Injury
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In city hospitals, subway-related traumatic amputations are a frequent pattern of injury, however there is a paucity of literature on this specific injury pattern. The purpose of this study was to describe the epidemiology of subway-related traumatic amputations, as well as compare them to non-subway traumatic amputations. ⋯ Prognostic Level III.
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During revision surgery for the management of patients presenting with long-bone upper extremity nonunion, it is crucial to rule out fracture-related infection (FRI). This is especially true if there are clinical signs suggestive of FRI, or if there is a history of prior FRI, open wound fracture, or surgery. This study aimed to determine the efficacy of frozen section analysis (FSA) in providing real-time diagnosis of FRI in patients with upper-limb long-bone nonunion undergoing revision surgery. ⋯ FSA showed high sensitivity and specificity for the detection of active infection during revision surgery for nonunion of the upper limb. Owing to its high negative predictive value, it can reliably rule out active infections during revision surgery. Since the results are obtained immediately during revision surgery, this approach offers the significant advantage of enabling real-time decision-making.
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Prior research suggests that plasma may improve outcomes in traumatic brain injury (TBI). We examined the association between plasma administration and mortality in moderate-severe TBI in a large retrospective cohort, hypothesizing plasma is associated with decreased mortality after accounting for confounding covariates. ⋯ Administration of plasma within the first four hours after hospital presentation was not associated with decreased or increased mortality in adult patients with moderate to severe TBI after confounder adjustment. Interaction analysis suggests the presence of hemorrhage improves the effect of plasma on mortality in TBI. This important clinical question should be answered with a prospective randomized study of plasma for nonbleeding patients with TBI.
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Unintentional injuries pose significant challenges to public health, impacting individuals and communities. They also create significant economic costs for society as a whole. Common preventable fatal unintentional injuries among adults of working age include, among others, falls, poisonings, traffic accidents and drowning. ⋯ Fatal unintentional injuries among the working-age population have decreased in Finland due to national collaborative efforts in recent decades. However, preventive measures are still needed, especially to prevent unintentional injuries caused by substance abuse.
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Musculoskeletal injuries enact a substantial burden in military settings, incurring high costs, long-term disability, and impacting military readiness. This has led to a prioritization of injury prevention programs. Understanding the challenges faced by those trying to implement these programs could help standardize and better inform future efforts. The purpose was to capture perceptions of barriers and facilitators to implementation of injury prevention programs in the US Armed Forces. ⋯ Factors leading to incidence and recovery of musculoskeletal injuries are multifactorial, requiring collaborative multidisciplinary approaches for optimal injury prevention program development and implementation. Leadership support/prioritization, unit-level cultural acceptance and sufficient resources are essential facilitators to implementing prevention programs. Developing standardized, relevant metrics for assessing program effectiveness and establishing organizational best practices are necessary for long term program viability and lasting change.