J Trauma
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Review Meta Analysis
Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis.
This systematic review aimed at evaluating the diagnostic accuracy of pulse examination in detecting surgical arterial lesions associated with knee dislocation. ⋯ Our findings suggest that the isolated presence of abnormal pedal pulses on initial examination of patients with knee dislocations is not sensitive enough to detect a surgical vascular injury. On the basis of this meta-analysis, an algorithm for the evaluation of these patients is presented.
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Comparative Study
When should a chest radiograph be obtained after chest tube removal in mechanically ventilated patients? A prospective study.
The purpose of this study was to determine the appropriate time interval between the removal of a chest tube and the chest radiograph (CXR). We hypothesized that a CXR obtained 1 hour after chest tube removal would exclude the presence of a recurrent pneumothorax. ⋯ A CXR obtained within 1 to 3 hours after chest tube removal effectively identifies pneumothorax in mechanically ventilated patients.
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Comparative Study
Identifying injuries and motor vehicle collision characteristics that together are suggestive of diaphragmatic rupture.
Diaphragmatic rupture (DR) remains a diagnostic challenge because of the lack of an accurate test demonstrating the injury. Our purpose was to identify motor vehicle collision (MVC) characteristics and patient injuries that collectively could identify the presence of a DR. ⋯ Specific MVC characteristics combined with patient injuries have been identified that are highly suggestive of DR. For this subpopulation, additional invasive procedures including exploratory laparotomy, laparoscopy, or thoracoscopy may be warranted to exclude DR.
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Comparative Study
Family impact greatest: predictors of quality of life and psychological adjustment in pediatric burn survivors.
Although there is some knowledge of psychological adjustment, almost nothing is known about quality of life in pediatric burn survivors. ⋯ If given optimal care, most pediatric burn survivors demonstrate excellent quality of life. Families with compromised relationships and patients with higher age at burn injury should be identified early, monitored closely, and offered psychosocial support as soon as dysfunctional family dynamics are detected.
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Comparative Study
The injured child is resistant to multiple organ failure: a different inflammatory response?
Although postinjury multiple organ failure (MOF) is a well-described phenomenon in adults, the incidence of this syndrome in children is unknown. The purpose of this study was to describe the incidence, course, and severity of pediatric postinjury MOF. We hypothesized that the incidence and severity of postinjury MOF in children would be less when compared with adults. ⋯ The incidence of postinjury MOF in the child is less than in the adult, given equivalent injury severity. These observations solidify the contention that postinjury MOF is rare in children, and is less severe when it occurs. Delineating the mechanism(s) whereby children are protected from postinjury MOF may provide insight into the development of strategies to prevent MOF in other age groups as well as various disease states.