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junctional hemorrhage

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
Elliot M Ross, Theodore T Redman
BACKGROUND: Noncompressible junctional and truncal hemorrhage remains a significant cause of combat casualty death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective treatment for many junctional and noncompressible hemorrhages. The current hospital standard for time of placement of REBOA is approximately 6 minutes. This study examined the training process and the ability of nonsurgical physicians to apply REBOA therapy in an austere field environment. METHODS: This was a skill acquisition and feasibility study...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Hiroshi Matsuoka, Aki Tamura, Masaki Kinehara, Akiho Shima, Arisa Uda, Hidetoshi Tahara, Akihiro Michihara
The claudin family shows organ- and tissue-specific expression of individual members. Deficiency or aberrant expression of distinct claudins has been reported to be associated with severe pathophysiological consequences. Claudin domain-containing 1 (CLDND1), also known as claudin-25, shows homology to this family of proteins. Furthermore, serum CLDND1-derived peptide antibody levels are elevated in patients with cerebral infarction, as compared with healthy controls. We previously reported that, in the adult murine brain, CLDND1 is abundantly expressed in the cerebellum in common sites of intracerebral hemorrhage, and CLDND1 levels are transiently decreased after hemorrhagic insult...
March 9, 2018: Biochemical and Biophysical Research Communications
Hiroto Inoue, Yuto Sato, Shuuhei Shintani, Hiroki Tanabe, Hiromichi Bamba, Yasunobu Komai, Tomoaki Nakamura, Takayuki Imai, Akira Andou
We report the case of a 61-year-old man who experienced severe adverse effects of capecitabine because of dihydropyrimidine dehydrogenase (DPD) deficiency. In 2016, he visited our hospital for adenocarcinoma of the gastroesophageal junction and was prescribed neoadjuvant chemotherapy with capecitabine, cisplatin, and trastuzumab. On day 14 of chemotherapy, he developed severe diarrhea, canker sores, enterocolitis, febrile neutropenia, and thrombocytopenia. He was then urgently hospitalized, and anticancer treatment was stopped...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Eiichiro Amano, Kokoro Ozaki, Satoru Egawa, Motohiro Suzuki, Takashi Hirai, Satoru Ishibashi, Takuya Ohkubo, Toshitaka Yoshii, Atsushi Okawa, Takanori Yokota
RATIONALE: OSAM is a rare ventriculoperitoneal (VP) shunt complication where cervical spinal cord compression by epidural venous plexus engorgement is caused by cerebrospinal fluid (CSF) overdrainage. Symmetrically indented deformity of the upper cervical spinal cord and surrounding epidural venous engorgement are characteristic radiological findings. Both of them are typically detected on magnetic resonance imaging (MRI) and enhanced computed tomography (CT). PATIENT CONCERNS: The 77-year-old man who underwent the placement of a VP shunt without an antisiphon device to treat post-subarachnoid hemorrhage (SAH) hydrocephalus presented with progressive quadriplegia 10 years postoperatively...
March 2018: Medicine (Baltimore)
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries were the most common mechanisms of trauma. Imaging plays a key role in the management of combat-related thoracic trauma casualties. This review discusses the imaging manifestations of thoracic injuries from penetrating trauma, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
Kensei Yamaguchi, Kazumasa Fujitani, Fumio Nagashima, Yasushi Omuro, Nozomu Machida, Tomohiro Nishina, Toshiko Koue, Mika Tsujimoto, Kaijiro Maeda, Taroh Satoh
BACKGROUND: Ramucirumab, a monoclonal antibody vascular endothelial growth factor receptor-2 antagonist, given as monotherapy improved survival in a global phase 3 study (REGARD) of patients with gastric cancer. However, REGARD did not include Japanese patients. This study evaluated the efficacy and safety of ramucirumab monotherapy in Japanese patients with advanced gastric cancer. METHODS: This multicenter, open-label, nonrandomized phase 2 study (Clinicaltrials...
March 5, 2018: Gastric Cancer
Sunil Munakomi, Pramod Chaudhary, Iype Cherian
Herein, we discuss a rare case of posttraumatic cervicovertebral junction subdural hematoma and associated cisterna magna subarachnoid hemorrhage. Due to progression in the hydrocephalus, he has undergone midline suboccipital craniectomy and evacuation of the hematoma. The patient made an uneventful recovery.
January 2018: Asian Journal of Neurosurgery
Danica Cvetković, Vladimir Živković, Irina Damjanjuk, Slobodan Nikolić
A 40-year-old drug addict, who was being treated with methadone and occupational therapy, committed suicide by striking a wooden pencil into his right eye socket. While still conscious, he hit his head hard against a table, jamming the pencil even deeper into his head. The autopsy showed that the pencil missed the globe and lodged in the inner part of the right eye socket. It pierced the orbital part of the right ethmoid bone, the right ethmoid cells, and the right superior nasal concha, then passed through the body of the sphenoid bone and the clivus of the occipital bone before stopping in the brain tissue...
February 24, 2018: Forensic Science, Medicine, and Pathology
Cassie Bennett, Malaroviyam Samikkannu, Farrah Mohammed, W Dalton Dietrich, Suhrud M Rajguru, Abhishek Prasad
Chronically implanted microelectrodes in the neural tissue elicit inflammatory responses that are time varying and have been shown to depend on multiple factors. Among these factors, blood brain barrier (BBB)-disruption has been hypothesized as one of the dominant factors resulting in electrode failure. A series of events that includes BBB and cell-membrane disruption occurs during electrode implantation that triggers multiple biochemical cascades responsible for microglial and astroglial activation, hemorrhage, edema, and release of pro-inflammatory neurotoxic cytokines that causes neuronal degeneration and dysfunction...
February 20, 2018: Biomaterials
Jie Ma, Yuding Fan, Yong Zhou, Wenzhi Liu, Nan Jiang, Jieming Zhang, Lingbing Zeng
The hemorrhagic disease of grass carp (Ctenopharyngodon idellus) induced by grass carp reovirus (GCRV) leads to huge economic losses in China and currently, there are no effective methods available for prevention and treatment. The various GCRV genotypes may be one of the major obstacles in the pursuit of an effective antiviral treatment. In this study, we exploited CRISPR/Cas9 gene editing to specifically knockout the DNA sequence of the grass carp Junctional Adhesion Molecule-A (gcJAM-A) and evaluated in vitro resistance against various GCRV genotypes...
February 22, 2018: Fish & Shellfish Immunology
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
Neha Chandan, Eden P Lake, Lawrence S Chan
Senear-Usher Syndrome, or pemphigus erythematosus, is an autoimmune skin blistering disorder with an overlapping clinical presentation of pemphigus foliaceus and lupus erythematosus. Lesions typically involve the scalp, face, and upper chest or back. This case study focuses on a patient who presentedwith progressive scalp ulcers, hyperpigmentation, and eroded plaques with overlying hemorrhagic crust. Pemphigus erythematosus was diagnosedwith direct immunofluorescence, demonstrating immunoglobulin G and complement deposition both intercellularly and at the dermoepidermal junction...
January 15, 2018: Dermatology Online Journal
Puzi Wang, Rongli Xie, Zhifeng Zhao, Jiajun Ren, Jian Fei
RATIONALE: Autoimmune pancreatitis is a form of chronic pancreatitis, characterized by diffused enlargement of the pancreas and irregular narrowing of the main pancreatic duct. The theory that portal hypertension is associated with autoimmune pancreatitis has not been emphasized. In addition, only a few studies report that the gastrointestinal tract hemorrhage caused by portal hypertension is associated with autoimmune pancreatitis. PATIENT CONCERNS: The patient was a 61-year-old male with pancreas occupying lesion detected in a physical examination...
February 2018: Medicine (Baltimore)
Zhandong Qiu, Jia Yang, Gang Deng, Yu Fang, Dayong Li, Suming Zhang
BACKGROUND Angiopoietin-like 4 (ANGPTL4) is neuroprotective when administered acutely for the treatment of cerebral ischemia. The aim of the present study was to evaluate the preventive effects of ANGPTL4 on the formation of brain edema and to determine whether it promotes the recovery of neurological function following intracerebral hemorrhage (ICH). MATERIAL AND METHODS Recombinant human ANGPTL4 (rhANGPTL4; 40 µg/kg) or a vehicle was administered intraperitoneally 5 min prior to bacterial collagenase-induced ICH in male C57/B6J mice...
February 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kinga G Blecharz-Lang, Josephin Wagner, Alexa Fries, Melina Nieminen-Kelhä, Jörg Rösner, Ulf C Schneider, Peter Vajkoczy
Compromised blood-brain barrier (BBB) by dysregulation of cellular junctions is a hallmark of many cerebrovascular disorders due to the pro-inflammatory cytokines action. Interleukin 6 (IL6) is implicated in inflammatory processes and in secondary brain injury after subarachnoid hemorrhage (SAH) but its role in the maintenance of cerebral endothelium still requires a precise elucidation. Although IL6 has been shown to exert pro-inflammatory action on brain microvascular endothelial cells (ECs), the expression of one of the IL6 receptors, the IL6R is controversially discussed...
February 10, 2018: Translational Stroke Research
Chanettee Chanthick, Aroonroong Suttitheptumrong, Nantapon Rawarak, Sa-Nga Pattanakitsakul
The major role of endothelial cells is to maintain homeostasis of vascular permeability and to preserve the integrity of vascular vessels to prevent fluid leakage. Properly functioning endothelial cells promote physiological balance and stability for blood circulation and fluid components. A monolayer of endothelial cells has the ability to regulate paracellular and transcellular pathways for transport proteins, solutes, and fluid. In addition to the paracellular pathway, the transcellular pathway is another route of endothelial permeability that mediates vascular permeability under physiologic conditions...
February 8, 2018: Viruses
Shibani Pati, Zhanglong Peng, Katherine Wataha, Byron Miyazawa, Daniel R Potter, Rosemary A Kozar
In severe trauma and hemorrhage the early and empiric use of fresh frozen plasma (FFP) is associated with decreased morbidity and mortality. However, utilization of FFP comes with the significant burden of shipping and storage of frozen blood products. Dried or lyophilized plasma (LP) can be stored at room temperature, transported easily, reconstituted rapidly with ready availability in remote and austere environments. We have previously demonstrated that FFP mitigates the endothelial injury that ensues after hemorrhagic shock (HS)...
2018: PloS One
Robert C Rennert, Reid Hoshide, Mark Calayag, Joanna Kemp, David D Gonda, Hal S Meltzer, Takanori Fukushima, John D Day, Michael L Levy
OBJECTIVE Treatment of hemorrhagic cavernous malformations within the lateral pontine region demands meticulous surgical planning and execution to maximize resection while minimizing morbidity. The authors report a single institution's experience using the extended middle fossa rhomboid approach for the safe resection of hemorrhagic cavernomas involving the lateral pons. METHODS A retrospective chart review was performed to identify and review the surgical outcomes of patients who underwent an extended middle fossa rhomboid approach for the resection of hemorrhagic cavernomas involving the lateral pons during a 10-year period at Rady Children's Hospital of San Diego...
February 2, 2018: Journal of Neurosurgery. Pediatrics
Amit Aurora, Janet L Roe, Nsini A Umoh, Michael Dubick, Joseph C Wenke, Thomas J Walters
BACKGROUND: Hemorrhagic shock due to extremity vascular injuries is common in combat injuries. Fluid resuscitation is the standard treatment for severe hemorrhage. Tourniquets (TK) used for hemorrhage control cause ischemia-reperfusion (I/R) injury that induces edema formation in the injured muscle. Resuscitation fluids affect edema formation; however, its effect on long-term functional response remains unknown. The objectives of this study are 1) compare acute muscle damage; 2) determine long-term functional recovery of ischemic muscle, and 3) compare local and systemic inflammatory response including the expression of junctional proteins following early resuscitation with Hextend (HEX) and Fresh Whole Blood (FWB) using a rodent model of combined hemorrhage and TK-induced limb I/R...
January 24, 2018: Journal of Trauma and Acute Care Surgery
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