Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2011
Physiological assessment of the polytrauma patient: initial and secondary surgeries.
The timing of fracture fixation in polytrauma patients has been debated for a long time. The decision between DCO (damage control orthopaedics) and ETC (early total care) is a difficult dilemma. Overzealous ETC in haemodynamically compromised patients with significant chest and head injuries can be detrimental. ⋯ The literature shows equivocal evidence for both settings. This article will summarize the historical background and controversies regarding patient assessment and decision making during the treatment of polytrauma patients. It will also give guidance for choosing DCO versus ETC in the clinical setting.
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Eur J Trauma Emerg S · Dec 2011
Mesenchymal stem cell (MSC) and endothelial progenitor cell (EPC) growth and adhesion in six different bone graft substitutes.
Several different synthetic and allograft bone graft substitutes are used clinically to treat large bone defects. In contrast to the "gold standard" of autologous bone grafts, these do not contain bone-forming (MSC) or vessel-forming (EPC) cells. In order to achieve the same level of success enjoyed by autologous bone grafts, they must be compatible with mesenchymal stem cells (MSC) and endothelial progenitor cells (EPC). In a previous study, we seeded MSC onto six different bone graft substitutes and then measured the cell adhesion, viability, differentiation, and morphology. In the present study, we seeded both MSC and EPC onto the same six bone graft substitutes and measured the same parameters. ⋯ When bone graft substitutes are used to help fill large defects, it is important that their interaction with these cells be supportive of bone healing.
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Eur J Trauma Emerg S · Dec 2011
Effective teaching modifies medical student attitudes toward pain symptoms.
Recent studies have raised the question of whether last year medical students and first year residents show an adequate attitude toward their patient's pain as reflected by prescribed pain medication. Underuse of analgetics could be demonstrated in several studies even after a correct diagnosis of pain was made and has led to the term "oligoanalgesia." Our study was aimed at evaluating the potential of improving student attitudes toward pain by changing the curriculum during the last year of medical education. ⋯ Our results confirm the importance of humanistic attitudes in future doctors in addition to the traditional implementation of knowledge and skills. Changes in the medical curriculum can positively influence these attitudes.
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Eur J Trauma Emerg S · Dec 2011
Endoscopic thoracic sympathectomy for posttraumatic complex regional pain syndrome.
Posttraumatic complex regional pain syndrome (CRPS) has a strongly negative impact on rehabilitation and activities of daily living. Treatment is most often unrewarding. ⋯ ETS is effective at decreasing pain and improving quality of life, and should therefore be considered in the treatment of CRPS.