Trauma Commons^™

Geriatric Trauma Triage - The Scope Of The Problem, Mya Cubitt, Rachel Key

Journal of Geriatric Emergency Medicine

n/a

Caregivers Of Youth In Foster Care In Texas And Their Role In Contraception Decision-Making For Adolescents In Care, Shelby Edmondson, Ana Belen Conrado, Hilda Loria, Jill Mcleigh, Jasmin Tiro, Simon Lee, Jenny Francis

Caregiver Needs and Supports

Few studies address the experiences of caregivers of adolescents in foster care. This study highlights a range of caregiver attitudes about contraception for adolescents in care. Provider training regarding contraception should include strategies to manage caregiver beliefs and extreme reactions to contraception use among youth in care.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Go With The Flow: An Experimental Analysis With Tubing Alternative With Irrigation., Scott S Hyland, Daniel T Degenova, Joseph P Scheschuk, Benjamin C Taylor

Trauma and Acute Care Articles

BACKGROUND AND AIMS: Literature regarding alternative tubing for fluid delivery in irrigation and debridement procedures is lacking. The purpose of this study was to compare three different apparatuses with varying quantities of irrigation fluid to assess efficiency of administration and evaluate overall time for fluid administration.

METHODS: This model was designed to compare available methods of gravity irrigation used in practice. Fluid flow time was measured for three types of tubing: single-lumen cystoscopy tubing, Y-type double-lumen cystoscopy tubing, and nonconductive suction tubing. Irrigation times were assessed for varying volumes of 3, 6, and 9 L to investigate the relationship between …

Vagus Nerve Stimulation Paired With Rehabilitation For Upper Limb Motor Impairment And Function After Chronic Ischemic Stroke: Subgroup Analysis Of The Randomized, Blinded, Pivotal, Vns-Rehab Device Trial, Jesse Dawson, Navzer D Engineer, Steven C Cramer, Steven L Wolf, Rushna Ali, Michael W O'Dell, David Pierce, Cecília N Prudente, Jessica Redgrave, Wuwei Feng, Charles Y Liu, Gerard E Francisco, Benjamin L Brown, Anand Dixit, Jen Alexander, Louis Demark, Vibor Krishna, Steven A Kautz, Arshad Majid, Brent Tarver, Duncan L Turner, Teresa J Kimberley

Faculty, Staff and Student Publications

BACKGROUND: Vagus Nerve Stimulation (VNS) paired with rehabilitation improved upper extremity impairment and function in a recent pivotal, randomized, triple-blind, sham-controlled trial in people with chronic arm weakness after stroke.

OBJECTIVE: We aimed to determine whether treatment effects varied across candidate subgroups, such as younger age or less injury.

METHODS: Participants were randomized to receive rehabilitation paired with active VNS or rehabilitation paired with sham stimulation (Control). The primary outcome was the change in impairment measured by the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score on the first day after completion of 6-weeks in-clinic therapy. We explored the effect of VNS …

Pediatric Facial Fractures In Patients With Autism Spectrum Disorder, Annie Glenney, Zhazira Irgebay, Meeti Mehta, Joseph Mocharnuk, Janina Kueper, Lucas A. Dvoracek, Justin Schreiber, Joseph Losee, Jesse Goldstein

St. Chris Research Day

No abstract provided.

Maximizing Patient Benefit In Interfacility Transfer For The Management Of Pediatric Hand Trauma, Annie Glenney, Zainab Balogun, Meeti Mehta, Shirley Liu, Vivian Wang, Lucille Cheng, Darya Fadavi, Alexander Davit Iii

St. Chris Research Day

No abstract provided.

Association Of Brain Age, Lesion Volume, And Functional Outcome In Patients With Stroke, Sook-Lei Liew, Nicolas Schweighofer, James H. Cole, Artemis Zavaliangos-Petropulu, Bethany P. Lo, Laura K.M. Han, Tim Hahn, Lianne Schmaal, Miranda R. Donnelly, Jessica N. Jeong, Zhizhuo Wang, Aisha Abdullah, Jun H. Kim, Alexandre Hutton, Giuseppe Barisano, Michael R. Borich, Lara A. Boyd, Amy Brodtmann, Cathrin M. Buetefisch, Winston D. Byblow, Jessica M. Cassidy, Charalambos C. Charalambous, Valentina Ciullo, Adriana Bastos Conforto, Rosalia Dacosta-Aguayo, Julie A. Dicarlo, Martin Domin, Adrienne N. Dula, Natalia Egorova-Brumley, Wuwei Feng, Fatemeh Geranmayeh, Chris M. Gregory, Colleen A. Hanlon, Kathryn Hayward, Jess A. Holguin, Brenton Hordacre, Neda Jahanshad, Steven A. Kautz, Mohamed Salah Khlif, Hosung Kim, Amy Kuceyeski, David J. Lin, Jingchun Liu, Martin Lotze, Bradley J. Macintosh, John L. Margetis, Maria Mataro, Feroze B. Mohamed, Emily R. Olafson, Gilsoon Park, Fabrizio Piras, Kate P. Revill, Pamela Roberts, Andrew D. Robertson, Nerses Sanossian, Heidi M. Schambra, Na Jin Seo, Surjo R. Soekadar, Gianfranco Spalletta, Cathy M. Stinear, Myriam Taga, Wai Kwong Tang, Greg T. Thielman, Daniela Vecchio, Nick S. Ward, Lars T. Westlye, Carolee J. Winstein, George F. Wittenberg, Steven L. Wolf, Kristin A. Wong, Chunshui Yu, Steven C. Cramer, Paul M. Thompson

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance. We hypothesized that more lesion damage would result in older brain age, which would in turn be associated with poorer outcomes. Related, we expected that brain age would mediate the relationship between lesion damage and outcomes. Finally, we hypothesized that structural brain resilience, which we define in …

Efficient Cancer Modeling Through Crispr-Cas9/Hdr-Based Somatic Precision Gene Editing In Mice, Wen Bu, Chad J Creighton, Kelsey S Heavener, Carolina Gutierrez, Yongchao Dou, Amy T Ku, Yiqun Zhang, Weiyu Jiang, Jazmin Urrutia, Wen Jiang, Fei Yue, Luyu Jia, Ahmed Atef Ibrahim, Bing Zhang, Shixia Huang, Yi Li

Faculty, Staff and Student Publications

CRISPR-Cas9 has been used successfully to introduce indels in somatic cells of rodents; however, precise editing of single nucleotides has been hampered by limitations of flexibility and efficiency. Here, we report technological modifications to the CRISPR-Cas9 vector system that now allows homology-directed repair-mediated precise editing of any proto-oncogene in murine somatic tissues to generate tumor models with high flexibility and efficiency. Somatic editing of either

Institutional Outcomes Of Blunt Liver & Splenic Injury In The Atomac Era, Shai Stewart Md, James Fraser, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St.Peter, Tolulope A. Oyetunji

Research Days

Background: The Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) practice management guideline (PMG) was created to standardize management of blunt liver or spleen injury (BLSI) across pediatric trauma centers. Evaluations of institutional outcomes after its adoption remain scarce. We describe our outcomes since PMG adoption at our institution.

Objectives/Goal: The purpose of this study was to assess patient outcomes and resource utilization after implementation of this protocol. We hypothesized there is no difference in length of stay (LOS) or complications regardless of grade of isolated injuries to the liver or spleen. In addition, there is limited guidance on the management of concurrent injuries to …

A Comparison Of Large Tbsa Scald Versus Flame Burns In Young Children, Ashley Daniel

Research Days

Background: It is generally accepted that of children with the same total body surface area of burns, those with flame burns seem to have longer lengths of stay and more complications than those with scald burns. Anecdotally we have seen the opposite to be true. Among a consortium of five US pediatric burn centers participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC), young children with scald burns seem to experience disproportionately more frequent and severe complications compared to their older counterparts and compared to patients of a similar age with flame burns.

Objectives/Goal: In this multi-institutional study, we compared …

Chest Wall Injury Pain With Movement, Lindsey Cavlovic

Theses & Dissertations

Rib fractures are the most common injury in patients who sustain trauma to the chest wall. These patients often report exacerbated pain severity with deep breathing, coughing, and performing movements of the upper body. Clinical experience in treating these patients shows that patients usually avoid movement due to increased pain severity. Most pain scores from patients with chest wall injuries are assessed while the patient lies comfortably in bed. Although pain is the primary complaint of patients with chest wall injury, the assessment of this pain is likely under-represented, given that these patients remain inactive due to the pain that …

Management And Considerations In The Usage Of Txa In Hemorrhagic Trauma Patients, Matthew Petterson, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Tranexamic acid is a synthetic reversible competitive inhibitor that exerts its action on plasminogen, preventing plasmin formation and deterring fibrinolysis.1 Current FDA-approved indications of TXA include heavy menstrual bleeding and short-term blood loss prevention in patients with hemophilia following tooth extraction.1 TXA has more recently been utilized in the management of massive hemorrhagic trauma patients despite this being an off-label use. While TXA has shown promise as a hemostatic agent for this patient population, considerations in the pre-hospital and hospital settings must be examined for its integration into massive hemorrhage protocols.

The Effect Of Graft Selection On Patients’ Subjective Readiness To Return To Sport After Acl Reconstruction, Adeeb Hanna, William Johns, Emma Johnson, Bryson Kelmer, Gabriel Onor, Kevin Freedman, Christopher Dodson, Michael Ciccotti

Rowan-Virtua Research Day

Background: Patients who undergo ACL reconstruction with allografts may have an easier functional recovery compared to autograft patients. This is due to decreased donor site morbidity and less muscle atrophy compared to autograft patients. This “easier” recovery may be perceived by patients and may result in a subjective earlier readiness for return to sports.

Hypothesis/Purpose: To determine if there is a difference in perceived readiness to return to sport (RTS) in the first year postoperative period between individuals who undergo ACL reconstruction utilizing bone-patellar tendon-bone (BTB) autografts or allografts.

Study Design: Prospective Cohort Study, Level II Methods: This was a …

Mental Health Disorders And Psychotropic Medication: Prevalence And Related Characteristics Among Individuals In Foster Care, Jill Mcleigh, Lauren Malthaner, Madeline Tovar, Mohsin Khan

Behavioral Health/Developmental Delay

This study sought to provide prevalence data for mental health (MH) diagnoses and psychotropic medication prescriptions among individuals in foster care and to examine their relationships with physical health status, maltreatment type, placement type, and demographic variables.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Integration Into Professional Practice: Emergency Medical Services, Eva Finkelstein

Senior Honors Projects

No abstract provided.

Exploring 5-Minute Heart Rate Variability In Spinal Cord Injury During Acute Inpatient Rehabilitation, Argyrios Stampas, Colton Malesovas, Michael Burke, Sahira Farooq, Mani Singh, Radha Korupolu, Sheng Li

Faculty, Staff and Student Publications

To explore the use of 5-minute heart rate variability (HRV) during inpatient rehabilitation in the acute phase of traumatic spinal cord injury (SCI). Longitudinal observational study. Acute inpatient rehabilitation (AIR). 10 patients with acute traumatic SCI. 5-minute HRV supine recordings twice daily on three different days per patient. HRV values were evaluated (1) within a single day (Early versus Late); (2) across the inpatient admission (initial, mid, and discharge); (3) by SCI phenotypes and by clinical outcomes (ex. pressure injuries (PI)). Patients had an average age of 38 years, 80% male, and 40% with tetraplegia. There were no HRV differences …

Major Differences In Transcriptional Alterations In Dorsal Root Ganglia Between Spinal Cord Injury And Peripheral Neuropathic Pain Models, Raquel Cuevas-Diaz Duran, Yong Li, Anibal Garza Carbajal, Yanan You, Carmen W Dessauer, Jiaqian Wu, Edgar T Walters

Faculty, Staff and Student Publications

Chronic, often intractable, pain is caused by neuropathic conditions such as traumatic peripheral nerve injury (PNI) and spinal cord injury (SCI). These conditions are associated with alterations in gene and protein expression correlated with functional changes in somatosensory neurons having cell bodies in dorsal root ganglia (DRGs). Most studies of DRG transcriptional alterations have utilized PNI models where axotomy-induced changes important for neural regeneration may overshadow changes that drive neuropathic pain. Both PNI and SCI produce DRG neuron hyperexcitability linked to pain, but contusive SCI produces little peripheral axotomy or peripheral nerve inflammation. Thus, comparison of transcriptional signatures of DRGs …

Youths’ Sense Of Mastery Scores In Correlation To Ptsd Criterion D Scores & Total Ptsd-Ri Scores, Katherine Conklin, Amanda Mraz

Undergraduate Research Symposium Posters

Childhood resilience levels impact the severity of posttraumatic stress disorder (PTSD). Resiliency is defined as a personal characteristic fostering effective coping, adaptive functional abilities, and motivation.

Examining Differences In Ptsd Symptomatology Among Youth Who Have Experienced Sexual And Psychological Maltreatment Using Nonparametric Analyses, Emma Domschot, Vanni Jefferson V. Arcaina

Undergraduate Research Symposium Posters

Child sexual abuse, even when accounting for co-occuring risk factors, may be predictive of worse clinical outcomes when comparing to other types of trauma (Kisiel et al., 2014). However, contrasting research suggests that psychological maltreatment may independently contribute to a negative risk of clinical outcomes comparable to child sexual abuse (Hodgon et al., 2014). Other studies suggest that complex trauma, in terms of experiencing prolonged and several traumas over a period of time, may often lead to an increased risk of post-traumatic stress disorder (John et al., 2019). The current study aimed to examine differences in PTSD symptomatology among youth …

The Relationship Between Concussion History And Lower Extremity Biomechanics During A Land And Cut Task, Nghi G. Vu, Warren O. Forbes, Jason M. Avedesian

Undergraduate Research Symposium Posters

In high impact landing tasks, athletes with a history of sports related concussion (SRC) have been found to demonstrate lower extremity (LE) biomechanics that are associated with elevated injury risk. However, the exact relationships between SRC history and LE biomechanics are inconclusive.