Articles: trauma.
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Eur J Trauma Emerg S · Feb 2009
Evaluation of Quality of Trauma Care in a Local Hospital Using a Customization of ASCOT.
Evaluating processes of care and outcomes of injured patients are important if improvements in the quality of care delivered to injured patients are to be accomplished. We applied a customized ASCOT model developed from our database as a tool to criticize the quality of care in a local hospital. ⋯ We believe that a customization of ASCOT model when used for evaluation of quality of care in a local hospital can be useful for detection of defects and improvement of the process of care delivered to the patients.
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Eur J Trauma Emerg S · Feb 2009
Cost-Drivers in Acute Treatment of Severe Trauma in Europe: A Systematic Review of Literature.
Throughout the world, trauma is a leading cause of morbidity and mortality in the young and most active group of society. While specialist trauma centers play a critical role in the survival after severe trauma, the assessment of trauma-related costs, budgeting for adequate trauma capacity, and determining the cost-effectiveness of interventions in critical care are fraught with difficulties. Through a systematic review of the European literature on severe trauma, we aimed to identify the key elements that drive the costs of acute trauma care. ⋯ Irrespective of the idiosyncrasies of the national healthcare systems in Europe, severity of injury, length of stay in ICU, surgical interventions and transfusion requirements represent the key drivers of acute trauma care for severe injury.
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To evaluate the outcomes of early comprehensive rehabilitation protocols for traumatic brain injury (TBI) using the functional independence measure (FIM), and to study the relationship between FIM and Glasgow coma scale (GCS) variables to determine which patients will be best served by rehabilitation therapies. ⋯ Early rehabilitation interventions significantly improved the FIM scores in moderate and severe TBI patients. ERRATUM NOTICE PUBLISHED IN NEUROSCIENCES 2009; 14: 306.
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This study was designed to evaluate the effects of terlipressin versus fluid resuscitation with normal saline, hypertonic saline or hypertonic-hyperoncotic hydroxyethyl starch, on hemodynamics, metabolics, blood loss and short-term survival in hemorrhagic shock. ⋯ Hyperkalemia accompanies hemorrhagic shock and, in addition to providing an early sign of the acute ischemic insult severity, may be responsible for cardiac arrest related to hemorrhagic shock.
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Emerging research implicates the participation of spinal dorsal horn (SDH) neurons and astrocytes in nerve injury-induced neuropathic pain. However, the crosstalk between spinal astrocytes and neurons in neuropathic pain is not clear. Using a lumbar 5 (L5) spinal nerve ligation (SNL) pain model, we testified our hypothesis that SDH neurons and astrocytes reciprocally regulate each other to maintain the persistent neuropathic pain states. ⋯ Meanwhile, L-AA shortened the duration of neuronal activation by SNL. Our data offers evidence that neuronal and astrocytic activations are closely related with the maintenance of neuropathic pain through a reciprocal "crosstalk". The current study suggests that neuronal and non-neuronal elements should be taken integrally into consideration for nociceptive transmission, and that the intervention of such interaction may offer some novel pain therapeutic strategies.