Injury
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Trauma-induced coagulopathy (TIC) refers to an abnormal coagulation process, an imbalance between coagulation and fibrinolysis due to several pathological factors, such as haemorrhage and tissue injury. Platelet activation and subsequent clot formation are associated with mitochondrial activity, suggesting a possible role for mitochondria in TIC. Comprehensive studies of mitochondrial dysfunction in platelets from severe trauma patients have not yet been performed. ⋯ The present study revealed that severe trauma is associated with platelet mitochondrial dysfunction resulting in reduced ATP synthesis and impaired extramitochondrial Ca2+ movement. These factors are required for platelet activation, recruitment and clot stability likely thus, platelet mitochondrial dysfunction contributes to the development of TIC.
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Introduction Computed Tomography (CT) to rule out pulmonary embolus (PE) is often ordered during post-trauma laparotomy clinical decompensation (CD) involving fever, tachycardia, tachypnea, and/or leukocytosis. We hypothesize this diagnostic modality is low-yield in the postoperative period when surgery-related sequelae are more probable. Methods This is a single-center retrospective cohort study of patients who underwent trauma laparotomy and had subsequent CT for CD from March 19, 2019 to June 30, 2022. ⋯ Predictors of clinical intervention required based on CT imaging were GI tract injury (AOR: 1.65, p = 0.0182), and elevated WBC (AOR: 1.038, p = 0.010 Conclusion Saddle and lobar PE incidence post-trauma laparotomy is low. SIRS-type symptoms prompting postoperative CT commonly have no procedural or antibiotic requirement. Postoperative decompensation is more likely related post-operative complications, and less likely a PE.
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Carpal tunnel syndrome (CTS) commonly presents after distal radius fractures. Assessing its degree of severity is essential to therapeutic decision-making - i.e. operative vs. conservative treatment. The role of the two-point discrimination (2PD) has not yet been evaluated as a potential indicator of severity during physical examination. Therefore, in our cross-sectional study, we aimed to find a correlation between 2PD values and disease severity, based on the gold-standard electromyography and electroneurography (EMG-ENG) and ultrasonography findings. ⋯ There is a significant correlation between 2PD values and the severity of carpal tunnel syndrome as determined by EMG-ENG; however, they are not interchangeable. Based on the results of our study, we propose that measuring two-point discrimination may be a quick and easy, reliable and cost-effective screening method to assess the severity of carpal tunnel syndrome following distal radius fractures.
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The purpose of this study is to report the data for patients followed-up in our intensive care unit due to the 6th February 2023, earthquake in Kahramanmaraş, Türkiye, and to investigate parameters affecting mortality. ⋯ Not only increased SOFA, serum potassium, serum phosphorus, and serum magnesium, but also decreased bicarbonate, and base deficit were associated with mortality in earthquake victims with crush syndrome in ICU.
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Multicenter Study
Propensity weighted analysis of chemical venous thromboembolism prophylaxis agents in isolated severe traumatic brain injury: An EAST sponsored multicenter study.
In patients with severe traumatic brain injury (TBI), clinicians must balance preventing venous thromboembolism (VTE) with the risk of intracranial hemorrhagic expansion (ICHE). We hypothesized that low molecular weight heparin (LMWH) would not increase risk of ICHE or VTE as compared to unfractionated heparin (UH) in patients with severe TBI. ⋯ Level III, Therapeutic Care Management.