J Trauma
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This study aimed to determine predictive factors of mortality after posttraumatic brain injury. ⋯ In Tunisia, head injury is a frequent cause of hospitalization, comprising 14.4% of all adult admissions. It is observed most often among young patients involved in traffic accidents. The short-term prognosis is poor, with a high (29%) mortality rate, and determined by demographic, clinical, radiologic, and biologic factors. Prevention is highly advised.
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Free abdominal fluid on ultrasound in unstable pelvic ring fracture: is laparotomy always necessary?
In unstable pelvic ring fractures free abdominal fluid on ultrasound (US) may be caused by retroperitoneal hematoma that passes into the abdominal cavity or by an additional intraabdominal lesion. In this study a clinical pathway for the therapy of potentially combined lesions was analyzed. ⋯ The finding of intraperitoneal fluid on US in the emergency department strongly correlates with significant intraabdominal lesions requiring surgical intervention. Early laparotomy appears indicated in these cases. Shock control in pelvic bleeding can be sufficiently achieved by internal tamponade and external fixation.
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Comparative Study
Chemiluminescence: comparison of whole blood with isolated polymorphonuclear leukocytes after major trauma.
Neutrophil (PMN) mediated tissue injury is central to the development of post-traumatic ARDS/MOF. Changes in activity caused by PMN isolation may be avoided by studying respiratory burst activity using whole blood chemiluminescence (WBCL). ⋯ PMN isolation alters behavior in vitro. This may lead to important differences of in vivo PMN function being obscured when studied in the laboratory setting. Further study of CL response and surface receptor expression is clearly warranted, both in WB and PMN preparations.
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This study aimed to determine whether nonsurgical management using transcatheter arterial embolization (TAE) is safe for patients with blunt multiple trauma who transiently respond to the initial fluid resuscitation. ⋯ Nonsurgical management using TAE can be performed safely even for patients with blunt multiple trauma who are in hemorrhagic hypotension if their hemodynamics are improved by resuscitation with 2 L of fluid.
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The Forward Army Surgical Team (FST) was designed to provide surgical capability far forward on the battlefield to stabilize and resuscitate those soldiers with life and limb threatening injuries. Operation Iraqi Freedom represents the largest military operation in which the FST concept of health care delivery has been employed. The purpose of our review is to describe the experience of the 555FST during the assault phase of Operation Iraqi Freedom. ⋯ Majority of the life threatening injuries evaluated involved EPWs. A combination of body armor and armored vehicles used by U.S. soldiers limited the number of torso injuries presenting to the FST. Early resuscitation and stabilization of U.S. soldiers, EPWs, and civilians can be successfully accomplished at the front lines by FSTs. Further modification of the FST's equipment will be needed to improve its ability in providing far forward surgical care.