J Trauma
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Recombinant factor VII (rFVII) is an attractive agent to control refractory, coagulopathic bleeding in patients following major surgery. The purpose of this review is to evaluate the published experiences of rFVII in adult, nonhemophilic, surgical and trauma patients. ⋯ Recombinant factor VII is an effective therapeutic agent for achieving hemostasis in nonhemophilic surgical patients. Published clinical experiences, however, are limited to small case series and case reports.
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This follow-up study of consecutive traffic accident victims aimed to characterize the variation in recuperation time, to estimate the incidence of delayed recovery, and to identify predictors of nonrecovery 1 and 6 months after the accident. This study included 318 of 811 consecutive patients. Whiplash type neck injuries (48%) were the most common, followed by other minor injuries (38%). ⋯ With control for mutual confounding variables in a multivariate model, injury severity, working status, and education were associated, respectively, with 4.5-fold, 3.2-fold and 2.3-fold gradients in odds of recovery not reported at 1 month. At 6 months, only working status (odds ratio [OR], 3.2) and education (OR, 2.3) were associated with the risk of reporting nonrecovery. The authors concluded that social factors are important predictors of outcome 1 and 6 months after minor traffic accidents.
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Comparative Study
A prospective comparison of the selective observation and routine exploration methods for penetrating abdominal stab wounds with organ or omentum evisceration.
Both routine laparotomy and selective observation methods have been used in the treatment of penetrating abdominal stab wounds with organ or omentum evisceration. There still are some conflicts about these treatment methods. ⋯ The selective observation method is safe and superior to routine laparotomy for the treatment of penetrating abdominal stab wounds with omentum evisceration.