J Trauma
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Randomized Controlled Trial
Low-intensity pulsed ultrasound as a useful adjuvant during distraction osteogenesis: a prospective, randomized controlled trial.
Low-intensity pulsed ultrasound (LIPUS) was proven to have a positive impact on bone healing in animal and clinical studies. ⋯ Therapeutic application of LIPUS during callus distraction constitutes a useful adjuvant treatment during distraction osteogenesis and has a positive effect on healing time with no negative effects.
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Conflicting data exist regarding optimal glycemic control in critically ill trauma patients. We therefore compared glucose parameters and outcomes among three different glycemic control regimens in a single trauma intensive care unit (ICU), hypothesizing that a moderate regimen would yield optimal avoidance of hyper- and hypoglycemia with equivalent outcomes when compared with a more aggressive approach. ⋯ Hyperglycemic events (glucose >180 mg/dL) most strongly predicted mortality. Of glucose control protocols analyzed, the "moderate" protocol had fewest hyperglycemic events. As outcomes were otherwise equivalent between "moderate" and "aggressive" protocols, we conclude that hyperglycemia can be safely avoided using a moderate glycemic control protocol without inducing hypoglycemia.
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Trauma system planners use patient home address as a proxy for injury location, although this proxy has not been validated. We sought to determine the precision of this proxy by evaluating the relationship between the location of injury death and the location of residence. ⋯ The preponderance of fatal injury deaths occur close to home. This supports the practice of trauma system's planning using home location available in administrative data to proxy injury location.
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There have been no rigorous studies exploring whether the severity of hand injury can predict health-related quality of life (HRQoL). The purpose of our study is to examine the relationship between the initial anatomic severity of hand injuries (evaluated by the Hand Injury Severity Scoring [HISS] system) and HRQoL in patients with hand injuries. ⋯ HISS is able to predict the physical HRQoL with useful levels of accuracy. It is strongly recommended that surgical therapy departments provide more detailed physiotherapy programs for the high-risk groups, such as dominant hand injury and age of ≥40, to improve their physical HRQoL.