Articles: trauma.
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Concussions are a common form of mild traumatic brain injury characterized by a transient alteration of cerebral function leading to a range of physical, cognitive, and emotional symptoms. Postconcussive symptoms (PCSs) usually resolve in about a week but can persist in 10% to 15% of patients. If left untreated, PCS can profoundly affect a patient's life. ⋯ The OMT techniques applied during treatment included balanced ligamentous tension, myofascial release, and osteopathy in the cranial field techniques. OMT is a nonpharmacological, noninvasive treatment that can benefit patients suffering with PCS. The authors would like to increase the awareness of clinicians and researchers for OMT's potential positive outcomes for PCS, as part of a multifactorial approach to care.
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Radiation Personal Protective Equipment (RPPE) is the subject of safety guidance from the British Orthopaedic Association (BOA). This pilot study aimed to examine potential performance differences in Trauma and Orthopaedic (T&O) Higher Surgical Trainees (HST) undertaking simulated Dynamic Hip Screw (DHS) surgery related to different RPPE attire. ⋯ Important differences in surgeon physiological measures (HR, temperature) and self-reported measures of comfort and temperature were found related to RPPE style. Understanding the effects that specific RPPE attire has on performance should influence RPPE choice and the findings help inform future research into this important topic.
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Spinal vertebral fractures pose a significant healthcare burden due to their frequency and impact on quality of life, resulting in substantial social costs. Minimally invasive surgery (MIS) offers advantages over traditional open surgery (OS), such as reduced tissue damage, less postoperative pain, and shorter hospital stays, although it involves higher implant costs. Research comparing the overall direct costs of these interventions is limited. This study aims to compare the direct hospital-care costs associated with OS and MIS for thoracolumbar vertebral fractures in Spain. ⋯ The study demonstrates that MIS is not inferior to OS in terms of costs, with some advantages like reduced blood bank expenses. Further high-quality randomized controlled trials with economic evaluations are needed for more definitive conclusions.
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Anesthesia and analgesia · Jan 2025
Anesthesia Trauma Guidelines: A Systematic Review of Global Accessibility and Quality.
This systematic review describes the available clinical practice guidelines (CPGs) for the anesthetic management of trauma and appraises the accessibility and quality of these resources. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted across 8 databases (MEDLINE, Embase, Web of Science, CABI Digital Library, Global Index Medicus, SciELO, Google Scholar, and National Institute for Health and Care Excellence) for guidelines from 2010 to 2023. ⋯ Though many countries and societies have contributed to the development of anesthesia CPGs for trauma, there has been a disproportionate lack of representation from LMICs, where the burden of trauma mortality is highest. In this study, we identify barriers to accessibility and areas for improving future guideline quality. We recommend ongoing efforts to incorporate perspectives from diverse settings and to increase the availability of high-quality, open-access guidelines to improve worldwide health outcomes in trauma.
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Eur J Trauma Emerg Surg · Jan 2025
Pre-injury narcotic drug use in isolated severe traumatic brain injury: effect on outcomes.
The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients. ⋯ Pre-injury narcotic drug use in isolated severe TBI is not associates with adverse outcomes. Further research is needed to understand the biochemical and physiological effects of narcotic drugs on TBI outcomes.