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BACKGROUND Whereas organized trauma care systems have decreased trauma mortality in the United States, trauma system design has not been well addressed in developing nations. We sought to determine areas in greatest need of improvement in the trauma systems of developing nations. METHODS We compared outcome of all seriously injured (Injury Severity Score(More)
OBJECTIVE To identify patterns of errors contributing to inpatient trauma deaths. METHODS All inpatient trauma deaths at a high-volume level I trauma center from 1996 to 2004 inclusive were audited. Data were collected with daily trauma registry chart abstraction, weekly morbidity and mortality reports, hospital quality assurance reports, and annual(More)
BACKGROUND Assessment of the societal importance of trauma relies, in large part, on hospital and other health service data. Such data are of limited value in developing nations if a significant proportion of injured persons do not receive formal medical care. METHODS We undertook an epidemiologic study of trauma in Ghana. Via household visits, we(More)
BACKGROUND The effect of recent advances in critical care and the emphasis on early fracture fixation in patients with fat embolism syndrome (FES) are unknown. OBJECTIVE To better define FES in current practice by conducting a 10-year review of the experiences at our level I trauma center. DESIGN The medical records of all patients in whom FES was(More)
A cornerstone of modern biomedical research is the use of mouse models to explore basic pathophysiological mechanisms, evaluate new therapeutic approaches, and make go or no-go decisions to carry new drug candidates forward into clinical trials. Systematic studies evaluating how well murine models mimic human inflammatory diseases are nonexistent. Here, we(More)
OBJECTIVE To determine the effectiveness of early, routine antioxidant supplementation using alpha-tocopherol and ascorbic acid in reducing the rate of pulmonary morbidity and organ dysfunction in critically ill surgical patients. SUMMARY BACKGROUND DATA Oxidative stress has been associated with the development of the acute respiratory distress syndrome(More)
OBJECTIVE To evaluate anatomic, physiologic, and mechanism-of-injury prehospital triage criteria as well as the subjective criterion of provider "gut feeling." DESIGN Prospective analysis. SETTING A state without a trauma system or official trauma center designation. PATIENTS Patients treated by emergency medical services personnel statewide over a(More)
OBJECTIVE To evaluate the long-term survival and factors that influence survival among a cohort of elderly trauma patients compared with an uninjured cohort. DESIGN A retrospective cohort analysis. DATA SOURCES Health Care Finance Administration, Baltimore, Md, Medicare data. SUBJECTS A cohort of elderly patients (n = 9424) hospitalized for injury in(More)
Acute ethanol (EtOH) intoxication has been identified as a risk factor for infectious complications in trauma and burn victims. However, the mechanism of this immune dysfunction has yet to be elucidated. The monocyte/macrophage production of cytokines, in particular IL-8 and TNF-alpha, is critical in the regulation of the acute inflammatory response to(More)