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Horst C Vollmar Martin E Butzlaff Rolf Lefering Monika A Rieger 《BMC health services research》2007,7(1):92
Background
Thus far important findings regarding the dementia syndrome have been implemented into patients' medical care only inadequately. A professional training accounting for both, general practitioners' (GP) needs and learning preferences as well as care-relevant aspects could be a major step towards improving medical care. In the WIDA-study, entitled "Knowledge translation on dementia in general practice" two different training concepts are developed, implemented and evaluated. Both concepts are building on an evidence-based, GP-related dementia guideline and communicate the guideline's essential insights. 相似文献3.
Peiniger S Nienaber U Lefering R Braun M Wafaisade A Wutzler S Borgmann M Spinella PC Maegele M;Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie 《Critical care (London, England)》2011,15(1):R68
Introduction
Retrospective studies have demonstrated a potential survival benefit from transfusion strategies using an early and more balanced ratio between fresh frozen plasma (FFP) concentration and packed red blood cell (pRBC) transfusions in patients with acute traumatic coagulopathy requiring massive transfusions. These results have mostly been derived from non-head-injured patients. The aim of the present study was to analyze whether a regime using a high FFP:pRBC transfusion ratio (FFP:pRBC ratio >1:2) would be associated with a similar survival benefit in severely injured patients with traumatic brain injury (TBI) (Abbreviated Injury Scale (AIS) score, head ≥3) as demonstrated for patients without TBI requiring massive transfusion (≥10 U of pRBCs). 相似文献4.
Differential immunoresponses following experimental traumatic brain injury,bone fracture and “two-hit”-combined neurotrauma 总被引：3，自引：0，他引：3
M. Maegele S. Sauerland B. Bouillon U. Schäfer H. Trübel P. Riess E. A. M. Neugebauer 《Inflammation research》2007,56(8):318-323
Objective and design: Cytokine-mediated immunoresponses are consequences of isolated traumatic brain injury (TBI) and muskuloskeletal trauma but
little is known when both impacts occur simulanteously in combined neurotrauma (CNT), i. e. TBI + muskuloskeletal trauma (bone
fracture).
Materials and Methods: A “two-hit”-experimental model of CNT (TBI + tibia fracture) was used to investigate circulating cytokine interleukin-1-beta,
-6, -10 and sTNF-R1 concentrations following peripheral bone fracture only, TBI only and CNT. Blood samples were drawn at
30 min, 6 h, 24 h, 48 h, and 7 days following trauma and circulating cytokine concentrations were determined via immunoassay.
Results: Circulating cytokines were increased after trauma (p <0.001 vs. controls), but peaked at different time points. sTNF R1 peaked
first at 30 min, followed by IL-6 at 6 h after trauma. IL-10 levels were highest at 24 h, and those for IL-1beta at 48 h after
trauma. Circulating IL-6 and IL-10 levels were highest in CNT at 8/10 time points studied (p <0.001).
Conclusion: Circulating cytokine IL-1-beta, -6, -10 and sTNF-R1 concentrations are increased after trauma (TBI, fracture and CNT) but
peak at different time points. Pronounced IL-6 and IL-10 responses after CNT may contribute to the increased susceptibility
for complications in CNT versus monotrauma.
Received 30 August 2006; returned for revision 10 November 2006; returned for final revision 28 February 2007; accepted by
M. Parnham 21 March 2007 相似文献
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Mark Schieren Andreas B. Böhmer Rolf Lefering Thomas Paffrath Frank Wappler Jerome Defosse 《Injury》2019,50(1):96-100
Introduction
Chest trauma and obesity are both associated with increased risks for respiratory complications (e.g. hypoxia, hypercarbia, pneumonia), which are frequent causes of posttraumatic morbidity and mortality. However, as there is only limited and inconsistent evidence, the aim of our study was to analyse the effect of body mass index (BMI) on patient outcomes after thoracic trauma.Patients and Methods
We screened 50.519 patients entered in TraumaRegister DGU®, between 2004–2009, when the BMI was part of the standardized dataset. After matching for injury patterns and severity of trauma we performed a matched tripled analysis with regard to the BMI (group 1: <25.0?kg/m2; group 2: 25.0–29.9?kg/m2; group 3: >30.0?kg/m2). Data are shown as percentages and mean values with standard deviation.Results
The matching process yielded a cohort of 828 patients with serious blunt thoracic trauma, evenly distributed over the 3 BMI groups (276 triplets). BMI did not have an impact on the need for prehospital or emergency department interventions. There was a trend towards more liberal use of whole-body-CT scanning with increasing BMI (group 1: 68.8%; group 2: 73.2%; group 3: 75.0%). Additional abdominal injuries were more common in normal weight patients (Group 1: 28.3%; Group 2: 14.9%; Group 3: 17.8%). Obesity (BMI?>?30.0?kg/m2) had a significant impact on the duration of mechanical ventilation (in days; group 1: 6.5 (9.4); group 2: 6.4 (8.9); group 3: 9.1 (14.4); p?=?0.002), ICU days (in days; group 1: 11.5 (11.5); group 2: 10.9 (9.6); group 3: 14.1 (16.7); p?=?0.005) and hospital length of stay (in days; group 1: 27.8 (19.3); group 2: 27.4 (19.2); group 3: 32.2 (25.9); p?=?0.009). There were no significant differences regarding overall mortality (group 1: 3.6%; group 2: 1.8%; group 3: 4.0%; p?=?0.26).Conclusions
Obesity has a negative impact on outcomes after blunt chest trauma, as it is associated with prolonged duration of mechanical ventilation, ICU and hospital length of stay. Mortality did not seem to be affected, yet, further research is required to confirm these results in a larger cohort. 相似文献10.