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[PMID]: 29477026
[Au] Autor:Khan K; Saeed S; Ramcharan A; Gray S
[Ad] Address:Department of Surgery, Harlem Hospital Columbia University Medical Center, New York, NY, USA. Electronic address: khank1@nychhc.org.
[Ti] Title:A case series of closed head trauma with pituitary stalk disruption resulting in hypopituitarism.
[So] Source:Int J Surg Case Rep;43:69-71, 2018 Feb 09.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction. We present a case series of two patients diagnosed with hypopituitarism after TBI and treated appropriately with favorable outcome. CASE PRESENTATIONS: The first case is a 34 year-old male, who presented to the emergency department with blunt head trauma after a motor vehicle accident while riding his bicycle. He suffered from severe cranio-facial injuries, resulting in multifocal hemorrhagic contusions, epidural hematoma, and extensive cranio-facial fractures involving the sinuses. The patient developed persistent hypotension with a blood pressure as low as 60/40 mmHg on hospital day three. The second case is a 56 year-old male with a history of schizophrenia, who suffered traumatic brain injury after he was hit by a train. The patient sustained multiple facial fractures, pneumocephalus and C2/7 transverse processes fractures. He also had persistent hypotension, unresponsive to standard treatment. Investigation revealed a deficiency of anterior pituitary hormones resulting from pituitary axis disruption. DISCUSSION: Hypopituitarism is becoming an increasingly recognized complication following TBI, ranging from total to isolated deficiencies. Traumatic Brain Injury is a major public health problem and is one of the leading causes of disability. Understanding and recognizing pituitary dysfunction after TBI can lead to better outcomes and improved quality of life. CONCLUSION: Patients with major head injury and, in particular, those with fractures of the base of the skull, must be closely monitored for signs and symptoms of endocrine dysfunction. Appropriate dynamic pituitary-function screening should be performed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:Publisher

  2 / 13515 MEDLINE  
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[PMID]: 29523358
[Au] Autor:Yu YR; DeMello AS; Greeley CS; Cox CS; Naik-Mathuria BJ; Wesson DE
[Ad] Address:Baylor College of Medicine, Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, United States.
[Ti] Title:Injury patterns of child abuse: Experience of two Level 1 pediatric trauma centers.
[So] Source:J Pediatr Surg;, 2018 Feb 10.
[Is] ISSN:1531-5037
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0-12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6-5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4-5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8-8.8). Although 76% of head injuries occurred in infants <1year, children ages 1-4years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p<0.001). CONCLUSION: Child abuse accounts for a large proportion of trauma fatalities in children under 5years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority. TYPE OF STUDY: Retrospective Review. LEVEL OF EVIDENCE: II.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 13515 MEDLINE  
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Bento, Ricardo Ferreira
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[PMID]: 29522265
[Au] Autor:Salomone R; Jácomo AL; Nascimento SBD; Lezirovitz K; Hojaij FC; Costa HJZR; Bento RF
[Ad] Address:Department of Otorhinolaryngology, University of São Paulo Medical School, São Paulo, Brazil.
[Ti] Title:Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic facial paralysis.
[So] Source:Head Neck;, 2018 Mar 09.
[Is] ISSN:1097-0347
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Recent studies in invertebrates have taught us that early cell membrane regeneration is determinant for axonal recovery and survival after trauma. Many authors obtained extraordinary results in neural regeneration using polyethylene glycol fusion protocols, which also involved microsutures and antioxidants. METHODS: Sixty rats were evaluated with functional and histological protocol after facial nerve neurotmesis. Groups A and B had their stumps coapted with microsuture after 24 hours of neurotmesis and groups C and D after 72 hours. In addition to the microstructure, groups B and D used the polyethylene glycol-fusion protocol for the modulation of the Ca . RESULTS: At the sixth week, the latency of group D and duration of group B was lower than groups A and C (P = .011). The axonal diameter of the groups that used polyethylene glycol-fusion was higher than those who did not use polyethylene glycol-fusion (P ≤ .001). CONCLUSION: Although not providing a functional improvement, polyethylene glycol-fusion slowed down demyelination.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/hed.25122

  4 / 13515 MEDLINE  
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[PMID]: 29519623
[Au] Autor:Harris M; Brantley T; Hammond D; Kalamchi S
[Ad] Address:University College London, London, UK. Electronic address: Malcolm.harris@ucl.ac.uk.
[Ti] Title:Demographic features of patients with concomitant facial fractures and closed head injuries in Maricopa, Arizona.
[So] Source:Oral Surg Oral Med Oral Pathol Oral Radiol;, 2018 Jan 31.
[Is] ISSN:2212-4411
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The aim of this study was to investigate the demographic profile of Native American patients with concomitant facial fractures and closed head injuries (CHIs) and to explore the validation of the craniofacial crumple zone. STUDY DESIGN: This was a retrospective, observational, case-control study of 2131 maxillofacial fractures from 2010 to 2014, of which 173 (8%) had concomitant CHIs. RESULTS: Of the study patients, 133 (77%) were males (mean age 40.6 years). Only 2.1% of the local population was Native American, but this group represented 24% of the patients with CHIs and sustained 4.6 times more (P value < .001) assault injuries and 2.6 times more concussion (P value < .001) compared with other groups. Other trauma comparisons were not significant. Of the 173 study patients, 86 (50%), had blood alcohol levels which exceeded 80 mg/100 mL compared with 93% of the Native Americans. CONCLUSIONS: Native American patients had a highly significant predisposition to violence and road traffic accidents resulting in maxillofacial fractures and CHIs. The high blood alcohol levels found in this group also reflected longstanding serious sociologic problems. This study provides a useful model to investigate the relative ethnic/racial role of comminuted paranasal structures for the protection of the brain (i.e., the crumple zone).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  5 / 13515 MEDLINE  
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[PMID]: 29519555
[Au] Autor:Sampietro de Luis JM
[Ad] Address:Servicio de Cirugía Plástica y Quemados, Hospital Universitario "Miguel Servet", Pº Isabel la Católica 1-3, 50009, Zaragoza. Electronic address: jmsampi@gmail.com.
[Ti] Title:Experience with NexoBrid in enzymatic debridement of facial burns.
[So] Source:Burns;, 2018 Mar 05.
[Is] ISSN:1879-1409
[Cp] Country of publication:Netherlands
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 13515 MEDLINE  
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[PMID]: 29513916
[Au] Autor:Marquardt CA; Goldman DJ; Cuthbert BN; Lissek S; Sponheim SR
[Ad] Address:Department of Psychology, University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA.
[Ti] Title:Symptoms of Posttraumatic Stress Rather Than Mild Traumatic Brain Injury Best Account for Altered Emotional Responses in Military Veterans.
[So] Source:J Trauma Stress;31(1):114-124, 2018 Feb.
[Is] ISSN:1573-6598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Emotional dysfunction is evident in posttraumatic stress disorder (PTSD), yet it is unclear what aspects of the disorder most directly relate to aberrant emotional responding. Also, the frequent co-occurrence of blast-related mild traumatic brain injuries (mTBIs) among recently deployed U.S. military personnel complicates efforts to understand the basis for emotional disruption. We studied a cross-sectional sample (enriched for PTSD and mTBI) of 123 U.S. veterans of wars in Iraq and Afghanistan. We measured subjective affective evaluations and peripheral psychophysiological responses to images with pleasant, neutral, unpleasant, and combat-related aversive content. When compared with other postdeployment participants, those who had combat-related PTSD rated pleasant image content as less positive (ηp2 = .04) and less arousing (ηp2 = .06), and exhibited heightened physiological responsivity to combat image content (ηp2 = .07). Symptoms of PTSD were associated with elevated skin conductance responses (ß = .28), reduced heart rate deceleration (ß = .44 to .47), and increased corrugator facial muscle electromyography (ß = .47). No effects for blast-related mTBI were observed across any affective modulation measures. These findings point to a greater impact of PTSD symptomatology than blast-related mTBI on emotional functioning and highlight the utility of dimensional assessments of psychopathology for understanding the effects of combat-stress conditions on adjustment to civilian life.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1002/jts.22259

  7 / 13515 MEDLINE  
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[PMID]: 29333809
[Au] Autor:Aguilar de la Red Y; Manrique Martín G; Guerrero Marquez G; González Herrero C; Vázquez López P; Míguez Navarro C
[Ad] Address:Hospital General Universitario Gregorio Marañón, Servicio de Pediatría, Madrid, España. yurenaaguilar@gmail.com.
[Ti] Title:Evaluación del manejo del dolor de la patología facial y oral en un Servicio de Urgencias Pediátrico y tras el alta domiciliaria. Assessment of orofacial pain management in a pediatric emergency department and at home after discharge.
[So] Source:Arch Argent Pediatr;116(1):28-34, 2018 02 01.
[Is] ISSN:1668-3501
[Cp] Country of publication:Argentina
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered. RESULTS: In total, 252patients (mean age: 4.5 years, SD: 3.89) were included. Pain assessment was recorded at the triage for 8.7%, and in the medical report, for 3.6%. Analgesia was administered to 41.3% in the emergency room. At discharge, no analgesia was prescribed to 13.9%; scheduled analgesia, to 25.4%; and as needed, to 60.3%. Pediatricians prescribed scheduled analgesia more frequently than surgeons (34.4% versus 16.5%, p < 0.01). At home, no analgesia was administered to 39.3%; scheduled analgesia, to 36.1%; and as needed, to 23%. There is little correlation between prescription at discharge and at home (Kappa: 0.178). Analgesia was considered adequate in 84% of cases, and was more frequent in trauma injuries than in infections (85.7% versus 14.3%, p < 0.01). CONCLUSIONS: Pain assessment and management was scarce in the emergency department. The most common prescription was as needed, contrary to what is recommended in the guidelines. Analgesic control worked better for trauma injuries than for infections.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.5546/aap.2018.eng.28

  8 / 13515 MEDLINE  
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[PMID]: 29451668
[Au] Autor:Irugu DVK; Singh A; Ch S; Panuganti A; Acharya A; Varma H; Thota R; Falcioni M; Reddy S
[Ad] Address:Department of Otorhinolaryngology and Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Title:Comparison between early and delayed facial nerve decompression in traumatic facial nerve paralysis - A retrospective study.
[So] Source:Codas;30(1):e20170063, 2018.
[Is] ISSN:2317-1782
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Purpose To study the intraoperative findings in case of early and delayed decompression of facial nerve paralysis and compare their results. Methods Retrospective data analysis of 23 cases of longitudinal temporal bone fracture with House-Brackmann grade V and VI facial nerve paralysis. All cases were thoroughly evaluated and underwent facial nerve decompression through the transmastoid approach. All cases were under regular follow-up till the date of manuscript submission. Results Clinical improvement of the facial nerve function was observed for early vs. delayed facial nerve decompression. In the early decompression group, facial nerve function improved to grade II in eight cases (80%) and grade III in two cases (20%), whereas in the delayed decompression group it improved to grade II in one case (7.70%), grade III in four cases (30.76%), grade IV in seven cases (53.84%), and grade V in one case (7.70%). Conclusions Early decompression of facial nerve provides better results than delayed decompression because it enables early expansion of the nerve.
[Mh] MeSH terms primary: Facial Nerve Injuries/surgery
Facial Paralysis/surgery
[Mh] MeSH terms secundary: Adult
Decompression, Surgical/methods
Facial Nerve Injuries/diagnostic imaging
Facial Paralysis/diagnostic imaging
Female
Humans
Male
Middle Aged
Retrospective Studies
Skull Fractures/physiopathology
Skull Fractures/surgery
Temporal Bone/injuries
Temporal Bone/surgery
Time-to-Treatment
Young Adult
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Js] Journal subset:IM
[Da] Date of entry for processing:180217
[St] Status:MEDLINE

  9 / 13515 MEDLINE  
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[PMID]: 29225134
[Au] Autor:You N; Choi MS; Roh TH; Jeong D; Kim SH
[Ad] Address:Department of Neurosurgery, Ajou University School of Medicine, Suwon, Republic of Korea.
[Ti] Title:Severe Facial Fracture is Related to Severe Traumatic Brain Injury.
[So] Source:World Neurosurg;111:e47-e52, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Facial fractures frequently occur with traumatic brain injury (TBI). The relationship between facial fractures and brain trauma remains controversial. The objective of this study was to analyze the correlation between facial fracture and TBI. METHODS: Clinical and radiologic data of a total of 206 patients were retrospectively collected from May 2011 to December 2015 in a single institute. Facial fracture was classified by the Facial Injury Severity Scale (FISS). TBI was grouped according to the Glasgow Coma Scale. Outcome was measured with the Glasgow Outcome Scale Extended 3, 6, and 12 months after trauma. RESULTS: There were 206 TBI patients with concomitant facial fracture including 166 (78.1%) males and 40 (19.4%) females. Mean age of all patients was 46 ± 19 years. Contusion and brain swelling were more frequent in higher FISS patients. Cranial surgery was done in 63 cases while facial fracture surgery was performed in 89 cases. There were 33 expired cases, including 6 cases due to multi-organ failure. High FISS was significantly associated with severe TBI and less favorable outcome 3 months after trauma. Concomitant surgical treatment for TBI and facial fracture was done in 21 cases without achieving more improved outcome compared with staged operations for 41 cases. CONCLUSION: Severity of facial fracture might be correlated with severity of TBI. Surgical timing of facial fracture with TBI patients does not affect the outcome of TBI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  10 / 13515 MEDLINE  
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[PMID]: 29173932
[Au] Autor:Halpern LR; Shealer ML; Cho R; McMichael EB; Rogers J; Ferguson-Young D; Mouton CP; Tabatabai M; Southerland J; Gangula P
[Ad] Address:Department of Oral and Maxillofacial Surgery, University of Utah, School of Dentistry, 530S Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: leslie.halpern@hsc.utah.edu.
[Ti] Title:Influence of Intimate Partner Violence (IPV) Exposure on Cardiovascular and Salivary Biosensors: Is There a Relationship?
[So] Source:J Natl Med Assoc;109(4):252-261, 2017 Winter.
[Is] ISSN:0027-9684
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND/PURPOSE: Intimate partner violence (IPV) is a global public health epidemic that initiates/exacerbates health consequences affecting a victim's lifespan. IPV can significantly predispose women to a lifetime risk of developing cardiovascular disease (CVD) due to the effects of stress and inflammation. This study investigates the correlation among IPV exposure, in-vivo CVD events, and inflammatory biomarkers as predictor indices(s) for CVD in female dental patients. METHODS: Of 37 women enrolled in this study, 19 were African-American (AA) and 18 non-African-American (non-AA) and their ages ranged from 19 to 63 years. IPV-exposure and stress-induced in-vivo CVD events such as Chest Pain (CP) and Heart palpitations were recorded from all enrolled subjects. Cardiovascular events were obtained through surveys by patient self-report. Saliva specimens were obtained from all women and were analyzed for CVD biomarkers using multiplex-ELISA. RESULTS: The prevalence of IPV was 51% (19/37) and statistically equivalent for AA and non-AA. The results show differences in experience of 1) CP (p < 0.01) and 2) heart palpitations (p < 0.02) when IPV + participants are compared with IPV- AA and non-AA cohorts. Of 10 CVD biomarkers analyzed, significant correlations between IPV+ and IPV- subjects were observed for biomarkers that include Interleukin-1ß/sCD40L; TNFα/sCD40L; Myoglobin/IL-1ß; CRP/sCD40L; CRP/IL-6; CRP/TNFα; TNFα/siCAM; CRP/MMP9; TNF-α/Adiponectin (p < 0.01). DISCUSSION/IMPLICATIONS: Analysis of in vivo CVD status showed that significant race/health disparities exist in IPV + cohorts, as well as increased expression of inflammatory mediators, specifically CRP, IL-1ß, IL-6, MMP9. Women who have experienced IPV may be a target cohort for primary prevention of CVD. The use of salivary biomarkers and our protocol may provide a less invasive method to help increase identification of victims at risk for IPV and CVD and potentially decrease other health injuries associated with IPV exposure.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review


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