Articles: trauma.
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Overweight and obesity are critical public health concerns with relevance to U.S. military personnel, as active duty service members must meet physical fitness and body composition standards. Biological sex and posttraumatic stress disorder (PTSD) diagnosis may affect service members' weight management efforts, but it is unclear what contribution each of these factors independently or in combination have on weight loss. ⋯ NCT01757847.
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As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS). ⋯ Across the MHS, there was a low volume of ACGME-minimum orthopedic trauma procedures performed. These data help to frame the current orthopedic trauma surgical volume in the United States MHS in support of efforts to maximize military surgeon training and readiness, ultimately in preparation for future conflicts.
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Curr Opin Crit Care · Jan 2025
Natural history of recovery and long-term outcome in critically ill patients with brain injury.
To increase knowledge of the natural history of recovery and long-term outcome following severe traumatic brain injury (sTBI). ⋯ Evidence from large multicenter studies with well characterized samples focusing on recovery trajectories beyond 1 year postinjury challenge conventional beliefs about outcome after sTBI. Signs of consciousness frequently emerge following discharge from the ICU setting and prediction of death and dependency within the first few weeks after injury is unreliable. Clinician knowledge of the frequency and time course to recovery of key behavioral milestones is central to evidence-based prognostic counseling.
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Review Meta Analysis
Is the Use of Tourniquets More Advantageous than Other Bleeding Control Techniques in Patients with Limb Hemorrhage? A Systematic Review and Meta-Analysis.
Background and Objectives: Trauma, particularly uncontrolled bleeding, is a major cause of death. Recent evidence-based guidelines recommend the use of a tourniquet when life-threating limb bleeding cannot be controlled with direct pressure. Prehospital hemorrhage management, according to the XABCDE protocol, emphasizes the critical role of tourniquets in controlling massive bleeding. ⋯ Tourniquet use demonstrated a non-significant reduction in the number of blood components transfused (MD = -0.65; 95% CI -5.23 to 3.93 for pRBC, MD = -0.55; 95% CI -4.06 to 2.97 for plasma). Conclusions: Despite increasing use in civilian settings, this systematic review and meta-analysis showed no significant reduction in mortality or blood product use associated with prehospital tourniquet use. Further research, including high-quality randomized controlled trials, is required, as well as awareness and education campaigns relating to proper tourniquet use in the prehospital setting.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter Study Observational StudyCostal fracture assessment for relief and enhancement of quality of life-CARE study.
Rib fractures account for 10-15% of trauma-related hospital admissions. Few data are available regarding long-term follow-up of patients undergoing non-operative management. Our aim is to evaluate quality of life at 1, 2, 4, 12 and 24 weeks from the trauma. Pain management, respiratory infection rate and length of hospitalization (LOS) will be recorded. ⋯ The results could have broad practical applications, providing guidance on best practices for rib fracture treatment. This could lead to greater efficacy in management protocols, reducing or increasing the need for surgical interventions. The study could have a significant impact on the health-care system by providing evidence to optimize healthcare resources through more targeted management. If the results demonstrate that conservative treatment is ineffective for certain types of fractures, these patients could be selected for surgical treatment, resulting in savings for the healthcare system and improvement in patient quality of life.