The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyEarly magnetic resonance imaging in spinal cord injury without radiological abnormality in adults: a retrospective study.
The purpose of this study was to describe the clinical and imaging characteristics of patients experiencing blunt spinal trauma without radiological abnormalities but transient or persistent neurological deficits. ⋯ Epidemiological study, level V.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyClinical characteristics and surgical outcomes of penetrating external genital injuries.
Penetrating external genital injuries, although uncommon, may present complex problems for the urologic and trauma surgeon. A paucity of data exists on the incidence, clinical characteristics, and management outcomes of these injuries because few institutions have the volume to report their experience. ⋯ Therapeutic study, level IV; epidemiologic study, level IV.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyComparisons of lactated Ringer's and Hextend resuscitation on hemodynamics and coagulation following femur injury and severe hemorrhage in pigs.
This study compared coagulation function after resuscitation with Hextend and lactated Ringer's (LR) solution in pigs with tissue injury and hemorrhagic shock. ⋯ After traumatic hemorrhage, coagulation function was restored within 6 hours with LR resuscitation but not with Hextend. The lack of recovery after Hextend is likely caused by greater hemodilution and possible effects of starches on coagulation substrates and further documents the need to restrict the use of high-molecular-weight starch in resuscitation fluids for bleeding casualties.
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J Trauma Acute Care Surg · Mar 2013
Randomized Controlled Trial Comparative StudyPlatelets are dominant contributors to hypercoagulability after injury.
Venous thromboembolic (VTE) disease has a high incidence following trauma, but debate remains regarding optimal prophylaxis. Thrombelastography (TEG) has been suggested to be optimal in guiding prophylaxis. Thus, we designed a phase II randomized controlled trial to test the hypothesis that TEG-guided prophylaxis with escalating low-molecular weight heparin (LMWH), followed by antiplatelet therapy would reduce VTE incidence. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudySingle-nucleotide polymorphisms in the Toll-like receptor pathway increase susceptibility to infections in severely injured trauma patients.
Sepsis and subsequent multiple-organ failure are the predominant causes of late mortality in trauma patients. Susceptibility and response to infection is, in part, heritable. Single-nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) and cluster of differentiation 14 (CD14) genes of innate immunity may play a key role. The aim of this study was to assess if SNPs in TLR/CD14 predisposed trauma patients to infection. ⋯ Prognostic and epidemiologic study, level II.