Poly-trauma History Research Articles

Lungs from polytrauma donors with significant chest trauma can be safely used for transplantation

BackgroundThe use of organs from polytrauma donors for lung transplantation is controversial in the literature. For many centers, the radiologic manifestation of lung contusions is a clear reason to reject an organ offer. This results in the loss of potentially viable organs for the donor pool. MethodsWe analyzed 1152 donor lungs procured by our transplant center between January 2010 and June 2018. These included 118 lungs with a history of polytrauma involving the chest. Sixteen polytrauma donor lungs were rejected after procurement. A total of 102 lungs were transplanted, divided into 2 groups: the polytrauma contusion group (n = 44), comprising polytrauma donors with radiologic signs of lung contusion at the time of offer, and the polytrauma clear group (n = 58), comprising polytrauma donors without lung contusion. Nontrauma donor lungs transplanted during the study period were assigned to a polytrauma control group (n = 650). Short- and long-term outcomes of the 3 groups were compared. ResultsBasic demographic data and preoperative factors were similar in the 3 groups. Rates of primary graft dysfunction grade 3 at 72 hours did not differ among the 3 groups (0.0% vs 3.4% vs 3.9%; P = .409). The duration of ventilation was similar the 3 groups: 45 hours (interquartile range [IQR], 28-94 hours), 37 hours (IQR, 22-71 hours), and 42 hours (IQR, 22-96 hours), respectively (P = .674). Long-term graft survival was not impaired in the trauma groups compared with controls. One-year survival rates were 84.1% for the polytrauma contusion group, 93.1% for the polytrauma clear group, and 83.1% for the no polytrauma group. Five-year graft survival in the 3 groups was 74.7%, 87.2%, and 70.0%, respectively. ConclusionsLung transplantation using organs from polytrauma donors is associated with similar short- and long-term results as transplantation from nontrauma donors. The presence or absence of radiologic signs of lung contusion at the time of offer has no impact on primary graft function and long-term survival.

Vacuum-assisted Closure in Integration of Skin Graft Over Scalp Wounds: A Randomised Control Trial.

To compare outcome of split thickness graft with and without vacuum-assisted closure over the scalp soft tissue defects in terms of graft take and complications. Randomised controlled trial. Department of Plastic Surgery, Jinnah Burns and Reconstructive Surgery Centre, Lahore, from June 2017 to June 2018. Patients with scalp soft tissue defects were recruited for the study. Patients with history of poly trauma, hypertension and diabetes mellitus were excluded. Patients were randomly divided into two groups by balloting lottery method. In group A, simple dressing were done after split thickness skin graft; and into group B, VAC dressing was applied after split thickness skin graft. Outcome variables (graft take and complications rate at recipient site) were assessed clinically at 2 weeks and analysed by Chi-square test with p-value <0.05 was taken as significant. Mean age of 120 patients was 33.44 ±14.65 years. Graft take was seen in 24 (40.0%) patients in group A and in 56 (93.3%) patients in group B (p = 0.0001). Seroma was recorded in eight (13.3%) in group A (simple dressing) patients and one patient (1.67%) in group B (VAC dressing, p = 0.015), hematoma was seen in 04 (6.67%) versus 0 (0.0%), respectively (p = 0.042) and graft edge dehiscence in 03 (5.0%) versus 0 (0.0%), respectively (p = 0.079). Outcome of split skin graft over scalp soft tissue defects with VAC dressing is better than simple dressing in terms of graft take and complications rate.

Splenogonadal fusion. A case report.

Splenogonadal fusion is a rare anomaly consisted of abnormal connection between spleen and gonad or derivatives of the mesonephros. It is usually presented as a painless scrotal mass in children, adolescents or men younger than 25 yoa. In most of the cases the diagnosis is made at pathologic examination of the removed tissue. The scarceness of reports in the literature underlines the rarity of this entity. Here we report a case of splenogonadal fusion in a 19-year-old male with a torsed testicle and history of polytrauma.

A rare pleural effusion in a young male.

A 28-year-old male presented with fever with right-sided chest pain for 2 weeks. Clinicoradiological picture was suggestive of right-sided pleural effusion. He had history of polytrauma following a road traffic accident and had to undergo emergency laparotomy a month ago. Microscopic and culture examination of the pleural fluid showed neutrophilia, high bilirubin content and presence of gram-negative bacilli. Ultrasound of the abdomen showed the presence of biloma in the liver and right subdiaphragmatic space with fistulous communication into the right thoracic cavity. The patient was managed successfully with complete recovery.

Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing: A Case Report.

Riviere, Charles MD1; Lavigne, Martin MD, MSc, FRCS1; Alghamdi, Ahmed MD, FRCS1; Vendittoli, Pascal-André MD, MSc, FRCS1 Author Information

A Correlative Study of the Spine Impairment Rating, The Pain Disability Status, and The Physical Performance Status of Individuals with Poly-Trauma History and with a Spine Impairment: Impact on Life Care Planning

PM&RVolume 5, Issue 9S p. S298-S298 Pain and Spine Medicine A Correlative Study of the Spine Impairment Rating, The Pain Disability Status, and The Physical Performance Status of Individuals with Poly-Trauma History and with a Spine Impairment: Impact on Life Care Planning Armando Miciano MD, Armando Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author Armando Miciano MD, Armando Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author First published: 17 September 2013 https://doi.org/10.1016/j.pmrj.2013.08.538Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume5, Issue9SSeptember 2013Pages S298-S298 RelatedInformation

A correlative study of the spine impairment rating, the pain disability status, and the physical performance status of individuals with poly-trauma history over two years and with a spine impairment

A correlative study of the spine impairment rating, the pain disability status, and the physical performance status of individuals with poly-trauma history over two years and with a spine impairment

Poster 361 A Correlative Study of the Self-Reported Pain Disability Questionnaire, From the AMA Guides 6th Edition, and the Clinician-Derived Functional Performance Tests on Individuals With Poly-Trauma History > 2 Years and With Chronic Pain: Case Series

PM&RVolume 4, Issue 10S p. S313-S313 2012 AAPM&R Annual Assembly Abstract Poster 361 A Correlative Study of the Self-Reported Pain Disability Questionnaire, From the AMA Guides 6th Edition, and the Clinician-Derived Functional Performance Tests on Individuals With Poly-Trauma History > 2 Years and With Chronic Pain: Case Series Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorChad Cross PhD, PStat(R), Chad Cross PhD, PStat(R) Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorMonique David RN, Monique David RN Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorChad Cross PhD, PStat(R), Chad Cross PhD, PStat(R) Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorMonique David RN, Monique David RN Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author First published: 23 October 2012 https://doi.org/10.1016/j.pmrj.2012.09.972Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume4, Issue10SOctober 2012Pages S313-S313 RelatedInformation

Poster 362 A Correlation of the Psychosocial Distress Status and the Physical Performance of Individuals With Poly-Trauma History >2 Years and Chronic Pain

PM&RVolume 4, Issue 10S p. S313-S314 2012 AAPM&R Annual Assembly Abstract Poster 362 A Correlation of the Psychosocial Distress Status and the Physical Performance of Individuals With Poly-Trauma History >2 Years and Chronic Pain Armando S. Miciano MD, Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author Armando S. Miciano MD, Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author First published: 23 October 2012 https://doi.org/10.1016/j.pmrj.2012.09.973Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume4, Issue10SOctober 2012Pages S313-S314 RelatedInformation

Poster 478 Permanent Impairments Due to Spine Disorder in Individuals With Poly-Trauma History and Chronic Pain, According to AMA Guides 6th Edition

Poster 478 Permanent Impairments Due to Spine Disorder in Individuals With Poly-Trauma History and Chronic Pain, According to AMA Guides 6th Edition

Poster 477 The Functional Status Due to Pain-Related Impairments, According to the AMA Guides 6th Ed., and the Physical Performance Status of Subjects With a > 2-Year Poly-Trauma History and With a Spine Impairment: A Descriptive Case Study

PM&RVolume 4, Issue 10S p. S353-S353 2012 AAPM&R Annual Assembly Abstract Poster 477 The Functional Status Due to Pain-Related Impairments, According to the AMA Guides 6th Ed., and the Physical Performance Status of Subjects With a > 2-Year Poly-Trauma History and With a Spine Impairment: A Descriptive Case Study Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorChad Cross PhD, PStat(R), Chad Cross PhD, PStat(R) Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this authorChad Cross PhD, PStat(R), Chad Cross PhD, PStat(R) Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author First published: 23 October 2012 https://doi.org/10.1016/j.pmrj.2012.09.1081Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume4, Issue10SOctober 2012Pages S353-S353 RelatedInformation

Gastrointestinal: PEG feeding tube migration into the colon; a late manifestation

A 53 year-old man presented with a 5-month history of severe diarrhoea and abdominal cramping immediately occurring after tube feeding. The Percutaneous Endoscopic Gastrostomy (PEG) tube was inserted 2 years previously, for enteral feeding, following diagnosis of an oropharyngeal carcinoma. The patient had no signs or symptoms of peritonitis. The skin surrounding the tube was inflamed with brown odorous fluid exuding. Upon checking the tube position using upper endoscopy no inner bumper was seen within the stomach. A fistulogram through the feeding tube revealed typical haustration of the colon rather than expected gastric appearances (Figure 1A). CT confirmed misplacement, localizing the position of the bumper in the transverse colon (Figure 1B, arrow). A gastrocolic fistula could not be visualized. Colonoscopy showed the inner bumper located near the splenic flexure (Figure 2A). The colon surrounding the inner bumper showed a soft tissue proliferation which was histologically identified as heterotopic gastric tissue (Figure 2B, arrows). The tube was removed endoscopically using a wire loop. Subsequently, a new PEG tube was inserted using ultrasound guidance. On insertion there were no signs of a persistent colocutaneous or gastrocolic fistula and tube feeding was restarted. Figure 1 Figure 2 Prior to the original PEG tube insertion, this patient had a history of polytrauma and underwent splenectomy. Anatomically, this facilitated an interposition of the colon between the anterior abdominal wall and the stomach. This, potentially, resulted in the placement of the initial PEG tube transcolonically on its way into the stomach, causing the development of an iatrogenic gastrocolic fistula. Over time, the inner PEG bumper imperceptibly migrated from the stomach into the colon, ultimately causing the reported symptoms. The heterotopic gastric tissue around the tube in the colonic wall provides independent proof for this migration. Since introduction of percutaneous endoscopic gastrostomy in 1980 by Gauderer and colleagues, the procedure has become a well-accepted and safe technique for long-term feeding of patients. The technique is performed by puncturing the stomach through the abdominal wall. The gastric wall is visualized through the abdominal wall by transillumination using a gastroscope and a fingerprint impression applied to the abdominal wall indents the gastric wall, aiding direct puncture of the needle into the stomach. In general the complication rate is low and migration of a PEG tube into the colon originally positioned in the stomach is an extraordinarily rare complication, typically occurring within days to month after insertion. It has also been found in patients with previous abdominal surgery. Characteristically, symptoms of a colonic PEG migration include sudden onset of diarrhoea and cramping, immediately after tube feeding and an odorous faecal exudate from the stoma. In most cases the PEG tubes can be removed endoscopically with spontaneous closure of the colocutaneous fistula within days. Contributed by

The functional status due to pain-related impairments, according to the AMA Guides 6th Ed., and the physical performance of subjects with a >two-year poly-trauma history and with pain-related impairment: a retrospective cross-sectional study

The functional status due to pain-related impairments, according to the AMA Guides 6th Ed., and the physical performance of subjects with a >two-year poly-trauma history and with pain-related impairment: a retrospective cross-sectional study

P-909 - Correlating the physical performance status and the psychosocial stress of individuals with poly-trauma history >two years and with chronic pain

Objectives were to determine the psychosocial stress (PSS) due to pain-related impairments (PRI) of individuals with polytrauma (PTM) history >two years and chronic pain (CP) using the Psychosocial Distress Status (PDS) sub-construct of the Pain Disability Questionnaire (PDQ), from the AMA Guides 6th Edition. A retrospective study was done in an outpatient rehabilitation clinic on 34 subjects with PTM & CP identified by the Self-Administered Co-Morbidity Questionnaire. PDQ, divided into Functional Status (FS) versus PDS, rated the PRI, and the Physical Performance Tests (PPT) were: Berg Balance Scale (BBS) and 6-Minute Walk Test (6MWT). Pearson correlation coefficients (r) examined PDS and PPT association with alpha of .01 used for statistical tests. Total PDQ outcomes were: 27% mild; 38% moderate; 29% severe; and, 6% extreme PRI. PDQ-PDS ranged 8–55 points, averaging 37 of 60. Statistically significant negative correlation was found between Total PDQ score and: BBS (r = −.577, p = .005), distance (r = −.468, p = .005), metabolic equivalents METs (r = −.482, p = .004), & speed (r = −.447, p = .008). PDQ-PDS also had a statistically significant negative correlation with BBS (r = −.472, p = .005), while PDQ-FS was negatively correlated with: BBS (r = −.596, p = .001), distance (r=−.539, p = .001), METs (r = −.545, p = .001), and speed (r = −.527, p = .001). Most Poly-Trauma subjects had moderate PRI, fair dynamic gait, and mild balance deficits, which was negatively affected by PSS. Findings suggest that the self-reported PDQ-PDS reliably indicates physical performance of PTM subjects with CP, and would be helpful as a PPT alternative in a clinical practice. Further research into its application amongst other patient populations would be beneficial.

Early presentation of postintubation tracheoesophageal fistula: Perioperative anesthetic management

Tracheoesophageal fistula (TEF) in adults occurs as a result of trauma, malignancy, cuff-induced tracheal necrosis from prolonged mechanical ventilation, traumatic endotracheal intubation, foreign body ingestion, prolonged presence of rigid nasogastric tube, and surgical complication. Anesthetic management for repair of TEF is a challenge. Challenges include difficulties in oxygenation or ventilation resulting from placement of endotracheal tube in or above the fistula; large fistula defect causing loss of tidal volume with subsequent gastric dilatation, atelactasis, and maintenance of one lung ventilation. The most common cause of acquired nonmalignant TEF is postintubation fistula, which develops after prolonged intubation for ventilatory support. Acquired TEF, which occurs after prolonged intubation, usually develops after 12–200 days of mechanical ventilation, with a mean of 42 days. We present a rare case of TEF that developed after 7 days of intubation. It was a difficult case to be diagnosed as patient had a history of polytrauma, followed by emergency intubation and both these conditions can contribute to tracheobronchial injury.

The Functional Status Due to Pain-Related Impairments, According to the AMA Guides 6th Ed., and the Physical Performance Status of Subjects with a >Two-Year Poly-Trauma History and with a Spine Impairment: a Descriptive Case Study

The Functional Status Due to Pain-Related Impairments, According to the AMA Guides 6th Ed., and the Physical Performance Status of Subjects with a >Two-Year Poly-Trauma History and with a Spine Impairment: a Descriptive Case Study

Poster 303 Direct Medical Costs of Opioid Management and the Functional Status of Subjects With Polytrauma History >2 Years and Chronic Noncancer Pain: Impact on Health Care Utilization and Life Care Planning

PM&RVolume 3, Issue 10S1 p. S277-S277 2011 AAPM&R Annual Assembly Abstract Poster 303 Direct Medical Costs of Opioid Management and the Functional Status of Subjects With Polytrauma History >2 Years and Chronic Noncancer Pain: Impact on Health Care Utilization and Life Care Planning Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author Armando S. Miciano MD, Armando S. Miciano MD Nevada Rehabilitation Institute, Las Vegas, NV, United StatesSearch for more papers by this author First published: 22 October 2011 https://doi.org/10.1016/j.pmrj.2011.08.331Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume3, Issue10S1September 2011Pages S277-S277 RelatedInformation

Poster 311 A Correlative Study of the Self-reported Ratings Determining Impairment Associated With Pain, From the AMA Guides 5th Edition, and the Clinician-derived Physical Performance Tests on Individuals With Polytrauma History and With Chronic Pain: Case Series

Poster 311 A Correlative Study of the Self-reported Ratings Determining Impairment Associated With Pain, From the AMA Guides 5th Edition, and the Clinician-derived Physical Performance Tests on Individuals With Polytrauma History and With Chronic Pain: Case Series

Direct medical costs of pain specialist visits, the multi-morbidity burden, pain-related impairment, and the physical performance on subjects with poly-trauma history &gt;two years and chronic non-malignant pain: impact on life care planning

Direct medical costs of pain specialist visits, the multi-morbidity burden, pain-related impairment, and the physical performance on subjects with poly-trauma history &gt;two years and chronic non-malignant pain: impact on life care planning

A correlative study of the self-reported Pain Disability Questionnaire, from the AMA Guides 6th Edition, and the clinician-derived Physical Performance Tests on Individuals with poly-trauma history &gt;two years and with chronic pain: case series

A correlative study of the self-reported Pain Disability Questionnaire, from the AMA Guides 6th Edition, and the clinician-derived Physical Performance Tests on Individuals with poly-trauma history &gt;two years and with chronic pain: case series