hMPV was detected in a substantial number of children with URIs and concomitant AOM.

Introduction Endovascular aortic repair has revolutionized the management of traumatic blunt aortic injury (BAI). However, debate continues about the extent of injury requiring endovascular repair, particularly with regard to minimal aortic injury (MAI). Therefore, we conducted a retrospective observational analysis of our experience with these patients. Methods We retrospectively reviewed all BAI presenting to an academic Level I trauma center over a ten-year period (2000–2010). Images were reviewed by a radiologist and graded according to Society for Vascular Surgery (SVS) guidelines (Grade I–IV). Demographics, injury severity, and outcomes were recorded. Results We identified 204 patients with BAI of the thoracic or abdominal aorta. Of these, 155 were deemed operative injuries at presentation, had grade III-IV injuries, or aortic dissection and were excluded from this analysis. The remaining 49 patients had 50 grade I–II injuries. We managed 46 grade I injuries (intimal tear or flap, 95%), and 4 grade II injuries (intramural hematoma, 5%) nonopertively. Of these, 41 patients had follow-up imaging at a mean of 86 days post-injury and constitute our study cohort. Mean age was 41 years and mean length of stay was 14 days. The majority (48 of 50, 96%) were thoracic aortic injuries and the remaining 2 (4%) were abdominal. On follow-up imaging, 23 of 43 (55%) had complete resolution of injury, 17 (40%) had no change in aortic injury, and 2 (5%) had progression of injury. Of the 2 patients with progression, one progressed from grade I to grade II and the other progressed from grade I to grade III (pseudoaneurysm). Mean time to progression was 16 days. Neither of the patients with injury progression required operative intervention or died during follow-up. Conclusions Injury progression in grade I–II BAI is rare (∼5%) and did not cause death in our study cohort. Since progression to grade III injury is possible, follow-up with repeat aortic imaging is reasonable.

A housestaff-led intervention utilizing education and data feedback with goal setting and peer comparison resulted in safe, significant reductions in daily laboratory testing rates.