J Trauma
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Early surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTI), a severe, potentially life threatening, rapidly progressive infection. The purpose of this study was to determine the influence of surgical procedure timing on the number of surgical debridements required. ⋯ In patients with NSTI, a delay of surgical treatment of >12 hours is associated with an increased number of surgical debridements and higher incidence of septic shock and acute renal failure.
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Traumatic brain injury (TBI) accounts for the largest proportion of injury-related deaths and disability in the United States. The proportion of TBI-related deaths that occur after admission in a hospital remains high despite improvement in medical technology. We provide findings on the risk factors of in-hospital death and demonstrate the risk associated with sepsis occurring in the hospital environment. ⋯ Sepsis occurring in the hospital environment and associated with nosocomial etiologies is a strong risk factor for in-hospital death after TBI. Reducing the risk of infections and subsequent sepsis through adherence with infection control measures is a critical step to reduce in-hospital deaths among patients with TBI.
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The modified medial Stoppa approach is an alternative and new surgical approach to access to the internal pelvis and medial wall of the acetabulum. There is little information about the clinical anatomic specifications of exposure in the literature. In this study, the pertinent surgical anatomy that involved the modified medial Stoppa approach was further defined and the anatomic positions and variations of the structures seen in the surgical site were analyzed. ⋯ Before clinical applications, performing cadaver dissection is important to minimize intraoperative complications. This study was the first anatomic study in the literature that reveals the structures that are at risk during surgical treatment of acetabular fractures, which was treated with the modified medial Stoppa approach.
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Cardiac-related injuries caused by blunt chest trauma remain a severe problem. The aim of this study was to investigate pathophysiological changes in the heart that might arise after behind armor blunt trauma or impacts of nonlethal projectiles. ⋯ This study indicates that nonlethal kinetic projectiles "eXact iMpact" does not cause heart-related damage under the examined conditions. On impact, sudden heart arrest may occur independently from the cardiac's electrical cycle. The cardiac enzyme, TnI, can be used as a reliable diagnostic marker to detect heart tissue damages after blunt chest trauma.