J Trauma
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Each year, approximately 4.7 million Americans sustain dog bites, the majority of which occur in children. In response to this alarming trend, injury prevention programs across the country have focused efforts on preventing dog bites in children. However, little attention has been given to non-bite dog-related injuries, and to date, no data have been presented on this type of injury in the western literature. ⋯ Dog bites have been recognized around the world as a substantial public health problem particularly in children. In our experience, we have seen that non-bite-related injuries should not be ignored. The injuries seen in this subset of children are the result of being struck or pushed, resulting in multiple, potentially severe injuries. These data underscore the unpredictable nature of animals and the need for adult supervision when animals and children interact.
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Knowledge concerning the trajectory and predictors of health-related quality of life (HRQoL) years after burn injury is fragmentary and these factors were therefore assessed using the EQ-5D questionnaire. ⋯ HRQoL after burn is conveniently screened by EQ VAS. Impairment after 2 years to 7 years is mainly reflected in the EQ dimensions Pain/Discomfort and Usual activities and can be predicted in part by information available before or at 12 months.
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Hospital complications can pose a threat to patients, contribute to higher mortality and morbidity, and increase both the average length of hospital stay (LOS) and the use of other resources. The purpose of this study is to express the relationship between complications and the use of hospital resources in financial parameters. ⋯ Complications increase hospital costs, and even a small reduction in the number of complications will result in a substantial hospital cost savings and a reduction in the emotional and physical burdens of patients.
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The aim of this study was to evaluate the time course of recovery from cerebral vulnerability, using microdialysis (MD) technique and cerebral vascular autoregulation measurement, to clarify the appropriate timing of subsequent major surgical procedures, and to minimize the possibility of secondary brain injury in patients with severe traumatic brain injury (STBI). ⋯ Our results indicated that cerebral vascular autoregulation would recover on the fourth day after STBI, and cerebral perfusion might be increased by recovery of autoregulation. Thus, subsequent nonemergent surgery should be performed at least 4 days after STBI to prevent secondary brain injury. In addition, we should keep in mind that the cerebral vulnerability might persist for 4 days after suffering STBI.
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To examine the impact of an ongoing comprehensive performance improvement and patient safety (PIPS) program implemented in 2005 on mortality outcomes for trauma patients at an established American College of Surgeons (ACS)-verified Level I Trauma Center. ⋯ Implementation of a multifaceted trauma PIPS program aimed at improving trauma care significantly reduced in-hospital mortality in a mature ACS Level I trauma center. Optimal care of the injured patient requires uncompromising commitment to PIPS.