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https://www.readbyqxmd.com/read/28329116/spontaneous-haemothorax-caused-by-a-ruptured-oesophageal-artery
#1
Wenxiong Zhang, Yongbing Wu, Xiaoqiang Zhang, Han Jiang
Spontaneous haemothorax is a subcategory of haemothorax that occurs in the absence of trauma or other causes. It is a rare emergency that can progress rapidly with massive blood loss leading to haemorrhagic shock and death. We describe a patient with massive spontaneous haemothorax caused by the disruption of an oesophageal artery from the middle segment of descending thoracic aorta. We sutured the bleeding artery in an emergency thoracotomy after the failure of interventional procedure.
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28328710/fatty-acid-saturation-of-albumin-used-in-resuscitation-fluids-modulates-cell-damage-in-shock-in-vitro-results-using-a-novel-technique-to-measure-fatty-acid-binding-capacity
#2
Alexander H Penn, Michael A Dubick, Ivo P Torres Filho
The use of albumin for resuscitation has not proven as beneficial in human trials as expected from numerous animal studies. One explanation could be the practice of adding fatty acid (FA) during manufacture of pharmaceutical albumin. During ischemia, unbound free FAs (FFA) in the circulation could potentially induce cellular damage. We hypothesized that albumins with higher available binding capacities (ABC) for FFAs may prevent that damage. Therefore, we developed a technique to measure ABC, determined if pharmaceutical human serum albumin (HSA) has decreased ABC compared to FA-free bovine serum albumin (BSA), and if binding capacity would affect hemolysis when blood is mixed with exogenous FFA at levels similar to those observed in shock...
March 21, 2017: Shock
https://www.readbyqxmd.com/read/28328682/early-tranexamic-acid-administration-ameliorates-the-endotheliopathy-of-trauma-and-shock-in-an-in-vitro-model
#3
Lawrence N Diebel, Jonathan V Martin, David M Liberati
BACKGROUND: Systemic vascular endothelial injury is a consequence of trauma-hemorrhagic shock (T/HS) which results in disturbances of coagulation, inflammation and endothelial barrier integrity. The effect of T/HS on the endothelium (Endotheliopathy of Trauma)[EoT] is of intense research interest and may lead to EoT directed therapies. Administration of tranexamic acid (TXA) in trauma patients is associated with a survival benefit and fewer complications if given early after injury. Mechanisms for this protective effect include the anti-fibrinolytic and anti-inflammatory effects of TXA...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328676/correlation-between-factor-f-xia-fixa-and-tissue-factor-and-trauma-severity
#4
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/28322249/the-protective-effects-of-shikonin-on-hepatic-ischemia-reperfusion-injury-are-mediated-by-the-activation-of-the-pi3k-akt-pathway
#5
Tong Liu, QingHui Zhang, Wenhui Mo, Qiang Yu, Shizan Xu, Jingjing Li, Sainan Li, Jiao Feng, Liwei Wu, Xiya Lu, Rong Zhang, Linqiang Li, Keran Cheng, Yuqing Zhou, Shunfeng Zhou, Rui Kong, Fan Wang, Weiqi Dai, Kan Chen, Yujing Xia, Jie Lu, Yingqun Zhou, Yan Zhao, Chuanyong Guo
Hepatic ischemia/reperfusion (I/R) injury, which can result in severe liver injury and dysfunction, occurs in a variety of conditions such as liver transplantation, shock, and trauma. Cell death in hepatic I/R injury has been linked to apoptosis and autophagy. Shikonin plays a significant protective role in ischemia/reperfusion injury. The purpose of the present study was to investigate the protective effect of shikonin on hepatic I/R injury and explore the underlying mechanism. Mice were subjected to segmental (70%) hepatic warm ischemia to induce hepatic I/R injury...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#6
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28303032/-scales-for-predicting-outcome-after-severe-trauma
#7
B Ali Ali, T Belzunegui Otano, M Fortún Moral, D Reyero Díez, M Castro Neira
In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results...
March 14, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28295125/treatment-of-locked-posterior-shoulder-dislocation-with-bone-defect
#8
Yousuf M Khira, Adel M Salama
Locked posterior shoulder dislocation is an uncommon condition and is associated with a reverse Hill-Sachs lesion in 50% of cases. The condition is likely to occur in cases of violent trauma, seizures, or electric shock. Unrecognized dislocation with humeral head fracture affects joint function and humeral head vascularity and may lead to chronic instability, osteonecrosis, and osteoarthritis. A group of 12 patients, including 10 men and 2 women, with neglected locked posterior shoulder dislocation with a reverse Hill-Sachs lesion were treated with the modified McLaughlin technique...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28291478/blast-wave-dynamics-at-the-cornea-as-a-function-of-eye-protection-form-and-fit
#9
Steven T Williams, Thomas H Harding, J Keegan Statz, John S Martin
A shock tube and anthropomorphic headforms were used to investigate eye protection form and fit using eyewear on the Authorized Protective Eyewear List in primary ocular blast trauma experiments. Time pressure recordings were obtained from highly linear pressure sensors mounted at the cornea of instrumented headforms of different sizes. A custom shock tube produced highly reliable shock waves and pressure recordings were collected as a function of shock wave orientation and protective eyewear. Eyewear protection coefficients were calculated as a function of a new metric of eyewear fit...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#10
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#11
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288453/medical-treatment-of-tattoo-complications
#12
Jørgen Serup
Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the 'moist wound' principle using plastic film, hydrocolloids, silver dressing, and compression. Bacterial infections during healing are treated with oral antibiotics, and a list of first-line antibiotics is proposed. Notice is given to severe infections with affected general condition, and it is emphasized that intravenous antibiotic treatment must be instituted as early as possible to prevent septic shock and death...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288070/novel-synthetic-host-defense-peptide-protects-against-organ-injury-dysfunction-in-a-rat-model-of-severe-hemorrhagic-shock
#13
Noriaki Yamada, Lukas B Martin, Elisabeth Zechendorf, Gareth S D Purvis, Fausto Chiazza, Barbara Varrone, Massimo Collino, Joanna Shepherd, Lena Heinbockel, Thomas Gutsmann, Wilmar Correa, Klaus Brandenburg, Gernot Marx, Tobias Schuerholz, Karim Brohi, Christoph Thiemermann
OBJECTIVE: To evaluate (1) levels of the host-defense/antimicrobial peptide LL-37 in patients with trauma and hemorrhagic shock (HS) and (2) the effects of a synthetic host-defense peptide; Pep19-4LF on multiple organ failure (MOF) associated with HS. BACKGROUND: HS is a common cause of death in severely injured patients. There is no specific therapy that reduces HS-associated MOF. METHODS: (1) LL-37 was measured in 47 trauma/HS patients admitted to an urban major trauma center...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#14
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28272178/workplace-violence-and-perceptions-of-safety-among-emergency-department-staff-members-experiences-expectations-tolerance-reporting-and-recommendations
#15
Darcy Copeland, Melissa Henry
Workplace violence (WPV) is a widely recognized problem in emergency departments (EDs). The majority of WPV studies do not include nonclinical staff and do not address expectations of violence, tolerance to violence, or perceptions of safety. Among a multidisciplinary sample of ED staff members, specific study aims were to (a) describe exposure to WPV; (b) describe perceptions of safety, tolerance to violence, and expectation of violence; (c) describe reporting behaviors and perceived barriers to reporting violence; (d) examine relationships between demographic variables, experiences of violence, tolerance to violence, perceptions of safety, and reporting behaviors; and (e) identify perceptions of viable interventions to improve workplace safety...
March 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28272069/does-prehospital-time-affect-survival-of-major-trauma-patients-where-there-is-no-prehospital-care
#16
S B Dharap, S Kamath, V Kumar
BACKGROUND: Survival after major trauma is considered to be time dependent. Efficient prehospital care with rapid transport is the norm in developed countries, which is not available in many lower middle and low-income countries. The aim of this study was to assess the effect of prehospital time and primary treatment given on survival of major trauma patients in a setting without prehospital care. MATERIALS AND METHODS: This prospective observational study was carried out in a university hospital in Mumbai, from January to December 2014...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28269737/the-autodigestion-hypothesis-proteolytic-receptor-cleavage-in-rheological-and-cardiovascular-cell-dysfunction1
#17
Geert W Schmid-Schönbein
Transformation of circulating leukocytes from a dormant into an activated state with changing rheological properties leads to a major shift of their behavior in the microcirculation. Low levels of pseudopod formation or expression of adhesion molecules facilitate relatively free passage through microvessels while activated leukocytes with pseudopods and enhanced levels of adhesion membrane proteins become trapped in microvessels, attach to the endothelium and migrate into the tissue. The transformation of leukocytes into an activated state is seen in many diseases...
March 2, 2017: Biorheology
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#18
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28265453/automated-closed-loop-resuscitation-of-multiple-hemorrhages-a-comparison-between-fuzzy-logic-and-decision-table-controllers-in-a-sheep-model
#19
Nicole Ribeiro Marques, Brent J Ford, Muzna N Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer
BACKGROUND: Hemorrhagic shock is the leading cause of trauma-related death in the military setting. Definitive surgical treatment of a combat casualty can be delayed and life-saving fluid resuscitation might be necessary in the field. Therefore, improved resuscitation strategies are critically needed for prolonged field and en route care. We developed an automated closed-loop control system capable of titrating fluid infusion to a target endpoint. We used the system to compare the performance of a decision table algorithm (DT) and a fuzzy logic controller (FL) to rescue and maintain the mean arterial pressure (MAP) at a target level during hemorrhages...
2017: Disaster Mil Med
https://www.readbyqxmd.com/read/28261769/evaluation-of-risk-factors-and-development-of-acute-kidney-injury-in-aneurysmal-subarachnoid-hemorrhage-head-injury-and-severe-sepsis-septic-shock-patients-during-icu-treatment
#20
Ceren Kamar, Achmet Ali, Demet Altun, Günseli Orhun, Akın Sabancı, Altay Sencer, İbrahim Özkan Akıncı
BACKGROUND: There are few studies examining development of acute kidney injury (AKI) in the various types of patients in intensive care units (ICUs). Presently described is evaluation of risk factors and development of AKI in different groups of ICU patients. METHODS: Present study was performed in 3 different ICUs. Development of AKI was measured using Acute Kidney Injury Network (AKIN) classification system. Total of 300 patients who were treated in trauma, neurosurgery, or general ICU departments (due to head injury, aneurysmal subarachnoid hemorrhage [aSAH], or severe sepsis/septic shock, respectively) were assessed for incidence, risk factors, and development of AKI...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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