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https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#1
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28342652/effective-hospital-wide-education-in-hemorrhage-control
#2
James R Hegvik, Sarah K Spilman, Sherry D Olson, Carrie A Gilchrist, Richard A Sidwell
BACKGROUND: Uncontrolled hemorrhage is the leading cause of potentially preventable traumatic death. Bleeding victims must receive immediate medical attention to save lives, and the first opportunity to control bleeding after trauma often comes from bystanders. Educating the general public is important for improving outcomes for hemorrhaging victims, and it is imperative for all people, including those with no clinical training, to have the knowledge to respond until trained medical specialists arrive...
March 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28341942/integrating-nimh-research-domain-criteria-rdoc-into-ptsd-research
#3
Ulrike Schmidt, Eric Vermetten
Three and a half decades of research on posttraumatic stress disorder (PTSD) has produced substantial knowledge on the pathobiology of this frequent and debilitating disease. However, despite all research efforts, so far no drug that has specifically targeted PTSD core symptoms progressed to clinical use. Instead, although not overly efficient, serotonin re-uptake inhibitors continue to be considered the gold standard of PTSD pharmacotherapy. The psychotherapeutic treatment and symptom-oriented drug therapy options available for PTSD treatment today show some efficacy, although not in all PTSD patients, in particular not in a substantial percent of those suffering from the detrimental sequelae of repeated childhood trauma or in veterans with combat related PTSD...
March 25, 2017: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/28341537/interleukin-6-expression-in-disc-derangement-of-human-temporomandibular-joint-and-association-with-osteoarthrosis
#4
Flavio de Alcântara Camejo, Marina Azevedo, Viviane Ambros, Karina São Thiago Caporal, Andrea Duarte Doetzer, Luis Eduardo Almeida, Marcia Olandoski, Lucia Noronha, Paula Cristina Trevilatto
The inflammatory process is a coordinated response that protects host after infection or trauma, involving several molecular reactions. Once the inflammation is closely linked to the process of destruction of the temporomandibular joint, this study aims to examine, by immunohistochemistry, the expression of interleukin-6 (IL-6), an important inflammatory marker, in temporomandibular articular discs of patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR) and its association with osteoarthrosis (OA)...
February 24, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28340013/implications-of-thoracic-epidural-analgesia-on-hospital-charges-in-rib-fracture-patients
#5
Courtney D Jensen, Jamie T Stark, Lewis E Jacobson, Jan M Powers, Kathy L Leslie, Jeffrey M Kinsella-Shaw, Michael F Joseph, Craig R Denegar
Objective.:  Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity. When a patient fractures three or more ribs, there is an elevated risk of complication. In response, treatments are often broadened and their durations prolonged; this affects cost. While health, function, and survival have been widely explored, patient billing has not...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#6
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are non-survivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, in order to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by non-medical combatant leaders within the 75th Ranger Regiment, U...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333832/immunologic-effects-of-trauma-and-transfusion
#7
Sanjna Shah, Philip C Spinella, Jennifer A Muszynski
The immunologic response to severe traumatic injury is complex - such that individual patients may face exceptionally different immunologic challenges at different points in time. It is in this context that one must consider potentially additive immunomodulatory effects of blood product transfusion. This review will consider first the immunologic response to traumatic injury, followed by the epidemiology and outcomes related to blood product transfusion in trauma patients, and lastly immunologic effects of transfusion in the context of trauma...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333518/the-relationship-between-trauma-and-research-a-response-to-burge-et-al-2017
#8
Catherine Cerulli
Comments on an article by Burge et al. (see record 2017-00531-001). The authors provide an important contribution to the field of intimate partner violence (IPV) research. In their article, Burge et al. contribute to IPV research by publishing a study that seeks to learn, from the voice of the participant (victim), what their experiences are in a study that required rigorous and frequent research-participant interactions. As a result, we see a new perspective emerge: might participation in research actually help victims? (PsycINFO Database Record...
March 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28333042/minocycline-releasing-pmma-system-as-a-space-maintainer-for-staged-bone-reconstructions-in-vitro-antibacterial-cytocompatibility-and-anti-inflammatory-characterization
#9
Tiago Silva, Liliana Grenho, Joana Barros, José Silva, Rosana Pinto, Ana Matos, Bruno Colaço, Helena Fernandes, Ana Bettencourt, Pedro S Gomes
In the present work, it is aimed the development and biological characterization of a poly methyl methacrylate (PMMA)-based minocycline delivery system, to be used as a space maintainer within craniofacial staged regenerative interventions. Developed delivery systems were characterized regarding solid state characteristics and assayed in vitro for anti-bacterial and anti-inflammatory activity, and cytocompatibility with human bone cells. Drug release profile allowed for an initial burst release and a more sustained and controlled release over time, with minimum inhibitory concentrations for the assayed and relevant pathogenic bacteria (i...
March 23, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28330928/surgery-for-cancer-a-trigger-for-metastases
#10
REVIEW
Samer Tohme, Richard L Simmons, Allan Tsung
Surgery is a crucial intervention and provides a chance of cure for patients with cancer. The perioperative period is characterized by an increased risk for accelerated growth of micrometastatic disease and increased formation of new metastatic foci. The true impact for cancer patients remains unclear. This review summarizes the often fragmentary clinical and experimental evidence supporting the role of surgery and inflammation as potential triggers for disease recurrence. Surgery induces increased shedding of cancer cells into the circulation, suppresses antitumor immunity allowing circulating cells to survive, upregulates adhesion molecules in target organs, recruits immune cells capable of entrapping tumor cells, and induces changes in the target tissue and in the cancer cells themselves to enhance migration and invasion to establish at the target site...
March 22, 2017: Cancer Research
https://www.readbyqxmd.com/read/28328676/correlation-between-factor-f-xia-fixa-and-tissue-factor-and-trauma-severity
#11
Shannon M Prior, Mitchell J Cohen, Amanda S Conroy, Mary F Nelson, Lucy Z Kornblith, Benjamin M Howard, Saulius Butenas
BACKGROUND: It has been observed that trauma patients often display elevated procoagulant activity that could be caused, in part, by tissue factor (TF). We previously observed that trauma patients with thermal, blunt and penetrating injuries have active FIXa and FXIa in their plasma. In the current study we evaluated the effect of injury severity, with or without accompanying shock, on the frequency and concentration of TF, FIXa and FXIa in plasma from trauma patients. METHODS: Eighty trauma patients were enrolled and divided equally into 4 groups based on their injury severity score (ISS) and base deficit (BD):Group 1: Non-severe injury, no shockGroup 2: Non-severe injury, with shockGroup 3: Severe injury, no shockGroup 4: Severe injury, with shockBlood was collected at a 0 time-point (first blood draw upon arrival at hospital) and citrate plasma was prepared, frozen and stored at -80C...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328564/variation-in-national-acgme-case-log-data-for-pediatric-orthopaedic-fellowships-are-fellow-coding-practices-responsible
#12
Philip K McClure, Marcella Woiczik, Lori Karol, Wudbhav N Sankar
BACKGROUND: The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28326653/the-impact-of-childhood-maltreatment-on-the-differential-efficacy-of-cbasp-versus-escitalopram-in-patients-with-chronic-depression-a-secondary-analysis
#13
Paul Bausch, Thomas Fangmeier, Ingo Zobel, Dieter Schoepf, Sarah Drost, Knut Schnell, Henrik Walter, Mathias Berger, Claus Normann, Elisabeth Schramm
Childhood maltreatment (CM) has been indicated as a predictor of a differential response to antidepressant treatment with psychotherapy compared to medication. In this secondary analysis, we investigated whether the presence of CM results in a differential indication for the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or escitalopram plus clinical management (ESC). Sixty patients with chronic depression were randomized to either 22 sessions of CBASP or ESC over the course of 8 weeks of acute and 20 weeks of extended treatment at 2 German treatment sites...
March 21, 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28324701/stress-reactivity-and-its-effects-on-subsequent-food-intake-in-depressed-and-healthy-women-with-and-without-adverse-childhood-experiences
#14
Katja Wingenfeld, Linn K Kuehl, Anita Boeker, Katharina Schultebraucks, Kristin Ritter, Julian Hellmann-Regen, Christian Otte, Carsten Spitzer
BACKGROUND: Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems. METHODS: We systematically examined the stress response and consecutive food intake in 32 women with MDD and ACE as determined by a clinical interview (Early Trauma Inventory), 52 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE...
March 12, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#15
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323285/utilization-of-machine-learning-for-prediction-of-post-traumatic-stress-a-re-examination-of-cortisol-in-the-prediction-and-pathways-to-non-remitting-ptsd
#16
I R Galatzer-Levy, S Ma, A Statnikov, R Yehuda, A Y Shalev
To date, studies of biological risk factors have revealed inconsistent relationships with subsequent post-traumatic stress disorder (PTSD). The inconsistent signal may reflect the use of data analytic tools that are ill equipped for modeling the complex interactions between biological and environmental factors that underlay post-traumatic psychopathology. Further, using symptom-based diagnostic status as the group outcome overlooks the inherent heterogeneity of PTSD, potentially contributing to failures to replicate...
March 21, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28321191/palmitoylethanolamide-reduces-neuropsychiatric-behaviors-by-restoring-cortical-electrophysiological-activity-in-a-mouse-model-of-mild-traumatic-brain-injury
#17
Francesca Guida, Serena Boccella, Monica Iannotta, Danilo De Gregorio, Catia Giordano, Carmela Belardo, Rosaria Romano, Enza Palazzo, Maria A Scafuro, Nicola Serra, Vito de Novellis, Francesco Rossi, Sabatino Maione, Livio Luongo
Traumatic brain injury (TBI) represents a major public health problem, which is associated with neurological dysfunction. In severe or moderate cases of TBI, in addition to its high mortality rate, subjects may encounter diverse behavioral dysfunctions. Previous reports suggest that an association between TBI and chronic pain syndromes tends to be more common in patients with mild forms of brain injury. Despite causing minimal brain damage, mild TBI (mTBI) often leads to persistent psychologically debilitating symptoms, which can include anxiety, various forms of memory and learning deficits, and depression...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28319850/methylation-of-hpa-axis-related-genes-in-men-with-hypersexual-disorder
#18
Jussi Jokinen, Adrian E Boström, Andreas Chatzittofis, Diana M Ciuculete, Katarina Görts Öberg, John N Flanagan, Stefan Arver, Helgi B Schiöth
Hypersexual Disorder (HD) defined as non-paraphilic sexual desire disorder with components of compulsivity, impulsivity and behavioral addiction, and proposed as a diagnosis in the DSM 5, shares some overlapping features with substance use disorder including common neurotransmitter systems and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. In this study, comprising 67 HD male patients and 39 male healthy volunteers, we aimed to identify HPA-axis coupled CpG-sites, in which modifications of the epigenetic profile are associated with hypersexuality...
March 10, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28319694/sexual-trauma-is-more-strongly-associated-with-tonic-immobility-than-other-types-of-trauma-a-population-based-study
#19
Juliana Kalaf, Evandro Silva Freire Coutinho, Liliane Maria Pereira Vilete, Mariana Pires Luz, William Berger, Mauro Mendlowicz, Eliane Volchan, Sergio Baxter Andreoli, Maria Inês Quintana, Jair de Jesus Mari, Ivan Figueira
BACKGROUND: Tonic immobility is an involuntary motor and vocal inhibition reaction, considered the last-ditch response of the defensive cascade model. It is elicited in context of inescapable threat and perception of entrapment. Our aim was to investigate the association between different traumatic events and peritraumatic tonic immobility (PTI) in a representative sample of the general population. METHODS: This is a cross-sectional study of general population from Rio de Janeiro and São Paulo with 3231 victims of traumatic events aged 15-75 years who completed the Tonic Immobility Scale (TIS)...
March 7, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28318416/conflicts-between-motivational-systems-related-to-attachment-trauma-key-to-understanding-the-intra-family-relationship-between-abused-children-and-their-abusers
#20
Giovanni Liotti
Research on disorganization of infant attachment provides evidence that it can be caused not only by violent aggression or very early sexual abuse, but also by covert maltreating behavior, which includes the abdication of the caregiver's responsibility to soothe the infant's distress. This paper argues that both overtly abusive caregivers and merely "abdicating" caregivers may cause disorganization of infant attachment through a simultaneous and conflicting activation of the motivational systems governing attachment and survival defense in the infant...
March 1, 2017: Journal of Trauma & Dissociation
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