European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2025
ReviewPrinciples of wound ballistics and their clinical implications in firearm injuries.
Ballistics is the science that studies the trajectory, range, and effects of projectiles. Knowledge of the principles of wound ballistics is of particular importance to the surgeon because they allow the optimization of the diagnosis and treatment of those injured by firearms. This review focuses on the updated knowledge of wound ballistics as it pertains to the diagnosis and treatment of gunshot wounds. ⋯ The understanding of wound ballistics enhances the ability to identify potential injuries and to optimize the treatment of gunshot wounds in adults.
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Eur J Trauma Emerg Surg · Feb 2025
Impact of interhospital transport on outcome in traumatic epidural hematoma: experiences of a level-1 trauma center.
Epidural hematomas (EDH) are associated with a high rate of mortality and morbidity. Good clinical outcome depends on initial Glasgow Coma Scale (GCS), pupillary abnormalities, hematoma volume, age and time to surgery. The latter is mostly influenced by distance to the next level-1-trauma center. ⋯ Interhospital transport did not cause a significant delay of surgical treatment and outcome was comparable between direct and indirect transport to specialized neurosurgical care. Direct transport was more common on severe TBI and in patients with pupillary abnormalities, but secondary transport also allowed for adequate care.
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Eur J Trauma Emerg Surg · Feb 2025
The optimal timing for definitive operative stabilization of pelvic fractures in polytrauma patients: effects on clinical outcomes - a systematic review.
The optimal timing for definitive surgical treatment of pelvic fractures in polytrauma patients remains a topic of ongoing discussion due to the complexity of these injuries. This analysis therefore aims to systematically compare early versus late definitive operative stabilization of pelvic fractures on outcome in polytrauma patients. ⋯ There is limited evidence regarding early definitive fracture repair (≤ 24 h) compared to late repair of pelvic fractures in polytrauma patients. One observational study showed a reduced incidence of septic respiratory complications, ARDS, and multi-organ failure (MOF) in polytrauma patients who received early definitive fracture repair.
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Eur J Trauma Emerg Surg · Feb 2025
Cannabidiol protects lung against inflammation and apoptosis in a rat model of blunt chest trauma via Bax/Bcl-2/Cas-9 signaling pathway.
This study aimed to investigate the hypothesis that cannabidiol (CBD), with known anti-inflammatory and anti-apoptotic effects, would reduce the severity of acute lung injury in pulmonary contusion following blunt chest trauma. ⋯ CBD reduces lung damage in lung contusions caused by blunt chest trauma through its anti-inflammatory and antiapoptotic effects. More detailed studies investigating other important intracellular pathways are needed.
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Eur J Trauma Emerg Surg · Feb 2025
Observational StudyEarly detection of muscle wasting assessed by ultrasound and analysis of growth factor and systemic inflammation mediators in critically ill trauma patients: an observational study.
The present study aims to describe initial changes in muscle thickness and composition, muscle growth signaling mediators, and systemic inflammation in critically ill patients after major trauma. ⋯ These findings reveal substantial thickness and muscle composition alterations within 48 h post-admission, worsening over five days. Despite standard rehabilitation care, changes in IGF-1 and IFN-y levels suggest early declines in muscle growth stimulus and increased inflammation.