Pretibial lacerations remain one of the commonest yet most neglected conditions facing emergency departments and plastic surgeons alike. Furthermore, these injuries afflict the most vulnerable groups of adults - the elderly and the infirm. It is essential therefore to have an approach to pretibial lacerations based on best available evidence, ...

Regenerative medicine is an emerging field aiming to the development of new reparative strategies to treat degenerative diseases, injury, and trauma through developmental pathways in order to rebuild the architecture of the original injured organ and take over its functionality. Most of the processes and interactions involved in the regenerative ...

Although the management of cervical spine trauma is relatively complex, multiple classification systems have attempted to simplify it through the use of descriptive terms. Most historical classification systems failed to yield sufficient prognostic information to guide clinical treatment until the Subaxial Injury Classification system was developed. This classification system takes ...

Individuals with disabilities have an elevated risk of residential injury. However, the prevalence of home hazards and safety practices among households where an individual with a disability resides is unknown. This study examined patterns of home hazards and safety practices among 1003 households across the United States in 2002. Households ...

The specialty of travel medicine encompasses a broad and dynamic practice. A thorough pretravel consultation provides an individual with a comprehensive, evidence-based, contextual discussion of the risk profile for specific itinerary-based, travel-related illness and injury, allowing the traveler to use this information in conjunction with his or her personal health ...

The management of traumatic brain injury (TBI) continues to evolve in a number of key areas. In the first instance there have been major advances in clinical information gathering and interpretation such that there are mow sophisticated prognostic models readily available. Secondly, technological advances have allowed the introduction of advanced ...

Building a successful trauma practice in the academic medicine sector requires planning, contemplation, and continuous reevaluation. Although there are no rigid formulas, there are some common sense approaches that can help you start along the path toward a successful academic trauma career. This article outlines a blueprint that I have ...

According to 2007 data, gunshot wounds from homicides, suicides, and accidents caused 31,000 deaths in the United States, with even higher numbers of serious, nonfatal injuries. In recent years, new evidence on effective treatment of patients with gunshot wounds has come from military settings and is being adapted for civilian ...

BACKGROUND: The rapidly developing array of online physician-only communities represents a potential extraordinary advance in the availability of educational and informational resources to physicians. These online communities provide physicians with a new range of controls over the information they process, but use of this social media technology carries some risk. ...

OBJECTIVES: There is an apparent conflict between published evidence and UK emergency medicine (EM) physician practice with regard to the use of intravenous fluids to treat patients intoxicated with alcohol. We conducted a survey of all EM physicians in North East (NE) England to determine opinion with regard to this ...

Lameness is the most commonly diagnosed condition in equine veterinary practice. To examine whether variations in management and husbandry strategies in riding schools could influence wastage due to orthopaedic injury schools with high (HUIO) or low (LUIO) insurance claims for orthopaedic injuries (as an indirect measure of wastage) were compared ...

The constant desire to improve outcomes in orthopaedic sports medicine requires us to continuously consider the challenges faced in the surgical repair or reconstruction of soft tissue and cartilaginous injury. In many cases, surgical efforts targeted at restoring normal anatomy and functional status are ultimately impaired by the biological aspect ...

PRACTICAL RELEVANCE: Feline trauma is commonly seen in general practice and frequently involves damage to the head. CLINICAL CHALLENGES: While craniofacial injuries following trauma vary widely in severity, affected cats can often be severely compromised in terms of their neurological, respiratory and cardiovascular status, and their management can be challenging ...

PRACTICAL RELEVANCE: Feline trauma patients are commonly seen in general practice and frequently have sustained some degree of brain injury. CLINICAL CHALLENGES: Cats with traumatic brain injuries may have a variety of clinical signs, ranging from minor neurological deficits to life-threatening neurological impairment. Appropriate management depends on prompt and accurate ...

Acute kidney injury (AKI) is common in hospitalized patients and is associated with significant morbidity and mortality. The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including loop diuretics, have been tested for the ...

BACKGROUND:: Observation and splenic artery embolotherapy (SAE) are nonoperative management (NOM) modalities for adult blunt splenic injury; however, they are quite different, inconsistently applied, and controversial. This meta-analysis compares the known outcomes data for observational management versus SAE by splenic injury grade cohort. METHODS:: Thirty-three blunt splenic injury outcomes articles, ...

Traumatic brain injuries that occur during sports have gained significant attention in the literature. Despite improved education and research on proper identification, risk management, and treatment, standardized methods for returning an athlete to play after a concussion are lacking in universal applicability. Current return-to-play guidelines are considered appropriate for the ...

Background: Glenohumeral dislocations are prevalent injuries in an athletic population, and proper, acute on-field management remains a topic of debate among health care professionals.Objective: Firstly, to provide a systematic approach to the on-field management of acute anterior glenohumeral dislocations for on-field health care professionals. Secondly, to present current methods of ...

The evaluation and management of mild traumatic brain injury (mTBI) in the occupational setting may pose significant challenges for even the most-seasoned practitioner. Providers must simultaneously address the clinical management of mTBI and be familiar with the systematic and administrative requirements related to the management of injured workers with mTBI ...

Concussion is a challenging injury for the sports medicine team, and neuropsychological testing has been used as an adjunct to other clinical measures for assessment and management, and to guide return-to-play decisions. Understanding the limitations as well as the role of neuropsychological testing in the evaluation and management of sports-related ...

Thrombosis is a physiologic hemostatic response to vascular injury. Thrombus generation has evolved as a complex event involving multiphasic biologic inputs and regulation. Pathologic thrombosis in cardiovascular medicine afflicts millions of U.S. citizens per year, exacting a death total in the hundreds of thousands of people. These morbid events are ...

The plum curculio, Conotrachelus nenuphar (Herbst), is a key pest of pome and stone fruit in eastern and central North America. For effective management of this insect pest in commercial apple (Malus spp.) orchards in the northeastern United States and Canada, one of the greatest challenges has been to determine ...

ETHNOPHARMACOLOGICAL CONTEXT: This review explores the medicinal and therapeutic applications of Sea buckthorn (Hippophae rhamnoides L.) in curtailing different types of acute as well as chronic maladies. The plant is being used in different parts of the world for its nutritional and medicinal properties. MATERIALS AND METHODS: Sea buckthorn based ...

Although the principles of burn management are still primarily focused on survival, as advances are realized in resuscitation, nutrition, and wound management, the functional and aesthetic outcomes following burn injury have become increasingly important. Acellular dermal matrix materials, which allow surgeons to minimize skin graft donor site morbidity in the ...

This article represents a consensus view of those TTWG members present in Birmingham and taking into account the views of the other group members via email discussion. We believe it represents clear guidance for the deployed clinician and recommend the use of selective non-operative management when appropriate.

Whiplash is the most common injury type arising from motor vehicle collisions, often leading to long-term suffering and disability. Prevention of such injuries is possible through the use of appropriate, correctly positioned, vehicular head restraints. To survey the awareness and knowledge level of vehicle fleet managers in the province of ...

COMMENTARY ON: Radcliff KE, Kepler CK, Delasotta LA, et al. Current management review of thoracolumbar cord syndromes. Spine J 2011;11:884-92 (in this issue).

Disasters often create large amounts of waste that must be managed as part of both immediate response and long-term recovery. While many federal, state, and local agencies have debris management plans, these plans often do not address chemical, biological, and radiological contamination. The Interagency Biological Restoration Demonstration's (IBRD) purpose was ...

There remains a significant paediatric workload through the military hospital in Camp Bastion. In this paper the authors review and discuss particular problems with resuscitation, investigation, anaesthetic and surgical issues in dealing with children suffering from ballistic injuries. Personal experience and recent papers are used for a qualitative analysis of ...

Gerodontology 2011; doi: 10.1111/j.1741-2358.2010.00431.x A clinico-demographic analysis of maxillofacial trauma in the elderly Introduction:  The elderly represent an increasing proportion of society. Management of maxillofacial trauma in this population may be complicated by coexisting medical conditions, requiring multi-disciplinary care. Methods:  This retrospective audit assesses the incidence and pattern of maxillofacial ...

BACKGROUND: Economic costs of spotted wing drosophila (SWD) include yield and associated revenue losses, labor and material costs for monitoring and management and revenue losses due to the closure of export markets should fruit from SWD-infested regions be banned by trading partners. This analysis focuses on two types of loss ...

This article discusses the epidemiology, diagnosis, and management of traumatic cerebrospinal fluid (CSF) leaks. An overview of traumatic CSF leaks is presented, and both conservative and operative therapies are reviewed. Management decisions are discussed based on the current literature. Controversial clinical topics are addressed, including the use of prophylactic antibiotics ...

ACADEMIC EMERGENCY MEDICINE 2011; 18:880-889 © 2011 by the Society for Academic Emergency Medicine ABSTRACT: Objectives:  The objective was to provide an overview of the recommendations and quality of evidence-based clinical practice guidelines (CPGs) for the emergency management of mild traumatic brain injury (mTBI), with a view to informing best ...

Vascular injuries in children result from invasive procedures, penetrating trauma, and blunt injuries. Depending on local practice patterns, these injuries are managed by a range of subspecialists with little guidance from the literature on the optimal approach to diagnosis and management of these challenging injuries. Recently, more aggressive operative approaches ...

Injuries to the fingertip are a very common presentation to the emergency department, yet are often poorly managed. These injuries have a functionally important impact on day to day living as the fingertip is the most used part of the upper limb and as such is frequently prone to trauma. ...

BACKGROUND Management of problem drinking presents the general practitioner with similar challenges and rewards to those associated with the management of other chronic conditions. OBJECTIVE This article presents a framework for managing alcohol problems in general practice based on national guidelines for the treatment of alcohol problems. DISCUSSION General practitioners ...

Abstract:This article presents a narrative or story-telling approach to managing trauma. The emphasis is on helping religious and spiritual caregivers, as first responders, to manage the impact of trauma on victims as well as on their own lives as caregivers. Religious and spiritual caregivers come from a wide range of ...

Injuries to the great vessels of the torso are commonly seen and managed in busy urban trauma centers. This same injury complex is rarely seen in military conflicts, likely because of the high kinetic energy of weapons causing the wounds seen in this setting. Although most of the great advancements ...

Musculoskeletal Disorders (MSD) often classified as sprains and strains to the low back, neck, shoulder or knee are the leading cost drivers in the workers compensation system. In 2009, soft tissue muscle injuries accounted for 40% of total injury cases requiring days away from work. The demand on U.S. employers ...

Biomechanical tests of post hoc probability have been proposed by prior authors as reliable tests of causation in forensic settings. Biomechanical assessment of injury kinetics and kinematics is a potentially important tool in forensic medicine, but there is also the potential for misapplication. The most reliable application is when biomechanical ...

The management of bone defects caused by trauma and nonunion continues to represent a substantial clinical challenge in the management of orthopaedic trauma patients. A variety of treatment options have been described and reported in the literature. The relative rarity of these injuries means that high level, comparative evidence to ...

Splenic injury is an uncommon complication of colonoscopy. Less than 100 cases are reported in the English language literature. The exact mechanism of injury to the spleen during colonoscopy is unknown; various authors propose several risk factors and possible mechanisms. Splenic injury can be graded or classified according to the ...

Blunt chest trauma resulting in right bronchial tear in an 8-year-old girl is reported. Use of bronchoscopy in the management of such an injury is highlighted.

Penetrating brain injury (PBI), though less prevalent than closed head trauma, carries a worse prognosis. The publication of Guidelines for the Management of Penetrating Brain Injury in 2001, attempted to standardize the management of PBI. This paper provides a precise and updated account of the medical and surgical management of ...

The accumulated knowledge and perceptions of communities 'at risk' are key elements in managing disaster risk at the local level. This paper demonstrates that local knowledge of flood hazards can be structured systematically into geographic information system (GIS) outputs. When combined with forecasting models and risk scenarios, they strengthen the ...

Traumatic brain injury (TBI) induced hypopituitarism remains a relevant medical problem, because it may affect a significant proportion of the population. In the last decade important studies have been published investigating pituitary dysfunction after TBI. Recently a group of experts gathered and revisited the topic of TBI induced hypopituitarism. During ...

Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in ...

Aim  This project sought to determine nurses' understanding and management of infants with intravenous (IV) therapy. There were three specific aims: •  To improve identification and management of extravasation injuries in neonates •  To ensure management of extravasation injuries in neonates is classified according to IV extravasation staging guidelines •  ...

Despite persisting controversy over shoulder dystocia prediction, prevention, and injury causation, the authors find considerable evidence in recent research in the field to recommend additional guidelines beyond the current American College of Obstetricians and Gynecologists and Royal College of Obstetricians and Gynecologists guidelines to improve clinical practice in managing patients ...

This is a case report of extra-peritoneal rectal injury, secondary to a gunshot, that was managed non-operatively. A 57-year old male presented with a single gunshot to the right buttock and had blood per rectum. Extra-peritoneal rectal injuries were seen on proctoscopy and he had no genitourinary injury. He was ...