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Hemorrhagic shock

Taiki Suzuki, Ryo Sekiya, Yuji Hamada, Miho Takahashi, Kazunari Karakida, Haruo Sakamoto
Here, we report a case of fatal bleeding in conjunction with mandibular medicationrelated osteonecrosis of the jaw (MRONJ). A 75-year-old Japanese man was referred to our department with osteonecrosis of the jaw due to bisphosphonate (BP) for multiple bone metastases from prostate cancer. Aggressive surgical intervention was ruled out due to a poor prognosis in terms of life expectancy. Death occurred due to hemorrhagic shock resulting from massive oral bleeding caused by necrosis of the mandible. Numerous reports have suggested that jaw necrosis is induced not only by BP, but also RANKL antibody, steroids, and molecularly-targeted agents...
2018: Bulletin of Tokyo Dental College
Lucy P Evans, Elizabeth A Newell, MaryAnn Mahajan, Stephen H Tsang, Polly J Ferguson, Jolonda Mahoney, Christopher D Hue, Edward W Vogel, Barclay Morrison, Ottavio Arancio, Russell Nichols, Alexander G Bassuk, Vinit B Mahajan
Objective: Limited attention has been given to ocular injuries associated with traumatic brain injury (TBI). The retina is an extension of the central nervous system and evaluation of ocular damage may offer a less-invasive approach to gauge TBI severity and response to treatment. We aim to characterize acute changes in the mouse eye after exposure to two different models of TBI to assess the utility of eye damage as a surrogate to brain injury. Methods: A model of blast TBI (bTBI) using a shock tube was compared to a lateral fluid percussion injury model (LFPI) using fluid pressure applied directly to the brain...
March 2018: Annals of Clinical and Translational Neurology
Christine M Leeper, Mark H Yazer, Franklyn P Cladis, Richard Saladino, Darrell J Triulzi, Barbara A Gaines
No abstract text is available yet for this article.
March 19, 2018: JAMA Pediatrics
Juliana Tolles, Roger J Lewis
The traditional approach to clinical trial design requires assuming precise values for multiple unknown parameters, resulting is a trial design that is unlikely to perform well if one or more of those assumptions turn out to be incorrect. During conduct of the trial, trial characteristics are often held fixed, even if incoming data suggest that one or more design assumptions were incorrect. This leads to an increased risk of a failed trial. In contrast, an adaptive clinical trial is designed to take advantage of partial, incoming data during the conduct of the trial, modifying key clinical trial characteristics according to prespecified rules, in order to avoid a failed or inconclusive trial, improve statistical efficacy, better treat patients within the trial, or achieve other scientific or ethical goals...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Karthik Vishwanath, Rajan Gurjar, David Wolf, Suzannah Riccardi, Michael Duggan, David King
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation...
February 1, 2018: Biomedical Optics Express
J Michael Dickson, Xu Wang, Alexander E St John, Esther B Lim, Susan A Stern, Nathan J White
Introduction: Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of traumatic death worldwide and particularly on the battlefield. They are especially challenging when present simultaneously (polytrauma), and clear blood pressure end points during fluid resuscitation are not well described for this situation. The goal of this study is to evaluate for any benefit of increasing blood pressure using a vasopressor on brain blood flow during initial fluid resuscitation in a swine polytrauma model...
March 14, 2018: Military Medicine
Neeraj Kumar, Kishore Kumar Krishnani, Sanjay Kumar Gupta, Narendra Pratap Singh
Nanotechnology is a novel arena with promising applications in the field of medicine, industry, and agriculture including fisheries. Cross-disciplinary interactions and the application of this technology in biological systems have led to the innovation of novel nanoparticle antioxidants, which are the subject of our study. In context with above background, we designed an experiment on nano-silver to elucidate its role for mitigation of abiotic and biotic stress. Three diets were formulated viz. silver nanoparticles (Ag-NPs) incorporated at 0...
March 14, 2018: Environmental Science and Pollution Research International
Mitchell R Dyer, DaShawn Hickman, Norman Luc, Shannon Haldeman, Patricia Loughran, Christa Pawlwoski, Anirban Sen Gupta, Matthew D Neal
BACKGROUND: Clinical resuscitative treatment of traumatic hemorrhage involves transfusion of RBC, platelets and plasma in controlled ratios. However, use of such blood components, especially platelets, present many challenges including availability, portability, contamination risks, and short shelf-life, which limit the use of platelet transfusions outside of large trauma centers such as remote civilian hospitals and austere pre-hospital settings. This has prompted significant research in platelet substitutes that may resolve the above issues while providing platelet-mimetic hemostatic action...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Penny S Reynolds, Bernard J Fisher, Jacquelyn McCarter, Christopher Sweeney, Erika J Martin, Paul Middleton, Matthew Ellenberg, Evan Fowler, Donald F Brophy, Alpha A Fowler, Bruce D Spiess, Ramesh Natarajan
BACKGROUND: Coagulopathy and inflammation induced by hemorrhagic shock and traumatic injury are associated with increased mortality and morbidity. Vitamin C (VitC) is an antioxidant with potential protective effects on the pro-inflammatory and pro-coagulant pathways. We hypothesized that high-dose VitC administered as a supplement to fluid resuscitation would attenuate inflammation, coagulation dysfunction, and end-organ tissue damage in a swine model of polytrauma and hemorrhage. METHODS: Male Sinclair swine (n = 24; mean body weight 27 kg) were anesthetized, intubated, mechanically ventilated, and instrumented for physiological monitoring...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Gaëtan-Romain Joliat, Ismail Labgaa, Emilie Uldry, Nicolas Demartines, Nermin Halkic
OBJECTIVE: Hepatocellular carcinomas (HCC) can infrequently rupture and cause hemorrhage. Little is known on recurrence rate (RR) and overall survival (OS) in case of ruptured HCC. This study aimed to assess RR, time to recurrence, and OS of operated ruptured HCC. PATIENTS AND METHODS: All operated patients with HCC (1999-2015) were reviewed. Patient demographics, perioperative details, and postoperative outcomes of ruptured HCC were recorded. RR, time to recurrence, and OS were calculated...
March 13, 2018: European Journal of Gastroenterology & Hepatology
Mariana Takaku, Andre Carnevali da Silva, Nathalie Izumi Iritsu, Pedro Thadeu Galvao Vianna, Yara Marcondes Machado Castiglia
Parecoxib, a selective COX-2 inhibitor, is used to improve analgesia in postoperative procedures. Here we evaluated whether pretreatment with a single dose of parecoxib affects the function, cell injury, and inflammatory response of the kidney of rats subjected to acute hemorrhage. Inflammatory response was determined according to serum and renal tissue cytokine levels (IL-1 α , IL-1 β , IL-6, IL-10, and TNF- α ). Forty-four adult Wistar rats anesthetized with sevoflurane were randomized into four groups: placebo/no hemorrhage (Plc/NH); parecoxib/no hemorrhage (Pcx/NH); placebo/hemorrhage (Plc/H); and parecoxib/hemorrhage (Pcx/H)...
2018: Pain Research and Treatment
Erik N Vu, Wilson C Y Wan, Titus C Yeung, David W Callaway
BACKGROUND: Uncontrolled hemorrhage remains a leading cause of preventable death in tactical and combat settings. Alternate routes of delivery of tranexamic acid (TXA), an adjunct in the management of hemorrhagic shock, are being studied. A working group for the Committee for Tactical Emergency Casualty Care reviewed the available evidence on the potential role for intramuscular (IM) administration of TXA in nonhospital settings as soon as possible from the point of injury. METHODS: EMBASE and MEDLINE/PubMed databases were sequentially searched by medical librarians for evidence of TXA use in the following contexts and/or using the following keywords: prehospital, trauma, hemorrhagic shock, optimal timing, optimal dose, safe volume, incidence of venous thromboembolism (VTE), IM bioavailability...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Lee-Hwa Tai, Abhirami A Ananth, Rashmi Seth, Almohanad Alkayyal, Jiqing Zhang, Christiano Tanese de Souza, Phillip Staibano, Michael A Kennedy, Rebecca C Auer
BACKGROUND: Cancer surgery can promote tumour metastases and worsen prognosis, however, the effect of perioperative complications on metastatic disease remains unclear. In this study we sought to evaluate the effect of common perioperative complications including perioperative blood loss, hypothermia, and sepsis on tumour metastases in a murine model. METHODS: Prior to surgery, pulmonary metastases were established by intravenous challenge of CT26LacZ colon cancer cells in BALB/c mice...
March 12, 2018: BMC Cancer
G Mulkerrin, N M Hogan, M Sheehan, M R Joyce
INTRODUCTION: Gastrointestinal Stromal Tumors (GISTs) are a rare slow growing malignancy, accounting for less than 1% of all gastrointestinal (GI) tract tumors. These tumors are usually discovered incidentally by endoscopy, surgery or radiology. However on occasions they may present with significant symptoms including GI blood loss. This case report discusses an atypical presentation of a GIST in a 57-year-old female. CASE PRESENTATION: A 57-year-old woman presented to the emergency department following one episode of melena...
March 1, 2018: International Journal of Surgery Case Reports
Konstantinos Tigkiropoulos, Fragiska Sigala, Diamantis I Tsilimigras, Demetrios Moris, Konstantinos Filis, Nikolaos Melas, Dimitrios Karamanos, Christos Kontogiannis, Ioannis Lazaridis, Nikolaos Saratzis
BACKGROUND: Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice due to lower rates of mortality, paraplegia and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. OBJECTIVES: To report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital as well as investigate post-implant hypertension...
March 7, 2018: Annals of Vascular Surgery
Brant M Wagener, Parker J Hu, Joo-Yeun Oh, Cilina A Evans, Jillian R Richter, Jaideep Honavar, Angela P Brandon, Judy Creighton, Shannon W Stephens, Charity Morgan, Randal O Dull, Marisa B Marques, Jeffrey D Kerby, Jean-Francois Pittet, Rakesh P Patel
BACKGROUND: Trauma is the leading cause of death and disability in patients aged 1-46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of organ injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood...
March 2018: PLoS Medicine
Todd O McKinley, Tyler McCarroll, Cameron Metzger, Ben L Zarzaur, Stephanie A Savage, Teresa M Bell, Greg E Gaski
BACKGROUND: Multiply injured patients are at risk of developing hemorrhagic shock and organ dysfunction. We determined how cumulative hypoperfusion predicted organ dysfunction by integrating serial shock index measurements. METHODS: In this study, we calculated Shock Volume (SHVL) which is a patient-specific index that quantifies cumulative hypoperfusion by integrating abnormally elevated shock index (heart rate/systolic blood pressure ≥ 0.9) values acutely after injury...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Melissa M Cushing, James Kelley, Ellen Klapper, David F Friedman, Ruchika Goel, Nancy M Heddle, Courtney K Hopkins, Julie Katz Karp, Monica B Pagano, Ajay Perumbeti, Glenn Ramsey, John D Roback, Joseph Schwartz, Beth H Shaz, Philip C Spinella, Claudia S Cohn, Claudia S Cohn, Melissa M Cushing, James Kelley, Ellen Klapper
BACKGROUND: The AABB compiles an annual synopsis of the published literature covering important developments in the field of Transfusion Medicine. For the first time, an abridged version of this work is being made available in TRANSFUSION, with the full-length report available as an Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS: Papers published in 2016 and early 2017 are included, as well as earlier papers cited for background...
March 9, 2018: Transfusion
Bouchra Kitab, Michinori Kohara, Kyoko Tsukiyama-Kohara
Dengue is the most prevalent arboviral disease in humans and leads to significant morbidity and socioeconomic burden in tropical and subtropical areas. Dengue is caused by infection with any of the four closely related serotypes of dengue virus (DENV1-4) and usually manifests as a mild febrile illness, but may develop into fatal dengue hemorrhagic fever and shock syndrome. There are no specific antiviral therapies against dengue because understanding of DENV biology is limited. A tetravalent chimeric dengue vaccine, Dengvaxia, has finally been licensed for use, but its efficacy was significantly lower against DENV-2 infections and in dengue-naïve individuals...
March 8, 2018: Archives of Virology
Roberto Bini, Osvaldo Chiara, Stefania Cimbanassi, Giorgio Olivero, Antonella Trombetta, Paolo Cotogni
Background: Hemorrhagic shock (HS) is a major threat to patients with trauma and spontaneous bleeding. The aim of the study was to investigate early effects of vasopressin on metabolic and hemodynamic parameters and endothelium permeability by measuring capillary leakage compared to those of other resuscitation strategies in a HS model. Methods: Forty-five Sprague-Dawley rats were randomized into five groups: S group ( n  = 5), sham-operated rats without shock or resuscitation; HS group ( n  = 10), HS and no resuscitation; RL group ( n  = 10), HS and resuscitation with Ringer's lactate (RL); RLB group ( n  = 10), HS and resuscitation with two-third shed blood plus RL; and vasopressin group ( n  = 10), HS and resuscitation with RL, followed by continuous infusion of 0...
2018: World Journal of Emergency Surgery: WJES
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