1,880 results match your criteria: "R Adams Cowley Shock Trauma Center.[Affiliation]"
The Use Of External Beam Radiation Therapy For Heterotopic Ossification Prophylaxis After Surgical Fixation Of Acetabular Fractures: A Randomized Controlled Trial.
J Orthop Trauma
November 2024
Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore MD.
Objectives: To determine the effect of external beam radiation (XRT) on preventing severe heterotopic ossification (HO) after acetabular surgery.
Methods: Design: Randomized controlled trial.
Setting: Two level I academic trauma centers.
Assessment of arousal recovery after cardiac arrest using diffusion kurtosis MRI with higher b-values: a pilot study.
Brain Inj
November 2024
R. Adams Cowley Shock Trauma Center, Program in Trauma, Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Objective: Comatose survivors of cardiac arrest (CA) pose a complex challenge for physicians reliant on imperfect studies to determine the extent of neurologic injury. Clinically available imaging is frequently relied upon despite limited sensitivity. We conducted a prospective pilot study comparing diffusion kurtosis imaging (DKI)-MRI and somatosensory evoked potentials (SSEPs) in comatose survivors of CA to investigate the benefit of utilizing higher diffusion b-values to enhance prediction of arousal recovery.
View Article and Find Full Text PDFLongitudinal Pain Management Claims in Maryland: Implications.
Crit Care Nurs Clin North Am
December 2024
Pain Medicine Department, Icahan School of Medicine & Mt Sinai Medical Center, 100 5th Ave New York, NY 10011, USA.
The study is a longitudinal review of pain management claims filed in the state of Maryland. Adverse outcomes associated with pain-related claims are often severe and include death, brain damage, and back and spinal cord sequelae. There is a lot to be learned from past experiences, identified in closed pain management claims, specifically on how to improve patient education, outcomes, quality, and safety.
View Article and Find Full Text PDFACR Appropriateness Criteria® Penetrating Torso Trauma.
J Am Coll Radiol
November 2024
Specialty Chair, Ohio State University Wexner Medical Center, Columbus, Ohio.
This document assesses the appropriateness of various imaging studies for acute penetrating trauma to the torso. Penetrating trauma most commonly occurs from gunshots and stabbings, although any object can impale the patient. Anatomic location, type of penetrating trauma, and hemodynamic status are among the many important factors when deciding upon if, what, and when imaging is needed to further evaluate the patient.
View Article and Find Full Text PDFHuman Capital and Productivity in Surgery Research Across the Globe: A Big Data Analysis Using Artificial Intelligence.
J Surg Res
November 2024
Economic Studies Program, Brookings Institution, Washington, District of Columbia; Public Policy Program, Aletheia Research Institution, Palo Alto, California.
Introduction: No investigation of each nation's contribution to knowledge production and human capital in surgery currently exists. Previous studies explored country-level research productivity only in few surgical subspecialties. To identify current and future leaders in surgery research, we conduct a retrospective observational study of each country's human capital and research productivity.
View Article and Find Full Text PDFRisk Factors for Postoperative Complications Following Mandibular Fracture Repair.
J Craniofac Surg
October 2024
Division of Plastic and Reconstructive Surgery, R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center.
Complications following mandibular fracture repair (MFR) may carry significant morbidity to patients. The purpose of our study is to determine the risk factors for postoperative complications following MFR. The authors conducted a retrospective cohort study of trauma patients who underwent MFR in 2018 and 2019.
View Article and Find Full Text PDFThe fallacy of a roadmap computed tomography after an abdominal gunshot wound: A road that leads to nowhere.
J Trauma Acute Care Surg
November 2024
From the Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland.
Article Synopsis
- - The study questions the value of preoperative abdominopelvic CT scans (CTAP) in patients with gunshot wounds to the abdomen, as current guidelines recommend them but their practical usefulness is being debated.
- - Out of 149 patients analyzed, 72.5% showed clear signs for immediate surgical intervention (laparotomy), but CTAP findings only matched actual injury patterns in 57% of cases, missing significant injuries in 36.2% of patients.
- - The results suggest that while CTAP might clarify unclear injury paths, it rarely changes management strategies for patients needing surgery and can lead to unnecessary operations in some cases.
Observation-first versus angioembolization-first approach in stable patients with blunt liver trauma: A WTA multicenter study.
J Trauma Acute Care Surg
November 2024
From the Division of Division of Trauma, Burns and Surgical Critical Care, Department of Surgery (P.D.N., J.N., N.A., A.G.), University of California, Irvine, Orange, California; Section of Surgical Sciences (J.M.S.), Vanderbilt University Medical Center, Nashville, TN; Department of Surgery, University of Colorado, Aurora, Colorado (M.C., H.C., R.M., S.U., C.C.B., C.V.); Department of Surgery (S.B., R.C.D.), UCSF-Fresno, Fresno, California; Division of Trauma and Acute Care Surgery (M.C.S.), Mount Carmel East; Trauma, Critical Care and Acute Care Surgery (A.L.), Grant Medical Center, Columbus, Ohio; Department of Surgery (M.S.F.), Lehigh Valley Health Network, Allentown, Pennsylvania; Departments of Emergency Medicine and Surgery, Program in Trauma (D.M.S.), R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Graduate Medical Education (M.S.T., H.M.G.V.), Methodist Dallas Medical Center, Dallas, Texas; Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery (C.J.M., T.J.M.), Spartanburg Regional Medical Center, Spartanburg, South Carolina; Department of Surgery (C.G.B.), University of Calgary, Calgary, Alberta, Canada; Division of Acute Care Surgery (K.M., G.M.), Loma Linda University Health, Loma Linda, California; Department of Surgery (D.J.H., H.A.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Trauma and Acute Care Surgery (T.J.S., J.R.), UCHealth Memorial Hospital, Colorado Springs, Colorado; Department of General Surgery (M.B.), Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Division of Trauma, Acute Care Surgery and Surgical Critical Care (N.K., M.C.), Banner-University Medical Center Phoenix, Phoenix, Arizona; Division of Trauma and Critical Care, Department of Surgery (N.K.D., E.J.L.), Cedars-Sinai Medical Center, Los Angeles, California; Department of Surgery (T.E., J.W.), Cooper University Hospital, Camden, New Jersey; Department of Surgery and Perioperative Care (T.C.P.C., V.E.), Dell Medical School, University of Texas at Austin, Austin, Texas; Division of Trauma Acute Care Surgery, Department of Surgery (K.P., K.C.), Banner Thunderbird Medical Center, Glendale, Arizona; Division of Trauma and Surgical Critical Care, Department of Surgery (S.B.), Hackensack University Medical Center, Hackensack, New Jersey; Division of Trauma and Surgical Critical Care, Department of Surgery (F.S.E.), Rutgers New Jersey Medical School, Newark, New Jersey; Department of Trauma and Acute Care Surgery (W.D., C.P.), Medical Center of the Rockies, Loveland, Colorado; University of Wisconsin-Madison School of Medicine and Public Health (N.L.W.), Madison, Wisconsin; Department of Trauma (J.M.H., K.L.), Ascension Via Christi Saint Francis, Wichita, Kansas; Department of Surgery (G.S.), Miami Valley Hospital, Wright State University, Dayton, Ohio; Department of Surgery (K.S.), Prisma Health-Upstate, Greenville, South Carolina; and Department of Surgery (L.A.H.), Boulder Community Hospital, Boulder, Colorado.
Background: Prior studies evaluating observation versus angioembolization (AE) for blunt liver injuries (BLT) with contrast extravasation (CE) on computed tomography imaging have yielded inconsistent conclusions, primarily due to limitations in single-center and/or retrospective study design. Therefore, this multicenter study aims to compare an observation versus AE-first approach for BLT, hypothesizing decreased liver-related complications (LRCs) with observation.
Methods: We conducted a post hoc analysis of a multicenter, prospective observational study (2019-2021) across 23 centers.
Neurosurgical Procedures in Patients Requiring Extracorporeal Membrane Oxygenation.
Crit Care Explor
October 2024
Departments of Neurology and Neurosurgery, University of Rochester Medical Center, Rochester, NY.
Article Synopsis
- The study examines the outcomes of patients who underwent ECMO (extracorporeal membrane oxygenation) following acute neurosurgical interventions across four high-volume centers in the U.S.
- Researchers reviewed data from 24 adults who underwent various neurosurgical procedures before or during ECMO, aiming to determine survival rates and neurologic outcomes.
- Findings showed that 63% of these patients survived to hospital discharge, with 80% of those having favorable neurologic outcomes, suggesting that ECMO could be beneficial even in cases with significant neurologic injury.
Supporting early-career military general surgeons: an Eastern Association for the Surgery of Trauma Military Committee position paper.
Trauma Surg Acute Care Open
October 2024
Surgery, Brian Allgood Army Community Hospital, Seoul, Korea (the Republic of).
Early-career surgeons must be exposed to a sufficient number of surgical cases of varying complexity in a mentored environment to allow them to solidify, sustain and build on the skills gained in training. Decreased operative volumes at military treatment facilities and assignments that do not include strong mentoring environments can place military surgeons at a disadvantage relative to their civilian counterparts during this critical time following training. The challenge of lower operative volumes in the current interwar lull has been exacerbated by the decline in beneficiary care conducted within the Military Healthcare System.
View Article and Find Full Text PDFDamage control thoracic surgery: What you need to know.
J Trauma Acute Care Surg
January 2025
From the Program in Trauma (M.H.G., J.V.O.C., T.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
Article Synopsis
- Damage control surgery in trauma focuses on stabilizing patients quickly to control bleeding and contamination, allowing for resuscitation and correction of critical conditions before more extensive repairs can be made.!
- While damage control techniques for abdominal and extremity injuries are well-established, damage control thoracic surgery presents unique challenges due to complexity, required expertise, and potential complications.!
- Recent advancements in surgical methods, perioperative care, and technologies like extracorporeal membrane oxygenation are improving decision-making and outcomes in damage control thoracic surgery for severe injuries.!
Hypoalbuminemia is a predictor of mortality in patients with cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation.
Perfusion
October 2024
Department of Medicine, University of Maryland School of Medicine, Program in Trauma, Baltimore, MD, USA.
Article Synopsis
- Hypoalbuminemia, or low albumin levels, in critically ill patients, particularly those with cardiac issues, is linked to higher mortality rates, especially when undergoing veno-arterial (V-A) ECMO treatment.
- A study analyzed albumin levels in 318 patients needing V-A ECMO, finding that those with pre-ECMO albumin levels ≤3 g/dL had a significantly higher in-hospital mortality rate (44.9%) compared to those with higher levels (27.5%).
- The research suggests that lower pre-ECMO albumin levels are correlated with not only increased mortality but also more complications, like the need for platelet transfusions and gastrointestinal bleeding, indicating that albumin levels could
Area Deprivation Index as a proxy for socioeconomic status in outpatient orthopaedic surgery patients - A prospective registry cross sectional study.
J Orthop
February 2025
Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Background: We aimed to determine if Area Deprivation Index (ADI) is associated with self-reported metrics socioeconomic status (SES), and to assess the relationship between ADI and preoperative score on common patient reported outcome scores (PROS).
Methods: Patients presenting for outpatient orthopaedic surgery completed Patient-Reported Outcome Metric Information System (PROMIS) and joint-specific PROS. ADI was determined from geocoded home address.
Timing of radiographic healing for distal femur fractures treated with intramedullary nails.
J Orthop Trauma
September 2024
University of California, Los Angeles.
Article Synopsis
- This study evaluated modified Radiographic Union Scale for Tibia (mRUST) scores over time in patients with distal femur fractures treated with intramedullary nails, to identify factors influencing healing and possible reoperation.
- Conducted in ten Level I Trauma Centers, the research included 155 fractures from 152 patients, focusing on mRUST scores at 3, 6, and 12 months post-surgery, with the primary goal of finding predictors for union timing.
- Results showed that a 3-month mRUST score of ≤8 indicated a higher chance of reoperation, and factors such as tobacco use and open fractures correlated with delayed healing times.
Resuscitative endovascular balloon occlusion of the aorta in the patient with obesity.
J Trauma Acute Care Surg
January 2025
From the Division of Trauma and Critical Care, Department of Surgery (M.L., J.M.B., L.M., J.T.S., D.T., P.M., S.T., O.J., J.D.), Tulane University School of Medicine, New Orleans, Louisiana; and R Adams Cowley Shock Trauma Center (J.D.), University of Maryland Medical Center, Baltimore, Maryland.
Background: Palpation of anatomic landmarks is difficult in patients with obesity, which could increase difficulty of achieving femoral access and resuscitative endovascular balloon occlusion of the aorta (REBOA) placement. The primary aim of this study was to examine the association between obesity and successful REBOA placement. We hypothesized that higher body mass index (BMI) would decrease first-attempt success and increase time to successful aortic occlusion (AO).
View Article and Find Full Text PDFA machine learning-based Coagulation Risk Index predicts acute traumatic coagulopathy in bleeding trauma patients.
J Trauma Acute Care Surg
September 2024
From the Department of Anesthesiology (J.E.R., S.Y., P.H.), Department of Surgery (S.Y., R.A.K., T.M.S., P.H.), Shock, Trauma, and Anesthesia Research (R.A.K.), University of Maryland School of Medicine (J.E.R., S.Y., R.A.K., T.M.S., P.H.), Program in Trauma (J.E.R., S.Y., R.A.K., T.M.S., P.H.), R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
Article Synopsis
- Acute traumatic coagulopathy (ATC) occurs shortly after injury and is associated with higher risks of massive transfusion and mortality in trauma patients.
- A machine learning-based Coagulation Risk Index (CRI) was developed to predict ATC using continuous vital signs recorded during the first 15 minutes after a patient’s admission to a trauma center.
- The CRI showed high accuracy in predicting ATC, achieving true positive rates of over 90% for different levels of international normalized ratio (INR), indicating its effectiveness for early identification of coagulopathy in bleeding trauma patients.
Comments on "A Shorter Door-in-Door-out Time Is Associated with Improved Outcome in Large Vessel Occlusion Stroke".
West J Emerg Med
September 2024
University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
Lighting the way forward: using resonance Raman spectroscopy to non-invasively assess tissue perfusion.
Trauma Surg Acute Care Open
September 2024
R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
SARS-CoV-2 infection perturbs the gastrointestinal tract and induces modest microbial translocation across the intestinal barrier.
J Virol
October 2024
Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Article Synopsis
- SARS-CoV-2 not only infects the respiratory system but also causes gastrointestinal (GI) symptoms, leading researchers to study its GI effects in both rhesus macaques and humans.
- In macaques, infection resulted in viral RNA found in both the respiratory tract and stool, along with decreased levels of certain immune cells in the intestine, suggesting immune disturbance.
- The study highlighted the translocation of bacteria across the gut barrier during infection and noted that humans recovering from COVID-19 showed decreases in inflammatory markers, indicating a resolution of inflammation linked to GI issues.
The Role of Troponin Testing in Patients with Supraventricular Tachycardia, Systematic Review and Meta-Analysis.
J Emerg Med
November 2024
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
Background: Supraventricular tachycardia (SVT) is commonly evaluated in the emergency department (ED). While troponin has been shown to be elevated in SVT, its usefulness for predicting coronary artery disease and future adverse cardiovascular outcomes has not been shown.
Objectives: We aimed to evaluate the prognostic utility of troponin measurement as part of SVT management in the ED.
Tricuspid Annular Plane Systolic Excursion (TAPSE) in COPD Patients, A Systematic Review and Meta-Analysis.
Clin Exp Emerg Med
September 2024
Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Introduction: Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic parameter that serves as a prognostic indicator for severity of COPD clinical course. This study, consisting of a systematic review and meta-analysis, evaluates the current literature to elucidate the relationship between TAPSE measurement in COPD patients versus control subjects to discern baseline evidence of right heart strain.
Methods: PubMedTM, ScopusTM, CINAHL, Web of Science, and Cochrane Review databases were searched from their beginning through November 1, 2023, for eligible studies.
Comments on "Opioid Prescribing by Emergency Physicians: Trends Study of Medicare Part D Prescriber Data 2013-2019".
J Emerg Med
October 2024
Department of Emergency Medicine, Wellspan York Hospital, York, Pennsylvania.
The Impact of the Critical Care Resuscitation Unit on Quaternary Care Accessibility for Rural Patients: A Comparative Analysis.
Crit Care Res Pract
August 2024
Department of Emergency Medicine University of Maryland School of Medicine, Baltimore, MD, USA.
Background: Previous research suggests that patients from rural areas who are critically ill with complex medical needs or require time-sensitive subspecialty interventions face worse healthcare outcomes and delays in care when compared to those from urban areas. The critical care resuscitation unit (CCRU) at our quaternary care center was established to expedite the transfer of critically ill patients or those who need time-sensitive intervention. This study investigates if disparities exist in treatments and outcomes among patients transferred to the CCRU from rural versus urban hospitals.
View Article and Find Full Text PDFIs the Orthopaedic Trauma Association-Open Fracture Classification (OTA-OFC) Better than the Gustilo-Anderson Classification at Predicting Fracture-Related Infections in the Tibia?
J Orthop Trauma
August 2024
Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.
Objectives: To investigate and compare the predictive ability of the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) and the Gustilo-Anderson classification systems for fracture-related infections (FRI) in patients with open tibia fractures.
Methods: Design: Retrospective cohort study.
Setting: Academic trauma center.
Risk factors for infection in severe open tibial shaft fractures.
Injury
November 2024
Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address:
Objective: To evaluate risk factors for infection in severe open tibial shaft fractures.
Methods: A secondary analysis of a multicenter prospective study investigated internal versus external fixation of severe open tibia fractures at 20 US Level I trauma centers. Adult patients, aged <65 years, with a Gustilo-Anderson Type IIIB or severe IIIA metaphyseal or diaphyseal tibia fracture were included.