Articles: trauma.
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Trauma is an increasing cause of mortality worldwide with road traffic accidents (RTAs) causing 1.3 million deaths annually with 90% of this mortality occurring in low and middle income countries. The rise in trauma deaths has been neglected with infectious diseases taking precedence. More research needs to be conducted in resource poor countries to establish the main causes of trauma and find better solutions to the rising trend in mortality. Much of the trauma research in resource poor countries has focused on urban areas. This study aims to find the leading causes of trauma at a rural Ugandan hospital. ⋯ RTAs were an important cause of morbidity and mortality in a rural Ugandan hospital as they also are in urban areas. Low cost initiatives to reduce speed, prevent alcohol impaired driving, improve public education and wider access to high quality trauma care are vital to reducing the mortality and morbidity caused by RTAs in Africa.
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J Trauma Manag Outcomes · Jan 2010
500 ml of blood loss does not decrease non-invasive tissue oxygen saturation (StO2) as measured by near infrared spectroscopy - A hypothesis generating pilot study in healthy adult women.
The goal when resuscitating trauma patients is to achieve adequate tissue perfusion. One parameter of tissue perfusion is tissue oxygen saturation (StO2), as measured by near infrared spectroscopy. Using a commercially available device, we investigated whether clinically relevant blood loss of 500 ml in healthy volunteers can be detected by changes in StO2 after a standardized ischemic event. ⋯ StO2 measured at the thenar eminence seems to be insensitive to blood loss of 500 ml in this setting. Probably blood loss greater than this might lead to detectable changes guiding the treating physician. The exact cut off for detectable changes and the time effect on repeated vascular occlusion tests should be explored further. Until now no such data exist.
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Uncontrolled hemorrhage is responsible for over 50% of all trauma-related deaths within the first 48 hours after admission. Clinical observations together with recent research resulted in an appreciation of the central role of coagulopathy in acute trauma care. A synopsis is presented of different retrospective analyses based upon datasets from severe multiply injured patients derived from the TR-DGU database (Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie (DGU)/ German Society of Trauma Surgery) with respect to frequency, risk stratification and therapeutic options of acute traumatic coagulopathy (ATC). ⋯ An early aggressive management of ATC including a more balanced administration of blood products to improve outcome is advocated.
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Retraction Of Publication
Retracted manuscript. Prehospital care of the adult trauma patient.
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Eur J Trauma Emerg S · Dec 2009
Posterior Fusion in Patients with Trauma, Instability, and Tumor of the Cervical Spine.
Trauma, instabilities and tumors of the cervical spine are treated with established methods of surgery. Therefore, anterior fusion is considered to be a standardized procedure for the lower cervical spine, while posterior and anterior instrumentation facilitates stabilization of the upper cervical spine. ⋯ Neurological deficit symptoms, bone quality and related diseases fundamentally lead to a decision of posterior access and fusion. Different pathologies and corresponding reasons for posterior surgical interventions on the cervical spine are described in this paper and discussed using the current literature.