Articles: trauma.
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Department of Veterans Affairs disability benefits for post-traumatic stress disorder (PTSD), also known as "service connection," have been shown to reduce homelessness and poverty, increase mental health engagement, and improve clinical outcomes. However, gender and race disparities in PTSD service connection have been described in Vietnam and post-Vietnam era Veterans. ⋯ Women were less likely to receive PTSD service connection compared to men; this difference was nearly completely mediated by gender differences in combat exposure. Black women were less likely than non-Black women to receive PTSD service connection, but we could not identify a plausible mechanism to explain this finding. On net, the base compensation package was lower for Veterans denied PTSD service connection than for those receiving PTSD service connection.
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Retrospective cohort study. ⋯ Our study suggests racial disparities in outcomes and discharge disposition for acute cSCI patients.
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Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage control resuscitation, with a focus on haemorrhage control, haemostatic resuscitation and permissive hypotension. ⋯ In this paper, we suggest that perhaps more consideration should be given to the diastolic blood pressure in bleeding trauma patients. The diastolic blood pressure is critical for coronary perfusion, and in turn the cardiac output responsible for cerebral blood flow. We suggest that a move to reframing resuscitation in terms of physiology may change the way that we resuscitate these patients and allow for more nuanced treatment strategies.
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Unstable posterior pelvic-ring fractures are rare and difficult to manage. There are many injury patterns, they are associated with high morbidity and mortality, and optimal surgical management remains contentions. This study aims to compare outcomes and complications for different surgical management of these injuries. ⋯ This study highlight bilateral posterior-pelvic ring injuries as a greater management challenge than unilateral injuries. It supports the use of percutaneous fixation with closed-reduction, decreased infection risk and decreased length-of-stay. It challenges the use of external fixators and supports less restrictive post-operative restrictions. This study also serves as a descriptive analysis for the current management of pelvic fractures in an Australian setting, shedding light on complication rates and profiles.
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Postgraduate medicine · Jan 2025
Trends of primary health care practitioners toward bleeding management in Saudi Arabia: a cross-sectional analysis.
High rates of morbidity and mortality are a result of trauma being a significant health burden in Saudi Arabia. We evaluated the current trends of primary healthcare (PHC) physicians in Saudi Arabia toward patients with bleeding and their referral awareness for percutaneous endovascular arterial embolization (EAE). ⋯ PHC physicians in Saudi Arabia require a better understanding of the indications of EAE to avoid referral and triage errors, inefficient use of healthcare resources, and suboptimal patient outcomes.