scholarly journals The Current Role of Interventional Radiology in the Management of Acute Trauma Patient

2021 ◽  
Vol 38 (01) ◽  
pp. 034-039
Author(s):  
Casey M. Luckhurst ◽  
April E. Mendoza
Keyword(s):  
Interventional Radiology ◽  
Causes Of Death ◽  
Multidisciplinary Teams ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Endovascular Techniques ◽  
Research And Innovation ◽  
Complex Patient ◽  
Common Causes

AbstractTrauma is one of the most common causes of death, particularly in younger individuals. The development of specialized trauma centers, trauma-specific intensive care units, and trauma-focused medical subspecialties has led to the formation of comprehensive multidisciplinary teams and an ever-growing body of research and innovation. The field of interventional radiology provides a unique set of minimally invasive, endovascular techniques that has largely changed the way that many trauma patients are managed. This article discusses the role of interventional radiology in the care of this complex patient population, and in particular how the specialty fits into the overall team management of these patients.

scholarly journals Advances in the understanding of trauma-induced coagulopathy

Blood ◽  
2016 ◽  
Vol 128 (8) ◽  
pp. 1043-1049 ◽  
Author(s):  
Ronald Chang ◽  
Jessica C. Cardenas ◽  
Charles E. Wade ◽  
John B. Holcomb
Keyword(s):  
Animal Studies ◽  
Causes Of Death ◽  
Endothelial Activation ◽  
The United States ◽  
Trauma Patients ◽  
Platelet Dysfunction ◽  
Intracranial Injury ◽  
Trauma Induced Coagulopathy ◽  
Common Causes

Abstract Ten percent of deaths worldwide are due to trauma, and it is the third most common cause of death in the United States. Despite a profound upregulation in procoagulant mechanisms, one-quarter of trauma patients present with laboratory-based evidence of trauma-induced coagulopathy (TIC), which is associated with poorer outcomes including increased mortality. The most common causes of death after trauma are hemorrhage and traumatic brain injury (TBI). The management of TIC has significant implications in both because many hemorrhagic deaths could be preventable, and TIC is associated with progression of intracranial injury after TBI. This review covers the most recent evidence and advances in our understanding of TIC, including the role of platelet dysfunction, endothelial activation, and fibrinolysis. Trauma induces a plethora of biochemical and physiologic changes, and despite numerous studies reporting differences in coagulation parameters between trauma patients and uninjured controls, it is unclear whether some of these differences may be “normal” after trauma. Comparisons between trauma patients with differing outcomes and use of animal studies have shed some light on this issue, but much of the data continue to be correlative with causative links lacking. In particular, there are little data linking the laboratory-based abnormalities with true clinically evident coagulopathic bleeding. For these reasons, TIC continues to be a significant diagnostic and therapeutic challenge.

scholarly journals Thoracic Trauma, Nonaortic Injuries

2021 ◽  
Vol 38 (01) ◽  
pp. 075-083
Author(s):  
Kai A. Jones ◽  
Shirin Sadri ◽  
Noor Ahmad ◽  
Joseph R. Weintraub ◽  
Stephen P. Reis
Keyword(s):  
Interventional Radiology ◽  
Operating Room ◽  
Thoracic Trauma ◽  
Causes Of Death ◽  
Vital Role ◽  
Trauma Patients ◽  
Vascular Injuries ◽  
Thoracic Injuries ◽  
Small Minority

AbstractTrauma is one of the leading causes of death worldwide. Approximately two-thirds of trauma patients have thoracic injuries. Nonvascular injury to the chest is most common; however, while vascular injuries to the chest make up a small minority of injuries in thoracic trauma, these injuries are most likely to require intervention by interventional radiology (IR). IR plays a vital role, with much to offer, in the evaluation and management of patients with both vascular and nonvascular thoracic trauma; in many cases, IR treatments obviate the need for these patients to go to the operating room. This article reviews the role of IR in the treatment of vascular an nonvascular traumatic thoracic injuries.

scholarly journals Causes of Death in COVID-19: A Minireview

2021 ◽  
pp. 311-314
Author(s):  
Shravani Dhale ◽  
Swarupa Chakole ◽  
Neha Bhatt
Keyword(s):  
Older Patients ◽  
Causes Of Death ◽  
Health Conditions ◽  
Minor Role ◽  
Health Issues ◽  
Common Causes ◽  
Strain Virus ◽  
A Minor ◽  
Inflammation Of The Lungs

Background: More than two million people have died worldwide as a result of the new corona strain virus SARS-CoV-2 and the associated COVID-19 syndrome. Older patients with pre-existing health problems are more likely to die from their illness. We found that septic shock and multiple failures were the most common causes of death, mainly due to inflammation of the lungs, although there was no definitive study on the causes of death and the role of pre-existing conditions. In a few cases, respiratory failure caused by excessive alveolar injury was the cause of immediate death. Comorbidities such as asthma, heart disease, and obesity were present in most cases. Conclusion: Our findings indicate that COVID-19 was related to death in the majority of decedents, rather than being a direct product of pre-existing health conditions and comorbidities. As a result, we conclude that COVID-19 killed most patients, with pre-existing health issues playing only a minor role in the death mechanism.

Palliative Care Consultations in Trauma Patients and Role of Do-Not-Resuscitate Orders: Propensity-Matched Study

2020 ◽  
Vol 37 (12) ◽  
pp. 1068-1075
Author(s):  
Alexander A. Fokin ◽  
Joanna Wycech ◽  
Jeffrey K. Katz ◽  
Alexander Tymchak ◽  
Richard L. Teitzman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Palliative Care ◽  
Length Of Stay ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Do Not Resuscitate ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Do Not Resuscitate Orders

Objective: To delineate characteristics of trauma patients associated with a palliative care consultation (PCC) and to analyze the role of do-not-resuscitate (DNR) orders and related outcomes. Methods: Retrospective study included 864 patients from 2 level one trauma centers admitted between 2012 and 2019.  Level 1 trauma centers are designated for admission of the most severe injured patients. Palliative care consultation group of 432 patients who received PCC and were compared to matched control (MC) group of 432 patients without PCC. Propensity matching covariates included Injury Severity Score, mechanism of injury, gender, and hospital length of stay (HLOS). Analysis included patient demographics, injury parameters, intensive care unit (ICU) admissions, ICU length of stay (ICULOS), duration of mechanical ventilation, timing of PCC and DNR, and mortality. Palliative care consultation patients were further analyzed based on DNR status: prehospital DNR, in-hospital DNR, and no DNR (NODNR). Results: Palliative care consultation compared to MC patients were older, predominantly Caucasian, with more frequent traumatic brain injury (TBI), ICU admissions, and mechanical ventilation. The average time to PCC was 5.3 days. Do-not-resuscitate orders were significantly more common in PCC compared to MC group (71.5% vs 11.1%, P < .001). Overall mortality was 90.7% in PCC and 6.0% in MC ( P < .001). In patients with DNR, mortality was 94.2% in PCC and 18.8% in MC. In-hospital DNR-PCC compared to NODNR-PCC patients had shorter ICULOS (5.0 vs 7.3 days, P = .04), HLOS (6.2 vs 13.2 days, P = .006), and time to discharge (1.0 vs 6.3 days, P = .04). Conclusions: Advanced age, DNR order, and TBI were associated with a PCC in trauma patients and resulted in significantly higher mortality in PCC than in MC patients. Combination of DNR and PCC was associated with shorter ICULOS, HLOS, and time from PCC to discharge.

scholarly journals Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

2020 ◽  
Vol 47 (3) ◽  
pp. 223-227
Author(s):  
Joo Sung Jung ◽  
Dong Hee Kang ◽  
Nam Kyu Lim
Keyword(s):  
South Korea ◽  
Plastic Surgery ◽  
Trauma System ◽  
Severe Trauma ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Common Diagnosis ◽  
Surgery Department

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients.Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6–91 years). The average ISS was 22.01 points (range, 16–75 points).Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission.Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

scholarly journals Resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
MARCELO AUGUSTO FONTENELLE RIBEIRO JÚNIOR ◽  
MEGAN BRENNER ◽  
ALEXANDER T. M. NGUYEN ◽  
CÉLIA Y. D. FENG ◽  
RAÍSSA REIS DE-MOURA ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Current Scenario ◽  
Trauma Injury ◽  
Ideal Method ◽  
Endovascular Balloon Occlusion ◽  
A Current ◽  
The Ideal

ABSTRACT In a current scenario where trauma injury and its consequences account for 9% of the worlds causes of death, the management of non-compressible torso hemorrhage can be problematic. With the improvement of medicine, the approach of these patients must be accurate and immediate so that the consequences may be minimal. Therefore, aiming the ideal method, studies have led to the development of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). This procedure has been used at select trauma centers as a resuscitative adjunct for trauma patients with non-compressible torso hemorrhage. Although the use of this technique is increasing, its effectiveness is still not clear. This article aims, through a detailed review, to inform an updated view about this procedure, its technique, variations, benefits, limitations and future.

scholarly journals The Role of Vaccination and Screening in Limiting the Worldwide Disease Burden of Preventable Female Cancers: A Review

Women ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Claudio Costantino ◽  
Davide Alba ◽  
Livia Cimino ◽  
Arianna Conforto ◽  
Walter Mazzucco
Keyword(s):  
Breast Cancer ◽  
Disease Burden ◽  
Malignant Disease ◽  
Causes Of Death ◽  
Breast Cancer Incidence ◽  
Survival Rates ◽  
Incidence And Mortality ◽  
Common Causes ◽  
Future Burden

Cancer represents one of the most common causes of death worldwide. Among women, breast cancer is the most diagnosed cancer and the principal cause of death due to malignant disease, while cervical cancer ranks fourth for both incidence and mortality. The present review aims to analyze the epidemiology of cervical and breast cancer (incidence, mortality, survival rates, and trends). Moreover, the most important primary and secondary preventive strategies (reduction of risk factors, exposure, vaccination, cancer screening) intended to reduce the future burden of cervical and breast cancer, that should be adopted actively and free of charge, were discussed in accordance to more recent and evidence-based findings.

The role of secretory leucoprotease inhibitor in the resolution of inflammatory responses

2007 ◽  
Vol 35 (2) ◽  
pp. 273-276 ◽  
Author(s):  
S. Weldon ◽  
N. McGarry ◽  
C.C. Taggart ◽  
N.G. McElvaney
Keyword(s):  
Immune Response ◽  
Protease Inhibitor ◽  
Chronic Lung Disease ◽  
Causes Of Death ◽  
Inflammatory Responses ◽  
Serine Protease Inhibitor ◽  
Multiple Functions ◽  
Common Causes ◽  
Inflammatory Profile

Chronic lung disease is one of the most common causes of death and disability worldwide. This group of diseases is characterized by a protease burden, an infective process and a dominant pro-inflammatory profile. While SLPI (secretory leucoprotease inhibitor) was initially identified as a serine protease inhibitor, it has since been shown that SLPI possesses other properties distinct from those associated with its antiprotease capabilities that play an important role in protecting the host from infection and injury. In the course of this review, we will highlight the findings from a range of studies that illustrate the multiple functions of SLPI and its role in the resolution of the immune response.

Suicidal Death Autopsy Analysis at Dhaka Medical College

1970 ◽  
Vol 40 (1) ◽  
pp. 18-21 ◽  
Author(s):  
MN Hossain ◽  
Z Rahman ◽  
S Akhter
Keyword(s):  
Forensic Medicine ◽  
Causes Of Death ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Autopsy Report ◽  
Common Causes ◽  
Suicidal Death

A cross sectional study was carried out at the department of Forensic Medicine in Dhaka Medical College during the period of January 2008 to December 2009. Data were collected from 3rd copy of the post mortem reports which were preserved in the department of Forensic Medicine with the verbal consent of the doctors who performed autopsy report. During this period total 5114 autopsies were conducted. Out of this 970 cases (19%) were suicidal in nature. It was noticed that all suicidal deaths occurred from 10 years to all age group respectively, but top amongst age group of suicidal deaths occurred in between 21 to 30 years of people. Suicidal deaths are more common in female than male. Suicidal deaths due to hanging is highest, next common causes of death due to organophosphorus compund poisoning. Suicidal deaths by hanging is more in female than male but in poisoning cases male are more lvictimised than female. Objectives of our study are to see the occurrence and methods of suicidal death. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9957 BMJ 2011; 40(1): 18-21

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