Articles: trauma.
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Background : Previous preclinical studies have demonstrated a pathobiome after traumatic injury; however, the impact of postinjury sepsis on gut epithelial permeability and bacterial translocation remains unknown. We hypothesized that polytrauma with postinjury pneumonia would result in impaired gut permeability leading to specific blood microbiome arrays. Methods : Male and proestrus female Sprague-Dawley rats were subjected to either polytrauma (PT), PT plus 2-hours daily chronic restraint stress (PT/CS), PT with postinjury day 1 inoculation with pseudomonas pneumonia (PT + PNA), PT/CS + PNA, or naive controls. ⋯ Females PT/CS + PNA had a significant abundance of Staphylococcus at day 2 and Streptococcus at day 7 in the blood biome compared to male counterparts ( P < 0.05). Conclusion : Multicompartmental trauma with postinjury pneumonia results in increased intestinal permeability and bacteremia with a unique blood biome, with sexual dimorphisms evident in the blood biome composition. These findings suggest that postinjury sepsis has clinical significance and could influence outcomes after severe trauma and critical illness.
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Eur J Trauma Emerg Surg · Dec 2024
Multicenter Study Observational StudyImpact of pre-existing medical conditions on mortality in geriatric trauma: a nationwide study in Japan.
To investigate the relationship between pre-existing medical conditions and outcomes in elderly trauma patients in Japan. ⋯ Data from JTDB suggests that pre-existing conditions like moderate or severe liver disease, congestive heart failure, and moderate or severe renal disease in elderly trauma patients are positively correlated with in-hospital mortality.
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Traffic accidents are significant causes of death and serious injury in children. Children's clinical findings are more subtle and there is a risk of faster deterioration. On the other hand, radiation sensitivity due to imaging is also high. These challenging factors highlight the importance of approaching pediatric trauma cases. In our study, we aimed to contribute to current approaches by examining the clinical course and profiles of children involved in traffic accidents. This study aimed to analyze the profiles and clinical courses of children involved in road traffic accidents. ⋯ In-vehicle accidents were the most frequent type of accident, and children under 4 years old had a higher incidence of in-car accidents than other age groups. Males made up 60 % of the cases, with boys having higher rates of motorcycle and extra-vehicular accidents compared to girls. While most children had no injuries from the accidents, those who did generally recovered well with outpatient monitoring. On the other hand, 89 % of patients underwent imaging at a high rate.
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Treatment priority in C5, C6, and C7 brachial plexus root avulsion is the recovery of shoulder function through reinnervation of shoulder muscles. The medial pectoral nerve is a potential donor for axillary nerve transfer, but outcomes are sparsely reported. This study reports the results of medial pectoral nerve transfer to the axillary nerve. ⋯ Medial pectoral nerve transfer to the axillary nerve did not yield superior results in shoulder abduction and deltoid reinnervation in our group of patients. At present, different nerve donors may also need to be considered for deltoid muscle reinnervation in patients with C5, C6, and C7 root avulsion to achieve better shoulder abduction recovery.
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Eur J Trauma Emerg Surg · Dec 2024
Trauma-related preventable death; data analysis and panel review at a level 1 trauma centre in Amsterdam, the Netherlands.
Trauma-related death is used as a parameter to evaluate the quality of trauma care and identify cases in which mortality could have been prevented under optimal trauma care conditions. The aim of this study was to identify trauma-related preventable death (TRPD) within our institute by an external expert panel and to evaluate inter-panel reliability. ⋯ Multidisciplinary panel review has a moderate inter-observer agreement regarding survivability and low agreement regarding categorical preventable death classification. A valid definition and classification of TRPD is required to improve inter-observer agreement and quality of trauma care.