J Trauma
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Many series have found that certain associated injuries occur with greater frequency in patients with scapula fractures than in patients without scapula fractures. However, several of the published series were limited by lack of a control group, inclusion of a patient population limited to the catchment area of one hospital, or inadequate control for injury severity. The goal of this study was to determine whether there was a relationship between scapula fractures and concomitant injury and which injuries related simply to the increased injury severity observed in this patient population. ⋯ III.
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The side of the head is vulnerable to trauma in bicycle injuries. Depreitere et al., demonstrated contact between a flat-faced pendulum, and the side of cadaver heads, when bicycle helmets was worn. ⋯ The tangential velocity component slightly improves the helmet performance, whereas prior shoulder impact on the road decreases the head impact velocity. It is concluded that current helmets provide adequate protection for typical lateral head impacts.
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Randomized Controlled Trial Multicenter Study
Improved survival of critically ill trauma patients treated with recombinant human erythropoietin.
A randomized, double-blind, placebo-controlled, multicenter trial (EPO-2, N = 1,302) in anemic critically ill patients demonstrated a 29-day survival benefit in the trauma subgroup receiving epoetin alfa (mortality 8.9% vs. 4.1%). A second similarly designed trial (EPO-3, N = 1,460) confirmed this survival benefit in the epoetin alfa-treated trauma cohort (mortality 6.7% vs. 3.5%). This analysis presents trauma cohort data from both trials for evaluation of the impact of baseline factors including trauma-specific variables on outcomes. ⋯ Epoetin alfa demonstrated a survival advantage in both of the critically ill trauma patient cohorts of two prospective, randomized clinical trials, which was not affected by baseline factors including trauma-specific variables. A definitive study in trauma subjects is warranted.