J Trauma
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Multicenter Study
Magnetic resonance imaging: utilization in the management of central nervous system trauma.
To determine the availability, use, and perceived value of magnetic resonance imaging (MR) in the management of acute central nervous system (CNS) trauma in United States Level I (or equivalent) trauma centers (TCs). ⋯ Most trauma directors consider MR important in the acute evaluation of spinal trauma and, to a lesser extent, for traumatic brain injury. Despite these opinions, the vast majority of these centers reported only "rare" to "occasional" use of MR in the setting of acute CNS trauma. Our results show that most TCs have on-site and continuously available MR facilities capable of cardiac and pulmonary monitoring. Other factors such as the higher relative cost of MR may be responsible for the discrepancy between the perceived value and the actual utilization of MR imaging in the setting of CNS trauma.
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Clinical Trial
Ultrasound evaluation of blunt abdominal trauma: program implementation, initial experience, and learning curve.
Although sonographic screening for blunt abdominal trauma is gaining acceptance, standards for implementation, training, credentialing, and quality control remain to be established. ⋯ This experience with the de novo implementation of a trauma US program suggests that the training and credentialing requirements in this study are sufficient to provide surgeon ultrasonographers with acceptable competence in US diagnosis of blunt abdominal trauma.
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Comparative Study
Use of recombinant hemoglobin solution in reversing lethal hemorrhagic hypovolemic oxygen debt shock.
To compare recombinant hemoglobin solution (rHb1.1) with colloid/blood (CB) resuscitation in a hemorrhagic shock (HS) model based on oxygen debt (O2D). ⋯ Lactate and BEA accurately quantify O2D in HS and resuscitation. rHb1.1 replacement is as good as CB with regard to survival, but leads to a more uniform reperfusion and produces a more complete resolution of ischemic acidosis.
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In this study, we evaluated scaphoid X-series, Carpal Box radiographs (longitudinal and transverse), planar tomography, computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of scaphoid fracture. The aim of this study was to evaluate the planar technique in the diagnosis of scaphoid fracture. The use of planar tomography, CT, and MRI was to see whether these methods are useful in the diagnosis of scaphoid fracture when other diagnostics modalities remains negative. ⋯ From the planar investigated methods, the 15-degree Carpal Box posterior-anterior, longitudinal and transverse views were most accurate in recognizing scaphoid fracture with also the highest agreement between the observers.