J Trauma
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Focused assessment with sonography for trauma (FAST) examination has been proved accurate for diagnosing trauma when performed by nonradiologist physicians. Recent reports have suggested that nonphysicians also may be able to perform the FAST examination reliably. A multipurpose ultrasound system is installed on the International Space Station as a component of the Human Research Facility. Nonphysician crew members aboard the International Space Station receive modest training in hardware operation, sonographic techniques, and remotely guided scanning. This report documents the first FAST examination conducted in space, as part of the sustained effort to maintain the highest possible level of available medical care during long-duration space flight. ⋯ It is possible to conduct a remotely guided FAST examination with excellent clinical results and speed, even with a significantly reduced video frame rate and a 2-second communication latency. A wider application of trauma ultrasound applications for remote medicine on earth appears to be possible and warranted.
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The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality. ⋯ HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures.
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Vascularized periosteal flaps (VPFs) are flexible osteogenic flaps, suitable for the reconstruction of small skeletal defects. Pedicled VPFs, harvested near the recipient site, minimize donor-site morbidity and procedure duration. The donor sites and the potential recipient sites for pedicled VPFs of the distal forearm-hand were identified in this study. ⋯ The VPFs identified in this study can be used for the reconstruction of small skeletal defects and for the treatment of osteonecrotic lesions and nonunions of the distal forearm, wrist, and hand. The choice of the most suitable VPF will be based on the anatomic location and the dimensions of the recipient site.