J Trauma
-
Rib fractures have a strong association with nonaccidental trauma (NAT) and severe trauma. The purposes of this study were to evaluate rib fractures in children to determine (1) the positive predictive value of a rib fracture in defining NAT and (2) the frequency of rib fractures as the only skeletal manifestation of NAT. ⋯ In this study, rib fracture(s) were the only skeletal manifestation of NAT in 29% of the children.
-
Comparative Study
Hypertonic saline improves tissue oxygenation and reduces systemic and pulmonary inflammatory response caused by hemorrhagic shock.
The treatment of hemorrhagic shock (HeS) with large volumes of fluid does not ensure an adequate peripheral perfusion or prevent inflammatory activation despite hemodynamic recovery. The purpose of this study was to compare the effect of hypertonic saline (HTS) and isotonic saline (IS) solutions on oxygenation, perfusion, tumor necrosis factor-alpha and interleukin-6 levels, accumulation of polymorphonuclear neutrophils, and pulmonary perivascular edema in the treatment of controlled HeS in rats. ⋯ HTS improved tissue oxygenation and perfusion and reduced systemic and pulmonary inflammatory responses compared with IS in the treatment of HeS in rats.
-
Comparative Study Clinical Trial
Rib fracture pain and disability: can we do better?
The purpose of this study was to determine the magnitude and duration of pain and disability in patients with rib fractures treated using current standard therapy. This was a prospective case series. ⋯ Rib fractures are a significant cause of pain and disability in patients with isolated thoracic injury and in patients with associated extrathoracic injuries. Developing new therapies to accelerate pain relief and healing would substantially improve the outcome of patients with rib fractures.
-
Comparative Study
Human polymorphonuclear cell death after exposure to resuscitation fluids in vitro: apoptosis versus necrosis.
Resuscitation fluids can have variable effects on key functions of circulating polymorphonuclear neutrophils (PMNs) such as oxidative burst, chemotaxis, and bacterial killing. We hypothesized that choice of resuscitation fluids will also affect the rate of PMN apoptosis. To test this, we studied cellular death (apoptosis and necrosis) in human PMNs after brief exposure to different hypertonic and isotonic fluids. ⋯ Hypertonic fluids and dextran decrease human polymorphonuclear cell survival through necrotic and apoptotic pathways, respectively.