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Golden hour

Trinath Kumar Mishra, Biswajit Das
BACKGROUND: Coronary artery disease (CAD) is rising in epidemic proportions with India not being an exception. CAD in Indian scenario has its onset at a younger age with multitude of risk factors. OBJECTIVE: This study was carried out to obtain complete information about demographic profile, risk factors, clinical scenario, therapeutic modalities, natural course, outcome and changing profile of acute ST-segment elevated myocardial infarction (STEMI) patients. METHODS: This cross-sectional study was conducted in 45,122 acute STEMI patients admitted 1st March 1990 to 1st March 2014...
June 2016: Journal of the Association of Physicians of India
Yvonne Rice, Mary DeLetter, Lisa Fryman, Evelyn Parrish, Cathie Velotta, Cynthia Talley
BACKGROUND: Care of the trauma patient requires a well-coordinated intensive effort during the golden hour to optimize survival. PURPOSE: We hypothesized that this program would improve knowledge, satisfaction, self-confidence, and simulated team performance. METHODS: A pre-, post-test design with N = 7 BSN nurses, 21 years of age, less than 2 years of intensive care unit and nursing experience. SETTING: Trauma intensive care unit, single-center academic Level 1 trauma center...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Sabine Gogolok, Claudia Garcia-Diaz, Steven M Pollard
Transcription activator-like effectors (TALEs) contain modular programmable DNA binding domains. Fusing TALEs with effector domains creates synthetic transcription factors (TALE-TFs) or nucleases (TALENs), enabling precise gene manipulations. The construction of TALEs remains challenging due to their repetitive sequences. Here we report a simple TALE assembly reaction (STAR) that enables individual laboratories to generate multiple TALEs in a facile manner. STAR uses an isothermal assembly ('Gibson assembly') that is labour- and cost-effective, accessible, rapid and scalable...
2016: Scientific Reports
Bryce Haac, Clare Rock, Anthony D Harris, Lisa Pineles, Deborah Stein, Thomas Scalea, Peter Hu, George Hagegeorge, Stephen Y Liang, Kerri A Thom
INTRODUCTION: Healthcare-associated infections are a significant health burden, and hand hygiene (HH) is an essential prevention strategy. World Health Organization (WHO) 2009 guidelines recommend washing hands during five moments of patient care; 1)before touching a patient; 2)before a clean procedure; 3)after body fluid exposure; and 4)after touching a patient or 5)patient surroundings. HH opportunities at these 5 moments are frequent and compliance is low (22-60%). Infection risk is particularly high in trauma patients, and HH compliance during active trauma resuscitation has yet to be evaluated...
August 17, 2016: Injury
Borwon Wittayachamnankul, Boriboon Chentanakij, Kamphee Sruamsiri, Nipon Chattipakorn
OBJECTIVE: The current practice in treatment of severe sepsis and septic shock is to ensure adequate oxygenation and perfusion in patients, along with prompt administration of antibiotics, within 6 hours from diagnosis, which is considered the "golden hour" for the patients. One of the goals of treatment is to restore normal tissue perfusion. With this goal in mind, some parameters have been used to determine the success of treatment and mortality rate; however, none has been proven to be the best predictor of mortality rate in sepsis patients...
August 10, 2016: Journal of Critical Care
Timothy F Platts-Mills, Christopher S Evans, Jane H Brice
No abstract text is available yet for this article.
August 24, 2016: Journal of the American Geriatrics Society
George E Black, Kyle K Sokol, Robert Shawhan, Matthew J Eckert, Shashikumar Salgar, Shannon T Marko, Zachary S Hoffer, Matthew J Martin
BACKGROUND: Suspended animation-like states have been achieved in small animal models, but not in larger species. Inducing metabolic suppression and temporary oxygen-independence could enhance survivability of massive injury. Based on prior analyses of key pathways, we hypothesized that PI3-kinase inhibition (PI3-KI) would produce metabolic suppression without worsening organ injury or systemic physiology. METHODS: Twenty swine were studied using LY294002 (LY), a non-selective PI3-KI: Animals were assigned to Trauma only (TO, N=3); DMSO only (DMSO, N=4), LY drug only (LYO, N=3); and Drug + trauma (LY+T , N=10) groups...
August 18, 2016: Journal of Trauma and Acute Care Surgery
Jonathan P Meizoso, Juliet J Ray, Charles A Karcutskie, Casey J Allen, Tanya L Zakrison, Gerd D Pust, Tulay Koru-Sengul, Enrique Ginzburg, Louis R Pizano, Carl I Schulman, Alan S Livingstone, Kenneth G Proctor, Nicholas Namias
INTRODUCTION: Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims is not established. We hypothesize that delaying surgery for more than 10 minutes from arrival increases all-cause mortality in hypotensive patients with GSW. METHODS: Data of adults (n = 309) with hypotension and GSW to the torso requiring immediate operation from January 2004 to September 2013 were retrospectively reviewed...
October 2016: Journal of Trauma and Acute Care Surgery
Deepesh Kumar, Anirban Dutta, Abhijit Das, Uttama Lahiri
Stroke is one of leading cause of death and disability worldwide. Early detection during golden hour and treatment of individual neurological dysfunction in stroke using easy-to-access biomarkers based on a simple-to-use, cost-effective, clinically-valid screening tool can bring a paradigm shift in healthcare, both urban and rural. In our research we have designed a quantitative automatic home-based oculomotor assessment tool that can play an important complementary role in prognosis of neurological disorders like stroke for the neurologist...
June 13, 2016: European Journal of Translational Myology
Giovanni Alemanno, Riccardo Somigli, Paolo Prosperi, Carlo Bergamini, Gherardo Maltinti, Alessio Giordano, Andrea Valeri
INTRODUCTION: Acute mesenteric ischemia is the most severe gastrointestinal complication of acute aortic dissection. The timing of diagnosis is of major importance, in fact the recognition of acute mesenteric ischemia often occurs too late due to the presence of unspecific symptoms and lack of reliable exams. Recently, indocyanine green fluorescence angiography has been adopted in order to measure blood perfusion and microcirculation. PRESENTATION OF CASE: We decided to perform a diagnostic laparoscopy with the support of intra-operative near-infrared indocyanine green fluorescence angiography, in order to detect an initial intestinal ischemia in a 68-year-old patient previously treated with a TEVAR procedure for a type-B aortic dissection...
2016: International Journal of Surgery Case Reports
Bradley M Dennis, Michael A Vella, Oliver L Gunter, Melissa D Smith, Catherine S Wilson, Mayur B Patel, Timothy C Nunez, Oscar D Guillamondegui
BACKGROUND: The Rural Trauma Team Development Course (RTTDC) is designed to teach knowledge and skills for the initial assessment and stabilization of trauma patients in resource-limited environments. The effect of RTTDC training on transfers from nontrauma centers to definitive care has not been studied. We hypothesized that RTTDC training would decrease referring hospital emergency department (ED) length of stay (LOS), time to call for transfer, pretransfer computed tomography (CT) imaging rate, and mortality rate...
October 2016: Journal of Trauma and Acute Care Surgery
Lior Carmi, Leah Fostick, Shimon Burshtein, Shlomit Cwikel-Hamzany, Joseph Zohar
One of the main changes in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was the separation of Stress Related Disorders from the Anxiety chapter. This separation paves the way to examine the unique characteristics of posttraumatic stress disorder (PTSD) (ie, identifiable onset, memory processes, etc) and related neural mechanisms. The time that elapses between the traumatic event and the manifestation of the disorder may also be addressed as the "golden hours," or the window of opportunity in which critical processes take place and relevant interventions may be administrated...
August 2016: CNS Spectrums
Joshua J Joseph, Justin B Echouffo-Tcheugui, Sherita H Golden, Haiying Chen, Nancy Swords Jenny, Mercedes R Carnethon, David Jacobs, Gregory L Burke, Dhananjay Vaidya, Pamela Ouyang, Alain G Bertoni
BACKGROUND: The association between physical activity (PA), sedentary behavior, and incident diabetes has been assessed in whites but is less well investigated in multiethnic populations. OBJECTIVE: To assess the association between PA, sedentary behavior, and incident diabetes in the Multi-Ethnic Study of Atherosclerosis. RESEARCH DESIGN AND METHODS: Incident diabetes was assessed among adults without prevalent baseline diabetes (2000-2002) at 5 in-person examinations between 2002 and 2012...
2016: BMJ Open Diabetes Research & Care
Tinisha M Lambeth, Mario A Rojas, Amy P Holmes, Robin B Dail
BACKGROUND: Very low birth-weight (<1500 g) infants are vulnerable to their environment during the first hour after birth. We designed an evidence-based golden hour protocol (GHP) with a goal to stabilize and perform admission procedures within 1 hour of birth at a level IIIB neonatal intensive care unit (NICU). PURPOSE: The aim of this quality improvement project was to ascertain whether an evidence-based GHP would improve care efficiency and short-term outcomes...
August 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
F Mück, K Wirth, M Muggenthaler, K G Kanz, U Kreimeier, D Maxien, U Linsenmeier, W Mutschler, S Wirth
BACKGROUND: Mass casualty incidents (MCI) have particularly high demands on patient care processes but occur rather rarely in daily hospital routine. Therefore, it is common to use simulations to train staff and to optimize institutional processes. OBJECTIVES: Aim of study was to compare the pre-therapeutic in-house workflow of two differently structured level 1 trauma sites in the case of a simulated mass casualty incident (MCI). MATERIALS AND METHODS: A MCI of 70 patients was simulated by actors in a manner that was as realistic as possible...
August 2016: Der Unfallchirurg
Tobias Spangenberg, Felix Meincke, Stephanie Brooks, Christian Frerker, Felix Kreidel, Thomas Thielsen, Tobias Schmidt, Karl-Heinz Kuck, Alexander Ghanem
OBJECTIVES: The feasibility and outcomes of 35 consecutive patients subjected to eCPR in the tertiary cardiology center were investigated. BACKGROUND: While conventional cardiopulmonary-resuscitation (cCPR) often times achieves only mediocre outcomes extracorporeal cardiopulmonary-resuscitation (eCPR) increasingly shifts into the focus of interest. However, the scientific evidence for eCPR is sparse, particularly in the cardiological setting. METHODS: Retrospective chart analysis of 35 patients treated with eCPR between 01/2014 and 10/2015...
June 17, 2016: Catheterization and Cardiovascular Interventions
Valerie Plant, Ashley Limkemann, Loren Liebrecht, Charles Blocher, Paula Ferrada, Michel Aboutanos, Martin J Mangino
INTRODUCTION: Polyethylene glycol-20k (PEG-20k) is highly effective for low volume resuscitation (LVR) by increasing tolerance to the low volume state. In our rodent shock model, PEG-20k increased survival and expanded the "golden hour" 16-fold compared to saline. The molecular mechanism is largely attributed to normalizations in cell and tissue fluid shifts after low flow ischemia resulting in efficient microvascular exchange. The objective of this study was to evaluate PEG-20k as a low volume resuscitation solution for hemorrhagic shock in a pre-clinical model...
June 8, 2016: Journal of Trauma and Acute Care Surgery
Jean P Gelinas, Keith R Walley
Recognition and management of agitation, delirium, and pain are key areas. Reduced use of sedatives is an important measure that must be coupled with increased patient engagement, mobilization, and exercise. Use of low tidal volumes and low mean airway pressures during mechanical ventilation is helpful. A key hemodynamic principle following early aggressive volume resuscitation is subsequent careful assessment to avoid unnecessary additional volume administration and adverse consequences of frank volume overload...
June 2016: Clinics in Chest Medicine
Anson Jose, Shakil Ahmed Nagori, Bhaskar Agarwal, Ongkila Bhutia, Ajoy Roychoudhury
Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC) management are often modified or supplemented with other methods in case of maxillofacial injuries...
April 2016: Journal of Emergencies, Trauma, and Shock
Elsio A Wunder, Claudio P Figueira, Gisele R Santos, Kristel Lourdault, Michael A Matthias, Joseph M Vinetz, Eduardo Ramos, David A Haake, Mathieu Picardeau, Mitermayer G Dos Reis, Albert I Ko
The pathogen Leptospira interrogans is a highly motile spirochete that causes acute and fulminant infections in humans and other accidental hosts. Hematogenous dissemination is important for infection by the pathogen but remains poorly understood because few animal model studies have used sensitive tools to quantify the bacteria. We evaluated the kinetics of leptospiral infection in Golden Syrian hamsters by a sensitive quantitative real-time PCR (TaqMan) with lipl32 as the target gene. The dissemination and bacterial burden were measured after intraperitoneal infection with a high dose (10(8)) or low dose (2...
July 2016: Infection and Immunity
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