Amplitude-determined seizure-threshold, electric field modeling, and electroconvulsive therapy antidepressant and cognitive outcomes.

Electroconvulsive therapy (ECT) pulse amplitude, which dictates the induced electric field (E-field) magnitude in the brain, is presently fixed at 800 or 900 milliamperes (mA) without clinical or scientific rationale. We have previously demonstrated that increased E-field strength improves ECT's antidepressant effect but worsens cognitive outcomes. Amplitude-determined seizure titration may reduce the E-field variability relative to fixed amplitude ECT.

Impact of Pharmacy Students on a Level II Trauma Center.

This study aims to quantify the benefits of allowing advanced pharmacy practice experience (APPE) students to make medical interventions while on rotation by analyzing their interventions made and the resulting cost avoidance. This retrospective, observational cohort study was completed using self-reported data of APPE student interventions made at a Level II trauma center, under the supervision of a clinical pharmacist. Interventions were analyzed for their impact on patient care and cost avoidance through a comprehensive literature search and online Quantifi reference.

Outcomes of Geriatric Trauma Patients on Preinjury Anticoagulation: A Multicenter Study.

Outpatient anticoagulation in the geriatric trauma patient is a challenging clinical problem. The aim of this study is to determine clinical outcomes associated with class of preinjury anticoagulants (PA) used by this population. This is a multicenter retrospective cohort study among four Level II trauma centers.

Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators.

Background: Improving clinical outcomes of trauma patients is a challenging problem at a statewide level, particularly if data from the state's registry are not publicly available. Promotion of optimal care throughout the state is not possible unless clinical benchmarks are available for comparison. Using publicly available administrative data from the State Department of Health and the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs), we sought to create a statewide method for benchmarking trauma mortality and at the same time also identifying a pattern of unique complications that have an independent influence on mortality.

Geriatric outcomes for trauma patients in the state of Florida after the advent of a large trauma network.

Background: Florida State has one of the largest geriatric populations in the United States. However, recent data show that up to the year 2010, geriatric trauma patients were least served by designated trauma centers (TCs). One existing TC and five provisional Level 2 TCs were combined to create a large-scale trauma network (TN).

Intrapleural thrombolysis for the management of undrained traumatic hemothorax: a prospective observational study.

Background: Tube thoracostomy is usually sufficient treatment for traumatic hemothorax. Occasionally, significant residual collections remain undrained. Open thoracotomy and video-assisted thoracoscopic surgery (VATS) have been used to manage undrained traumatic hemothoraces (UTHs).

Trauma deaths in a mature urban trauma system: is "trimodal" distribution a valid concept?

Background: Trimodal distribution of trauma deaths, described more than 20 years ago, is still widely taught in the design of trauma systems. The purpose of this study was to examine the applicability of this trimodal distribution in a modern trauma system.

Study Design: A study of trauma registry and emergency medical services records of trauma deaths in the County of Los Angeles was conducted over a 3-year period.

Lessons learned in the management of thirteen celiac axis injuries.

Objectives: Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury.

Methods: This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries.

Traumatic ureteral injuries: a single institution experience validating the American Association for the Surgery of Trauma-Organ Injury Scale grading scale.

Purpose: Ureteral injuries are uncommon and challenging. In this study we report our institutional experience with ureteral injuries. We evaluated the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for ureteral injuries as a predictor of outcomes for complexity of repair, morbidity, mortality and associated injuries.

Angiographic embolization for pelvic fractures in older patients.

Hypothesis: Old age predicts reliably the presence of pelvic bleeding, requiring angiographic embolization (AE) among blunt trauma patients with major pelvic fractures.

Design: Four-year prospective observational study (April 1, 1999, to May 31, 2003).

Setting: Academic level I trauma center practicing AE liberally.

Necrotizing soft-tissue infections.

It has been more than 130 years since NSTIs were first described. Despite the development of various classification systems and progress in surgical management, these infections continue to have high mortality and pose enormous diagnostic and therapeutic challenges. For optimal outcome, treatment involves rapid institution of appropriate antibiotic coverage and early wide surgical debridement.

Klüver-Bucy syndrome as a result of minor head trauma.

Klüver-Bucy syndrome (KBS) has been described as a disconnection of the temporal lobes from the remainder of the brain. Its presence in minor head trauma has not been previously reported. We therefore report what we believe to be the first case of KBS due to mild head trauma and unilateral injury to a temporal lobe.