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https://www.readbyqxmd.com/read/29306988/acute-phase-response-after-fatal-traumatic-brain-injury
#1
Benjamin Ondruschka, Sandra Schuch, Dirk Pohlers, Heike Franke, Jan Dreßler
An inflammatory response occurring after fatal traumatic brain injury (TBI) initiates time-dependent cascades of acute phase response. This may offer the potential to monitor postmortem biomarker levels of several pro-inflammatory cytokines to gain information about the cause of death and the trauma survival time. Cerebrospinal fluid (CSF) and serum samples were collected from forensic autopsies of 95 adult cadavers after postmortem intervals up to 6 days. The cases were divided according to their cause of death into fatal TBI (n = 46) with different survival times and age- and gender-matching non-TBI fatalities as controls (n = 49)...
January 6, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29306344/preweaning-mortality-in-piglets-in-loose-housed-herds-etiology-and-prevalence
#2
C Kielland, H Wisløff, M Valheim, A K Fauske, O Reksen, T Framstad
Preweaning mortality in piglets is a welfare issue, as well as an ethical and economic concern in commercial pig farming. Studying the causes of preweaning mortality and their prevalence is necessary to reduce losses. Preweaning piglet mortality was investigated in a field study including 347 sows from 14 loose-housed Norwegian piglet-producing herds. A total of 5254 piglets were born in these herds during the study period, and 1200 piglets were necropsied. The cause of death was based on pathoanatomical diagnosis (PAD)...
January 8, 2018: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/29283920/does-lactate-affect-the-association-of-early-hyperglycemia-and-multiple-organ-failure-in-severely-injured-blunt-trauma-patients
#3
Justin E Richards, Thomas M Scalea, Michael A Mazzeffi, Peter Rock, Samuel M Galvagno
BACKGROUND: Early hyperglycemia is associated with multiple organ failure (MOF) after traumatic injury; however, few studies have considered the contribution of depth of clinical shock. We hypothesize that when considered simultaneously, glucose and lactate are associated with MOF in severely injured blunt trauma patients. METHODS: We performed a retrospective investigation at a single tertiary care trauma center. Inclusion criteria were patient age ≥18 years, injury severity score (ISS) >15, blunt mechanism of injury, and an intensive care unit length of stay >48 hours...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29280924/metabolomics-and-precision-medicine-in-trauma-the-state-of-the-field
#4
Sudha P Jayaraman, Rahul J Anand, Jonathan H DeAntonio, Martin Mangino, Michel B Aboutanos, Vigneshwar Kasirajan, Rao Ivatury, Alex B Valadka, Olena Glushakova, Ronald L Hayes, Lorin M Bachmann, Gretchen M Brophy, Daniel Contaifer, Urszula O Warncke, Donald F Brophy, Dayanjan S Wijesinghe
Trauma is a major problem in the United States. Mortality from trauma is the number one cause of death under the age of 45 in the US and is the third leading cause of death for all age groups. There are nearly 200,000 deaths per year due to trauma in the US at a cost of over $671 billion in combined health care costs and lost productivity. Unsurprisingly, trauma accounts for about 30% of all life-years lost in the US. Due to immense development of trauma systems, a large majority of trauma patients survive the injury but then go on to die from complications arising from the injury...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29279631/a-clinical-study-on-the-initial-assessment-of-arterial-lactate-and-base-deficit-as-predictors-of-outcome-in-trauma-patients
#5
Rameshbabu Homanna Javali, Prithvishree Ravindra, Akkamahadevi Patil, Madhu Srinivasarangan, Harshit Mundada, S B Adarsh, S Nisarg
Background: Trauma is a leading cause of mortality in India. Outcomes can be improved by early recognition of hemorrhagic shock and expedited management. At present, we rely on traditional vital signs, which are not sensitive measures. Point of care biochemical markers have been emerging as prognostic markers in trauma, but have not been studied in Indian setting. Aims: This study aims to study the association between arterial lactate and base deficit (BD) at emergency department (ED) admission and 24 h outcome in trauma patients at risk of hemodynamic compromise...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29261771/endotheliopathy-is-associated-with-higher-levels-of-cell-free-dna-following-major-trauma-a-prospective-observational-study
#6
David N Naumann, Jon Hazeldine, Robert J Dinsdale, Jon R Bishop, Mark J Midwinter, Paul Harrison, Sam D Hutchings, Janet M Lord
BACKGROUND: Cell free deoxyribonucleic acid (cfDNA) has been proposed as a biomarker of secondary complications following trauma. Raised thrombomodulin and syndecan-1 levels have been used to indicate endotheliopathy, and are associated with inflammation, coagulopathy, and mortality. The current study aimed to analyse the association between cfDNA and biomarkers of endotheliopathy in a cohort of trauma patients, and whether raised levels of cfDNA were associated with poorer clinical outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#7
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251715/a-retrospective-analysis-of-the-respiratory-adjusted-shock-index-rasi-to-determine-the-presence-of-occult-shock-in-trauma-patients
#8
Nicholas Caputo, James Reilly, Marc Kanter, Jason West
BACKGROUND: The shock index (SI), calculated as HR/SBP, is a simple hemodynamic marker that may be used to assess for the presence of occult shock in trauma patients. The normal range for a healthy adult patient is 0.5 to 0.7. Recently, studies have demonstrated that tachypnea is the most important predictor of cardiac arrest in hospital wards and is an important indicator of derangements across multiple organ systems. As such, we have sought to determine whether the inclusion of the patient's respiratory rate to the already existing shock index (called the Respiratory Adjusted Shock Index- RASI), calculated as HR/SBP*(RR/10), will improve the overall diagnostic accuracy of detecting patients in early occult shock...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251714/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-and-meta-analysis
#9
Alexandre Tran, Maher Matar, Jacinthe Lampron, Ewout W Steyerberg, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Delays in appropriate triage of bleeding trauma patients result in poor outcomes. Clinical gestalt is fallible and objective measures of risk stratification are needed. The objective of this review is to identify and assess prediction models and predictors for the early identification of traumatic hemorrhage patients requiring massive transfusion, surgery or embolization. METHODS: We searched electronic databases through to September 31st, 2016 for studies describing clinical, laboratory and imaging predictors available within the first hour of resuscitation for identifying patients requiring major intervention for hemorrhage within the first 24 hours...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29243811/decrease-of-superficial-serine-and-lactate-in-the-stratum-corneum-due-to-repetitive-frictional-trauma
#10
Lai San Wong, Atsushi Otsuka, Hideaki Tanizaki, Yumi Nonomura, Chisa Nakashima, Yosuke Yamamoto, Yu Ta Yen, Pawinee Rerknimitr, Tetsuya Honda, Kenji Kabashima
BACKGROUND: Repetitive frictional trauma can be induced in daily and occupational activities, such as daily ablutions with washcloths. The influence of frictional trauma on the skin barrier function, especially in the perspective of the components of stratum corneum (SC), has not yet been studied in detail. Raman spectroscopy is a noninvasive optical technique based on inelastic light scattering that is capable of measuring several components in the skin. In this study, we used Raman spectroscopy to investigate the change in natural moisturizing factor (NMF) components in the SC following repetitive physical friction...
December 15, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#11
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29194320/no-iv-no-problem-intraosseous-administration-of-tranexamic-acid-is-as-effective-as-intravenous-in-a-porcine-hemorrhage-model
#12
Michael S Lallemand, Donald M Moe, John M McClellan, Michael Loughren, Shannon Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: The acute coagulopathy of trauma is often accompanied by hyperfibrinolysis. TXA can reverse this phenomenon, and, when given early, decreases mortality from bleeding. Establishing IV access can be difficult in trauma and IO access is often preferred for drug administration. Currently, there is no data on the efficacy of IO administered TXA. Our objectives were to compare serum concentrations of tranexamic acid (TXA) when given IV and intraosseous (IO) and to compare the efficacy of IO administered TXA to IV at reversing hyperfibrinolysis METHODS: Using a porcine hemorrhage and ischemia-reperfusion (IR) model, 18 swine underwent hemorrhagic shock followed by a tissue plasminogen activator (tPA) infusion to induce hyperfibrinolysis...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29193548/rephill-protocol-for-a-randomised-controlled-trial-of-pre-hospital-blood-product-resuscitation-for-trauma
#13
I M Smith, N Crombie, J R Bishop, A McLaughlin, D N Naumann, M Herbert, J M Hancox, G Slinn, N Ives, M Grant, G D Perkins, H Doughty, M J Midwinter
OBJECTIVES: To describe the 'Resuscitation with Pre-HospItaL bLood products' trial (RePHILL) - a multi-centre randomised controlled trial of pre-hospital blood product (PHBP) administration vs standard care for traumatic haemorrhage. BACKGROUND: PHBP are increasingly used for pre-hospital trauma resuscitation despite a lack of robust evidence demonstrating superiority over crystalloids. Provision of PHBP carries additional logistical and regulatory implications, and requires a sustainable supply of universal blood components...
November 28, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29183276/the-effectiveness-of-prehospital-hypertonic-saline-for-hypotensive-trauma-patients-a-systematic-review-and-meta-analysis
#14
I E Blanchard, A Ahmad, K L Tang, P E Ronksley, D Lorenzetti, G Lazarenko, E S Lang, C J Doig, H T Stelfox
BACKGROUND: The optimal prehospital fluid for the treatment of hypotension is unknown. Hypertonic fluids may increase circulatory volume and mute the pro-inflammatory response of the body to injury and illness. The purpose of this systematic review is to determine whether in patients presenting with hypotension in the prehospital setting (population), the administration of hypertonic saline (intervention), compared to an isotonic fluid (control), improves survival to hospital discharge (outcome)...
November 28, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29175959/disrupted-neuro-glial-metabolic-coupling-after-peripheral-surgery
#15
Teresa Femenía, Alfredo Giménez-Cassina, Simone Codeluppi, Teresa Fernández-Zafra, Yurika Katsu-Jiménez, Niccolò Terrando, Lars I Eriksson, Marta Gómez-Galán
Immune-related events in the periphery can remotely affect brain function, contributing to neurodegenerative processes and cognitive decline. In mice, peripheral surgery induces a systemic inflammatory response associated with changes in hippocampal synaptic plasticity and transient cognitive decline, however the underlying mechanisms remain unknown. Here we investigated the effect of peripheral surgery on neuronal-glial function within hippocampal neuronal circuits of relevance to cognitive processing in male mice at 6, 24, and 72h post-surgery...
November 24, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#16
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29120938/fibrinogen-on-admission-in-trauma-score-early-prediction-of-low-plasma-fibrinogen-concentrations-in-trauma-patients
#17
Tobias Gauss, Sébastien Campion, Sébastien Kerever, Mathilde Eurin, Mathieu Raux, Anatole Harrois, Catherine Paugam-Burtz, Sophie Hamada
BACKGROUND: Early recognition of low fibrinogen concentrations in trauma patients is crucial for timely haemostatic treatment and laboratory testing is too slow to inform decision-making. OBJECTIVE: To develop a simple clinical tool to predict low fibrinogen concentrations in trauma patients on arrival. DESIGN: Retrospective cohort study. SETTING: Three designated level 1 trauma centres in the Paris Region, from January 2011 to December 2013...
November 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29117026/the-american-association-for-the-surgery-of-trauma-severity-grade-is-valid-and-generalizable-in-adhesive-small-bowel-obstruction
#18
Martin D Zielinski, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Daniel C Cullinane, David Turay, Ji-Ming Yune, Salina Wydo, Kenji Inaba, D Dante Yeh, Therese M Duane, Andrea Pakula, Ruby Skinner, Jill Watras, Carlos J Rodriguez, Kenneth A Widom, John Cull, Julie Dunn, Eric A Toschlog, Valerie G Sams, John C Graybill
INTRODUCTION: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma (EAST) multi-institutional SBO prospective observational study. METHODS: Adults (age≥18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), labs (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
November 7, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29102048/ethyl-pyruvate-reduces-acute-lung-damage-following-trauma-and-hemorrhagic-shock-via-inhibition-of-nf-%C3%AE%C2%BAb-and-hmgb1
#19
Borna Relja, Nils Wagner, Niklas Franz, Scott Dieteren, Katharina Mörs, Julia Schmidt, Ingo Marzi, Mario Perl
OBJECTIVE: After blunt thoracic trauma (TxT) and hemorrhagic shock with resuscitation (H/R) intense local inflammatory response and cell loss frequently impair the pulmonary function. Ethyl pyruvate (EP) has been reported to improve the pathophysiologic derangements in models of acute inflammation. Here, we studied the effects of EP on inflammation and lung damage after TxT+H/R. METHODS: Twenty four female Lewis rats (180-240g) were randomly divided into 3 groups: two groups underwent TxT followed by hemorrhagic shock (35±3mmHg) for 60min and resuscitation with either Ringers-Lactat (RL) alone or RL supplemented with EP (EP, 50mg/kg)...
October 16, 2017: Immunobiology
https://www.readbyqxmd.com/read/29094801/photoluminescence-intensity-ratio-of-eu-conjugated-lactates-a-simple-optical-imaging-technique-for-biomarker-analysis-for-critical-diseases
#20
Tarun Kakkar, Nikita Thomas, Eric Kumi Barimah, Gin Jose, Sikha Saha
Instant measurement of elevated biomarker such as lactic acid offers the most promising approaches for early treatment and prevention of many critical diseases including cardiac arrest, stroke, septic shock, trauma, liver dysfunction, and as well as for monitoring lactic acid level during intense exercise. In the present study a unique dependence of visible photoluminescence of Eu(3+) ions resulting from (5) D0 to (7) FJ(J=0,1,2,3,4) transitions, which can be exploited for rapid detection of biomarkers both in vitro and ex vivo has been reported...
November 2, 2017: Journal of Biophotonics
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