The Journal of surgical research
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Postoperative venous thromboembolism (VTE) is increasingly viewed as a quality of care metric, although risk-adjusted incident rates of postoperative VTE and VTE after hospital discharge (VTEDC) are not available. We sought to characterize the predictors of VTE and VTEDC to develop nomograms to estimate individual risk of VTE and VTEDC. ⋯ Substantial variation exists in the incidence of VTE and VTEDC, depending on patient and procedural factors. We constructed nomograms to predict individual risk of 30-d VTE and VTEDC. These may allow more targeted quality improvement interventions to reduce VTE and VTEDC in high-risk general and thoracic surgery patients.
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Posttraumatic lung contusion is common after blunt chest trauma, and patients often need ventilatory support. Lung contusion induces an inflammatory response signified by primed polymorph neutrophil granulocytes (PMNs) in blood and tissue. Mechanical ventilation (MV) can also cause an inflammatory response. The aim of this study was to develop an animal model to investigate the effect of high-volume ventilation on the inflammatory response in blunt chest trauma. ⋯ The blast generator generated reproducible blunt chest trauma in rats. Mechanical ventilation after lung contusion induced a larger overall inflammatory response than MV alone, which indicates that local damage contributes not only to local inflammation, but also to systemic inflammation. This emphasizes the importance of lung protective ventilation strategies after pulmonary contusion.
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Comparative Study
Intravital pathophysiological comparison of acid- and alkali-burn injuries in a murine model.
The breakdown of skin microcirculation plays a key role in the pathophysiology of chemical burns. Available data for alkali and acid injuries are rare. To determine the pathophysiological similarities and differences, two comparable in vivo acid and alkali burn models were developed. ⋯ The comparison of analogous intravital acid and alkali burns shows that despite many similarities in the microcirculatory parameters, there was a marked difference particularly in the course of the tissue regeneration by angiogenesis. The longer lasting destruction by alkali burns stands in contrast to the later onset but faster regeneration by angiogenesis compared with that by acid burns.
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Blacks, Hispanics, and women are underrepresented in academic medicine. This study sought to identify recent trends in the academic appointments of underrepresented groups at all levels of academic medicine. ⋯ Minorities, including Asian Americans, and women remain grossly underrepresented in academic medicine. Blacks have shown the least progress during this 12-y period. The disparity is greatest at the highest levels (professor, chairperson, and dean) of our field. We must redouble our efforts to recruit, retain, and advance minorities in academic medicine.
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Recidivism is a well-known problem in adult trauma patients. Trauma recidivists are a population that warrants further intervention to prevent future trauma. Among pediatric patients, the recidivism rate, demographics, mechanism, and mortality are unknown. We hypothesized that specific groups of pediatric trauma recidivists could be identified for targeted prevention efforts. ⋯ The pediatric recidivism rate in our population is small. Nevertheless, recidivists are more than twice as likely to be injured by penetrating trauma, especially GSWs. Targeted screening and counseling in this demographic may be helpful in reducing youth trauma recidivism.