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Reliability, Validity, Clinical Utility, and Responsiveness of Measures for Assessing Mobility and Physical Function in Patients with Traumatic Injury in the Acute Care Hospital Setting: A Prospective Study.

Phys Ther 2021 Jul 29. Epub 2021 Jul 29.

Department of Physiotherapy, The Alfred Hospital, Prahran, Melbourne, VIC 3181.

Objective: The longer-term impact of injury is increasingly recognized, but the early phases of recovery are less well understood. The best tools to measure early recovery of mobility and physical function following traumatic injury are unclear. The purpose of this study was to assess the clinical utility, validity, reliability, and responsiveness of 4 mobility and physical function measures in patients following traumatic injury. Read More

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Long-term prescription opioid use among US military service members injured in combat.

J Trauma Acute Care Surg 2021 Aug;91(2S Suppl 2):S213-S220

From the Center for Surgery and Public Health, Department of Surgery (M.K.D., A.M., M.P.J., J.S.W., Z.C., A.J.S.) and Department of Orthopedic Surgery (A.J.P., A.J.S.), Brigham and Women's Hospital, Harvard Medical School, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Department of Surgery (P.A.L.) and Department of Preventive Medicine and Biostatistics (T.P.K.), F. Edward Hébert School of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland.

Introduction: During the Global War on Terrorism, many US Military service members sustained injuries with potentially long-lasting functional limitations and chronic pain. We sought to understand the patterns of prescription opioid use among service members injured in combat.

Methods: We queried the Military Health System Data Repository to identify service members injured in combat between 2007 and 2011. Read More

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[Comparison of femoral tunnel and early curative effect analysis between arthroscopic three approach and traditional anteromedial portal for reconstruction of anterior cruciate ligament].

Zhongguo Gu Shang 2021 Jul;34(7):628-35

Department of Joint Surgery, the Second Clinical Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.

Objective: To study the three-approach and traditional anterior medial technique to establish the femoral tunnel of position, length, and coronal angle and the early efficacy of anterior cruciate ligament reconstruction.

Methods: Through retrospective research, from December 2018 to June 2019, a total of 36 patients diagnosed with simple anterior cruciate ligament tear and undergoing surgery were collected. All patients had a clear history of knee sprains and were divided into two groups. Read More

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Performance of the Hull Salford Cambridge Decision Rule (HSC DR) for early discharge of patients with findings on CT scan of the brain: a CENTER-TBI validation study.

Emerg Med J 2021 Jul 27. Epub 2021 Jul 27.

Centre for Urgent and Emergency Care Research (CURE), School of Health and Related Research (ScHARR). Emergency Department, Salford Royal Hospital, University of Sheffield and Salford Royal Hospital, Sheffield, UK.

Background: There is international variation in hospital admission practices for patients with mild traumatic brain injury (TBI) and injuries on CT scan. Only a small proportion of patients require neurosurgical intervention, while many guidelines recommend routine admission of all patients. We aim to validate the Hull Salford Cambridge Decision Rule (HSC DR) and the Brain Injury Guidelines (BIG) criteria to select low-risk patients for discharge from the emergency department. Read More

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Bone suture anchor repair and functional outcome of a triceps tendon rupture, a rare clinical entity.

BMJ Case Rep 2021 Jul 27;14(7). Epub 2021 Jul 27.

Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands

Triceps tendon rupture is rare and easily missed on presentation. A 58-year-old man was seen in our accident and emergency department with an inability to extend his right elbow against gravity after he fell. Ultrasound and MRI confirmed the suspected diagnosis of a traumatic triceps tendon rupture and excluded additional injuries. Read More

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Cytokines as new biomarkers of skin wound vitality.

Int J Legal Med 2021 Jul 27. Epub 2021 Jul 27.

IRMB, INM, INSERM, CHU Montpellier, (LBPC-PPC), University of Montpellier, Montpellier, France.

Background: The diagnosis of skin wound vitality is currently based on standard histology, but histological findings lack sensitivity in case of a short survival time. New reliable biomarkers of vitality are therefore strongly needed. We assessed the ability of 10 candidate cytokines (IFN-γ, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α) to discriminate between vital and early post-mortem wounds. Read More

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Open fracture-dislocation of the knee associated with nonunion of the medial femoral condyle and chronic tendon patellar rupture.

Acta Biomed 2021 Jul 26;92(S3):e2021013. Epub 2021 Jul 26.

Università Degli Studi di Parma.

Background And Aim Of Work: The incidence of coronal fractures of the femoral condyle, Hoffa fractures, ranges from 8.7% to 13% of all fractures of the distal femur and are often observed in polytraumas. Hoffa fractures may be misdiagnosed and consequently not properly treated. Read More

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Anterior and antero-lateral mini-invasive approaches for primary total hip replacement.

Acta Biomed 2021 Jul 26;92(S3):e2021014. Epub 2021 Jul 26.

ISS San Marino.

Background And Aim Of The Work: the literature provides conflicting data regarding the various approaches for hip prosthetic surgery. This study analysed our case series on the anterior and anterolateral minimally invasive approaches, trying to define the indications, complications, the technical tips, the advantages and disadvantages.

Methods: from 2011 to 2019 we performed 1227 interventions of which 1020 had a regular follow-up, up to an average period of 5. Read More

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Partial depletion and repopulation of microglia have different effects in the acute MPTP mouse model of Parkinson's disease.

Cell Prolif 2021 Jul 26:e13094. Epub 2021 Jul 26.

Department of Translational Neuroscience, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Jing' an District Centre Hospital of Shanghai Institutes of Brain Science, Fudan University, Shanghai, China.

Objectives: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by the progressive and selective degeneration of dopaminergic neurons. Microglial activation and neuroinflammation are associated with the pathogenesis of PD. However, the relationship between microglial activation and PD pathology remains to be explored. Read More

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IDEO energy-storing orthosis: Effects on lower extremity function and preservation.

Injury 2021 Jul 18. Epub 2021 Jul 18.

USU-WRNMMC Department of Surgery, Bethesda, MD, United States.

Introduction: The Intrepid Dynamic Exoskeletal Orthosis (IDEO) brace is a custom energy-storing orthosis design meant to improve gait, stability, and function after lower extremity injury or limb salvage. Early studies demonstrated the potential for the IDEO to improve functional performance, in conjunction with its paired return to run (RTR) rehabilitation program, compared to other brace types, and an impressively decreased rate of late amputation. The current study aimed to investigate these functional and revision outcomes from our institution to determine which patients may benefit most from IDEO bracing and what factors of the IDEO design and rehabilitation program are most important for improved outcomes after lower extremity trauma and/or loss of function. Read More

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Prognostic Value of Hemorrhagic Brainstem Injury on Early Computed Tomography: A TRACK-TBI Study.

Neurocrit Care 2021 Jul 26. Epub 2021 Jul 26.

Department of Neurological Surgery, Harborview Medical Center, University of Washington School of Medicine, 325 9th Ave, Box 359924, Seattle, WA, 98104, USA.

Background: Traumatic brainstem injury has yet to be incorporated into widely used imaging classification systems for traumatic brain injury (TBI), and questions remain regarding prognostic implications for this TBI subgroup. To address this, retrospective data on patients from the multicenter prospective Transforming Research and Clinical Knowledge in TBI study were studied.

Methods: Patients with brainstem and cerebrum injury (BSI+) were matched by age, sex, and admission Glasgow Coma Scale (GCS) score to patients with cerebrum injuries only. Read More

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What are the Predictors of Return to Work for People With Elbow, Wrist, and Hand Conditions? A Systematic Review.

J Occup Rehabil 2021 Jul 26. Epub 2021 Jul 26.

Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA.

Purpose Conditions affecting the elbow, forearm, wrist, and hand can cause debilitating pain and loss of function in the working population. While there is knowledge about intervention options for this region of the body, there is limited research on systematically identifying the predictors of return to work in this population. Methods A systematic literature review identified all English-language studies that assess predictors of return to work for people with elbow, wrist, and hand conditions from 2009 to 2021 using PRISMA guidelines. Read More

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Could radio-morphological changes in humerus greater tuberosity be an early indicator of rotator cuff tendon injuries?

Skeletal Radiol 2021 Jul 26. Epub 2021 Jul 26.

Faculty of Medicine, Department of Radiology, Çanakkale Onsekiz Mart University, 17100, Çanakkale, Turkey.

Objectives: To reveal the possible relationship between greater tuberosity volume with rotator cuff tendon injuries.

Materials And Methods: In our study, the morphology of the greater tuberosity was evaluated retrospectively by using radiographs and MR images of 335 cases. While critical shoulder angle (CSA) was measured on radiographs, greater tuberosity (GT) area and volume were calculated, and also supraspinatus, infraspinatus, and teres minor tendons were evaluated, on MR images. Read More

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Educating Certified Nursing Assistants to Communicate Skin Changes to Reduce Pressure Injuries.

J Gerontol Nurs 2021 Aug 1;47(8):21-28. Epub 2021 Aug 1.

Pressure injuries (PIs) are common and costly complications in long-term care (LTC) residents. Educating and coaching certified nursing assistants (CNAs) to communicate early skin changes is a PI surveillance strategy that may influence PI outcomes. A communication guide related to Skin, Clean, Activity, and Nutrition was developed for CNAs to promote prompt upstream communication to licensed nurses. Read More

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Fifth Metatarsal Fracture-A Systematic Review of the Treatment of Fractures of the Base of the Fifth Metatarsal Bone.

Dtsch Arztebl Int 2021 Sep 6(Forthcoming). Epub 2021 Sep 6.

Background: Metatarsal fractures are among the most common foot and ankle injuries, with an annual incidence of 6.7 per 100 000 persons. Approximately 30% of metatarsal fractures affect the base of the fifth metatarsal bone. Read More

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September 2021

[Comparison of early effectiveness of arthroscopic suture bridge technique and conventional double tunnel suture technique in treatment of avulsion fracture of posterior cruciate ligament insertion].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jul;35(7):829-835

Department of Orthopedics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou Fujian, 363000, P.R.China.

Objective: To compare the early effectiveness of arthroscopic suture bridge technique and conventional double tunnel suture technique in the treatment of avulsion fracture of posterior cruciate ligament (PCL) insertion.

Methods: Between June 2013 and December 2018, 62 patients with tibial avulsion fracture of PCL insertion that met the criteria were selected and randomly divided into trial group (using arthroscopic suture bridge technique) and control group (using conventional double tunnel suture technique), 31 cases in each group. There was no significant difference in gender, age, injured side, cause of injury, time from injury to operation, Meyers & McKeever classification, Kellgren-Lawrence classification, and preoperative knee range of motion, difference of posterior relaxation of bilateral knee joints, International Knee Documentation Committee (IKDC) score, and Lysholm score between the two groups ( >0. Read More

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Comparison of Anterior, Posterior, and Combined Surgical Approaches on the Outcomes of Patients Suffering from Subaxial Cervical Spine Injuries.

Bull Emerg Trauma 2021 Jul;9(3):133-137

Resident of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran.

Objective: To investigate the radiological and clinical outcomes of different surgical approaches in cervical spinal trauma in northeastern of Iran.

Methods: The present study was conducted retrospectively from January 2011 to December 2017 in Mashhad, Iran. The demographic characteristics, hospitalization duration, and patient's surgery detail data were extracted from the patients' medical records. Read More

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[Roles of adenosine monophosphate activated protein kinase in skeletal muscle atrophy in rats with severe scald].

Zhonghua Shao Shang Za Zhi 2021 Jul;37(7):640-646

Department of Burns and Plastic Surgery, Burns Institute of PLA, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China.

To investigate the expression and phosphorylation level change of adenosine monophosphate activated protein kinase (AMPK) in skeletal muscle of severely scald rats and its roles in skeletal muscle atrophy in severely scalded rats. The experimental research method was applied. Totally 100 6-week-old male Wistar rats were divided into sham injury group and scald group according to the random number table, with 50 rats in each group. Read More

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Impaired meningeal lymphatic vessels exacerbate early brain injury after experimental subarachnoid hemorrhage.

Brain Res 2021 Jul 22:147584. Epub 2021 Jul 22.

Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, China; Department of Neurosurgery, Tianjin Medical University General Hospital, China. Electronic address:

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Tertiary peritonitis: considerations for complex team-based care.

Eur J Trauma Emerg Surg 2021 Jul 24. Epub 2021 Jul 24.

Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA, 19104, USA.

Peritonitis, as a major consequence of hollow visceral perforation, anastomotic disruption, ischemic necrosis, or other injuries of the gastrointestinal tract, often drives acute care in the emergency department, operating room, and the ICU. Chronic critical illness (CCI) represents a devastating challenge in modern surgical critical care where successful interventions have fostered a growing cohort of patients with prolonged dependence on mechanical ventilation and other organ supportive therapies who would previously have succumbed much earlier in the acute phase of critical illness. An important subset of CCI patients are those who have survived an emergency abdominal operation, but who subsequently require prolonged open abdomen management complicated by persistent peritoneal space infection or colonization, fistula formation, and gastrointestinal (GI) tract dysfunction; these patients are described as having tertiary peritonitis (TP). Read More

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Grade III pivot shift as an early sign of knee decompensation in chronic ACL-injured knees with bimeniscal tears.

Knee Surg Sports Traumatol Arthrosc 2021 Jul 23. Epub 2021 Jul 23.

Sports Clinic, Centre Hospitalier de Luxembourg-Clinique d'Eich, 78 Rue d'Eich, 1460, Luxembourg, Luxembourg.

Purpose: To analyse possible associations between the preoperative pivot shift (PS) test and both patient and injury characteristics in anterior cruciate ligament (ACL)-injured knees, considering previously neglected meniscal injuries such as ramp and root tears. The hypothesis was that a preoperative grade III PS was associated with the amount of intra-articular soft-tissue damage and chronicity of the injury.

Methods: The cohort involved 376 patients who underwent primary ACL reconstruction (239 males/137 females; median age 26). Read More

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Functional outcome of early weight bearing for acute Achilles tendon rupture treated conservatively in a weight-bearing orthosis.

Foot Ankle Surg 2021 Jul 2. Epub 2021 Jul 2.

Department of Trauma & Orthopaedics, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, United Kingdom.

Background: The optimal management for Achilles tendon (AT) ruptures is controversial and still continues to encourage debate. Conventionally, operative repair was favoured secondary to its lower rates of re-rupture, however in more recent years, we have seen promising results and a reduction in complications with conservative management. One reason for this improvement may be due to the introduction of a functional weight-bearing orthosis, however, results for complete AT ruptures is still unclear. Read More

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Complement Factor C5a Inhibits Apoptosis of Neutrophils-A Mechanism in Polytrauma?

J Clin Med 2021 Jul 17;10(14). Epub 2021 Jul 17.

Institute of Clinical and Experimental Trauma-Immunology (ITI), University of Ulm, 89081 Ulm, Germany.

Life-threatening polytrauma results in early activation of the complement and apoptotic system, as well as leukocytes, ultimately leading to the clearance of damaged cells. However, little is known about interactions between the complement and apoptotic systems in PMN (polymorphonuclear neutrophils) after multiple injuries. PMN from polytrauma patients and healthy volunteers were obtained and assessed for apoptotic events along the post-traumatic time course. Read More

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Sports Specialization and Sports-Related Injuries in Japanese School-Aged Children and Adolescents: A Retrospective Descriptive Study.

Int J Environ Res Public Health 2021 Jul 9;18(14). Epub 2021 Jul 9.

Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.

Although early sports specialization is associated with sports-related injuries, relevant quantitative studies on young non-elite athletes, the majority of sports participants, are scarce. We described sports specialization time points and the characteristics of sports-related injuries. Undergraduate students at a university in Japan ( = 830) recalled their history of sports participation from elementary to high school and sports-related injuries in a self-administered questionnaire. Read More

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[Effect of early mechanical ventilation on the expression of inflammatory factors and prognosis in patients with severe traumatic brain injury].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Jun;33(6):727-730

Department of Critical Care Medicine, Xinhua Hospital Chongming Branch, Shanghai 202150, China.

Objective: To observe the effect of early mechanical ventilation on the expression of inflammatory factors and prognosis of patients with severe traumatic brain injury (sTBI).

Methods: From January 2017 to December 2020, 138 patients with sTBI admitted to the department of the emergency of Xinhua Hospital Chongming Branch were enrolled. Although some patients were admitted to hospital without acute respiratory failure, their Glasgow coma score (GCS) were less than 8, they bad risk of hypoxia, so early mechanical ventilation was required. Read More

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Esophagopharyngeal perforation and prevertebral abscess after anterior cervical discectomy and fusion: a case report.

J Spine Surg 2021 Jun;7(2):225-232

Chief of Spine Surgery, Department of Orthopaedic Surgery, New York University Langone Hospital-Brooklyn, Tribeca, New York, NY, USA.

Anterior cervical discectomy and fusion (ACDF) represents one of the most commonly performed spine surgeries. Dysphagia secondary to esophageal injury during retraction is one of the most common complications, and usually leads to self-limiting dysphagia. However, actual perforation and violation of the esophageal tissue is much rarer and can lead to delayed deep infections. Read More

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Cardiac arrhythmias six months following traumatic spinal cord injury.

J Spinal Cord Med 2021 Jul 22:1-7. Epub 2021 Jul 22.

Clinic for Spinal Cord Injuries, Rigshospitalet, Copenhagen, Denmark.

Objective: To investigate the incidence of cardiac arrhythmias at six months following traumatic spinal cord injury (SCI) and to compare the prevalence of arrhythmias between participants with cervical and thoracic SCI.

Design: A prospective observational study using continuous twenty-four-hour Holter monitoring.

Setting: Inpatient rehabilitation unit of a university research hospital and patient home setting. Read More

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Diagnostic sensitivity of impulse oscillometry in early detection of patients exposed to risk factors chronic obstructive pulmonary diseases.

Med J Islam Repub Iran 2021 12;35:89. Epub 2021 Jul 12.

Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Impulse oscillometry (IOS) is a method that does not depend on the cooperation of the patient and can detect small airway diseases with higher sensitivity than spirometry. However, the clinical application value of IOS in the screening of patients exposed to risk factors COPD and early diagnosis remains unclear. The aim of this study is to evaluate diagnostic sensitivity of IOS in the early detection of patients exposed to risk factors COPD. Read More

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Dysbaric osteonecrosis of the humeral head in a patient with type 2 decompressive sickness.

Spinal Cord Ser Cases 2021 Jul 21;7(1):62. Epub 2021 Jul 21.

Trauma and Rehabilitation Unit, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, M6 8HD, UK.

Introduction: Dysbaric osteonecrosis, albeit rare, have been reported in patients with decompression sickness. We report a patient with dysbaric osteonecrosis, diagnosed 60 days after presenting with decompression sickness.

Case Presentation: A 38-year-old, previously fit and healthy male, noted his tank running out of air at approximately 40-50 m while diving, surfaced rapidly before losing consciousness. Read More

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[Rate of methicillin-resistant Staphylococcus aureus in pediatric emergency departments in Spain].

An Pediatr (Barc) 2021 Jul 18. Epub 2021 Jul 18.

Hospital Universitario Infantil Niño Jesús, Madrid, España.

Introduction: Staphylococcusaureus (S. aureus) is a common germ present in bacterial infections in children. Lately, the rate of methicillin-resistant S. Read More

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