J Trauma
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Although brain cooling has recently been reported as effective in improving the survival after heatstroke generation in rats, the mechanisms underlying the therapeutic effects of brain cooling are not fully elucidated. This study was conducted to test whether the acute lung inflammation and damage that might occur during heatstroke could be affected by brain cooling. ⋯ These experimental data indicate that acute lung inflammation and damage is a target of brain cooling after heatstroke injury.
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The ability to detect damage to the intervertebral structures is critical in the management of patients after blunt trauma. A practical and inexpensive method to identify severe structural damage not clearly seen on computed tomography would be of benefit. The objective of this study was to assess whether ligamentous injury in the subaxial cervical spine can be reliably detected by analysis of lateral radiographs taken with and without axial traction. ⋯ This study supports further clinical investigations to determine whether low-level axial traction may be a useful adjunct for detecting unstable subaxial cervical spine injuries in an acute setting.
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Comparative Study
Effects of fluid resuscitation with hypertonic saline dextrane or Ringer's acetate after nonhemorrhagic shock caused by pulmonary contusion.
Injured lungs are sensitive to fluid resuscitation after trauma. Such treatment can increase lung water content and lead to desaturation. Hypertonic saline with dextran (HSD) has hyperosmotic properties that promote plasma volume expansion, thus potentially reducing these side effects. The aim of this study was to (1) evaluate whether fluid treatment counteracts hypotension and improves survival after nonhemorrhagic shock caused by lung contusion and (2) analyze whether resuscitation with HSD is more efficient than treatment with Ringer's acetate (RA) in terms of blood oxygenation, the amount of lung water, circulatory effects, and inflammatory response. ⋯ Fluid treatment does not affect blood pressure or mortality in this model of nonhemorrhagic shock caused by lung contusion. However, our data indicate that HSD, when compared with RA, has advantages for the injured lung.
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Victims of violence are likely to become repeat victims of violence. Emergency department-based secondary prevention initiatives have been proposed to help break the cycle of violence for these youth. Trauma centers, by nature of their designation, are often charged with the responsibility of developing these prevention initiatives. We hypothesize that the majority of youth who are injured by violence are treated in nontrauma centers. Given the goal is to prevent recurrent injury, trauma center-based initiatives may be misdirected. ⋯ Given the vast majority of patients are not seen at trauma centers, any prevention initiatives located here will not achieve the goals of preventing recurrent injury on a population basis. Secondary prevention initiatives should be implemented and evaluated in nontrauma centers.
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Although explosion injuries caused by terror attacks or in war are evaluated in many studies, limited information about civil explosion injuries can be found in the literature. ⋯ The mortality from gas explosion-related burns correlated significantly with burned TBSA, ABSI score, accompanying inhalation injuries, and lung contusions. Despite comparable ABSI scores, the mortality from gas explosion-related burns was significantly higher than the mortality for all burn victims.