Does size matter? A prospective analysis of 28-32 versus 36-40 French chest tube size in trauma.

Background: The optimal chest tube size for the drainage of traumatic hemothoraces and pneumothoraces is unknown. The purpose of this study was to compare the efficacy of small versus large chest tubes for use in thoracic trauma. Our hypothesis was that (1) there would be no difference in clinically relevant outcomes including retained hemothoraces, the need for additional tube insertion, and invasive procedures and (2) there would be an increase in pain with the insertion of large versus small tubes.

Outcomes of blunt assault at a level I trauma center.

Background: Physical assault is common in trauma patients. Penetrating injuries resulting from interpersonal violence have been well described in literature, but there have been few studies examining the injury patterns due to assaults with hands and feet or blunt instruments.

Methods: The Trauma Registry of an American College of Surgeons Level I center was queried for all patients with an E-code diagnosis of assault by hands and feet or blunt instrument for the period of January 1, 1992 to September 30, 2005.

Leukoreduction is associated with a decreased incidence of late onset acute respiratory distress syndrome after injury.

Transfusions are known to be associated with Acute Respiratory Distress Syndrome (ARDS). Transfusion of leukoreduced products may be associated with a decreased incidence of late posttraumatic ARDS (late ARDS). Data from ventilated and transfused trauma patients were analyzed.

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).

Femoral vessel injuries: analysis of factors predictive of outcomes.

Background: Femoral vessel injuries are the most common vascular injuries treated in a Level I trauma center. No studies have identified risk factors for survival and complications.

Study Design: We performed a retrospective, 132-month study that included univariate and multivariate analyses.

Septic arthritis in patients with human immunodeficiency virus.

The literature contains few descriptions of the infective organisms and diagnostic issues associated with musculoskeletal infections in patients with HIV. We retrospectively reviewed 19 patients with HIV treated at our musculoskeletal infection ward for septic arthritis. The mean CD4 count was 154/mm (range, 7-482/mm), and 11 patients had a CD4 count < 200/mm and were diagnosed with AIDS.

Treatment of hypertension in African Americans and Latinos: the effect of JNC VI on urban prescribing practices.

In 1997, national recommendations for the treatment of hypertension were made in the form of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). African American hypertensives are considered a special population with a higher prevalence of hypertension, and therefore, unique treatment needs. The study objective was to review medication use among an African American and Latino urban population in relation to the JNC recommendations.

Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy.

Objective: To evaluate the authors' experience with periduodenal perforations to define a systematic management approach.

Summary Background Data: Traditionally, traumatic and atraumatic duodenal perforations have been managed surgically; however, in the last decade, management has shifted toward a more selective approach. Some authors advocate routine nonsurgical management, but the reported death rate of medical treatment failures is almost 50%.

Traumatic injury to the superior mesenteric artery.

Background: Superior mesenteric artery (SMA) injuries are rare and devastating injuries incurring very high mortality rates. It is the purpose of this study to review our experience with these injuries, to analyze Fullen's classification based on anatomical zone and injury grade for its predictive value, and to correlate the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury with mortality.

Methods: Retrospective study was made over a 65-month period of all patients sustaining SMA injuries in an urban level I trauma center.