J Trauma
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Induced hypothermia is used clinically to prevent ischemic injury during elective procedures. We present an animal model of asanguinous hypothermic (10 degrees C) circulatory arrest, induced through a left anterior lateral thoracotomy after exsanguinating uncontrolled hemorrhage. ⋯ Induction of hypothermic arrest through the chest after exsanguination is possible. The further development of this technique may provide an extended state of "suspended animation" to allow for repairs of hemorrhaging injuries in trauma patients who require emergency department thoracotomy.
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To determine the utility of near-infrared spectroscopy in the diagnosis of lower extremity compartment syndrome (CS). ⋯ Near-infrared spectroscopy-derived StO2 values in the lower extremities of trauma patients with CS were diminished relative to the control patients and usually normalized after fasciotomy. Near-infrared spectroscopy evaluation may offer a rapid, noninvasive method of assessing extremities at risk for CS.
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Comparative Study
Limb salvage for chronic tibial osteomyelitis: an outcomes study.
The decision to undergo a limb salvage procedure is difficult and multifaceted. This study reviews the outcomes of patients with chronic tibial osteomyelitis who underwent limb salvage and hopes to enhance our understanding of the impact this complex procedure has on the patient's ability to have a functional and fulfilling life. ⋯ Limb salvage seems to be a satisfactory option for patients with chronic tibial osteomyelitis. A history of smoking and advanced age may have adverse affects and are relative contraindications.
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Intolerance of enteral nutrition interrupts caloric balance and increases hospital costs. This study proposes that enteral feeding by percutaneous endoscopic gastrojejunostomy (PEGJ) provides continuous uninterrupted nutrition with greater consistency than percutaneous endoscopic gastrostomy (PEG). ⋯ This study suggests that enteral nutrition delivered by means of PEGJ is better tolerated than enteral nutrition delivered by means of PEG in trauma patients with no abdominal conditions that preclude percutaneous feeding tube placement.
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Toward the establishment of an injury surveillance system in Uganda, the first step was to initiate hospital-based trauma registries that generate relevant and timely data on the causes, severity, morbidity, mortality, and outcomes of injuries at Mulago and Kawolo hospitals. This would help establish injury patterns and priorities in these hospital populations. The registries are based on a minimal data set and a new injury severity instrument, the Kampala Trauma Score (KTS). The usefulness of the registry and the qualities of the KTS are presented. ⋯ A trauma registry and injury severity measurement are both possible and useful in sub-Saharan Africa. This minimal data set and the KTS are recommended for investigators with similar resource constraints.