Articles: injury.
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Multicenter Study
Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome.
The purpose of this study was to examine the impact of upper extremity injuries (UEIs) on health-related quality of life (HRQoL) in adult patients compared with victims of other types of injuries and with the general population, in order to establish recovery patterns of different types of UEIs and determine predictors for suboptimal outcome in the long term. ⋯ The impact of UEIs on HRQoL exceeds the health consequences of the group with all injuries. Proximal UEIs had a lower HRQoL and slower recovery than distal injuries. The predictors for the outcome on specific UEIs need to be further investigated in clinical studies, to understand how these differences affect patient-reported outcome measures. These data provide additional insight into treatment outcome and are needed to improve quality of care.
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Critical care medicine · Oct 2014
Multicenter StudyAcute Care Clinical Indicators Associated With Discharge Outcomes in Children With Severe Traumatic Brain Injury.
The effect of the 2003 severe pediatric traumatic brain injury (TBI) guidelines on outcomes has not been examined. We aimed to develop a set of acute care guideline-influenced clinical indicators of adherence and tested the relationship between these indicators during the first 72 hours after hospital admission and discharge outcomes. ⋯ Acute care clinical indicators of adherence to the Pediatric Guidelines were associated with significantly higher discharge survival and improved discharge Glasgow Outcome Scale. Some indicators were protective, regardless of treatment location, suggesting the need for an interdisciplinary approach to the care of children with severe traumatic brain injury.
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Thrombosis research · Oct 2014
Multicenter Study Observational StudySerum soluble CD40 Ligand levels are associated with severity and mortality of brain trauma injury patients.
Serum soluble CD40 Ligand (sCD40L) levels, which exhibit prothrombotic and proinflammatory properties, have not been studied in patients with traumatic brain injury (TBI). Thus, the objective of this study was to determine whether serum sCD40L levels are associated with severity and mortality in patients with severe TBI. ⋯ To our knowledge, this is the first study reporting data on serum sCD40L levels in patients with severe TBI. The most relevant and newer findings of our study are that serum sCD40L levels in non-surviving patients with severe TBI are higher than in surviving ones, and that there are an association between serum sCD40L levels and TBI severity and mortality.
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Randomized Controlled Trial Multicenter Study
Effects of intravenous infusion of hydrogen-rich fluid combined with intra-cisternal infusion of magnesium sulfate in severe aneurysmal subarachnoid hemorrhage: study protocol for a randomized controlled trial.
The failures of recent studies intended to prevent cerebral vasospasm have moved the focus of research into delayed cerebral ischemia away from cerebral artery constriction towards other mechanisms. Recent accumulating evidence has suggested that early brain injury is also involved in the development of delayed cerebral ischemia, and that hydrogen can prevent early brain injury. Therefore, we have established a combination therapy of intravenous hydrogen infusion and intra-cisternal magnesium sulfate infusion for the treatment of both early brain injury and cerebral vasospasm. The present randomized controlled clinical trial is designed to investigate the effects of this novel therapeutic strategy on the occurrence of cerebral vasospasm, delayed cerebral ischemia, and clinical outcomes after high-grade subarachnoid hemorrhage. ⋯ The present protocol for a randomized, placebo-controlled study of intravenous hydrogen therapy with intra-cisternal magnesium infusion is expected to establish the efficacy and safety of this therapeutic strategy.
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Randomized Controlled Trial Multicenter Study
Compression stockings in ankle sprain: a multicenter randomized study.
Ankle sprain is a frequently encountered traumatic injury in emergency departments and is associated with important health expenses. However, the appropriate care of this traumatic injury remains a matter of debate. We tested the hypothesis that compression stockings speed up recovery from ankle sprain. ⋯ Compression stockings failed to significantly modify the time to return to normal painless walking in ankle sprain. A beneficial effect was observed only in a subgroup of patients, as compression stockings significantly decreased the time to return to sport activity.