J Trauma
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In previous animal studies, induction of therapeutic hypothermia (HT) in hemorrhagic shock (HS) had beneficial effects on the hemodynamic and metabolic parameters and on the survival. However, the effect of induced HT on acute lung injury (ALI) in HS has not been investigated. We sought to determine the effects of HT on ALI in HS. ⋯ HT attenuates HS-induced ALI in rats by the modulation of GSK, HSP 72, iNOS, and NF-kappaB.
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The homodigital reverse vascular island flap-a regional, axial-patterned skin flap elevated with a vascular pedicle from the proximal digit-is a one-step procedure used to replace skin and soft tissue loss or destruction in the distal finger. The purpose of this study was to evaluate the clinical outcome. ⋯ The homodigital reverse island flap is an ideal surgical treatment for distal digital defects with a lower complication rate and good functional result, and the indication of age can be extended for older patients with a good preoperative evaluation.
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Early prediction of the need for massive transfusion (MT) remains difficult. We hypothesized that MT protocol (MTP) utilization would improve by identifying markers for MT (>10 units packed red blood cell [PRBC] in 24 hours) in torso gunshot wounds (GSW) requiring early transfusion and operation. ⋯ In patients requiring early operation and transfusion after torso GSW: (1) early initiation of MTP is reasonable for transpelvic and multicavitary trajectories regardless of initial hemodynamic status as multiple or difficult to control bleeding sources are likely and (2) early initiation of MTP in patients with LRT may be guided by a combination of hypotension and acidosis, indicating massive blood loss.
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Traumatic brain injury is a common cause of death after traumatic insults. Alcohol intoxication is a recognized contributor to the occurrence of these injuries. The specific effects of alcohol exposure on injury severity and subsequent outcomes, however, remain controversial. The aim of this study was to investigate the relationship between blood alcohol levels (BAL) and outcomes in patients with isolated severe traumatic brain injuries (sTBI). ⋯ Among patients with isolated sTBI, BAL do not seem to be associated with overall injury severity, head injury severity, or the occurrence of major morbidities. Similarly, hospital and intensive care unit lengths are not affected by high admission BAL level. The adjusted overall in-hospital mortality, however, is significantly lower in patients presenting with the high BAL (>or=0.08 g/dL) after isolated sTBI.