J Trauma
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Primary cutaneous mucormycosis in trauma patients has been rarely reported. We describe three cases occurring in noncompromised hosts and review the literature. Prompt diagnosis and aggressive treatment with vigorous local care and appropriate antibiotics are recommended.
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The incidence of respiratory tract infections was determined in 59 multiple trauma patients requiring prolonged intensive care (greater than 5 days) and receiving no antibiotic prophylaxis. Early pneumonia (less than 48 hr) with S. aureus, S. pneumoniae, and/or H. influenzae was found in 44% of patients. Secondary colonization of the oropharynx and respiratory tract with ICU-associated Gram-negative bacilli followed by pneumonia occurred in 12 patients (20%). ⋯ The incidence of early pneumonia was significantly reduced (p less than 0.001). Five patients (8%) developed an infection. Superinfections were not observed.
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We have developed and validated an abbreviated Burn-Specific Health Scale. The scale is self-administered by the patient, easy to score, and divided for purposes of analysis into several domains of life function. This scale has potential usefulness in many areas of burn care.
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Case Reports
Neurologic recovery following rapid spinal realignment for complete cervical spinal cord injury.
A case of impressive neurologic recovery after a complete cervical spinal cord injury is presented. The importance of prehospital recognition and immobilization and prompt management of cervical spine injuries is emphasized. Full reduction of the fracture-dislocation of C3 on C4 was accomplished 90 minutes postinjury.
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Evaluation of trauma care must be an integral part of any system designed for care of seriously injured patients. However, outcome review should offer comparability to national standards or norms. The TRISS method offers a standard approach for evaluating outcome of trauma care. ⋯ Methods for calculating statistics associated with TRISS are presented. The Z and M statistics are explained with the nonstatistician in mind. We feel this article is a source for those interested in developing or upgrading trauma care evaluation.