It doesn't hurt as long as I don't move: Aligning pain assessment in patients with rib fractures with mobilization needed for recovery.

Background: Rib fracture pain is a major issue but likely underappreciated, given that patients avoid activity due to the pain. Pain is one criterion used to determine if someone is a candidate for surgical stabilization of rib fractures (SSRF). The purpose of this study was to assess pain for rib fracture patients, hypothesizing pain from rib fractures is underappreciated in current practice.

Scanning the aged to minimize missed injury: An Eastern Association for the Surgery of Trauma multicenter study.

Background: Despite the high incidence of blunt trauma in older adults, there is a lack of evidence-based guidance for computed tomography (CT) imaging in this population. We aimed to identify an algorithm to guide use of a pan-scan (head/cervical spine [C-spine]/torso) or a selective scan (head/C-spine ± torso). We hypothesized that a patient's initial history and examination could be used to guide imaging.

The Relationship Between an Individual's Birthday and Admission for Traumatic Injury.

Background: Birthdays provide an opportunity to celebrate; however, they can also be associated with various adverse medical events. This is the first study to examine the association between birthdays and in-hospital trauma team evaluation.

Methods: This retrospective study analyzed trauma registry patients 19-89 years of age, who were evaluated by in-hospital trauma services from 1/1/2011 to 12/31/2021.

The Impact of Relocating a Trauma Center: Observations on Patient Injury Demographics and Resident Volumes.

Introduction Changing the physical zip code location of an academic trauma center may affect the distribution and surgical volume of its trauma patients. General surgical residency case log requirements may also be affected. This study describes the impact of moving a level I trauma center to a different zip code location, on the hospital and resident trauma case volumes.

Takotsubo Cardiomyopathy and Trauma: The Role of Injuries as Physical Stressors.

Introduction: Physical stressors are common predisposing factors for takotsubo cardiomyopathy (TTC). However, the role of traumatic injuries in TTC has not been well defined. This study describes the characteristics of TTC in the broad spectrum of traumatic injuries using the information available in the National Trauma Data Bank (NTDB).

Defining a specialty through its literature: A bibliometric analysis of acute care surgery 2005 to 2020.

Background: Acute care surgery (ACS) has grown and evolved since it was conceived in 2005. However, ACS is not recognized in the National Library of Medicine's Medical Subject Heading thesaurus. This article uses bibliometrics to help define an identity for ACS as a subspecialty of surgery and argue for its addition to the Medical Subject Heading thesaurus.

In-hospital outcomes of intercostal nerve cryoablation and surgical stabilization of rib fractures.

Background: Severe pain and pulmonary complications commonly follow rib fractures, both of which may be improved by surgical stabilization of rib fractures (SSRFs). However, significant postoperative pain still persists which may negatively impact in-hospital outcomes. Combining intercostal nerve cryoablation (INCA) with SSRF may improve those outcomes by further decreasing postoperative pain, opioid consumption, and pulmonary complications.

Clinical Characteristics Associated With Higher Enoxaparin Dosing Requirements for Venous Thromboembolism Prophylaxis in Trauma Patients.

Introduction: Enoxaparin dosed by an anti-Xa trough level is effective at reducing venous thromboembolism (VTE) in trauma patients. We identified the patient characteristics associated with higher enoxaparin dosing based on anti-Xa trough levels.

Methods: A retrospective review was conducted on trauma patients admitted between August 2014 and February 2018 who received enoxaparin dosed by the anti-Xa trough level.

Which Trauma Patients Require Lower Enoxaparin Dosing for Venous Thromboembolism Prophylaxis?

Trauma patients have a high risk for venous thromboembolism (VTE) such that an increased enoxaparin dose is necessary to reduce related complications. Given that most trauma patients require an enoxaparin dose of at least 40 mg every 12 hours for VTE prophylaxis, we sought to identify which patients require enoxaparin 30 mg every 12 hours and hypothesized that both weight and low creatinine clearance (CrCl) would more likely determine enoxaparin dosing than age, body mass index (BMI), or body surface area (BSA). Single institution data were collected on trauma patients between August 2014 and February 2018 to compare trauma patients who required enoxaparin 30 mg to those who required ≥40 mg every 12 hours.

Liposome-siRNA-peptide complexes cross the blood-brain barrier and significantly decrease PrP on neuronal cells and PrP in infected cell cultures.

Background: Recent advances toward an effective therapy for prion diseases employ RNA interference to suppress PrP(C) expression and subsequent prion neuropathology, exploiting the phenomenon that disease severity and progression correlate with host PrP(C) expression levels. However, delivery of lentivirus encoding PrP shRNA has demonstrated only modest efficacy in vivo.

Methodology/principal Findings: Here we describe a new siRNA delivery system incorporating a small peptide that binds siRNA and acetylcholine receptors (AchRs), acting as a molecular messenger for delivery to neurons, and cationic liposomes that protect siRNA-peptide complexes from serum degradation.