J Trauma
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Postacute care is an essential component of medical care aimed at returning trauma patients to their preinjury functional status. Rehabilitation services, skilled nursing facilities, and home care all play a role in facilitating the healing process. Access to such care may be limited based on insurance status, leaving the uninsured with limited resources to reach full recovery. We hypothesized that access to specialized postacute care is less available to patients who lack health insurance. ⋯ Insurance status is an important predictor of hospital disposition and access to specialized posthospital care. Uninsured patients are less likely to have access to the full range of medical care available to ensure complete recovery from traumatic injuries.
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Arterial base deficit (ABD) measurement is a standard test for assessment of the trauma patient's metabolic response to shock. Venous blood is readily available earlier during the trauma resuscitation. The aim of this study is to analyze the difference (correlation, agreement, clinical significance) between the first peripheral venous base deficit (pVBD) and the first ABD during trauma resuscitation. ⋯ There is near perfect correlation and clinically acceptable agreement between pABD and pVBD values on simultaneous testing. pVBD is an acceptable test to assess trauma patients' initial metabolic status when occult blood loss suspected.
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To determine whether preinjury statin use is associated with survival and functional recovery in older adult victims of moderate/severe head trauma. ⋯ Preinjury statin use in older adult traumatic brain injury victims is associated with reduced risk of death and improved functional recovery at 12 months postinjury. Individuals with cardiovascular comorbidities lose this benefit of premorbid statin use. Statins, as possible protective agents in head trauma, warrant further study.
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Temporary abdominal closure (TAC) is often performed after an open abdomen to prevent postoperative complications. Reducing the time of TAC and performing a skin grafting as early as possible would improve the outcome of open abdomen. This study was designed to evaluate the effects of different TAC materials and topically applied exogenous growth factors on the growth of granulation tissue covered on the wound areas after the open abdomen. ⋯ Polypropylene mesh could promote the growth of granulation tissue after the open abdomen. Topical application of rhGH or rbFGF further hastens the process, with the effect of rbFGF being the greatest.
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The mechanisms of agmatine-induced neuroprotective effects in traumatic brain injury (TBI) remain unclear. This study was to test whether inhibition of gliosis, angiogenesis, and neurogenesis attenuating TBI could be agmatine stimulated. ⋯ Resultantly, agmatine therapy may attenuate TBI in rats via promoting angiogenesis, neurogenesis, and inhibition of gliosis.