Background The purpose of this study was to evaluate the roles cervical spine radiographs (CSR) and computed tomography (CTC) in exclusion injury for adult blunt trauma patients. Methods At authors’ institution, all patients with physical findings posterior midline neck tenderness, altered mental status, or neurologic deficit are considered at risk undergo both CSR CTC evaluation spine. TRACS database level 1 center institution queried from November 2000 October 2001. Patient severity score...

Objective To determine the effect of trauma on arginase, an arginine-metabolizing enzyme, in cells immune system humans. Summary Background Data Arginase, classically considered enzyme exclusive to liver, is now known exist system. Arginase expression induced these by cytokines interleukin (IL) 4, IL-10, and transforming growth factor beta, corresponding a T-helper 2 cytokine profile. In contrast, nitric oxide synthase IL-1, tumor necrosis factor, gamma interferon, 1 Trauma associated with...

It has been shown that spinal fracture fixation within 3 days can reduce the incidence of pneumonia, length stay, number ventilator days, and hospital charges. Our institutional protocol calls for surgical stabilization fractures admission. We hypothesized compliance with an early (within admission) would improve non-neurologic outcome in patients fractures.The trauma registry was queried period January 1988 through October 2001 to identify requiring stabilization. Patients were analyzed...

STATEMENT OF THE PROBLEM The ideal time for performing a tracheostomy has not been clearly established. Periods ranging from 3 days to weeks have suggested in the literature. With current operative methods, it established that can be performed with low rate of complications. In review 281 tracheostomies, as well another 2,862 cases literature, Zeitouni and Kost1 reported 0% mortality their series 0.3% other since 1973. risks prolonged endotracheal intubation—such patient discomfort,...

BACKGROUND Procalcitonin (PCT), the prohormone of calcitonin, has an early and highly specific increase in response to systemic bacterial infection. The objectives this study were determine natural history PCT for patients with critical illness trauma, utility as a marker sepsis versus inflammatory syndrome (SIRS), association level mortality. METHODS assays done on eligible trauma admitted intensive care unit (ICU) Level I center from June 2009 2010, at hours 0, 6, 12, 24, daily until...

To determine surgical, postoperative, and postdischarge complications associated with percutaneous dilational tracheostomy (PDT) in an 8-year experience at the University of Kentucky.There are known risks transport critically ill patients to operating room for elective tracheostomy, less-than-optimal conditions may interfere open bedside tracheostomy. PDT has been introduced as alternative Despite information supporting its safety utility, technique criticized because advocates had not...

Background: Respiratory complications can undermine outcome from low cervical spinal cord injury (SCI) (C5-T1). Most devastating of these is catastrophic loss airway control. This study sought to determine the incidence and effect (CLA) define need for elective intubation with subsequent tracheostomy prevent potentially fatal outcomes. Methods: A database 54,838 consecutive patients treated in a level I trauma center between January 1988 December 2004 was queried identify SCI, without...

Introduction: The ideal timing of spinal fixation is controversial. A recent study showed that early spine reduced morbidity and resource utilization. We previously noted a trend toward higher mortality in patients undergoing fixation. This was done to analyze whether the had significant effect on mortality. Methods: registry our Level I trauma program queried for all with at least one vertebral injury. Anatomic physiologic variables included age, initial Glasgow Coma Scale score, systolic...

Background: To examine the efficacy of early versus late spinal fracture fixation, we reviewed National Trauma Data Bank (NTDB) records to identify breakpoint in reported timing operative fixation. Using this then analyzed outcome for those treated late, hypothesizing that group would experience better as reflected by resource utilization and complications. Methods: The NTDB was queried patients with any level required surgical stabilization. Histogram analysis postinjury day initial...

Concussions are commonly diagnosed in pediatric patients presenting to the emergency department (ED). The primary objective of this study was evaluate compliance with ED discharge instructions for concussion management.A prospective cohort conducted from November 2011 2012 a at regional Level 1 trauma center, serving 35,000 per year. Subjects were aged 8 years 17 and discharged diagnosis concussion. Exclusion criteria included recent (past 3 months) head injury, hospital admission,...

The advent of nonoperative management liver injuries has made it imperative that surgeons be familiar with the potential delayed complications this approach. In report, we describe a minimally invasive strategy for bile peritonitis following blunt injuries. Two cases are presented in which massive ascites was managed laparoscopic localization and drainage leak, irrigation peritoneal cavity, postoperative endoscopic retrograde cholangiography duct stenting. both leak ceased, patients...

Elderly patients, an increasing segment of the population, who sustain traumatic brain injury (TBI) are known to have worse outcomes, including higher mortality. This objective this study was examine Crash Injury Research Engineering Network and determine at what age motor vehicle crash fatalities from head injuries increased.The database queried 1996 2009. Study inclusion criteria were adult occupants with TBI, Abbreviated Scale score ≥2. The which mortality increased calculated. Patients...

Although the utility of base deficit as an indicator hypoperfusion and physiologic derangement in adults is well established, its value assessment children not clear. The purpose this study was to evaluate tool with regard injury severity, infectious morbidity, outcome a pediatric trauma population. A retrospective review 6-year period database our level 1 center performed. One hundred seventeen severely injured requiring mechanical ventilation were identified. Initial deficit, Injury...

ABSTRACT To examine the developmental course of children's understanding print concepts, orthographic linguistic awareness, Concepts About Print (CAP) test was given to 29 boys and 27 girls three times during their kindergarten year on two occasions first‐grade year. That approximately 20% these children did not understand print‐direction letter‐word concepts at beginning first grade confirmed previous findings that many entering formal reading instruction may have little knowledge register....

Severe traumatic brain injury carries major public health consequences, with patients suffering long-term disability physiological, cognitive, and behavioral changes. Animal-assisted therapy, the use of human animal bonds in goal-directed interventions, has been a suggested but its efficacy acute outcomes remains unknown.This study aimed to assess animal-assisted therapy's effects on cognitive outcome scores hospitalized severe brain-injured patients.This single-center, randomized,...

Nutritional support is the key to successful recovery of any patient. Small bowel necrosis described in patients being fed with enteral nutrition after surgery. Five small surgery will be discussed and an etiology proposed. A retrospective review patient data was performed. Data collected on type surgical procedures performed, given patient, basic laboratory data, length stay, discharge status. total five patients’ charts were reviewed. Three had pancreaticoduodenectomy for a pancreatic mass...

Introduction: It is well-known that noncompliance with seat belt use results in worse injury. The impact of on hospital resource consumption and charges less well known. This study was carried out to examine the economic burden use. Methods: Trauma registry data were reviewed for patients involved motor vehicle crashes 2003 2004. Routine demographic analyzed. Outcome included length stay, intensive care unit number ventilator days, mortality. Hospital charges, rate collection, (measured by...

Background: Recent studies indicate that prehospital endotracheal intubation (PHEI) is associated with increased septic morbidity. Because the decision to intubate in field considered a life-sustaining mandate we analyzed our experience validate these reports and compare done more controlled circumstances on patient arrival at trauma center. Methods: The registry of Level l center was queried from January 2002 through December 2003 for patients who required emergent EI had hospital stay >2...