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https://www.readbyqxmd.com/read/29785654/a-systematic-review-and-meta-analysis-of-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-management-of-major-exsanguination
#1
REVIEW
B L S Borger van der Burg, Thijs T C F van Dongen, J J Morrison, P P A Hedeman Joosten, J J DuBose, T M Hörer, R Hoencamp
BACKGROUND: Circulatory collapse is a leading cause of mortality among traumatic major exsanguination and in ruptured aortic aneurysm patients. Approximately 40% of patients die before hemorrhage control is achieved. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive surgical or endovascular repair. A systematic review was conducted for the current clinical use of REBOA in patients with hemodynamic instability and to discuss its potential role in improving prehospital and in-hospital outcome...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29784591/accuracy-and-outcome-of-rapid-ultrasound-in-shock-and-hypotension-rush-in-egyptian-polytrauma-patients
#2
Adel Hamed Elbaih, Ahmed Mohamed Housseini, Mohamed E M Khalifa
PURPOSE: "Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes...
March 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29777581/in-vivo-performance-of-a-visible-wavelength-optical-sensor-for-monitoring-intestinal-perfusion-and-oxygenation
#3
Mitchell B Robinson, Anna M Wisniowiecki, Ryan J Butcher, Mark A Wilson, M Nance Ericson, Gerard L Cote
Traumatic injury resulting in hemorrhage is a prevalent cause of death worldwide. The current standard of care for trauma patients is to restore hemostasis by controlling bleeding and administering intravenous volume resuscitation. Adequate resuscitation to restore tissue blood flow and oxygenation is critical within the first hours following admission to assess severity and avoid complications. However, current clinical methods for guiding resuscitation are not sensitive or specific enough to adequately understand the patient condition...
May 2018: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29766124/routine-repeat-head-ct-may-not-be-necessary-for-patients-with-mild-tbi
#4
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764673/comparison-between-thromboelastography-and-conventional-coagulation-test-should-we-abandon-conventional-coagulation-tests-in-polytrauma-patients
#5
Jaume Tur Martínez, Patrizio Petrone, Alexander Axelrad, Corrado P Marini
INTRODUCTION: TEG provides an in-vivo assessment of viscoelastic clot strength in whole blood compared with CCT, which may not reflect the influence of platelets. The aim of this study was to compare TEG vs. CCT in trauma patients stratified by mechanism of injury (MOI) and pre-existing coagulation status. METHODS: A retrospective, observational study of 230 polytrauma patients admitted to a University Hospital Level 1 Trauma Center, with TEG and CCT on admission stratified by MOI: multiple trauma (MT), isolated traumatic brain injury (TBI) or MT+TBI...
May 12, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29754117/sleep-problems-six-months-after-continuous-earthquake-activity-in-a-greek-island
#6
H Lazaratou, Th Paparrigopoulos, Chr Anomitri, N Alexandropoulou, G Galanos, Ch Papageorgiou
Natural disasters, such as earthquakes, are traumatic events causing both acute and enduring stress to affected individuals. Psychosocial consequences include posttraumatic stress disorder (PTSD), reactions of anxiety and depression and sleep problems. The island of Cephalonia in Ionian Sea is characterized by its high seismic activity. More specifically, this activity has been considered to be the highest of the Balkan Peninsula and Europe in general. In January and February of 2014 a long sequence of earthquakes, which included two main shocks of 6...
January 2018: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29751827/timp-2-igfbp7-predicts-acute-kidney-injury-in-out-of-hospital-cardiac-arrest-survivors
#7
Christoph Adler, Tobias Heller, Felix Schregel, Henning Hagmann, Martin Hellmich, Joana Adler, Hannes Reuter
BACKGROUND: Acute kidney injury (AKI) is a common complication after cardiopulmonary resuscitation (CPR) and predicts in-hospital mortality. To which extent post-resuscitation disease or the initial event of cardiac arrest and the duration of insufficient cardiac output triggers AKI is challenging to discriminate. Knowledge on molecular mediators of AKI is scarce. Early identification of patients at high risk of AKI is hampered by the low sensitivity of the established tests in clinical routine practice...
May 12, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29738768/differential-effects-of-voluntary-wheel-running-and-toy-rotation-on-the-mrna-expression-of-neurotrophic-factors-and-fkbp5-in-a-post-traumatic-stress-disorder-rat-model-with-the-shuttle-box-task
#8
Masaaki Tanichi, Hiroyuki Toda, Kunio Shimizu, Minori Koga, Taku Saito, Shingo Enomoto, Shuken Boku, Fumiho Asai, Yumi Mitsui, Masanori Nagamine, Masanori Fujita, Aihide Yoshino
Life-threatening experiences can result in the development of post-traumatic stress disorder. We have developed an animal model for post-traumatic stress disorder (PTSD) using a shuttle box in rats. In this paradigm, the rats were exposed to inescapable foot-shock stress (IS) in a shuttle box, and then an avoidance/escape task was performed in the same box 2 weeks after IS. A previous study using this paradigm revealed that environmental enrichment (EE) ameliorated avoidance/numbing-like behaviors, but not hyperarousal-like behaviors, and EE also elevated hippocampal brain-derived neurotrophic factor (BDNF) expression...
May 5, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29704520/trends-in-the-incidence-and-outcome-of-paediatric-out-of-hospital-cardiac-arrest-a-17-year-observational-study
#9
Ziad Nehme, Siva Namachivayam, Anri Forrest, Warwick Butt, Stephen Bernard, Karen Smith
BACKGROUND: System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. METHODS: Between 2000 and 2016, we included children aged ≤16 years who suffered a non-traumatic OHCA in the state of Victoria, Australia. Trends in incidence and unadjusted outcomes were assessed using linear regression and a non-parametric test for trend...
April 25, 2018: Resuscitation
https://www.readbyqxmd.com/read/29704283/selective-dopamine-d-3-receptor-antagonism-significantly-attenuates-stress-induced-immobility-in-a-rat-model-of-post-traumatic-stress-disorder
#10
Onarae V Rice, Charles R Ashby, Clark Dixon, William Laurenzo, Jason Hayden, Rui Song, Jin Li, Amit K Tiwari, Eliot L Gardner
Post-traumatic stress disorder (PTSD) is a debilitating psychiatric syndrome that occurs in individuals exposed to extremely threatening or traumatic events. In both animals and humans, dopamine (DA) function appears to be dysregulated in brain areas involved in the conditioned fear response(s) that underlie PTSD. In this study, we determined the effect of the selective DA D3 receptor antagonists YQA14A (6.25, 12.5 and 25 mg/kg i.p.) and SB-277011A (6 mg/kg i.p.) on tone-induced fear (assessed by measuring freeze time) in a modified version of the single-prolonged stress (SPS) model of PTSD in adult male Sprague-Dawley rats...
April 27, 2018: Synapse
https://www.readbyqxmd.com/read/29693126/neuroprotective-effects-of-dexmedetomidine-on-traumatic-brain-injury-involvement-of-neuronal-apoptosis-and-hsp70-expression
#11
Man-He Zhang, Xiu-Min Zhou, Jian-Zhong Cui, Kai-Jie Wang, Yan Feng, Hong-Ao Zhang
The aim of the present study was to investigate the protective effect of dexmedetomidine (Dex) on traumatic brain injury (TBI), and further evaluate whether the underlying neuroprotective mechanisms are associated with neurological apoptosis and the expression of 70 kDa heat shock protein (HSP70) in the hippocampus. A total of 90 adult male Sprague‑Dawley rats were randomly assigned into 3 groups (n=30/group): Sham, TBI and Dex groups. The rat models of TBI were established using a modified weight‑drop device and Dex (15 µg/kg) was intravenously administered immediately following TBI...
April 19, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29690826/mesenchymal-stem-cell-derived-exosomes-provide-neuroprotection-and-improve-long-term-neurologic-outcomes-in-a-swine-model-of-traumatic-brain-injury-and-hemorrhagic-shock
#12
Aaron M Williams, Isabel S Dennahy, Umar F Bhatti, Ihab Halaweish, Ye Xiong, Panpan Chang, Vahagn C Nikolian, Kiril Chtraklin, Jordana Brown, Yanlu Zhang, Zheng Gang Zhang, Michael Chopp, Benjamin Buller, Hasan B Alam
Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) remains a leading cause of preventable death worldwide. Mesenchymal stem cell-derived exosomes have demonstrated promise in small animal models of neurologic injury. To investigate the effects of exosome treatment in a clinically realistic large animal model, Yorkshire swine were subjected to TBI and HS. Animals were maintained in shock for 2 hours prior to resuscitation with normal saline (NS). Animals were then either resuscitated with NS (3 x volume of shed blood) or with the same volume of NS with delayed exosome administration (1x10<sup>13</sup> particles/4ml) (n=5/cohort)...
April 25, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29689641/inducing-different-brain-injury-levels-using-shock-wave-lithotripsy
#13
Afshin A Divani, Pascal Salazar, Manoj Monga, Greg J Beilman, Karen S SantaCruz
OBJECTIVES: To assess the feasibility of inducing different severities of shock wave (SW)-induced traumatic brain injury (TBI) using lithotripsy. METHODS: Wistar rats (n = 36) were divided into 2 groups: group 1 (n = 20) received 5 SW pulses, and group 2 (n = 16) received 15 SWs pulses. The SW pulses were delivered to the right side of the frontal cortex. Neurologic and behavioral assessments (Garcia test, beam walking, rotarod, and elevated plus maze) were performed at the baseline and at 3, 6, 24, 72, and 168 hours after injury...
April 24, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29685373/resuscitative-endovascular-balloon-occlusion-of-the-aorta-improves-cardiac-compression-fraction-versus-resuscitative-thoracotomy-in-patients-in-traumatic-arrest
#14
William Teeter, Anna Romagnoli, Philip Wasicek, Peter Hu, Shiming Yang, Deborah Stein, Thomas Scalea, Megan Brenner
STUDY OBJECTIVE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is emerging as an alternative to resuscitative thoracotomy for proximal aortic control in select patients with exsanguinating hemorrhage below the diaphragm. The purpose of this study is to compare interruptions in closed chest compression or open chest cardiac massage during REBOA versus resuscitative thoracotomy. METHODS: From May 2014 to December 2016, patients in arrest who received aortic occlusion with REBOA or resuscitative thoracotomy were included...
April 20, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#15
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29679443/a-20-year-review-the-use-of-exception-from-informed-consent-and-waiver-of-informed-consent-in-emergency-research
#16
Lauren Klein, Johanna Moore, Michelle Biros
BACKGROUND: Due to the acuity and time sensitive needs of their clinical condition, patients presenting with certain emergent pathologies may lack capacity to provide meaningful prospective informed consent to participate in clinical research. For these reasons, these populations have often been excluded from research investigations. To mitigate this, regulations allowing Exception from Informed Consent (EFIC) (21 CFR 50.24) or Waiver of Informed Consent (WIC) (45 CFR 46.101) were developed in 1996...
April 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#17
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29676615/walter-b-cannon-s-world-war-i-experience-treatment-of-traumatic-shock-then-and-now
#18
Kathy L Ryan
Walter B. Cannon (1871-1945), perhaps America's preeminent physiologist, volunteered for service with the Army Expeditionary Force (AEF) during World War I. He initially served with Base Hospital No. 5, a unit made up of Harvard clinicians, before moving forward to the front lines to serve at a casualty clearing station run by the British. During his time there, he performed research on wounded soldiers to understand the nature and causes of traumatic shock. Subsequently, Cannon performed animal experimentation on the causes of traumatic shock in the London laboratory of Dr...
June 1, 2018: Advances in Physiology Education
https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#19
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29667630/-the-principal-and-auxiliary-immunohistochemical-markers-of-intravital-mechanical-strangulation-asphyxia
#20
D V Bogomolov, V A Fetisov, O P Denisova, Yu V Zbrueva, G G Semenov
The objective of the present study was the evaluation of the auxiliary methods for the diagnostics of the intravital formation of the constriction marks; the secondary objective was to determine the pace at which the death and asphyxia occur. MATERIAL AND METHODS: The materials on which the study was based included 17 cases of mechanical strangulation asphyxia involving 13 men and 4 women at the age from 8 to 28 years. All cases of hanging were associated with different blood alcohol levels...
2018: Sudebno-meditsinskaia Ekspertiza
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