European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Comparative StudyDoes a gentamicin-coated intramedullary nail prevent postoperative infection in Gustilo type I and II tibial open fractures? A comparative study and retrospective analysis.
Tibial open shaft fractures are very common and susceptible to infection, which can lead to significant morbidity especially infection and non-union. Antibiotic coated nail is one option for fixing open shaft tibial fractures to minimise infection. This study aimed to compare the clinical outcome of Gentamicin-coated tibial nails versus regular unreamed interlocking tibial nails in the treatment of type I and II tibial open fractures. ⋯ We hypothesized that Gentamicin-coated nail is effective in preventing infection in Gustilo type I and II open fractures compared to non-antibiotic-coated regular nails.
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Eur J Trauma Emerg Surg · Jan 2025
Outcomes of electrical injuries in the emergency department: epidemiology, severity predictors, and chronic sequelae.
Electrical injuries (EIs) represent a significant clinical challenge due to their complex pathophysiology and variable presentation, ranging from minor burns to severe internal organ damage. Despite their prevalence in both; domestic and occupational settings, there remains a rareness of systematic guidelines and comprehensive literature to aid clinicians in effectively managing these injuries. Understanding these factors is crucial for developing protocols that can mitigate the risk of delayed complications, such as cardiac arrhythmias, in patients who initially appear stable. ⋯ EIs are frequent, with diverse clinical presentations requiring multidisciplinary care. Awareness of potential delayed complications is essential, and prevention is crucial.
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Eur J Trauma Emerg Surg · Jan 2025
Alcohol drinking leads to sex-dependent differentiation of T cells.
Global per capita alcohol consumption is increasing, posing significant socioeconomic and medical challenges also due to alcohol-related traumatic injuries but also its biological effects. Trauma as a leading cause of death in young adults, is often associated with an increased risk of complications, such as sepsis and multiple organ failure, due to immunological imbalances. Regulatory T cells play a crucial role in maintaining immune homeostasis by regulating the inflammatory response. Since it is crucial to understand the effects of alcohol in healthy volunteers, in order to refer findings from trauma cohorts, this study investigates the time- and dose-dependent modulation of CD4+ lymphocytes and their subsets following acute alcohol consumption, considering both general and sex-specific variations. ⋯ Acute alcohol consumption induces immune modulation persisting for days, impacting T cell subsets differently in men and women. The prolonged modulation in men may contribute to slightly poorer clinical outcomes, emphasizing the need to consider these effects in trauma patients with acute alcohol intoxication.
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisAccuracy of GFAP and UCH-L1 in predicting brain abnormalities on CT scans after mild traumatic brain injury: a systematic review and meta-analysis.
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In recent years, blood biomarkers including glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown a promising ability to detect head CT abnormalities following TBI. This review aims to combine the existing research on GFAP and UCH-L1 biomarkers and examine how well they can predict abnormal CT results after mild TBI. ⋯ Present results suggest that GFAP and UCH-L1 have the clinical potential for screening mild TBI patients for intracranial abnormalities on head CT scans.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter Study Observational StudyD-dimer cutoff values for predicting functional prognosis in patients with severe head trauma: a multi-centre prospective observational study.
D-dimer, a fibrinolysis indicator, may predict functional and life outcomes in traumatic brain injury (TBI) patients. We aimed to identify optimal D-dimer cutoff values for poor functional outcomes in severe TBI. ⋯ A cutoff value of 27.2 µg/mL for early-stage D-dimer levels could predict the functional prognosis of patients with severe isolated TBI.