J Trauma
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Unintentional firearm deaths among children have been declining steadily in the United States. This study investigates whether Child Access Prevention (CAP) laws are associated with this decline. ⋯ Unintentional firearm deaths are declining in the United States, with the rate for children under age 15 declining faster than adults. States that allowed felony prosecution of offenders experienced a greater effect of CAP laws than states that did not. CAP laws may have had some influence on the continued reduction in national death rates.
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Comparative Study
Do trauma centers improve functional outcomes: a national trauma databank analysis?
The development of a tiered trauma care system has lead to improved survival for the critically injured. The question as to whether the increased survival associated with the establishment of tiered levels of trauma care is paralleled by an improved functional outcome has not, however, been addressed. ⋯ These data indicate that the complex care delivered by advanced level trauma centers is associated with improved functional outcomes. Further investigations to identify the reasons for differences in these outcomes are necessary to improve care at lower tiered hospitals particularly for minimally injured patients.
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Published reports about locked nailing for displaced comminuted proximal humeral fractures are few and the results contradictory. ⋯ Locked nailing can be an effective treatment for selected severely displaced three-part proximal humeral fractures. It is particularly useful for fractures with diaphyseal involvement. Familiarity with the fracture deformity and experience with the surgical techniques are critical for successful treatment results.
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Multicenter Study Comparative Study
The effect of a protocol of aggressive donor management: Implications for the national organ donor shortage.
The disparity between the number of people awaiting organ transplantation and the number of organs available has become a public health crisis. As many as 25% of potential donors are lost as a result of cardiovascular collapse (CVC) before organ harvest. A policy of aggressive donor management (ADM) may decrease the number of cadaveric donors lost as a result of CVC. ⋯ An aggressive donor management protocol decreases the number of donors lost as a result of cardiovascular collapse and increases the number of harvested organs per potential donor.