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Full-Text Articles in Medical Specialties
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Bryan G Kane MD
Background: Falls in the elderly cause serious injury. Objective: We aimed to determine subjects’ comfort in discussing fall risk and home safety evaluations. Methods: This prospective study surveyed a convenience sample of subjects ($50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey—validated surveys measuring fall concern and functional decline. Other data—environmental living conditions, participant behaviors, fall frequency—were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Results: Participants (n = 416, 38% males, …
Evaluation And Management Of Mild Traumatic Brain Injury: An Eastern Association For The Surgery Of Trauma Practice Management Guideline, Ronald Barbosa, Randeep Jawa, Jennifer Watters, Jennifer Knight, Andrew Kerwin, Eleanor Winston, Robert Barraco, Brian Tucker, James Bardes, Susan Rowell
Evaluation And Management Of Mild Traumatic Brain Injury: An Eastern Association For The Surgery Of Trauma Practice Management Guideline, Ronald Barbosa, Randeep Jawa, Jennifer Watters, Jennifer Knight, Andrew Kerwin, Eleanor Winston, Robert Barraco, Brian Tucker, James Bardes, Susan Rowell
Robert D Barraco MD, MPH
BACKGROUND: An estimated 1.1 million people sustain a mild traumatic brain injury (MTBI) annually in the United States. The natural history of MTBI remains poorly characterized, and its optimal clinical management is unclear. The Eastern Association for the Surgery of Trauma had previously published a set of practice management guidelines for MTBI in 2001. The purpose of this review was to update these guidelines to reflect the literature published since that time.
METHODS: The PubMed and Cochrane Library databases were searched for articles related to MTBI published between 1998 and 2011. Selected older references were also examined.
RESULTS: A total …
Practice Management Guidelines For The Diagnosis And Management Of Injury In The Pregnant Patient: The East Practice Management Guidelines Work Group, Robert Barraco, William Chiu, Thomas Clancy, John Como, James Ebert, L Hess, William Hoff, Michele Holevar, J Quirk, Bruce J Simon, Patrice Weiss
Practice Management Guidelines For The Diagnosis And Management Of Injury In The Pregnant Patient: The East Practice Management Guidelines Work Group, Robert Barraco, William Chiu, Thomas Clancy, John Como, James Ebert, L Hess, William Hoff, Michele Holevar, J Quirk, Bruce J Simon, Patrice Weiss
Robert D Barraco MD, MPH
Trauma during pregnancy has presented very unique challenges over the centuries. From the first report of Ambrose Pare of a gunshot wound to the uterus in the 1600s to the present, there have existed controversies and inconsistencies in diagnosis, management, prognostics, and outcome. Anxiety is heightened by the addition of another, smaller patient. Trauma affects 7% of all pregnancies and requires admission in 4 of 1000 pregnancies. The incidence increases with advancing gestational age. Just over half of trauma during pregnancy occurs in the third trimester. Motor vehicle crashes comprise 50% of these traumas, and falls and assaults account for …
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Robert D Barraco MD, MPH
Background: Falls in the elderly cause serious injury. Objective: We aimed to determine subjects’ comfort in discussing fall risk and home safety evaluations. Methods: This prospective study surveyed a convenience sample of subjects ($50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey—validated surveys measuring fall concern and functional decline. Other data—environmental living conditions, participant behaviors, fall frequency—were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Results: Participants (n = 416, 38% males, …
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane
Marna R Greenberg DO, MPH, FACEP
Background: Falls in the elderly cause serious injury. Objective: We aimed to determine subjects’ comfort in discussing fall risk and home safety evaluations. Methods: This prospective study surveyed a convenience sample of subjects ($50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey—validated surveys measuring fall concern and functional decline. Other data—environmental living conditions, participant behaviors, fall frequency—were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Results: Participants (n = 416, 38% males, …
Family Presence During Trauma Resuscitation: Ready For Primetime?, Mae Pasquale, Michael Pasquale, Leslie Baga, Sherrine Eid, Jane Leske
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
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.
Impact Of Age And Anticoagulation: Need For Neurosurgical Intervention In Trauma Patients With Mild Traumatic Brain Injury, Margaret Moore, Michael Pasquale, Michael Badellino
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
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
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], …
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
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, …