Active clinical trials for "Wounds and Injuries"

Using a prospective cohort of children admitted to the PICU, the investigators will determine HRV monitoring is feasible, if a decreased HRV in the 7 days following moderate or severe TBI in children is associated with a worse outcome 6 months post-TBI and investigate HRV as a tool that can predict adverse events (neurological crisis) within 2 days following TBI.

This study aims to determine changes in kidney function during and after critical illness, comparing conventional creatinine based methods with the gold standard to accurately establish the presence of new or worsened chronic kidney disease. In addition, investigators will assess the confounding effect of muscle wasting on the conventional assessment of kidney function and investigate the information that measures of kidney function may contribute to the assessment of musculoskeletal health after critical illness.

New markers of AKI including plasma Neutrophil Gelatinase Associated Lipocalin (NGAL) and Interleukin 18(IL-18) may form a biomarker panel that may help predict AKI earlier in the course of disease than creatinine. Biomarkers for renal injury decreases following successful Renal transplantation. The level of decrease in biomarkers, correlates with the renal graft function, and this fall occurs earlier than the fall in creatinine and/or increase in the Urine output. Should graft dysfunction occurs, investigating the fall in biomarkers could provide a window of opportunity for therapeutic interventions and also guide in evaluating the effectiveness of such interventions. NGAL is a 25 kilo Dalton(kDa) ligand-binding protein of the lipocalin family, present in human tissues including kidney. NGAL is induced early in ischemic or nephrotoxic injury to the kidney. It has also been evaluated as a biomarker of acute injury in kidney transplantation. Interleukin (IL)-18 is synthesized as an inactive 23 kDa precursor by several tissues including monocytes, macrophages, and proximal tubular epithelial cells. Urine IL-18 is elevated in patients with acute tubular necrosis and in urinary tract infection, chronic renal insufficiency, and prerenal azotemia. Delayed graft function and slow graft function are associated with poor graft survival at one year. Early prediction of graft dysfunction could help prognosticate and initiate renoprotective measures. Urine biomarkers including NGAL and IL 18 have shown promise in this regard, but it may be fraught with risk of biomarker dilution, an effect of urinary flow rate on biomarker levels. The investigators hypothesized that plasma NGAL and plasma IL-18 can detect reduced renal graft function in renal transplant recipients within the first 2 postoperative days.

The study will assess the associations between various asymmetries (strength, flexibility, balance, etc.) in different athletes. After the measurements, injury occurrence will be tracked prospectively for 1 year, and retrospective analysis will be performed as well. The main aim of the study is to determine the asymmetries that impose the biggest injury risk for athletes.

Carpal tunnel syndrome (CTS) is the most common nerve compression disorder in the upper extremity. It can be treated with surgical or nonsurgical methods. When nonsurgical treatment is indicated, local corticosteroid injection into the carpal tunnel can be used to reduce pain and tingling sensation. Currently, the most widely used ultrasound (US)-guided CTS-injection method are transverse and longitudinal approach. Although we can accurately place needle within the carpal tunnel using this approach and this approach is easy to learn, median nerve injury (MNI) is still an inevitable complication and difficult to be treat. MNI is the most serious complication associated with a local corticosteroid injection for CTS among them. A MNI will be presented with shooting pain at the injection time or transient exacerbation of CTS symptoms following the corticosteroid injection because of the pain which often masked by anesthetic during injection. Permanent damage of MN should be considered if the symptoms persist and exacerbate for more than 48 hours. A surgical intervention such as neurolysis, resection or graft repair or a gentle debridement of the crystal from the nerve may be performed in the patients with median nerve damage. Hence, early recognition of MNI before corticosteroid injection may avoid the permanent damage of MN. Accordingly, the aim of this study is to determine the relationship between the MNI with the possible influencing factors and findings in the US-guided corticosteroid injection for patients with CTS with and to compare the therapeutic efficacy in the patients with and without MNI.

Brachial plexus block is a common regional anesthesia technique which is performed by anesthesiologists to anesthetize the arm for surgery. In this study, we are investigating the relationship between the nerve conduction (induced by brachial plexus block) and the patients' symptoms before and after the brachial plexus block. We will attach a nerve conduction device (SSEP device) to monitor the patients' arm conduction and we will assess the patients' symptoms simultaneously.

This study was to find out whether laparoscopic colorectal surgery is detrimental to the kidneys via PVI monitoring. To detect the kidney injury, so-called kidney troponin NGAL ,which gives earlier information than creatin in renal ischemic injury, was used.

This study was designed to explore the adverse events and associated risk factors before and after protocol-based NOM of BSI over a 12-year period in our institution.

The consumption of alcohol and other drugs is one of the main risk factors for traumatism. In addition, patients who have suffered an accident in relation to the consumption of these substances present a high risk of recidivism. In the case of alcohol, its relationship with traumatisms has been known for many years now and is still one of the main risk factors. Secondary prevention is an important area of action and improvement in the treatment of this type of patient by considering actions, such as a brief motivational intervention, in order to avoid recidivism. The objective of motivational intervention is to make the patient aware of the relationship between the consumption of these substances and the accident, and induce them to carry out a change in habits. The objective of the present investigation project is to determine the efficacy of secondary prevention in reducing recurrence of traumatisms. In order to this, a multicenter randomised controlled trial has been designed in which the intervention group with patients admitted for sever traumatism with positive screening for alcohol or other drugs, will be submitted to a brief motivational intervention. The main outcome will be trauma recurrence within a three year follow-up.

In cases of cardiac surgery or sepsis which cause inflammation, oxidative stress, endothelial injury and vasoplegia, serum vitamin C concentration is sharply decreased. The anti-inflammatory and anti-oxidant effects of vitamin C and the effects of reducing vasoconstrictor use have been demonstrated in patients with sepsis and septic shock, however, the foregoing effects have not been validated in patients undergoing cardiac surgery. In this study, investigators investigate the effect of intravenous vitamin C on the incidence of acute renal injury after valvular heart surgery.