J Trauma
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Multicenter Study Comparative Study
Blunt traumatic occult pneumothorax: is observation safe?--results of a prospective, AAST multicenter study.
An occult pneumothorax (OPTX) is found incidentally in 2% to 10% of all blunt trauma patients. Indications for intervention remain controversial. We sought to determine which factors predicted failed observation in blunt trauma patients. ⋯ Most blunt trauma patients with OPTX can be carefully monitored without tube thoracostomy; however, OPTX progression and respiratory distress are independently associated with observation failure.
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Multicenter Study Comparative Study
Routine follow-up imaging of kidney injuries may not be justified.
The purpose of this investigation was to determine the yield of repeat follow-up imaging in patients sustaining renal trauma. ⋯ Selective reimaging of renal injuries based on clinical and laboratory criteria seems to be safe regardless of injury mechanism or management. High-grade penetrating injuries undergoing operative intervention should carry the highest degree of vigilance and lowest threshold for repeat imaging.
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Case Reports
Clinical application of the flap based on the distal cutaneous branch of the ulnar artery.
To introduce our experiences of using the flap based on the distal cutaneous branch of the ulnar artery. ⋯ Because the flap does not compromise the dominant hand arteries and provides a reliable blood supply, it is a good choice for soft tissue reconstruction of defects in the dorsal and palmar aspects of the hand.
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Comparative Study
Analysis of different decision aids for clinical use in pediatric head injury in an emergency department of a general hospital.
The diagnostic algorithm in children with head injury remains uncertain. The National Emergency X-Radiography Utilization Study II (NEXUS II) recently proposed a new decision aid. We analyzed the data prospectively recorded in a local database to evaluate the sensitivity and specificity of the variables proposed by NEXUS II, by comparing with an Italian proposal. ⋯ In our setting, the variables selected by the Italian proposal had higher discriminating capacity for intracranial lesions than those proposed by the NEXUS II rule, in children with head injury. These results should be considered in children with head injury attending an emergency department of a general hospital.