Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2011
Blunt traumatic carotid artery dissection still a pitfall? The rationale for aggressive screening.
The optimal diagnostic strategy for carotid dissection following blunt trauma is yet unclear. The rationale for aggressive screening will be discussed based on a consecutive case series of blunt traumatic carotid artery dissection (CAD). ⋯ Screening may increase the rate of early CAD diagnosis, but it is unclear if screening will also result in early detection of a treatable lesion. Trials have to provide the answer to whether initiating therapy will lead to improvements in the outcome in traumatic CAD. We therefore believe that screening is a basic condition for initiation of future clinical trials.
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To determine the injury patterns, complications, and mortality after alcohol consumption in trauma patients. ⋯ In a mixed population of trauma patients, an AP screen is associated with an increased incidence of admission hypotension and depressed GCS score. In this case-matched study, alcohol exposure appeared to increase mortality after injury.
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Eur J Trauma Emerg S · Apr 2011
Isolated blunt chest injury leads to transient activation of circulating neutrophils.
The acute respiratory distress syndrome (ARDS) is a severe and frequently seen complication in multi-trauma patients. ARDS is caused by an excessive innate immune response with a clear role for neutrophils. As ARDS is more frequently seen in trauma patients with chest injury, we investigated the influence of chest injury on the systemic neutrophil response and the development of ARDS. ⋯ Blunt chest trauma caused a systemic inflammatory reaction with transient activation of neutrophils and mobilization of young neutrophils into the circulation. Isolated chest injury, however, was not abundant enough to cause ARDS, so a second hit appears crucial.
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Eur J Trauma Emerg S · Apr 2011
Accuracy of CT-assisted pedicle screw placement after CT-controlled, presurgical guide wire implantation in traumatic and pathological fractures in the thoracic spine.
The aim of this study was to evaluate the accuracy of pedicle screw placement after computed tomography (CT)-assisted positioning of guide wires and subsequent insertion of transpedicular screws in particularly narrow pedicles in the thoracic spine. Transpedicular pedicle screw placement has been commonly used for a number of decades. However, a significant number of malpositioned screws still occur, especially in the thoracic spine, potentially correlating with relevant complications, e.g., neurological deterioration. ⋯ The CT-assisted pedicle screw implantation procedure using guide wires implanted prior to surgery is an accurate, reliable, and safe method for dorsal spondylodesis in the treatment of a variety of spinal instabilities, including fractures, tumors, and infections.
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Polytrauma patients usually suffer from both life-threatening injuries, where early intervention is mandatory in order to prevent mortality from uncontrollable haemorrhage-especially during the "golden hour", and secondary injuries of lower priority which receive delayed referral or treatment. Non-life-threatening injuries can sometimes be overlooked and so remain untreated until a much later stage. The aim of this study was to investigate the incidence of eye (ocular and orbital) injuries in polytrauma (injury severity score >15) patients and describe their complexities and outcomes. ⋯ Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment.