BACKGROUND Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characteriz...

OBJECTIVE To clarify the usefulness of ultrasonography (US) as a diagnostic instrument for intraperitoneal free air (IPFA), which is thought to be useful in the fields of emergency medicine and traumatology. DESIGN Prospective observational study. SETTING Tertiary critical care and emergency center. PATIENTS A total of 484 patients with severe chest-abdominal-pelvic blunt trauma or, in th...

Objective: To investigate the symptoms and pathology related to classification of temporomandibular joint traumatic arthritis (TMJTA) and the use of classification of various forms. Methods: The clinical and imaging data of 41 patients with TMJTA caused by joint blunt trauma, 32 patients with chronic TMJTA caused by condylar fractures and 6 patients with a long time opening limitation after con...

重症外傷における凝固障害の病態については，2020年に国際血栓止血学会の3つの学術標準化委員会が共同声明を発表しているが，いまだ，国際的な合意形成を得られておらず議論が続いている．我々は，外傷そのものを原因とする受傷直後の凝固障害（trauma induced coagulopathy）の病態を線溶亢進型DICとしてとらえている．このtrauma coagulopathyは，①凝固活性化因子が全身循環をめぐる凝固の活性化，②線溶亢進，③消費性凝固障害から形成される．また，このtrauma coagulopathyに対する治療は，①早期の抗線溶療法と②フィブリノゲンを中心とした凝固因子の積極的な補充が中心となる．重症外傷では，時間経過とともにDICの病型が変化するため，その病態理解と適切な治療介入が重要である．

Neuroinflammation is a prominent feature of the response to CNS trauma. It also an important hallmark various neurodegenerative diseases in which inflammation contributes progression pathology. Inflammation can contribute secondary damage and therefore excellent therapeutic target for range neurological conditions. nervous system complex varies its fine details different involves wide variety s...

Purpose: Following musculoskeletal trauma, a high proportion of people develop chronic pain, irrespective the severity injury. Central sensitisation (CS) characterised by features such as secondary hyperalgesia, tactile allodynia and widespread could offer an explanation to transition from acute pain. No study has evaluated early CS in this population. This exploratory aimed investigate CS, alo...

Background The extensive use of computed tomography (CT) after acute head injury is costly and carries potential iatrogenic risk. This systematic review examined the usefulness of blood-based glial fibrillary acidic protein (GFAP) for predicting acute trauma-related CT-positive intracranial lesions following head trauma. The main objective was to summarize the current evidence on blood-based GF...

BACKGROUND Acute kidney injury (AKI) has been hard to assess due to the lack of standard definitions. Recently, the Risk, Injury, Failure, Loss and End-Stage Kidney (RIFLE) classification has been proposed to classify AKI in a number of clinical settings. This study aims to estimate the frequency and levels of severity of AKI and to study its association with patient mortality and length of sta...

In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, ...