J Trauma
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This study was performed to determine the effects of orthopedic trauma on pregnancy outcomes in pregnant trauma patients. ⋯ Our findings indicate that traumatized pregnant women with orthopedic injuries are high-risk obstetrical patients and may benefit from referral to a medical center capable of handling both the primary injury and the potential preterm birth associated with the injury.
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The aim of this study was to assess the outcome of immediate plate osteosynthesis in the surgical treatment of open humeral shaft fractures. ⋯ Immediate plate osteosynthesis for open humeral shaft fractures has been shown to produce excellent results regarding bone union and absence of deep infections and is a safe technique in the management of these injuries.
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Cardiac injury is one of the most lethal injuries. The objective of this study was to determine the real amount of risk factors for penetrating cardiac injuries. ⋯ Our data have shown the real amount of risk variables for mortality in penetrating cardiac injuries by using binary logistic model.
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Multicenter Study
Posttraumatic stress disorder after injury: does admission to intensive care unit increase risk?
This study aimed to index the prevalence of posttraumatic stress disorder (PTSD) after injury requiring intensive care unit (ICU) admission to investigate whether an ICU admission after injury increases risk for PTSD and to identify predictors of PTSD after ICU admission. ⋯ Injury patients are three times more likely to develop later PTSD if they have an ICU admission. Given we controlled for many risk variables, it seems that an ICU admission itself may contribute to the development of PTSD. Mental health services such as screening and early intervention may be particularly useful for this population.
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Multicenter Study
Management of patients with traumatic intracranial injury in hospitals without neurosurgical service.
Many patients with intracranial bleeding (ICB) are being evaluated in hospitals with no neurosurgical service. Some of the patients may be safely managed in the primary hospital without transferring them to a designated neurosurgical center. In Israel, there are three approaches to alert patients with ICB: mandatory transfer, remote telemedicine neurosurgical consultation, and clinical-radiologic guidelines. We evaluated the outcome of alert patients with low-risk ICB who were managed in centers without neurosurgical service. ⋯ Despite the small sample size of this study, the presented data suggest that some patients with ICB can be safely and definitively managed in centers with no on-site neurosurgical service. The need for transfer may be based on telemedicine consultation or clinical -radiologic guidelines. Further larger scale studies are warranted.