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prevention pressure injury

Thorsten Tjardes, Markus Luecking
Introduction: To achieve the aim of zero preventable deaths on the battlefield a deeper understanding of uncontrolled hemorrhage from junctional or proximal extremity sources is mandatory. While tourniquet application to the extremities has drastically reduced morbidity and mortality, there is still room for improvement regarding the timing of tourniquet placement as the available evidence clearly points out a tight correlation between timing of tourniquet application and outcome. To save as many lives as possible the "point of no return" regarding the circulatory breakdown due to hemorrhage, colloquially addressed as platinum 5 min, needs to be determined...
March 14, 2018: Military Medicine
Vasilije Stambolija, Martina Miklić Bublić, Marin Lozić, Jakob Nemir, Miroslav Ščap
Background: Low brain tissue oxygen tension (PbtO2 ), or brain hypoxia, is an independent predictor of poor outcome. Increasing inspirational fraction of oxygen could have a significant influence on treating lower PbtO2 . Combined PbtO2 therapy, compared to the approach that focus only on regulation of cerebral perfusion pressure and intracranial pressure, shows better patient outcomes. Monitoring of PbtO2 could be helpful in individualizing treatment, preventing or limiting secondary brain injury, and maintaining better patient outcome...
2018: Surgical Neurology International
Yuhui Yang, Xue Liu, Yunpeng Liu, Hui Fu, Ying Gao, Xing Liu, Xiaoliang Jiang
Background and objective: Chronic inflammatory is involved in the development of salt-sensitive hypertension and other cardiovascular diseases. PSGL-1 plays an important role in the inflammatory response. Methods and results: In this study, we used PSGL-1-/- and PSGL-1+/+ mice fed with high salt diet to measure the blood pressure, inflammatory response and vascular injury. We found that, in PSGL-1+/+ mice, high salt diet resulted in high blood pressure with the increased expression of serum inflammatory cytokines IL-6, IL-1β and TNFɑ, vascular injury markers MCP-1, ET-1, and VWF, and renal macrophages and T cells infiltration, and endothelium-dependent acetylcholine vasodilation dysfunction...
2018: Cell & Bioscience
Kevin Woo
Maintaining skin integrity is espoused by several international authorities as a benchmark for patient safety and quality of care. National guidelines advocate the use of prophylactic multi-layer foam dressings over bony prominences for the prevention of pressure ulcers or injuries. The purpose of this study was to evaluate the implementation of best practice guidelines including the use of multi-layer foam dressings for the prevention of pressure injuries. The analysis involved data from a total number of 62 unique patients...
March 12, 2018: Surgical Technology International
Karen J Riemenschneider
Prevention of hospital-acquired pressure injuries (HAPIs) remains a crucial clinical challenge especially for those patients undergoing surgery. The purpose of this project was to examine whether a 5-layer silicone foam dressing applied to the sacrum of patients undergoing vascular surgery decreased the occurrence of sacral pressure injuries and to explore participant characteristics associated with the development of operating room (OR)-related pressure injuries. A pre-/postintervention design, quality improvement project in a convenience sample of 81 patients undergoing vascular surgery, in a 700-bed level I trauma acute care setting, in the Northeastern United States...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Melissa C Monarca, Patty Marteka, Karen Breda
One-third of hospital-acquired pressure injuries are related to medical devices. The purpose of this quality improvement project was to create an evidence-based guideline in one acute care hospital setting for the prevention of medical device-related pressure injuries (MDRPIs) and to implement the hospital-wide use of a new nasogastric tube securement device to offload pressure to the nares. The first phase of this project comprised development of a guideline along with multiple education opportunities. The second phase of this project consisted of evaluation and subsequent conversion to a new nasogastric tube securement device...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Mikel Gray
No abstract text is available yet for this article.
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Daniel Podd
Pressure injuries (previously called pressure ulcers) are a common finding among patients in acute, long-term, or home settings. Numerous pathophysiologic and risk mechanisms factor into the development of pressure injuries. The timely recognition of these injuries is imperative. Many treatments exist for pressure injuries but the focus of patient management should be on preventing injury-related complications.
March 6, 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Qian Ding, Zhen Li, Bin Liu, Liping Ling, Xiangguo Tian, Chunqing Zhang
Propranolol is known to reduce portal pressure by decreasing blood flow to the splanchnic circulation and the liver. However, it is unknown if propranolol improves fibrogenesis and sinusoidal remodeling in the cirrhotic liver. The aim of this study was to investigate the therapeutic effects of propranolol on carbon tetrachloride (CCl4 )-induced liver fibrosis in a mouse model and the intrinsic mechanisms underlying those effects. In this study, a hepatic cirrhosis mouse model was induced by CCl4 administration for 6weeks...
March 4, 2018: Human Pathology
Jawad Chishtie, Farrukh Chishtie, Karen Yoshida, Robert Balogh
BACKGROUND: The 2005 South Asian earthquake led to large-scale injuries and disabilities in northern Pakistan, which were dealt with using various approaches. In this regard, a community-based rehabilitation approach was initiated in the Muzaffarabad district of Pakistan in early 2006, focused on preventing complications among persons with Spinal Cord Injury. This case study briefly describes its development, aims and service provision components, in addition to the distribution of injuries from the disaster...
March 7, 2018: Disability and Rehabilitation
Morgayn I Read, Rebecca N Millen, Dominic M McCann, Joanne C Harrison, Douglas S Kerr, Ivan A Sammut
OBJECTIVE: Altered autonomic activity has been implicated in the development of cardiac dysfunction during seizures. This study investigates whether intervening in seizure progression with diazepam will reduce seizure-induced cardiomyopathy. Second, this study examines the hypothesis that combining atenolol with diazepam, as an intervention after seizure onset, will combat cardiac injury during status epilepticus. METHODS: Male Sprague-Dawley rats were implanted with electroencephalographic/electrocardiographic electrodes to allow simultaneous recordings during seizures induced by intrahippocampal (2 nmol, 1 μL) kainic acid (KA)...
March 7, 2018: Epilepsia
Yonglai Zhang, Rui Sha, Kaiguo Wang, Hao Li, Bo Yan, Naibao Zhou
Tetrahydropalmatine exerts numerous pharmacological activities, including analgesic and narcotic effects; anti-arrhythmic, blood pressure lowering and cardioprotective effects; protective effects against cerebral ischemia-reperfusion injury; inhibition of platelet aggregation; prevention of ulcerative diseases and inhibition of gastric acid secretion; antitumor effects; and beneficial effects on the withdrawal symptoms associated with drug addiction. The present study aimed to investigate the protective effects of tetrahydropalmatine against ketamine‑induced learning and memory impairment in mice...
March 7, 2018: Molecular Medicine Reports
Holly Kramer, Richard Cooper
PURPOSE OF REVIEW: The Systolic Blood Pressure Intervention Trial demonstrated significant decreases in cardiovascular events and total mortality with intensive systolic blood pressure lowering in adults with high cardiovascular risk in the absence of diabetes but benefits were accompanied by increased risk of adverse events. RECENT FINDINGS: Over 100,000 deaths and 46,000 cases of heart failure may be prevented annually if intensive systolic blood pressure lowering is implemented in 17 million US adults who are age 50 years and older, and have high cardiovascular risk in the absence of diabetes and meet eligibility for the Systolic Blood Pressure Intervention Trial...
March 6, 2018: Current Hypertension Reports
Jialin Sun, Menghua Li, Shiyong Fan, Zhongwu Guo, Bohua Zhong, Xueyuan Jin, Weiguo Shi
Portal hypertension (PHT) is a common liver disease that is closely related to cirrhosis and has a high morbidity and mortality. The present study aimed to probe the efficacy of a novel nitric oxide (NO)-releasing agent with NO linked to ursodeoxycholic acid (UDCA) through threonine (UDCA-Thr-NO) as a liver-targeted therapy for cirrhosis and PHT. After intraperitoneal treatment of dimethyl nitrosamine-induced cirrhotic rats for 3 or 4 weeks, UDCA-Thr-NO could prevent ascites formation and reduce portal pressure instead of carotid artery pressure, when compared with UDCA or compound embryonic bovine liver extract tablets...
2018: American Journal of Translational Research
Majdi Omri, Halim Bouaouina, Hajer Kraiem, Naoufel Chebili, Mehdi Methamem, Mohamed Aymen Jaouadi, Mounir Naija, Walid Naija, Mohamed Nejib Karoui
BACKGROUND: During primary survey of trauma patients, missed injuries and delayed diagnosis can be a potential source of morbidity and mortality. OBJECTIVE: To assess type and frequency of missed injuries in prehospital care in trauma patients and to analyze their contributing factors and implications. METHODS:   It is a descriptive and analytic prospective study. It was performed over six months which had included 200 trauma patients. The initial assessment made by the out-of hospital team of Sousse was compared to the second survey made in the emergency room and intensive care unit after the radiological assessment...
May 2017: La Tunisie Médicale
Konrad Kadzielawa, Biji Mathew, Clara R Stelman, Arden Zhengdeng Lei, Leianne Torres, Steven Roth
PURPOSE: The pathophysiology of retinal ischemia involves mechanisms including inflammation and apoptosis. Ischemic post-conditioning (Post-C), a brief non-lethal ischemia, induces a long-term ischemic tolerance, but the mechanisms of ischemic post-conditioning in the retina have only been described on a limited basis. Accordingly, we conducted this study to determine the molecular events in retinal ischemic post-conditioning and to identify targets for therapeutic strategies for retinal ischemia...
March 5, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Zhi-Hua Wan, Guo-Hao Li, Yong-Lian Guo, Wen-Zhou Li, Lin Chen, Yuan-Jie Zhang
BACKGROUND: Cavernous nerve injury (CNI) causes fibrosis and loss of smooth muscle cells (SMCs) in the corpus cavernosum and leads to erectile dysfunction, and lysyl oxidase (LOX) activation has been found to play an important role in fibrotic diseases. AIM: To evaluate the role of LOX in penile fibrosis after bilateral CNI (BCNI). METHODS: Rats underwent BCNI or a sham operation and were treated with vehicle or β-aminopropionitrile, a specific LOX activity inhibitor...
March 2018: Journal of Sexual Medicine
N F Davis, E M Cunnane, R O 'c Mooney, J C Forde, M T Walsh
OBJECTIVE: To evaluate the feasibility of a novel 'safety-valve' device for preventing catheter related urethral trauma during urethral catheterisation (UC). To assess the opinions of clinicians on the performance of the safety-valve device. MATERIALS AND METHODS: A validated prototype 'safety-valve' device for preventing catheter balloon inflation related urethral injuries was prospectively piloted in male patients requiring UC in a tertiary referral teaching hospital (n=100)...
March 1, 2018: Urology
Giovanna Maria Dimitri, Shruti Agrawal, Adam Young, Joseph Donnelly, Xiuyun Liu, Peter Smielewski, Peter Hutchinson, Marek Czosnyka, Pietro Lio, Christina Haubrich
OBJECTIVES: The detection of increasing intracranial pressure (ICP) is important in preventing secondary brain injuries. Before mean ICP increases critically, transient ICP elevations may be observed. We have observed ICP transients of less than 10 min duration ,which occurred simultaneously with transient increases in heart rate (HR). These simultaneous events in HR and ICP suggest a direct interaction or communication between the heart and the brain. METHODS: This chapter describes four mathematical methods and their applicability in detecting the above heart-brain cross-talk events during long-term monitoring of ICP...
2018: Acta Neurochirurgica. Supplement
Ponraj Kamatchi Sundaram, Pankaj Arora, Jinendrakumar Ramalingam, Jorson D'Costa
Background: Severe head injury (SHI) is a major cause of mortality and morbidity across the world. The current paradigm of management of SHI involves admission in Intensive Care Unit (ICU), mechanical ventilation (MV), and intracranial pressure (ICP) monitoring. Such resources are expensive and often unavailable in the developing world. Objective: MV or ICP monitoring was unavailable for our patients due to the scarcity of resources. Hence, other alternatives were considered to prevent secondary brain injury due to hypoxia...
January 2018: Asian Journal of Neurosurgery
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