Medicine and Health Sciences Commons^™

Epithelial Cells Are Active Participants In Vocal Fold Wound Healing: An In Vivo Animal Model Of Injury, Ciara Leydon, Mitsuyoshi Imaizumi, Rebecca S. Bartlett, Sarah F. Wang, Susan L. Thibeault

Communication Disorders Faculty Publications

Vocal fold epithelial cells likely play an important, yet currently poorly defined, role in healing following injury, irritation and inflammation. In the present study, we sought to identify a possible role for growth factors, epidermal growth factor (EGF) and transforming growth factor-beta 1 (TGFβ1), in epithelial regeneration during wound healing as a necessary first step for uncovering potential signaling mechanisms of vocal fold wound repair and remodeling. Using a rat model, we created unilateral vocal fold injuries and examined the timeline for epithelial healing and regeneration during early and late stages of wound healing using immunohistochemistry (IHC). We observed time-dependent …

Development Of A Fatal Noncompressible Truncal Hemorrhage Model With Combined Hepatic And Portal Venous Injury In Normothermic Normovolemic Swine, Ujwal R. Yanala, Jason M. Johanning, Iraklis I. Pipinos, Gustavo F. Larsen, William H. Velander, Mark A. Carlson

William H. Velander Publications

Noncompressible truncal hemorrhage and brain injury currently account for most early mortality of warfighters on the battlefield. There is no effective treatment for noncompressible truncal hemorrhage, other than rapid evacuation to a surgical facility. The availability of an effective field treatment for noncompressible truncal hemorrhage could increase the number of warfighters salvaged from this frequently-lethal scenario. Our intent was to develop a porcine model of noncompressible truncal hemorrhage with a ,50% one-hour mortality so that we could develop new treatments for this difficult problem. Normovolemic normothermic domestic swine (barrows, 3 months old, 34–36 kg) underwent one of three injury types …

National Trauma Institute Prospective Evaluation Of The Ventilator Bundle In Trauma Patients: Does It Really Work?, Martin A. Croce Md, Karen J. Brasel Md, Mph, Raul Coimbra Md, Phd, Charles A. Adams Jr, Md, Preston R. Miller Md, Michael D. Pasquale Md, Facs, Fccm, Chanchai S. Mcdonald Phd, Somchan Vuthipadadon Phd, Timothy C. Fabian Md, Elizabeth A. Tolley Phd

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Since its introduction by the Institute for Healthcare Improvement, the ventilator bundle (VB) has been credited with a reduction in ventilator-associated pneumonia (VAP). The VB consists of stress ulcer prophylaxis, deep venous thrombosis prophylaxis, head-of-bed elevation, and daily sedation vacation with weaning assessment. While there is little compelling evidence that the VB is effective, it has been widely accepted. The Centers for Medical and Medicaid Services has suggested that VAP should be a "never event" and may reduce payment to providers. To provide evidence of its efficacy, the National Trauma Institute organized a prospective multi-institutional trial to evaluate the …

Introduction Of A Mobile Device Based Tertiary Survey Application Reduces Missed Injuries: A Multi-Center Prospective Study, Bradley S. Moffat

Electronic Thesis and Dissertation Repository

Missed injuries in trauma patients are a significant source of preventable morbidity. The tertiary survey is a head-to-toe physical exam performed within 24 hours of admission to identify any injuries which may have been missed during initial assessment and resuscitation. The Physician Assist Trauma Software (PATS) is an electronic program designed to guide users through a thorough tertiary survey and document the results. This thesis project was designed to study the impact of implementing this novel mobile device based electronic tertiary survey program on missed injuries. The first phase of this study involved quantifying and characterizing the missed injury rate …

Research Brief: "Preferences For Gender-Targeted Health Information: A Study Of Male Veterans Who Have Experienced Military Sexual Trauma", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about male veterans' preferences for health information provided to them after experiencing military sexual trauma and the effect of that information on use of mental health services. In policy and practice, veterans who have experienced military sexual trauma should seek military sexual trauma care from the VA, health practitioners should learn more about military sexual assault to better help servicemembers, and gender-targeted literature should be distributed to servicemembers who have experienced military sexual trauma; the VHA should include gender-specific resources for male veterans who experienced military sexual trauma. Suggestions for future research include the addition of a …

Self-Reported Head Injury And Risk Of Late-Life Impairment And Ad Pathology In An Ad Center Cohort, Erin L. Abner, Peter T. Nelson, Frederick A. Schmitt, Steven R. Browning, David W. Fardo, Lijie Wan, Gregory A. Jicha, Gregory E. Cooper, Charles D. Smith, Allison M. Caban-Holt, Linda J. Van Eldik, Richard J. Kryscio

Sanders-Brown Center on Aging Faculty Publications

Aims: To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes. Methods: Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury. Results: The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.21 and 1.34 …

Research Brief: "Women At War: Understanding How Women Veterans Cope With Combat And Military Sexual Trauma", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about stressors during military service that OEF/OIF female veterans experienced and how they coped with the stress. In policy and practice, female veterans should tell healthcare providers of their healthcare needs, and should form support groups with other veteran women; family members should support returning female service members; the VA should adapt its services to address the needs of female veterans, policymakers should allocate funding toward creating non-VA mental health and substance abuse counseling, and the VA should offer gender-specific mental health programs. Suggestions for future research include analyzing differences between age groups and length of time …

Strategies For Prevention Of Road Traffic Injuries (Rtis) In Pakistan: Situational Analysis., Adeel Ahmed Khan, Zafar Fatmi

Community Health Sciences

Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet …

Family Presence During Trauma Resuscitation: Ready For Primetime?, Mae Pasquale, Michael Pasquale, Leslie Baga, Sherrine Eid, Jane Leske

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: The concept of family presence during trauma resuscitation (FPTR) remains controversial. Healthcare providers have expressed concern that resuscitation of severely injured trauma patients is inappropriate for family members as they may have psychologic distress, disrupt resuscitative efforts, or misinterpret provider actions, which can ultimately impact satisfaction with care. The minimal evidence that exists is descriptive or anecdotal.

METHODS: Using a previously developed FPTR protocol, a prospective, comparative study assessing 50 adult family members, who were present (n = 25) or not present (n = 25) with their severely injured adult family member during resuscitation, was conducted. Family member anxiety …

Health Care Reform At Trauma Centers--Mortality, Complications, And Length Of Stay, Shahid Shafi, Sunni Barnes, David Nicewander, David Ballard, Avery Nathens, Angela Ingraham, Mark Hemmila, Sandra Goble, Melanie Neal, Michael Pasquale, John Fildes, Larry Gentilello

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Family Presence During Trauma Resuscitation: Ready For Primetime?, Mae Pasquale, Michael Pasquale, Leslie Baga, Sherrine Eid, Jane Leske

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Health Care Reform At Trauma Centers: Mortality, Complications, And Length Of Stay (Presentation), Shahid Shafi, Sunni Barnes, David Nicewander, David Ballard, Avery Nathens, Angela Ingraham, Mark Hemmila, John Fildes, Michael Pasquale, Larry Gentilello

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

A Statewide Survey Of Institutional Trauma Human Resource Allocation And Associated Patient Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Bryan G Kane MD

No abstract provided.

Does Destination Determine Destiny? A Statewide Analysis Of Trauma Center Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Bryan G Kane MD

No abstract provided.

Breakthrough Series Collaborative To Support Trauma-Informed Practice In Early Care & Education, Anne Douglass

Office of Community Partnerships Posters

This study investigated the use of a Breakthrough Series Collaborative (BSC) to promote the adoption of trauma-informed practices in urban early care & education (ECE) programs. Through this BSC, ECE programs implement new practices to promote safe, stable, and nurturing relationships and prevent trauma exposure; protect children exposed to trauma, help children heal, and support family protective factors that help children thrive.

Use Of Geocoding And Us Census Data To Assess Determinants Of Outcome In Trauma Patients, Krista M. Goodman Md, John J. Hong Md, Sherrine Eid Mph, Leslie Baga Bsn, Ccrc, Michael M. Badellino Md, Mph, Facs, Michael D. Pasquale Md, Facs

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Impact Of Age And Anticoagulation: Need For Neurosurgical Intervention In Trauma Patients With Mild Traumatic Brain Injury, Margaret Moore, Michael Pasquale, Michael Badellino

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Of the 500,000 brain injuries in the United States annually, 80% are considered mild (mild traumatic brain injury). Unfortunately, 2% to 3% of them will subsequently deteriorate and result in severe neurologic dysfunction. Intracerebral changes in the elderly, chronic oral anticoagulation, and platelet inhibition may contribute to the development of intracranial bleeding after minor head injury. We sought to investigate the association of age and the use of anticoagulation and antiplatelet therapy with neurologic deterioration and the need for neurosurgical intervention in patients presenting with mild traumatic brain injury. METHODS: A retrospective review of all adult (>14 years) …

Hepatic Angioembolization In Trauma Patients: Indications And Complications., Tim Misselbeck, Erik Teicher, Mark Cipolle, Michael Pasquale, Kamalesh Shah, Dale Dangleben, Michael Badellino

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Hepatic angiography (HA) and hepatic angioembolization (HAE) are increasingly used to diagnose and treat intrahepatic arterial injuries. This study was performed to review indications, outcomes, and complications of HA/HAE in blunt trauma patients who underwent HAE as adjunct management of hepatic injury.

METHODS: A retrospective review of consecutive cases of HA/HAE at a Level I trauma center during an 8-year period. Data include demographics, physiologic condition, liver injury grade, HA/HAE indications, outcomes, morbidity, and mortality.

RESULTS: Seventy-nine patients underwent diagnostic HA; 31 (39%) had subsequent HAE. Fifty-eight hemodynamically stable patients had computerized axial tomographic (CT) scan followed by HA. …

A Randomized, Double-Blind, Placebo-Controlled Study To Assess The Effect Of Recombinant Human Erythropoietin On Functional Outcomes In Anemic, Critically Ill, Trauma Subjects: The Long Term Trauma Outcomes Study, Fred Luchette, Michael Pasquale, Timothy Fabian, Wayne Langholff, Marsha Wolfson

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS: Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks after discharge or until the Hb level was >12.0 g/dL, whichever occurred first. The 36-question Short Form Health Assessment questionnaire (SF-36) was used to evaluate physical function (PF) outcomes at baseline, at hospital discharge, and at several time points posthospital discharge. RESULTS: One hundred ninety-two patients were enrolled (epoetin alfa [n = 97], …

Trauma Systems: A Comprehensive Review Of Where We Are Today, Michael Pasquale

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Utilizing Tqip At Your Trauma Center, Michael Pasquale

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Tqip (Trauma Quality Improvement Program): Do The Data Tell The Whole Story About Outcomes, Michael Pasquale

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Hips Can Lie: Impact Of Excluding Isolated Hip Fractures On External Benchmarking Of Trauma Center Performance, David Gomez, Barbara Haas, Mark Hemmila, Michael Pasquale, Sandra Goble, Melanie Neal, N Mann, Wayne Meredith, Henry Cryer, Shahid Shafi, Avery Nathens

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Trauma centers (TCs) vary in the inclusion of patients with isolated hip fractures (IHFs) in their registries. This inconsistent case ascertainment may have significant implications on the assessment of TC performance and external benchmarking efforts. METHODS: Data were derived from the National Trauma Data Bank (2007-8.1). We included patients (aged 16 years or older) with Injury Severity Score value ≥ 9 who were admitted to Level I and II TCs. To ensure data quality, we limited the study to TC that routinely reported comorbidities and Abbreviated Injury Scale codes. IHF were defined as patients, aged 65 years or older, …

National Trauma Institute Prospective Evaluation Of The Ventilator Bundle In Trauma Patients: Does It Really Work? (Presentation), Martin Croce, Karen Brasel, Raul Coimbra, Charles Adams, Preston Miller, Michael Pasquale, Chanchai Mcdonald, Somchan Vuthipadadon, Timothy Fabian, Elizabeth Tolley

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

A Statewide Survey Of Institutional Trauma Human Resource Allocation And Associated Patient Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Does Destination Determine Destiny? A Statewide Analysis Of Trauma Center Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Laboring To Mother In The Context Of Past Trauma: The Transition To Motherhood, Berman Helene, Robin Mason, Jodi Hall, Susan Rodger, Catherine C. Classen, Marilyn K. Evans, Lori E. Ross, Gloria Alvernaz Mulcahy, Leonarda Carranza, Fatmeh Al-Zoubi

Journal Articles

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The …

Prescribing Multiple Neurostimulants During Rehabilitation For Severe Brain Injury., Amy A. Herrold, Theresa Louise-Bender Pape, Ann Guernon, Trudy Mallinson, Eileen Collins, Neil Jordan

Clinical Research and Leadership Faculty Publications

Background. Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.

Method. Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful …

Trauma-Informed Services And Trauma Awareness Among Staff On The College Campus, Tricia Wisniewski

Honors Program Theses

For college students to work through the effects of trauma and be able to live a more normalized life, the availability of effective trauma-informed services on campus environments is crucial. Therefore, I chose to investigate the availability of trauma-informed services to all students on the college campus. The purpose of this study is to examine the relatively unexplored area of trauma informed services in the context of college campus through survey methods at the University of Northern Iowa (UNI). In particular, this study focuses on trauma-informed services and employees’ trauma awareness in four service units on the UNI campus: the …

Research Brief: "Suicides In The Military: The Post-Modern Combat Veteran And The Hemingway Effect", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about current suicide prevention interventions within the military. In policy and practice, practitioners should monitor the wellness of aging veterans and ensure that a support system exists for their veteran patients, while veterans should participate in social events with other veterans; the VA and DoD should implement programs to ensure that veterans have feelings of belongingness and the VA should monitor veterans' well-being for 2-3 years after service during transitions. Suggestions for future research include examining the communities and veteran service organizations that produce the most useful support for veterans with mental health problems.