J Trauma
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Federal law prohibits firearm possession by felons and certain others. Little is known about criminal activity resulting in new ineligibility to possess firearms among persons who have previously purchased them. ⋯ Among legal purchasers of handguns, the incidence of new felonious and violent criminal activity resulting in ineligibility to possess firearms is low for those with no prior criminal history but is substantially higher for those with a prior criminal record and is affected by demographic characteristics.
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Comparative Study
Ventilator-associated pneumonia in trauma patients is associated with lower mortality: results from EU-VAP study.
Differences in trauma patients developing ventilator-associated pneumonia (VAP) are described regarding etiology and risk factors associated. We aim to describe the differences in outcomes in trauma and nontrauma patients with VAP. ⋯ Trauma patients developing VAP had different demographic characteristics and episodes of etiology. After adjustment for potential confounders, VAP episodes in trauma patients are associated with lower mortality when compared with nontrauma patients.
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The differentiation between anteroposterior compression (APC)-I and APC-II pelvic fracture patterns is critical in determining operative versus nonoperative treatment. We instituted a protocol in which a stress examination was performed for patients presenting with an APC-I injury diagnosed with static radiographs to reveal the true extent of the injury. ⋯ Measurements of symphyseal diastasis can significantly vary depending on the radiographic modality (CT vs. plain films) and during application of a stress force. The use of stress examination under general anesthesia in the acute setting of pelvic injury can be beneficial in accurately diagnosing the severity of injury and choosing appropriate treatment.
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Catecholamine surge after traumatic brain injury (TBI) is associated with infectious morbidity and potentially preventable mortality. Previous studies have supported the protective effect of beta-adrenergic blockade in patients with TBI. We hypothesize that suppression of the catecholamine surge in multiple-injured TBI patients with beta-adrenergic blockade decreases mortality. ⋯ BB are associated with significantly reduced mortality in patients with TBI. This simple, inexpensive intervention may have a profound effect on mortality in this population of injured patients and requires further prospective study.
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The ability to detect damage to the intervertebral structures is critical in the management of patients after blunt trauma. A practical and inexpensive method to identify severe structural damage not clearly seen on computed tomography would be of benefit. The objective of this study was to assess whether ligamentous injury in the subaxial cervical spine can be reliably detected by analysis of lateral radiographs taken with and without axial traction. ⋯ This study supports further clinical investigations to determine whether low-level axial traction may be a useful adjunct for detecting unstable subaxial cervical spine injuries in an acute setting.