The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Comparative StudyThe effect of care bundle development on surgical site infection after hemiarthroplasty: an 8-year review.
Proximal femoral fracture is the most common reason for emergency orthopedic admission in the United Kingdom with an annual cost of £ 1.7 billion to the National Health Service. Surgical site infection (SSI) after proximal femoral fracture increases patient morbidity and mortality. Methicillin-resistant Staphylococcus aureus (MRSA) poses a particular risk in this patient cohort as a large proportion of these patients are residents of long-term care facilities and are therefore transient or chronic carriers of MRSA. We recorded the effect of three stages of care bundle development on the infection and specifically the MRSA rate after hemiarthroplasty over an 8-year period. ⋯ IV, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyVenous thromboembolism in the elderly: the result of comorbid conditions or a consequence of injury?
Venous thromboembolism (VTE) is a common complication in trauma patients. Several risk factors have been identified that may place patients at in increased risk for VTE including preexisting medical conditions, iatrogenic factors, and injury-related factors. Advanced age has also been implicated as a risk factor for VTE. The purpose of this study was to determine the incidence and outcomes of VTE in geriatric trauma patients as well as to identify risk factors for VTE in this population. ⋯ II, prognostic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyRemote inflammatory response in liver is dependent on the segmental level of spinal cord injury.
Traumatic spinal cord injury (SCI) triggers a systemic inflammatory response (SIR) that contributes to a high incidence of secondary organ complications, particularly after a cervical or high-level thoracic injury. Because liver plays a key role in initiating and propagating the SIR, the aim of this study was to assess the effects that SCI at differing segmental levels has on the intensity of the inflammatory response in the liver. ⋯ Our findings indicate that traumatic SCI triggers an acute SIR that contributes to hepatocellular injury. SCI-induced remote injury/dysfunction to the liver appears to be transient and is more robust after an upper thoracic SCI compared with a lower thoracic SCI.
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J Trauma Acute Care Surg · May 2012
Comparative StudyThe severity of brain damage determines bone marrow stromal cell therapy efficacy in a traumatic brain injury model.
Patients who survive traumatic brain injury (TBI) can undergo serious sensorial and motor function deficits. Once damage occurs, there is no effective treatment to bring patients to full recovery. Recent studies, however, show bone marrow stromal cells (BMSC) as a potential therapy for TBI. ⋯ These findings suggest that the severity of neurologic damage may determine the potential effect of cell therapy when applied to chronically established TBI.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative Study Controlled Clinical TrialSerum levels of ubiquitin C-terminal hydrolase distinguish mild traumatic brain injury from trauma controls and are elevated in mild and moderate traumatic brain injury patients with intracranial lesions and neurosurgical intervention.
This study compared early serum levels of ubiquitin C-terminal hydrolase (UCH-L1) from patients with mild and moderate traumatic brain injury (TBI) with uninjured and injured controls and examined their association with traumatic intracranial lesions on computed tomography (CT) scan (CT positive) and the need for neurosurgical intervention (NSI). ⋯ II, prognostic study.