J Trauma
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To evaluate whether older injured motor vehicular crash (MVC) occupants' access to trauma centers (TC) reflects the lower threshold suggested in triaging recommendations. ⋯ In contrast to the American College of Surgeons triaging recommendations, injured MVC occupants older than 60 years are less likely to be transported to a TC than their younger counterparts. Further studies should establish whether the lower access to TC experienced by the older population is a function of geographical factors, emergency medical services unconscious bias, or other factors.
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Female gender may protect against infectious complications after injury. This protection may be due to a beneficial effect of estrogen (E2) as the salutary effects are age and estrus cycle related. However, outcome may be worse in females developing infectious complications or organ failure after injury. To assess the role of E2 in postshock organ failure, we studied the effect of E2 on parameters of lung injury in an in vitro cell culture model. ⋯ Exposure of HT-29 cells to either H/R or E2 had a deleterious effect on HMVEC monolayers. In addition, there seemed to be a synergistic effect of H/R and E2 on pulmonary endothelial injury. This study supports the findings noted in recent clinical studies suggesting E2 decreases infectious complications but may be associated with poorer outcomes if complications occur.
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To examine the association of scene mobility status (SMS) and injury severity and mortality among motor vehicular crash (MVC) victims. ⋯ MVC occupants who "self-exited" or "exited with assistance" experienced a very low injury severity and mortality. Further efforts are needed to decrease the overtriaging of these patients.
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Hyperbaric oxygen preconditioning (HBO₂P + HAE) has been found to be beneficial in preventing the occurrence of ischemic damage to brain, spinal cord, heart, and liver in several disease models. In addition, pulmonary inflammation and edema are associated with a marked reduction in the expression levels of both aquaporin (AQP) 1 and AQP5 in the lung. Here, the aims of this study are first to ascertain whether acute lung injury can be induced by simulated high altitude in rats and second to assess whether HBO2P + HAE is able to prevent the occurrence of the proposed high altitude-induced ALI. ⋯ Our results suggest that high altitude pulmonary injury may be prevented by HBO2P + HAE in rats.
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To evaluate the feasibility of aortic balloon catheter occlusion in intra-abdominal hemorrhage. ⋯ A 40-minute ABO followed by surgical damage control improved survival in this animal model of uncontrolled hemorrhagic shock caused by abdominal trauma. ABO could be considered for the management of severe abdominal trauma.