J Trauma
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Injuries sustained while skiing or snowboarding are commonly encountered in emergency departments near winter resorts. The purpose of this study is to identify and compare the types of injuries likely to be found in the skier or snowboarder patient. An additional goal of this study is to provide a description of the demographics and hospitalizations for these patients. ⋯ Patients injured while skiing or snowboarding are predominantly men, and participants in both sports are at risk for sustaining major injuries. The types of injuries differ and are dependent on the sport. An awareness of these differences will help skiers and snowboarders minimize their risk of injury by altering their riding strategies and by choosing appropriate protective equipment.
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Discussion still remains which polytraumatized patients require radiologic thoracolumbar spine (TL spine) screening. The purpose of this study is to determine whether pelvic fractures are associated with TL spine fractures after a blunt trauma. Additionally, the sensitivity of conventional TL spine radiographs and pelvic radiographs (PXRs) is evaluated. ⋯ Our data suggest that a pelvic fracture is not a predictor for clinically relevant TL spine fractures. Furthermore, our data confirm the superior sensitivity of CT for detecting TL spine injury and pelvic fractures.
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With the onset of improved protective equipment against fragmentation, blast-induced neurotrauma has emerged as the "signature wound" of the current conflicts in the Middle East. Current research has focused on this phenomenon; however, the exact mechanism of injury and ways to mitigate the ensuing pathophysiology remain largely unknown. The data presented and literature reviewed formed the fundamentals of a successful grant from the U.S. Office of Naval Research to Wayne State University. ⋯ A physiologic- or biofidelic-based blast-induced tolerance curve may redefine current acceleration-based curves that are only valid to assess tertiary blast injury. Identification of additional pharmaceutical candidates will both confirm or deny current hypotheses on neural pathways of continued injury and help to develop novel prophylactic treatments.
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Randomized Controlled Trial
Abnormal coagulation tests are associated with progression of traumatic intracranial hemorrhage.
Intracranial hemorrhage (ICH) is common in traumatic brain injury (TBI) and a major determinant of death and disability. ICH commonly increases in size and coagulopathy has been implicated in such progression. We investigated the association between coagulopathy diagnosed by routine laboratory tests and ICH progression. ⋯ This study demonstrates an association between coagulopathy, diagnosed by routine laboratorial tests in the first 24 hours, with ICH progression; and ICH progression with mortality in patients with severe TBI. The causal relationship between coagulopathy and ICH progression will require further studies.