J Trauma
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As familiarity with military massive transfusion (MT) triggers has increased, there is a growing interest in applying these in the civilian population to initiate MT protocols (MTP) earlier. We hypothesize that these triggers do not have equal predictability for MT and understanding the contribution of each would improve our ability to initiate the MTP earlier. ⋯ Triggers have differential predictive values for need for transfusion. Defining the individual utility of each criterion will help to identify those most likely to benefit from an early initiation of the MTP.
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Comparative Study
Minor head injury in warfarinized patients: indicators of risk for intracranial hemorrhage.
Head injury represents one of the most important and frequent traumatic pathology in the emergency department. Among the different risk factors, preinjury use of warfarin has received considerable attention in trauma literature. The aim of this study was to identify further risk indicators of intracranial hemorrhage (ICH) to improve risk stratification of warfarinized patients with minor head injuries. ⋯ This study highlights the strong relationship between INR values and the probability of ICH, as shown in previous studies. The high negative predictive value of the identified cutoff, if confirmed, could be used to exclude ICH.
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Comparative Study
Tumor necrosis factor alpha gene polymorphism is associated with the outcome of trauma patients in Chinese Han population.
Tumor necrosis factor (TNF) is a proinflammatory cytokine that plays a major role in the sepsis and multiple organ dysfunction secondary to major trauma. The purpose of this article was to research the clinical relevance of the TNF gene polymorphism in patients with major trauma. ⋯ The TNF-α/-308 polymorphism might be used as a biomarker for the assessment of outcome of trauma patients, but the TNF-β/252 gene polymorphism might not influence the development of complications in patients with major trauma.
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Comparative Study
Pediatric vascular injuries: acute management and early outcomes.
Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. ⋯ Pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt. Injuries to the torso carry a high mortality. Limb salvage is almost universal.
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Comparative Study
Body cooling ameliorating spinal cord injury may be neurogenesis-, anti-inflammation- and angiogenesis-associated in rats.
Body cooling (BC) or mild hypothermia therapy (about 33°C) is reportedly effective for spinal cord injury (SCI). However, the mechanisms underlying the beneficial effects of BC remain unclear, so does BC ameliorating SCI via promoting neurogenesis, anti-inflammation, and angiogenesis. ⋯ BC (33°C) improved SCI outcomes by promoting angiogenesis, neurogenesis, and anti-inflammation in a rat SCI model.