Eur J Trauma Emerg S
-
Eur J Trauma Emerg S · Dec 2011
The treatment of traumatic shock: recent advances and unresolved questions.
Uncontrolled bleeding remains a leading cause of potentially preventable death after trauma. Timely, adequate resuscitation in traumatic shock is an essential, lifesaving aspect of polytrauma care. ⋯ The increase in knowledge regarding the pathophysiology of trauma, the availability of adjuncts, and the array of resuscitation monitoring options available have all contributed to a potentially improved approach to resuscitation. The purpose of this report is to review the most important advances in traumatic shock therapy in the last five years.
-
Eur J Trauma Emerg S · Dec 2011
Effective teaching modifies medical student attitudes toward pain symptoms.
Recent studies have raised the question of whether last year medical students and first year residents show an adequate attitude toward their patient's pain as reflected by prescribed pain medication. Underuse of analgetics could be demonstrated in several studies even after a correct diagnosis of pain was made and has led to the term "oligoanalgesia." Our study was aimed at evaluating the potential of improving student attitudes toward pain by changing the curriculum during the last year of medical education. ⋯ Our results confirm the importance of humanistic attitudes in future doctors in addition to the traditional implementation of knowledge and skills. Changes in the medical curriculum can positively influence these attitudes.
-
Eur J Trauma Emerg S · Dec 2011
Introduction of guidelines to facilitate enteral nutrition in a surgical intensive care unit is associated with earlier enteral feeding.
Patients treated postoperatively in surgical intensive care units often receive delayed enteral nutrition. We hypothesized that the introduction of guidelines promoting early enteral nutrition is associated with earlier enteral feeding. ⋯ Introduction of guidelines to facilitate enteral nutrition in a surgical intensive care unit was associated with earlier enteral feeding.
-
Eur J Trauma Emerg S · Dec 2011
Reliability of measurement techniques for the hepato-splanchnic region in multiple-trauma patients.
Relevant information on the adequacy of intestinal perfusion is needed. The objective of our study was to investigate the relationship between the difference in intra-mucosal and arterial CO2 pressure (pCO2 gap) and the outcome in multiply injured patients and relations between the pCO2 gap and intestinal permeability (IP). ⋯ The pCO2 gap in trauma patients on intra-gastric enteral nutrition in the phase of present technical solutions has no prognostic value for the development of MOF, but IP correlated with it.
-
Eur J Trauma Emerg S · Dec 2011
Effects on the ubiquitin proteasome system after closed soft-tissue trauma in rat skeletal muscle.
Previous studies have suggested that an increased catabolic stage of skeletal muscle in pathological situations is mainly a reflection of ubiquitin-proteasome system-controlled proteolysis. The proteolytic mechanisms that occur after local muscle trauma are poorly defined. We investigated the effects of closed soft-tissue trauma on ubiquitin-proteasome dependent protein breakdown in rats (n = 25). ⋯ Cellular levels of free and protein-conjugated ubiquitin were significantly elevated upon decreased proteolytic activity. Our data support an early-state anti-proteolytic role of the ubiquitin-proteasome pathway after local injury. This further implies that there is a yet-to-be elucidated complex regulatory mechanism of muscle regeneration that involves various proteolytic systems.