The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2012
Endothelial glycocalyx degradation induces endogenous heparinization in patients with severe injury and early traumatic coagulopathy.
There is emerging evidence that early trauma-induced coagulopathy (TIC) is mechanistically linked to disruption of the vascular endothelium and its glycocalyx, assessed by thrombomodulin and syndecan 1, respectively. This study evaluated if degradation of the endothelial glycocalyx and ensuing release of its heparin-like substances induce autoheparinization and thereby contributes to TIC. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jul 2012
Patterns of pediatric injury in South Africa: an analysis of hospital data between 1997 and 2006.
Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Despite the magnitude of this burden, there is lack of data to characterize the etiology and risk factors associated with childhood injuries, especially in low- and middle-income countries. The aim of this article is to describe the demographics, mechanisms, and severity of injuries during a 10-year time period using hospital-based data in Cape Town, South Africa. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jul 2012
Does the size of the hemoperitoneum help to discriminate the bleeding source and guide therapeutic decisions in blunt trauma patients with pelvic ring fracture?
In blunt trauma patients with a hemoperitoneum and a pelvic injury, multiple sources of active bleeding may exist. The purpose of this study was to determine whether the size of the hemoperitoneum helps to establish the bleeding source and guide therapeutic decisions in patients with pelvic fractures. ⋯ In patients with pelvic fractures, hemoperitoneum does not mean peritoneal injury requiring hemostatic procedure. Semiquantitative analysis of the hemoperitoneum improves predictability of peritoneal hemorrhage than qualitative analysis of hemoperitoneum. However, there remains numerous false-positives even in presence of large hemoperitoneum associated with hypotension.
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J Trauma Acute Care Surg · Jul 2012
Spine injuries in polytraumatized pediatric patients: characteristics and experience from a Level I trauma center over two decades.
Spine injuries, a common component in polytrauma, are relatively rare in pediatric patients. Previous studies mainly described injuries to the cervical region, whereas information of injury patterns to the thoracic and lumbosacral region lack in the current literature. The aim of this study was to determine the incidence and characteristics of polytraumatized children and associated spine injuries in different pediatric development ages. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jul 2012
Injury profiles related to mortality in patients with a low Injury Severity Score: a case-mix issue?
Outcome prediction models are widely used to evaluate trauma care. External benchmarking provides individual institutions with a tool to compare survival with a reference dataset. However, these models do have limitations. In this study, the hypothesis was tested whether specific injuries are associated with increased mortality and whether differences in case-mix of these injuries influence outcome comparison. ⋯ Prognostic study, level II.