J Trauma
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Randomized Controlled Trial Clinical Trial
Transplantation of cryopreserved cultured epidermal allografts.
To optimize cryopreservation methods for cultured epidermal allografts (CEAs) for transplantation onto wounds. ⋯ CEAs can be successfully cryopreserved for long-term storage. Upon retrieval from storage, CEAs may be used to treat partial thickness wounds.
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Comparative Study
Validation of trauma and injury severity score in blunt trauma patients by using a Canadian trauma registry.
To compare outcomes in blunt trauma by using Trauma and Injury Severity Score (TRISS) models derived from the Major Trauma Outcome Study (MTOS) and the Ontario Trauma Registry (OTR) as well as to evaluate the role of the Revised Trauma Score within the TRISS model. ⋯ TRISS demonstrated satisfactory performance in a Canadian blunt trauma population. Although revision of coefficients led to a better fit on the Hosmer-Lemeshow statistic, ROC curves demonstrated virtually identical performance of the MTOS and Ontario-based TRISS models. The poor performance of the Revised Trauma Score and the observation that its use led to the exclusion of 40% of cases with a higher mortality raises concerns regarding its use in the TRISS model.
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This study was designed to investigate the epidemiology and prognostic factors determining survival in penetrating injuries of the aorta. ⋯ Penetrating aortic injuries still have a very high mortality rate with no improvement in survival despite improved trauma services. Injury to the thoracic aorta, gunshot wounds, unrecordable blood pressure on admission, and the need for emergency room thoracotomy, are important predictors of high mortality.
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To evaluate the hypothesis that alert nonintoxicated trauma patients with negative clinical examinations are at no risk of cervical spine injury and do not need any radiographic investigation. ⋯ Clinical examination alone can reliably assess all blunt trauma patients who are alert, nonintoxicated, and report no neck symptoms. In the absence of any palpation or motion neck tenderness during examination, the patient may be released from cervical spine precautions without any radiographic investigations.
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To quantify the occurrence of arterial hypotension and arterial oxygen desaturation in a series of patients with head trauma rescued by helicopter. ⋯ Hypoxemia and shock are frequent findings on patients at the accident scene. Hypoxemia is more frequently detected and promptly corrected, white arterial hypotension is more difficult to control. Both insults may have a significant impact on outcome.