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A line-field confocal optical coherence tomography (LC-OCT) combines confocal microscopy and optical coherence tomography into a single, rapid, easy-to-use device. This meta-analysis was performed to determine the reliability of LC-OCT for diagnosing malignant skin tumors. PubMed, EMBASE, Web of Science databases, and the Cochrane Library were searched for research studies in the English language from inception till December 2023. To assess quality and the risk of bias, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used. The sensitivity and specificity of each study were calculated. The bivariate summary sensitivity and specificity were calculated using the linear mixed model. Five studies with 904 reported per lesion analyses in our study; the specificity and sensitivity ranged from 67% to 97% and 72% to 92%, respectively. The pooled specificity and sensitivity were 91% (95% CI: 76–97%) and 86.9% (95% CI: 81.8–90.8%), respectively. The summary sensitivity and specificity from the bivariate approach are 86.9% (95% CI: 81.8–90.8%) and 91.1% (95% CI: 76.7–97.0%), respectively. The area under the curve is 0.914. LC-OCT shows great sensitivity and specificity in diagnosing malignant skin tumors. However, due to the limited number of studies included in our meta-analysis, it is premature to elucidate the true potential of LC-OCT. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to find the factors that were associated with tracheostomy procedures in ventilated pediatric trauma patients. Methods: The Trauma Quality Improvement Program (TQIP) database of the calendar year 2017 through 2019 was accessed for the study. All patients <18 years old and who were on mechanical ventilation for more than 96 hours were included in the study. Multiple logistic regression analysis was performed to find the factors that were associated with a tracheostomy. Results: Out of 2653 patients, 1907 (71.88%) patients underwent tracheostomy. The patients who underwent tracheostomy had a lower median [IQR] of Glasgow Coma Scale (GCS) (3 [3-8] vs 5 [3-10], P <.001) and had a higher proportion of severe spine injury (On Abbreviated Injury Scale [AIS]≥3) (11.6% vs 8.8%, P =.044) when compared with patients who did not have tracheostomy. Lower GCS scores and severe spine injury were associated with higher odds of tracheostomy, with all P values <.05. Higher proportion of tracheostomy procedures were performed at level I pediatric trauma centers as compared to non-designated pediatric centers (odds ratio [95% CI]: 1.848 [1.524-2.242], P <.001). Conclusion: A lower GCS score, severe spine injury and highest level trauma centers were associated with a tracheostomy. [ABSTRACT FROM AUTHOR]

Background: Alcohol withdrawal syndrome (AWS) is associated with increased occurrence of pneumonia and longer hospital stay. The purpose of the study is to find a national estimate of pulmonary complications in AWS patients using the National Trauma Quality Improvement Program (TQIP) database. Methods: We accessed the TQIP database focusing on the calendar years 2013-2016 and included all adult admitted trauma patients. The two groups (AWS and no AWS) were compared on baseline characteristics, injury, comorbidities, and outcomes. We performed univariate analysis followed by propensity matching. Results: Out of 534 880 patients who qualified for the study, 6929 (1.29%) patients had developed AWS. The propensity matching balanced the two groups on all the baseline characteristics, injury severity, and comorbidities and created 6929 pairs. One-to-one pair-matched analysis showed a significantly increased occurrence of pneumonia (12% vs 4.3%), acute respiratory distress syndrome (ARDS) (2.7% vs 1%), and sepsis (2.4% vs 1.1%) in AWS patients when compared with the patients without the AWS. Conclusion: The study showed approximately a 3-fold increase in ARDS and pneumonia and a more than two-fold increase in sepsis in AWS patients. Early intervention in high-risk AWS patients may reduce the complications. [ABSTRACT FROM AUTHOR]

Objective : Recent studies have suggested that an initial systolic blood pressure (SBP) in the range of 90-110 mmHg in a trauma patient may be indicative of hypoperfusion and is associated with poor patient outcome. However, the use of initial SBP as a surrogate for predicting internal bleeding is yet to be validated. The purpose of this study was to assess the presenting SBPs in patients with torso trauma and evidence of ongoing internal hemorrhage. Setting and Design : This was a retrospective chart review conducted at the Level II Trauma Center. Materials and Methods : Adult patients who sustained trauma and underwent chest and/or abdominal computed tomography (CT) scans and angiography were included in the study. Demographic and clinical information was extracted from patients who had CT scan and angiography. Extravasation of contrast material on CT scan and angiography was considered positive for ongoing internal bleeding. Results : From January 2002 through July 2007, a total of 113 consecutive patients were included in this study. Forty-seven patients had evidence of ongoing internal bleeding (41.6%; 95% confidence interval: 32.4%, 51.2%). When comparing patients with and without ongoing bleeding, these two groups were similar in their gender, race, pulse, injury severity score and shock index. However, bleeding patients were typically older [mean (standard deviation): 44.5 (20.5) vs 37.3 (19.1) years; P = 0.051], had a lower initial SBP [116.2 (36.0) vs 130.0 (30.4) mmHg; P = 0.006] and had a higher Glasgow coma scale (GCS) [13.1 (4.0) vs 12.1 (4.4); P = 0.09]. From a multivariate logistic regression analysis, older age (P = 0.046) and lower SBP (P = 0.01) were significantly associated with bleeding, when controlled for gender, race and GCS. Among the 47 patients with ongoing bleeding, only seven patients (15%) had a SBP lower than 90 mmHg and 25 patients (53%) had a SBP higher than or equal to 120 mmHg. The spleen was the most frequently injured organ identified with active bleeding. Conclusions : Initial SBP cannot predict the ongoing internal bleeding.