J Trauma
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To review our experience with craniocerebral injuries caused by plastic bullets, and to delineate prognostic factors for outcome. ⋯ Plastic bullet-induced craniocerebral injuries carry a lower morbidity and mortality rate compared with other gunshot wounds. However, plastic bullets do incur a significant risk of injury. Their use should be carefully regulated.
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To identify preventable prehospital deaths, caused by trauma. ⋯ Upgrading of the emergency medical care service is required.
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To examine hospital, trauma system, and reimbursement factors that offset the financial burdens of trauma care delivery and to assess how proposed Medicaid and Medicare budget cuts may affect the ability of hospitals to alleviate financial pressures related to trauma care delivery. ⋯ Proposed Medicaid and Medicare payment cuts are likely to eliminate the delicate financial balance that many urban hospitals have achieved in providing trauma care. The erosion in funding from public programs may portend a new wave of trauma center closures as hospitals seek to deal with reduced reimbursement by eliminating unprofitable services.
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To study hemodynamic effects of growth hormone (GH) and its main mediator, insulin-like growth factor-1, in a model of critical illness. ⋯ GH promoted metabolic acidosis in traumatized sepsis and impaired compensation of a subsequent hemorrhage.