The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2013
Multicenter Study Comparative StudyAnalysis of radiation exposure among pediatric trauma patients at national trauma centers.
Injured children undergo radiologic studies as part of trauma evaluations. Children are more sensitive than adult patients to the effects of ionizing radiation. Few studies have described the radiation exposure to pediatric patients during trauma evaluations. We sought to describe the rate of use of radiology studies and to estimate the effective dose of radiation delivered to pediatric trauma patients presenting to trauma centers within the United States. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Randomized Controlled Trial Comparative StudyPlatelets are dominant contributors to hypercoagulability after injury.
Venous thromboembolic (VTE) disease has a high incidence following trauma, but debate remains regarding optimal prophylaxis. Thrombelastography (TEG) has been suggested to be optimal in guiding prophylaxis. Thus, we designed a phase II randomized controlled trial to test the hypothesis that TEG-guided prophylaxis with escalating low-molecular weight heparin (LMWH), followed by antiplatelet therapy would reduce VTE incidence. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Randomized Controlled Trial Comparative StudyUrinary proteomics analysis for sepsis biomarkers with iTRAQ labeling and two-dimensional liquid chromatography-tandem mass spectrometry.
Proteomics has only recently been applied to the field of critical care research. Sepsis is a major factor contributing to intensive care unit admissions and deaths. The purpose of this study was to screen potential urinary biomarkers for sepsis using A proteomics approach. ⋯ Diagnostic study, level IV.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudySingle-nucleotide polymorphisms in the Toll-like receptor pathway increase susceptibility to infections in severely injured trauma patients.
Sepsis and subsequent multiple-organ failure are the predominant causes of late mortality in trauma patients. Susceptibility and response to infection is, in part, heritable. Single-nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) and cluster of differentiation 14 (CD14) genes of innate immunity may play a key role. The aim of this study was to assess if SNPs in TLR/CD14 predisposed trauma patients to infection. ⋯ Prognostic and epidemiologic study, level II.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyClinical characteristics and surgical outcomes of penetrating external genital injuries.
Penetrating external genital injuries, although uncommon, may present complex problems for the urologic and trauma surgeon. A paucity of data exists on the incidence, clinical characteristics, and management outcomes of these injuries because few institutions have the volume to report their experience. ⋯ Therapeutic study, level IV; epidemiologic study, level IV.