J Trauma
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A central question in suicide research is whether firearm availability increases the overall number of suicides rather than the proportion of suicides from guns. ⋯ When it comes to suicide, the availability of household firearms matters-a lot.
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Methylene blue has been used to treat hypovolemic states. This study evaluated prehospital resuscitation after refractory hemorrhagic shock with a combination of methylene blue and limited-volume lactated Ringer's solution. ⋯ Resuscitation after refractory hemorrhagic shock using a combination of methylene blue and limited-volume lactated Ringer's solution improves prehospital survival and hemodynamic stability and reduces ischemic damage in an acute setting. This form of therapy has been proved useful as a temporizing measure for resuscitation after refractory hemorrhagic shock in a canine model and warrants further study for its application to the hemorrhagic trauma patient.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment of complex tibial plateau fractures using the less invasive stabilization system plate: clinical experience and a laboratory comparison with double plating.
Bicondylar tibial plateau fractures are complex injuries, historically associated with high complication rates. The purpose of this study was: 1) to evaluate the clinical use L.I.S.S plating system for stabilization of bicondylar tibial plateau fractures. 2) To compare the biomechanics of this plating system with a double plate construct. ⋯ The L.I.S.S plating system provides stable fixation of complex bicondylar tibial plateau fractures allowing early range of knee motion with favorable clinical results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Early tracheostomy versus prolonged endotracheal intubation in severe head injury.
To see if early tracheostomy (fifth day) reduces duration of mechanical ventilation, ICU stay, incidence of pneumonia and mortality in comparison with prolonged intubation (PI) in patients with head injury. ⋯ In severe head injury early tracheostomy decreases total days of mechanical ventilation or mechanical ventilation time after development of pneumonia.