J Trauma
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Hypertonic saline solution treatment of uncontrolled hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in arterial blood pressure, and increased mortality. The effect of dehydration induced by either water deprivation or heating on this response was studied in rats. The animals were divided into four groups: group 1 (n = 32), normal rats; group 2 (n = 30), water deprivation for 12 hours; group 3 (n = 30), heating at 37 degrees C for 5 hours; and group 4 (n = 30), heating as in group 3 and water deprivation as in group 2. ⋯ Tail resection in group 1a resulted in bleeding of 4.9 +/- 0.3 mL, and fall in mean arterial pressure (MAP) to 50 +/- 3 mm Hg (p < 0.001). Blood loss and fall in hematocrit in groups 2, 3, and 4 was significantly lower than in group 1. The fall in MAP and pulse rate was similar in all four groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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To determine if pre-existing conditions significantly improve the ability of current (TRISS and ASCOT) methods for predicting survival of patients with trauma from low falls. ⋯ Pre-existing conditions and male gender are significantly related to survival of patients with trauma from low falls, and should be included along with age and the various physiologic and anatomic measures currently being used to predict survival for those patients.
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Typical bilateral cheiro-oral syndrome was encountered in a 74-year-old man who had bilateral subdural hematoma after a minor head injury. The delayed grave neurologic deficits occurred 1 month later without expansion of the hematoma. Removal of the lesions reversed both cheiro-oral syndrome and his late-onset neurological disabilities.
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To measure the functional outcome we analyzed 723 consecutive patients with multiple injuries (Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS) > or = 16, mean ISS 30.1) treated at the University Hospital Groningen, the Netherlands, between 1985 and 1989. Age, sex, type of accident, AIS/ISS, discharge destination, length of hospital stay and functional outcome (measured by the Glasgow Outcome Scale) are described. The patients were young (mean age 33.4 years) and 186 died (25.7%) mainly because of severe head injuries. ⋯ These injuries, together with spinal cord injuries, appeared to be responsible for the majority of permanent disabilities. Although the functional outcome deteriorated linearly with increasing AIS/ISS, the final functional result was good: in the first half year after injury there was considerable recovery; after that there was further slight recuperation. Two years after injury, 68% had mild or no disabilities, 19% were moderately disabled, and 7% severely disabled.
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Analyses were conducted to estimate the effectiveness of airbags in reducing driver fatalities in motor vehicle crashes. ⋯ Various estimates of airbag effectiveness are beginning to yield consistent results. These analyses confirm that driver airbags are reducing fatalities in the frontal crashes for which they are designed.