J Trauma
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Comparative Study
Comparative use of magnetic resonance imaging and electrophysiologic investigation for the prognosis of head injury.
To compare magnetic resonance imaging (MRI) and electrophysiologic investigation as prognostic methods in acute head injury. ⋯ MRI scans performed early after head injury provide several indicators for unfavorable outcome. Electrophysiologic investigations add to this prognostic evidence. Both methods have comparably high specificity. However, because of the higher density of prognostic information obtained, MRI seems superior to electrophysiologic testing.
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Handguns are a ubiquitous consumer product in the United States, which annually cause significant morbidity and mortality. Handgun safety devices are often proposed as potential solutions to this problem. Their effectiveness at reducing handgun injuries and deaths is intensely debated. However, to effectively analyze the potential utility of handgun safety devices, physicians need to be aware of the safety devices available in the consumer market and how they operate. ⋯ Physicians have the potential to reduce the risk of firearm injuries with their patients and communities. Providing accurate information on firearm safety devices and their limitations is important, just as it is for other aspects of health care advice. Armed with accurate information, physicians can hopefully be effective in firearm injury prevention.
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The main disadvantage of the pedicled groin flap for hand reconstruction is the long period of immobilization required. Early division of the pedicled groin flap is desirable for both patients and surgeons. The aims of this study were to investigate whether ischemic preconditioning can effectively accelerate the neovascularization of the junction between the donor and recipient sites in the pedicled flap, and the most objective method of judging the timing of early division of the pedicled groin flap. This report is the first prospective study to use ischemic preconditioning for early division of pedicled cutaneous flap combined with laser Doppler measurement. ⋯ With ischemic preconditioning, the pedicled groin flap can be safely divided postoperatively at a mean period of 8.4 days according to the laser Doppler measurement, especially when the perfusion unit ratio of clamping over nonclamping reaches more than 36.6%.
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These studies address the question of the relative roles of humoral and neural pathways in the genesis and control of the fever component of the acute phase response. ⋯ Fever development for animals receiving LPS in experiment 1 demonstrates a temporal relationship -- with increments in plasma levels of LPS and pyrogenic cytokines obtained in experiment 2 after administration of LPS either i.p. or i.v. Vagotomy had no discernible effect on the responses regardless of the route of administration of LPS.