Injury
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Infected animal bites and localised infections are traditionally managed by inpatient admission, intravenous antibiotics, and localised washout +/- debridement. Our hand trauma protocol was modified to accommodate the challenges faced in delivering this pathway during the COVID-19 pandemic. ⋯ III.
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Restoring motor function and preventing re-rupture and adhesion during Achilles tendon healing remain significant clinical challenges. Increasing evidence suggests that miRNA plays a crucial role in tendon healing and regeneration. The previously designed nanosphere hydrogel sustained-release system enables targeted, controlled release of drugs. ⋯ Although gross observation suggested that the miR-34a-5p mimic group had a minimal inhibitory effect on the adhesion of Achilles tendon tissue, tension analysis demonstrated that it effectively increased the maximum tensile strength. Additionally, in vitro experiments showed that miR-34a-5p mimic could increase tendon cells proliferation and improve tendon cells viability. This study confirmed the efficacy of the miR-34a-5p nanosphere hydrogel sustained-release system in tendon injury repair, presenting it as a promising treatment strategy for clinical practice.
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The development of national registries from routinely collected health data has transformed the research landscape by improving access to large sample populations. This growing volume of data enables researchers to address critical questions but also challenges clinicians in conducting, evaluating, and applying the research. The National Trauma Data Bank (NTDB), the largest aggregate of deidentified trauma data in the world, is increasingly utilized for retrospective studies on trauma. This scoping review aimed to assess the quality of reporting of NTDB-based orthopedic trauma publications. ⋯ This study highlights the methodological gaps in the NTDB-based orthopedic trauma publications and identifies areas for improvement, including the management of missing data, selection of the study population through data cleaning, identification of sources of bias, and transparency in data accessibility. Future work should test the reproducibility of these studies and evaluate adherence to established guidelines across a broader range of databases and disciplines.
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Review
Management of post-injury anticoagulation in the traumatic brain injury patient: A scoping review.
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality among trauma patients. The care of these patients continues to be a complex endeavor with prevention of associated complications, often requiring as much attention as that of the treatment of the primary injury. Paramount among these are venous thromboembolic events (VTE) due to their high incidence, additive effect on the risk of morbidity and mortality, and the careful balance that must be utilized in their diagnosis and treatment to prevent progression of the brain injury itself. ⋯ The timing of prophylaxis remains important, as the risk of VTE increases with each day that prophylaxis is held. Consensus findings favor initiation within 24-72 h, in the absence of documented progression, life threatening bleeding, or need for major surgical intervention. Despite available data, there continues to be significant variability in practice patterns which we hope to address with this review.