J Trauma
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized, prospective comparison of increased preload versus inotropes in the resuscitation of trauma patients: effects on cardiopulmonary function and visceral perfusion.
To evaluate the effects of maintaining increased levels of preload on cardiopulmonary function and visceral perfusion during resuscitation. ⋯ Patients resuscitated at higher levels of preload have significantly better visceral perfusion than those resuscitated at normal preload with addition of inotropes. This higher preload does not adversely affect pulmonary function.
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To determine whether there is an association between criminal activity and preference for a particular class of handgun among young adults who purchase handguns legally. ⋯ In this population, criminal activity both before and after handgun purchase was associated with a preference for small, inexpensive handguns.
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Nonunion of the pelvic bones is uncommon. It may be under-diagnosed because of the difficulty in visualization of the fracture and interpretation with conventional radiography. The authors report four cases of nonunion involving the pelvic bones. ⋯ The two patients with nonunion of the anterior iliac crest had major displacement caused by muscle pull. Pain on weight-bearing and awkward gait were common symptoms. All patients required surgical management for symptomatic relief.
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Sepsis and multisystem organ failure are common after hemorrhagic shock. The aims of this study were to determine whether hemorrhagic shock would promote the translocation of bacteria and if it correlates with clinical outcome in patients with blunt abdominal trauma. ⋯ We conclude that BT occurs after blunt abdominal trauma in humans and correlates with the presence of hemorrhagic shock, but the clinical significance of BT in trauma patients remains unclear.