatic mechanisms frequently leading to cellular dysfunction and ultimately organ and system failure. Regardless of the type and severity of injury, gender dimorphism in outcomes following trauma have been reported, with females having lower mortality than males, suggesting that sex steroid hormones (SSH) play an important role in the response of body systems (...) to trauma. In addition, several clinical and experimental studies have demonstrated the effects of SSH on the clinical course and outcomes following injury. Animal studies have reported the ability of SSH to modulate immune, inflammatory, metabolic and organ responses following traumatic injury. This indicates that homeostatic mechanisms, via direct and indirect pathways, can be maintained by SSH at local and systemic levels and hence result in more favourable prognosis. Here, we discuss the role
Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines Thromboelastography or Rotational Thromboelastography for Trauma (...) : A Review of the Clinical and Cost-Effectiveness and Guidelines Published on: September 8, 2017 Project Number: RC0924-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness evidence regarding the use of thromboelastography (TEG) or rotational thromboelastography (ROTEG) to guide transfusion requirements for trauma patients with bleeding? What is the cost-effectiveness of TEG or ROTEG to guide
Comparative analysis of gender differences in outcomes after trauma in India and the USA: case for standardised coding of injury mechanisms in trauma registries While females generally have better outcomes than males after traumatic injury, higher mortality has been shown to occur in females after intentional trauma in lower-income countries. However, gender differences in trauma outcomes in different countries have not been previously compared. We conducted a two-country comparative analysis (...) to characterise gender differences in mortality for different mechanisms of injury.Two urban trauma databases were analysed from India and the USA for fall, motor vehicle collision (MVC) and assault patients between 2013 and 2015. Coarsened exact matching was used to match the two groups based on gender, age, injury severity score, Glasgow Coma Score and type of injury (blunt vs penetrating). The primary outcome of mortality was studied by using logistic regression to calculate the odds of death in the four
Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines Concurrent Treatment for Substance Use Disorder and Trauma
Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan (...) Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013. We compared the median values for trauma case volumes, numbers of deaths, and case fatality rates from both data sources, and also evaluated the variability in discrepancies for the intrahospital differences of these outcomes.The analyses included 136 hospitals. In the registry and annual evaluation data, the median case volumes were 120.5 cases and 180.5 cases, respectively; the median
Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures.The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures (...) in traumatic patients.This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity.The mean age of patients with upper and lower limb trauma were 31.43±12.32
Venous thromboembolism in major trauma patients: a singleâ€center retrospective cohort study of the epidemiology and utility of Dâ€dimer for screening Venous thromboembolism (VTE) can be a life-threatening complication after major trauma. The aim of this study was to investigate the epidemiology of VTE and to assess the usefulness of D-dimer for screening for VTE in major trauma cases among the Japanese population.We examined a single-center retrospective cohort of severely injured trauma (...) operating characteristic curve (AUROC) to predict VTE.The study cohort consisted of 204 trauma patients (median Injury Severity Score, 20). Of the 204 patients, 65 (32%) developed VTE. The median time from admission to VTE diagnosis was 10 days. In multiple logistic regression analysis, higher Injury Severity Score and the presence of lower extremity fractures were revealed to be a risk factor for VTE. D-dimer levels at day 10 showed moderate accuracy, of which the AUROC was 0.785 (95% confidence
Perineal techniques during the second stage of labour for reducing perineal trauma. Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011 (...) studies, 7247 women; low-quality evidence), but there was considerable heterogeneity between the four included studies.There were no data for perineal trauma requiring suturing. Warm compresses versus control (hands off or no warm compress)A warm compress did not have any clear effect on the incidence of intact perineum (average RR 1.02, 95% CI 0.85 to 1.21; 1799 women; four studies; moderate-quality evidence), perineal trauma requiring suturing (average RR 1.14, 95% CI 0.79 to 1.66; 76 women; one
Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial. The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown.To determine if the FAST examination during initial evaluation of injured children improves clinical care.A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years (...) treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center.Patients were randomly assigned to a standard trauma evaluation with the FAST examination by the treating ED physician or a standard trauma evaluation alone.Coprimary outcomes were rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges.Among the 925 patients who were randomized (mean [SD] age, 9.7 [5.3] years; 575
Glasgow Coma Scale for field triage of trauma: a systematic review Glasgow Coma Scale for field triage of trauma: a systematic review Glasgow Coma Scale for field triage of trauma: a systematic review Chou R, Totten AM, Pappas M, Carney N, Dandy S, Grusing S, Fu R, Wasson N, Newgard C Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Chou R, Totten AM, Pappas M (...) , Carney N, Dandy S, Grusing S, Fu R, Wasson N, Newgard C. Glasgow Coma Scale for field triage of trauma: a systematic review. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 182. 2017 Authors' objectives To assess the predictive utility, reliability, and ease of use of the total Glasgow Coma Scale (tGCS) versus the motor component of the Glasgow Coma Scale (mGCS) for field triage of trauma, and effects on clinical decisionmaking and clinical outcomes
Self-harm and violent criminality among young people who experienced trauma-related hospital admission during childhood: a Danish national cohort study Development of a better understanding of subsequent pathways for individuals who experienced trauma during childhood might usefully inform clinicians and public health professionals regarding the causes of self-harm and interpersonal violence. We aimed to examine these risks during late adolescence and early adulthood among people admitted (...) of self-harm and violent offending, respectively, as adverse outcomes at ages 15-35 years. Sex-specific incidence rate ratios (IRRs; relative risks) and cumulative incidence percentage values (absolute risks) were estimated. The confounding influence of parental socioeconomic status was also explored.1 087 672 Danish people were included in this study. The prevalence of any trauma-related hospital admission was 10% (105 753 per 1 087 672; males: 64 454 [11%]; females: 44 299 [8%]) and for both sexes
Characteristics of trauma mortality in the Northern Territory, Australia While factors including remoteness, alcohol consumption, age and Indigenous ethnicity are well-documented associations of trauma mortality, less is known of trauma seasonality. This is particularly relevant to Australia's Northern Territory, with its tropical regions experiencing a climate of wet (hot and humid) and dry (warm) seasons annually. The aim of this study was to therefore, examine the characteristics of trauma (...) mortality in the Top End, Northern Territory, Australia.A retrospective review of the National Coroners Information System (NCIS) database from 1 January 2003 to 31 December 2007 analysed four-hundred and sixteen traumatic deaths where the trauma event and death occurred within the Top End of the Northern Territory.The annual traumatic death rate for the Top End was 58.7 per 100 000, with variance between regions (accessible 38.1; remote 119.1 per 100000, respectively). Overall alcohol was involved
Lupus profundus limited to a site of trauma: Case report and review of the literature Lupus erythematosus profundus (LEP) is a rare form of chronic cutaneous lupus erythematosus. We report on a case of a 56-year-old Caucasian woman who presented with a single, persistent, painful rash on the left hip and lateral aspect of the left upper thigh, which had been present for 2.5 years. The patient had a history of previous injury to this area before the rash started. Clinical findings showed
Influence of Syrgical Trauma on Nitric Oxide and Nitrotyrosine Serum Levels in Patients Undergoing Laparoscopic Or Conventional Cholecystectomy Oxidative stress represents tissue damage caused by reactive forms of oxygen and nitrogen due to the inability of antioxidant mechanisms to reduce reactive forms into more stable ones. The aim of the study was to evaluate the influence of surgical trauma on nitric oxide (NO) and nitrotyrosine (NT) values in patients undergoing conventional (...) postoperatively in conventionally operated patients i.e. the control group, vs. the treatment group. Further randomized studies are needed for a better understanding of the impact of surgical trauma on oxidative stress response.
Towards an inclusive system for major trauma 2017 www.kce.fgov.be KCE REPORT 281 TOWARDS AN INCLUSIVE SYSTEM FOR MAJOR TRAUMA 2017 www.kce.fgov.be KCE REPORT 281 HEALTH SERVICES RESEARCH TOWARDS AN INCLUSIVE SYSTEM FOR MAJOR TRAUMA MARIA-ISABEL FARFAN-PORTET, CECILE DUBOIS, PATRIEK MISTIAEN, AUDREY CORDON, SABINE STORDEUR, KOEN VAN DEN HEEDE COLOPHON Title: Towards an inclusive system for major trauma Authors of the scientific report: Maria-Isabel Farfan-Portet (KCE), Cécile Dubois (KCE (...) Saint-Luc, Belgian Orthopaedic Trauma Association [BOTA]), Peter De Paepe (UZ Gent, Trauma Task Force [TTF]), Saïd Hachimi-Idrissi (UZ Gent, Belgian Society of Emergency and Disaster Medicine [BeSEDiM]), Stefaan Nijs (UZ Leuven, Belgian Trauma Society [BTS]), François Pitance (CHR La Citadelle, Liège, Trauma Task Force [TTF]), Frank Plasschaert (UZ Gent, Belgische Vereniging voor Orthopedie en Traumatologie [BVOT]), Bart Poffyn (UZ Gent, Belgische Vereniging voor Orthopedie en Traumatologie [BVOT
Trauma in pregnant women: Assessing detection of post-traumatic placental abruption on contrast-enhanced CT versus Ultrasound To evaluate detection of post-traumatic placental abruption with contrast-enhanced CT (CECT) and comparison with Ultrasound (US).Picture Archive and Date System database at a level-1 trauma center was retrospectively reviewed using keywords pregnancy, trauma, and/or placental abruption over 10 years. CT was compared to US, if performed within 24 h. Two subspecialty
Child Trauma Exposure and Psychopathology: Mechanisms of Risk and Resilience Exposure to trauma in childhood is associated with elevated risk for multiple forms of psychopathology. Here we present a biopsychosocial model outlining the mechanisms that link child trauma with psychopathology and protective factors that can mitigate these risk pathways. We focus on four mechanisms of enhanced threat processing: information processing biases that facilitate rapid identification of environmental (...) trauma.