Medicine and Health Sciences Commons^™

The Position Of The Eastern Association For The Surgery Of Trauma On The Future Of Trauma Surgery., Michael F Rotondo, Thomas J Esposito, Patrick M Reilly, Philip S Barie, J Wayne Meredith, Virginia A Eddy, Reuven Rabinovici, Lenworth M Jacobs, Paul R G Cunningham, Eric R Frykberg, Michael Rhodes, Michael D. Pasquale Md, Facs, Fccm, Blaine L Enderson, John J Locurto, Nabil A Atweh, Rao R Ivatury

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Utility Of Chest Radiographs After Guidewire Exchanges Of Central Venous Catheters., P Frassinelli, Michael D. Pasquale Md, Facs, Fccm, M D Cipolle, M Rhodes

Michael D Pasquale MD, FACS, FCCM

OBJECTIVE: To determine whether chest radiographs are warranted after uncomplicated guidewire exchanges of central venous catheters in patients admitted to a Level I trauma intensive care unit.

DESIGN: Prospective study performed in two phases.

SETTING: Intensive care unit in a Level I trauma center.

PATIENTS: Patients admitted to a Level I trauma center intensive care unit who required central venous catheter guidewire exchanges.

INTERVENTIONS: Criteria for uncomplicated guidewire exchanges were established and followed. A catheter exchange checklist was completed at each procedure, and a chest radiograph was performed after each guidewire exchange. The complications followed were catheter malposition, pneumothorax, hemothorax, …

Outcome After Decompressive Craniectomy For The Treatment Of Severe Traumatic Brain Injury., Jerry Lee Howard, Mark D Cipolle, Meredith Anderson, Victoria Sabella, Daniele Shollenberger, P Mark Li, Michael D. Pasquale Md, Facs, Fccm

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Using decompressive craniectomy as part of the treatment regimen for severe traumatic brain injury (STBI) has become more common at our Level I trauma center. This study was designed to examine this practice with particular attention to long-term functional outcome.

METHODS: A retrospective review of prospectively collected data was performed for patients with STBI admitted from January 1, 2003 to December 31, 2005. Our institution manages patients using the Brain Trauma Foundation Guidelines. Data collected from patients undergoing decompressive craniectomy included: age, Injury Severity Score, admission and follow-up Glasgow Coma Score, timing of, and indication for decompressive craniectomy, and …

Use Of Greenfield Filters In Renal Transplant Patients--Are They Safe?, Michael D. Pasquale Md, Facs, Fccm, J H Abrams, J S Najarian, F B Cerra

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Massive Hematochezia Secondary To Graft-Versus-Host Disease And Cytomegalovirus., M Shabahang, Michael D. Pasquale Md, Facs, Fccm, P Bitterman, E Cirenza, T Spitzer, S R Evans

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Multicenter Study Of Noninvasive Monitoring Systems As Alternatives To Invasive Monitoring Of Acutely Ill Emergency Patients., W C Shoemaker, H Belzberg, C C Wo, D P Milzman, Michael D. Pasquale Md, Facs, Fccm, L Baga, M A Fuss, G J Fulda, K Yarbrough, J P Van Dewater, P J Ferraro, D Thangathurai, P Roffey, G Velmahos, J A Murray, J A Asensio, K Eltawil, W R Dougherty, M J Sullivan, R S Patil, J Adibi, C B James, D Demetriades

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Recent reports showed lack of effectiveness of pulmonary artery catheterization in critically ill medical patients and relatively late-stage surgical patients with organ failure. Since invasive monitoring requires critical care environments, the early hemodynamic patterns may have been missed. Ideally, early noninvasive hemodynamic monitoring systems, if reliable, could be used as the "front end" of invasive monitoring to supply more complete descriptions of circulatory pathophysiology.

OBJECTIVES: To evaluate the accuracy and reliability of noninvasive hemodynamic monitoring consisting of a new bioimpedance method for estimating cardiac output combined with arterial BP, pulse oximetry, and transcutaneous PO2 and PCO2; we compared this …

Making The Case For A Paradigm Shift In Trauma Surgery., Thomas J Esposito, Michael Rotondo, Philip S Barie, Patrick Reilly, Michael D. Pasquale Md, Facs, Fccm

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Elective Colostomy Closure In An Aids Patient., Michael D. Pasquale Md, Facs, Fccm, J M Kenkel, R W Holt

Michael D Pasquale MD, FACS, FCCM

This article describes a 27-year-old patient with acquired immunodeficiency syndrome (AIDS) who underwent emergency sigmoid colostomy, Hartmann's pouch, and presacral drainage for rectal perforation. Three months later, he underwent uneventful elective colostomy closure, a procedure previously unreported in an AIDS patient. He remained without gastrointestinal symptoms for 14 months after colostomy closure until he died from central nervous system toxoplasmosis. A diagnosis of AIDS alone should not preclude colostomy closure in AIDS patients.

Multicenter, Randomized, Prospective Trial Of Early Tracheostomy., H J Sugerman, L Wolfe, Michael D. Pasquale Md, Facs, Fccm, F B Rogers, K F O'Malley, M Knudson, L Dinardo, M Gordon, S Schaffer

Michael D Pasquale MD, FACS, FCCM

OBJECTIVES: Determine the effect of early (days 3-5) or late (days 10-14) tracheostomy on intensive care unit length of stay (ICU LOS), frequency of pneumonia, and mortality, and evidence of short-term or long-term pharyngeal, laryngeal, or tracheal injury in head trauma, non-head trauma, and critically ill nontrauma patients.

STUDY DESIGN: Randomized, prospective.

SETTING: Five Level I trauma centers.

METHODS: Data were obtained prospectively and included Acute Physiology and Chronic Health Evaluation III score (AIII), Glasgow Coma Scale score, Emergency Room Trauma Score, Injury Severity Score, Acute Injury Score, type of endotracheal tube or tracheostomy, level of positive end-expiratory pressure, and …

Impact Of Cirrhosis On Outcomes In Trauma., Dale A Dangleben, Omid Jazaeri, Thomas Wasser, Mark Cipolle, Michael D. Pasquale Md, Facs, Fccm

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Cirrhosis as an independent predictor of poor outcomes in trauma patients was identified in 1990. We hypothesized that the degree of preinjury hepatic dysfunction is, by itself, an independent predictor of mortality.

STUDY DESIGN: The trauma registry at our Level I trauma center was queried for all ICD-9 codes for liver disease from 1999 to 2003, and patients were categorized as having Child-Turcotte-Pugh (CTP) class A, B, or C cirrhosis. Data analyzed included age, mechanism of injury, Abbreviated Injury Score (AIS), Injury Severity Score (ISS), Glasgow Coma Score (GCS), hospital length of stay, ventilator days, procedures performed, transfusion of …

Defining "Dead On Arrival": Impact On A Level I Trauma Center., Michael D. Pasquale Md, Facs, Fccm, M Rhodes, M D Cipolle, T Hanley, T Wasser

Michael D Pasquale MD, FACS, FCCM

OBJECTIVE: To determine the potential impact of defining criteria for "dead on arrival" (DOA) on a Level I trauma center.

METHODS: From 1990 to 1994, trauma patients having cardiopulmonary resuscitation (CPR) performed by certified prehospital personnel were reviewed for time of CPR, outcome, and costs to determine whether any benefit would have been realized had DOA criteria been followed.

RESULTS: A total of 106 patients had prehospital CPR; 20 did not meet DOA criteria and underwent resuscitation, three survived (15%). Eighty-six patients met DOA criteria; 16 were pronounced dead without further resuscitative efforts (in-hospital costs of $200/patient), while 70 (81%) …

Latina Adolescent Outreach Project, Susan C. Scwartz, Claudia Guerra, Julianna Deardorff, Janice Barlow

Susan C. Schwartz

• To culturally adapt and translate into Spanish three components of the Breast Cancer and Environment – Peer Education Tool Kit (2006) for Marin County Latina adolescents: Top Twelve Messages, Teen Brochure, and Personal Action Plan

• To disseminate the adapted, translated materials to high school health educators and community organizations

Adolescent Breast Cancer Prevention, Risk Reduction And Education Project, Susan C. Schwartz, Janice Barlow

Susan C. Schwartz

The Adolescent Breast Cancer Prevention, Risk Reduction and Education Project was developed in 2003 in recognition of the growing scientific evidence that early life events play an important role in the development of breast cancer and the onset of puberty is thought to be a key seventy influencing subsequent breast cancer risk.

Breast Cancer And Environment Peer Education Tool Kit -- Community Action Panel, Susan C. Schwartz

Susan C. Schwartz

The Breast Cancer and Environment Peer Education Tool Kit culminates three years of dedicated effort by the Zero Breast Cancer leadership and staff, community partners and advisors, and peer education specialists in the San Francisco Bay Area. The teen breast cancer risk awareness curriculum tools that Zero Breast Cancer is making available to the broader community evolved from a formative community assessment to address the need for ageappropriate teen breast cancer outreach education in a community known for high breast cancer incidence.

The impetus to develop this program has been threefold: 1) to disseminate knowledge back to the community that …

Mycobacterium Chelonae Associated With Rapid Erosion Of Non-Sutured Laparoscopic Gastric Band, Muhammed Ashraf Memon, Breda Memon, Michael Whitby

Muhammed Ashraf Memon

Introduction

To describe a case of rapidly eroded laparoscopic placed non-sutured gastric band secondary to Mycobacterium chelonae.

Presentation of case

A 65 year old male, who had undergone laparoscopic gastric banding two months prior for morbid obesity, presented to the clinic complaining of abdominal pain and night time fever of 4 days duration. Urgent gastroscopy revealed eroded gastric band which was removed laparoscopically.

Discussion

M. chelonae are not uncommon in Queensland. Although the mode of acquisition of infection remains unclear, it is suspected that human disease results from environmental exposure to dirty soil and water. The patient lives in rural …

Understanding The Employment Barriers And Support Needs Of People Living With Psychosis, Margaret Hampson, Richard Hicks, Bruce Watt

Bruce Watt

This study investigated the employment barriers and support needs of people living with psychosis. A purposive community sample of 137 volunteers drawn from six key stakeholder groups were invited to participate in focus groups and semi-structured individual interviews to elicit their perceptions on the employment barriers and support needs of people living with psychosis. The stakeholder groups included in this study were people with lived experience of schizophrenia or bipolar disorder, carers, health professionals, employers, employment service providers, and community members. Data obtained from 14 focus groups and 31 semi-structured individual interviews were transcribed, imported into NVivo 10, and coded …

The Male Of The Species: A Profile Of Men In Nursing, David Stanley, Tania Beament, Darren Falconer, Margaret Haigh, Rosemary Saunders, Karen Stanley, Peter Wall, Sharon Nielson

Darren Falconer

Aim : To establish a profile of men in nursing in Western Australia and explore the perception of men in nursing from the perspective of male and female nurses. Background : A project team, including some of the current authors, produced a YouTube video and DVD about men in nursing which led to further enquiry on this topic. Design : The study employed a non-experimental, comparative, descriptive research design focused on a quantitative methodology, using an online survey in early 2014. Method : A convenience sample incorporated registered and enrolled nurses and midwives in Western Australia. Findings : The range …

“So I Feel Like I’M Getting It And Then Sometimes I Think Ok, No I’M Not”: Couple And Family Therapists Learning An Evidence-Based Practice, Robert Allan, Michael Ungar, Virginia Eatough

Robert Allan

This research concerns itself with the experiences of couple and family therapists (CFTs) learning about and using an evidence-based practice (EBP). The engagement with EBP is growing across many aspects of the mental health and health care systems. The EBP model is now being applied in a broad range of health and human service systems, including mental and behavioural health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence-based approaches in the practice of CFT and research literature is also evolving (Sexton et al., 2011; Sprenkle 2012). Interestingly, while the research delves …

Antiproliferative Effect Of Oleuropein In Prostate Cell Lines, Rosaria Acquaviva, Claudia Di Giacomo, Valeria Sorrenti, Fabio Galvano, Rosa Santangelo, Venera Cardile, Silvia Gangia, Nicolantonio D'Orazio, Nader G. Abraham, Luca Vanella

Nader G. Abraham

Currently, there is increasing interest in the in vivo protective effects of natural antioxidants found in dietary plants against oxidative damage caused by free radical species. Oxidative stress has been invoked as a causative agent in cancer and epidemiological data suggest that the consumption of fruits and vegetables may be associated with a lower incidence of cancer. The fruit of the Olea europaea L. and olive oil contain hundreds of phytochemicals and its extracts have recently been shown to exhibit antioxidant properties, due to the action of oleuropein. In view of these considerations, in this study, we investigated the effects …

Expression Of Heme Oxygenase-1 In Thick Ascending Loop Of Henle Attenuates Angiotensin Ii-Dependent Hypertension, David E. Stec, Heather A. Drummond, Moneete U. Gousette, Megan V. Storm, Nader G. Abraham, Eva Csongradi

Nader G. Abraham

Kidney-specific induction of heme oxygenase-1 (HO-1) attenuates the development of angiotensin II (Ang II) -dependent hypertension, but the relative contribution of vascular versus tubular induction of HO-1 is unknown. To determine the specific contribution of thick ascending loop of Henle (TALH) -derived HO-1, we generated a transgenic mouse in which the uromodulin promoter controlled expression of human HO-1. Quantitative RT-PCR and confocal microscopy confirmed successful localization of the HO-1 transgene to TALH tubule segments. Medullary HO activity, but not cortical HO activity, was significantly higher in transgenic mice than control mice. Enhanced TALH HO-1 attenuated the hypertension induced by Ang …

Apolipoprotein A-I Mimetic Peptide L-4f Prevents Myocardial And Coronary Dysfunction In Diabetic Mice, C. Vecoli, J. Cao, D. Neglia, K. Inoue, Komal Sodhi, L. Vanella, K. K. Gabrielson, D. Bedja, N. Paolocci, A. L'Abbate, Nader G. Abraham

Nader G. Abraham

Diabetes is a major health problem associated with adverse cardiovascular outcomes. The apolipoprotein A-I mimetic peptide L-4F is a putative anti-diabetic drug, has antioxidant and anti-inflammatory proprieties and improves endothelial function. In obese mice L-4F increases adiponectin levels, improving insulin sensitivity and reducing visceral adiposity. We hypothesized that the pleiotropic actions of L-4F can prevent heart and coronary dysfunction in a mouse model of genetically induced Type II diabetes. We treated db/db mice with either L-4F or vehicle for 8 weeks. Trans-thoracic echocardiography was performed; thereafter, isolated hearts were subjected to ischemia/reperfusion (IR). Glucose, insulin, adiponectin, and pro-inflammatory cytokines (IL-1β, …

A Model Lightning Safety Policy For Athletics., Brian Bennett M.Ed

Brian Bennett, M.Ed

OBJECTIVE: The purpose of this paper is to present a model policy on lightning safety for athletic trainers.

BACKGROUND: Among college athletic programs in the United States there is a serious lack of written policy on lightning safety. Available evidence shows that most National Collegiate Athletic Association (NCAA) Division I institutions, even though they are located in high lightning activity areas of the country, do not have formal, written lightning safety policies.

CLINICAL ADVANTAGES/ RECOMMENDATIONS: The policy presented herein, which is at the forefront of such policies, is the lightning safety policy written as part of a policies and procedures …

Sue Dean In Conversation With Sue Evans December 2013 In Ballarat, Victoria, Sue Evans

Dr Sue Evans

Sue Dean is a fighter. Over the best part of the last two decades she has fought for an increased standard of professionalism within herbal medicine, as well as establishing her own successful practice in regional Victoria. Today, she has a different fight on her hands - she is battling a form of breast cancer that is showing itself resistant to treatment. As she says, with characteristic wry humour, 'Mine would be an absolutely fascinating case if only it wasn't me'.

Do Cochrane Summaries Help Student Midwives Understand The Findings Of Cochrane Systematic Reviews: The Brief Randomised Trial, Fiona Alderdice, Jenny Mcneill, Toby Lasserson, Elaine Beller, Margaret Carroll, Vanora Hundley, Judith Sunderland, Declan Devane, Jane Noyes, Susan Key, Janine Wyn-Davies, Mike Clarke

Elaine Beller

Background

Abstracts and plain language summaries (PLS) are often the first, and sometimes the only, point of contact between readers and systematic reviews. It is important to identify how these summaries are used and to know the impact of different elements, including the authors’ conclusions. The trial aims to assess whether (a) the abstract or the PLS of a Cochrane Review is a better aid for midwifery students in assessing the evidence, (b) inclusion of authors’ conclusions helps them and (c) there is an interaction between the type of summary and the presence or absence of the conclusions.

Methods

Eight …

General Practitioner Antimicrobial Stewardship Programme Study (Gaps): Protocol For A Cluster Randomised Controlled Trial, Minyon L. Avent, Malene Hansen, Charles Gilks, Chris Del Mar, Kate Halton, Hanna Sidjabat, Lisa Hall, Annette J. Dobson, David L. Paterson, Mieke Van Driel

Malene Hansen

Background There is a strong link between antibiotic consumption and the rate of antibiotic resistance. In Australia, the vast majority of antibiotics are prescribed by general practitioners, and the most common indication is for acute respiratory infections. The aim of this study is to assess if implementing a package of integrated, multifaceted interventions reduces antibiotic prescribing for acute respiratory infections in general practice. Methods/design This is a cluster randomised trial comparing two parallel groups of general practitioners in 28 urban general practices in Queensland, Australia: 14 intervention and 14 control practices. The protocol was peer-reviewed by content experts who were …

The Role Of Surveillance Duplex Scanning In Preventing Venous Thromboembolism In Trauma Patients., Mark D. Cipolle, Randolph Wojcik Md, Elizabeth Seislove, Thomas E. Wasser, Michael D. Pasquale Md, Facs, Fccm

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: This study was performed to determine the role of duplex scanning in preventing pulmonary embolism (PE), the correlation of venous thromboembolism (VTE) risk score with the incidence of deep venous thrombosis (DVT), and patients who may benefit from surveillance duplex scanning.

METHODS: Age, sex, Injury Severity Score (ISS), VTE score, length of stay, diagnoses, and bleeding risk were recorded from the trauma registry in patients who had a duplex scan from 1995 to 2000.

RESULTS: There were 1,513 duplex scans obtained (10,141 trauma admissions), 253 (2.5%) cases of DVT (52% above-knee, 8% upper extremity), and 30 cases of PE …

Outcome Of Blunt Thoracic Aortic Injury In A Level I Trauma Center: An 8-Year Review., E J Frick, M D Cipolle, Michael D. Pasquale Md, Facs, Fccm, T E Wasser, M Rhodes, Raymond L. Singer Md, S A Nastasee

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: The purpose of this study was to evaluate our experience with blunt thoracic aortic injury and identify factors predictive of outcome.

METHODS: Hospital charts, trauma registry data, and autopsies of 64 patients with blunt thoracic aortic injury from 1988 to 1995 were reviewed.

RESULTS: Patients were identified and segregated based on admission physiology. Group 1 patients (n = 19) arrived in arrest. Group 2 patients (n = 10) arrived in shock with systolic BP 90. Group 3 patients (n = 35) arrived with systolic BP>90. All patients in groups 1 and 2 expired. Injury Severity Scores for nonsurvivors …

National Athletic Trainers' Association Position Statement: Lightning Safety For Athletics And Recreation., K M Walsh, Brian Bennett M.Ed, M A Cooper, R L Holle, R Kithil, R E López

Brian Bennett

OBJECTIVE: To educate athletic trainers and others about the dangers of lightning, provide lightning-safety guidelines, define safe structures and locations, and advocate prehospital care for lightning-strike victims.

BACKGROUND: Lightning may be the most frequently encountered severe-storm hazard endangering physically active people each year. Millions of lightning flashes strike the ground annually in the United States, causing nearly 100 deaths and 400 injuries. Three quarters of all lightning casualties occur between May and September, and nearly four fifths occur between 10:00 AM and 7:00 PM, which coincides with the hours for most athletic or recreational activities. Additionally, lightning casualties from sports …

Tibialis Anterior Tendon Transfer For Posterior Tibial Tendon Insufficiency., Crystal L Ramanujam, John J. Stapleton Dpm, Facfas, Thomas Zgonis

John J Stapleton DPM, FACFAS

The Cobb procedure is useful for addressing stage 2 posterior tibial tendon dysfunction and is often accompanied by a medial displacement calcaneal osteotomy and/or lateral column lengthening. The Cobb procedure can also be combined with selected medial column arthrodesis and realignment osteotomies along with equinus correction when indicated.

Traceability Of Twenty Medicinal Plants In The Markets Of Northern Peru, Sue Evans, C Téllez, C Vega

Dr Sue Evans

The social, cultural and economic value of medicinal plants is prominent in many parts of South America, providing important economic and health benefits. However, market pressures and an absence of appropriate conservation policies are putting species at risk. These problems are exacerbated by an informal market system with poor remuneration for plant collectors which makes for a fragile economy. This study, located in the coastal cities of Chiclayo and Trujillo in northern Peru, focuses on market vendors. The objective of the study is to establish market vendors’ knowledge about the traceability, conservation status and botanical identification of twenty (20) medicinal …