J Trauma
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The association of methamphetamine exposure and outcomes after trauma is not known. ⋯ Patients exposed to Methamphetamines do not have increased mortality or complications or lengths of ICU and hospital stay. However, they are more likely to require admission to the ICU.
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Randomized Controlled Trial Multicenter Study Comparative Study
Phase I/II clinical evaluation of StrataGraft: a consistent, pathogen-free human skin substitute.
Large wounds often require temporary allograft placement to optimize the wound bed and prevent infection until permanent closure is feasible. We developed and clinically tested a second-generation living human skin substitute (StrataGraft). StrataGraft provides both a dermis and a fully-stratified, biologically-functional epidermis generated from a pathogen-free, long-lived human keratinocyte progenitor cell line, Neonatal Immortalized KeratinocyteS (NIKS). ⋯ The major finding of this phase I/II clinical study is that performance of StrataGraft skin substitute was comparable to cadaver allograft for the temporary management of complex skin defects. StrataGraft skin substitute may also eliminate the risk for disease transmission associated with allograft tissue and offer additional protection to the wound bed through inherent antimicrobial properties. StrataGraft is a pathogen-free human skin substitute that is ideal for the management of severe skin wounds before autografting.
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Comparative Study
Comparative study of different intraoperative 3-D image intensifiers in orthopedic trauma care.
Recently, isocentric C-arm fluoroscopy (Iso-C 3D) has been introduced as a precise imaging modality for intraoperative evaluation and management of fractures and osteosyntheses. The Siemens Iso-C 3D collects multiple fluoroscopic images during a 190-degree arc of rotation around the anatomic region of interest and reconstructs them into sagittal, axial, and coronal planes. Like the Iso-C 3D, the new Ziehm Vario 3D imaging system reconstructs images in multiple planes, but only requires a 136-degree arc of rotation. The purpose of this study was to compare the image quality and range of applicability of these two imaging systems. ⋯ Although the Iso-C 3D imaging system was superior in delineating the joint surfaces, the image quality, and the overall clinical applicability, the study revealed that both devices provided 3D images with sufficient quality to the surgeon to assess clinically relevant questions, including the quality of fracture reduction and implant positioning. On the other hand, the Ziehm Vario 3D is capable of doing scans of the shoulder area, which could not be taken with the Siemens Iso-C 3D because of the isocentric design.
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The objective of this study was to determine the optimal use of fresh-frozen plasma (FFP) in trauma. Our hypothesis was that a higher FFP: packed red blood cells (PRBC) ratio is associated with improved survival. ⋯ Higher FFP:PRBC ratio is an independent predictor of survival in massively transfused patients. Aggressive early use of FFP may improve outcome in massively transfused trauma patients.
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Firearms are a major cause of injury and death. We sought to determine (1) the prevalence of movie scenes that depicted firearms and verbal firearm safety messages; (2) the context and health outcomes in firearm scenes; and (3) the association between the Motion Picture Association of America ratings and firearm scene characteristics. ⋯ Depictions of firearms in top revenue-grossing movies were common, but safety messages were exceedingly rare. Major motion pictures present an under-used opportunity for education about firearm safety.