J Trauma
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Despite numerous studies analyzing this topic, specific advantages of helicopter transport of blunt polytrauma patients as compared with ground ambulances have not yet been identified unequivocally. ⋯ Primary transfer by HEMS into a Level I trauma center reduces mortality markedly. In principle, this benefit can be attributed to superior preclinical therapy, primary admission to a Level I trauma center, or both. However, the identical probability of survival of the AMB-UNI and HEMS-UNI groups in this and comparable studies does not confirm generally better survival rates on account of a more aggressive on-site approach.
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Insight into the distribution and determinants of both short- and long-term disability can be used to prioritize the development of prevention policies and to improve trauma care. We report on a large follow-up study in a comprehensive population of injury patients. ⋯ Injury is a major source of disease burden and work absence. Both hospitalized and nonhospitalized patients contribute significantly to this burden.
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Randomized Controlled Trial Clinical Trial
The long-term effect of oxandrolone on hepatic acute phase proteins in severely burned children.
Acute phase protein production is a hallmark of severe burns. We wondered whether anabolic treatment with oxandrolone would affect these proteins. ⋯ Treatment with oxandrolone in severe burns significantly increases constitutive protein and reduces acute phase protein levels.
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Blunt cerebrovascular artery injury (BCI) remains difficult to diagnose but is recognized with increasing frequency after motor vehicle collisions (MVCs). Failure to detect this injury in a timely fashion can be devastating. Criteria that can be used to heighten the suspicion of this injury have been suggested; however, more encompassing screening has been recommended. To address this need, we sought to describe occupant, vehicle, and collision characteristics among MVC occupants who sustained a BCI. ⋯ This study indicates that BCI is both a rare and lethal injury typified by specific occupant and collision characteristics. These characteristics provide insight as to the cause of this injury that may aid in the evaluation and management of the blunt trauma patient at risk for BCI.
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The resources needed and those available to support trauma care for a given region are currently unknown. Resource use and availability were evaluated for injured subjects across a large sample of the United States. ⋯ A substantial minority of major trauma patients in the United States are treated in nondesignated trauma centers. The variability in the availability of trauma resources indicates a lack of consensus with respect to the resources required for trauma system implementation.