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https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#1
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#2
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29138652/trauma-a-major-cause-of-death-among-surgical-inpatients-of-a-nigerian-tertiary-hospital
#3
Onyeanunam Ngozi Ekeke, Kelechi Emmanuel Okonta
Introduction: Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29135807/effects-of-stressor-controllability-on-transcriptional-levels-of-c-fos-arc-and-brain-derived-neurotrophic-factor-in-mouse-amygdala-and-medial-prefrontal-cortex
#4
Mayumi Machida, György Lonart, Larry D Sanford
Controllability is an important factor in determining stress outcomes. Uncontrollable stress is associated with the development of psychopathology such as post-traumatic stress disorder, whereas controllable stress is associated with adaptive stress responses and positive outcomes. In this study, we investigated how controllability affects poststress neurobiology by assessing transcriptional levels of activity-dependent genes in medial prefrontal cortex (mPFC) and amygdala, regions important in mediating stress outcomes...
November 13, 2017: Neuroreport
https://www.readbyqxmd.com/read/29135535/blood-glucose-concentrations-in-prehospital-trauma-patients-with-traumatic-shock-a-retrospective-analysis
#5
Janett Kreutziger, Wolfgang Lederer, Stefan Schmid, Hanno Ulmer, Volker Wenzel, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen
BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship between traumatic shock and prehospital blood glucose concentrations. The secondary aim was to determine the additional predictive value of prehospital blood glucose concentration for traumatic shock when compared with vital parameters alone...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#6
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29118875/a-fatal-case-of-intra-abdominal-hemorrhage-following-diagnostic-blind-percutaneous-liver-biopsy-in-a-patient-with-peliosis-hepatis
#7
Saptarshi Biswas, Shekhar Gogna, Prem Patel
Peliosis hepatis (PH) is a rare vascular condition of the liver characterized by the presence of cystic blood filled cavities distributed randomly throughout the liver parenchyma. We describe a case of a 42-year-old previously healthy male patient, airlifted to us in a state of hemorrhagic shock after undergoing percutaneous diagnostic liver biopsy for lesions seen on CT scan. Repeat CT scan with IV contrast on presentation in our hospital showed intraperitoneal bleeding. Hepatic angiography failed to identify any specific bleeding source...
October 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29115091/efficacy-of-uncross-matched-type-o-packed-red-blood-cell-transfusion-to-traumatic-shock-patients-a-propensity-score-match-study
#8
Byung Hee Kang, Donghwan Choi, Jayun Cho, Junsik Kwon, Yo Huh, Jonghwan Moon, Younghwan Kim, Kyoungwon Jung, John Cook Jong Lee
A new blood bank system was established in our trauma bay, which allowed immediate utilization of uncross-matched type O packed red blood cells (UORBCs). We investigated the efficacy of UORBC compared to that of the ABO type-specific packed red blood cells (ABO RBCs) from before the bank was installed. From March 2016 to February 2017, data from trauma patients who received UORBCs in the trauma bay were compared with those of trauma patients who received ABO RBCs from January 2013 to December 2015. Propensity matching was used to overcome retrospective bias...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29112105/secretome-conveys-the-protective-effects-of-ascs-therapeutic-potential-following-hemorrhagic-shock
#9
Mostafa Ashmwe, Carina Penzenstadler, Arian Bahrami, Anton Klotz, Mohammad Jafarmadar, Asmita Banerjee, Susanne Wolbank, Heinz Redl, Soheyl Bahrami
OBJECTIVES: We tested whether resuscitation supplemented with a) rat adipose-derived stem cells (ASCs) or b) secretome (conditioned media) of ASCs can ameliorate inflammation, cell/organ injury, and/or improve outcome after Hemorrhagic traumatic shock (HTS). INTERVENTIONS: Rats were subjected to HTS and a resuscitation protocol that mimics pre-hospital restrictive reperfusion followed by an adequate reperfusion phase. 20 minutes into the restrictive reperfusion, animals received an intravenous bolus of 2x10 cells (ASC group) or the secretome produced by 2x10 ASCs/24 h (ASC-Secretome group)...
November 3, 2017: Shock
https://www.readbyqxmd.com/read/29107397/traumatic-injury-to-the-portal-vein-with-shock-bowel
#10
Nicholas C Cleveland, Don N Nguyen, Cassie D Tran, Rishi K Maheshwary, Matthew S Hartman
A portal vein aneurysm is the dilatation of the portal vein due to a defect in the vein wall. This rare disease manifestation is difficult to predict and has the potential for severe complications. We describe the case of a 68-year-old man involved in a motor vehicle collision who presented with abdominal hemorrhage found on ultrasound, hypotension, and vague abdominal pain. The patient underwent an exploratory laparotomy to control bleeding. Surgery and a subsequent abdominal computed tomography revealed the presence of a portal vein pseudoaneurysm and shock bowel...
October 3, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29106786/iatrogenic-perforation-of-hypopharynx-as-a-cause-of-severe-descending-necrotizing-mediastinitis-a-case-report
#11
(no author information available yet)
The authors present a case report of severe descending necrotizing mediastinitis (DNM) etiologically of unrecognized traumatic endotracheal intubation with hypopharynx-esophageal junction perforation. Patient was treated inadequately for seven days in local hospital what was the cause of sepsis progression into the septic shock with multiorgan dysfunction syndrome. Patient was transferred to specialized hospital and was immediately operated in general anaesthesia - combined transcervical approach and lateral thoracotomy was used for mediastinal drainage and debridement...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29101529/an-overview-of-cytokines-and-heat-shock-response-in-polytraumatized-patients
#12
REVIEW
Maria Concepción Guisasola, Berta Alonso, Beatriz Bravo, Javier Vaquero, Francisco Chana
Early after injury, local tissue damage induces a local and systemic inflammatory response that activates the immune system and leads to the development of systemic inflammatory response syndrome (SIRS). This post-traumatic response often results in uncontrolled release of inflammatory mediators and over-activation of the immune system, which occasionally results in multiple organ dysfunction syndrome (MODS). In parallel, a state of immunosuppression develops. This counter-regulating suppression of different cellular and humoral immune functions has been termed "compensatory anti-inflammatory response syndrome (CARS)...
November 3, 2017: Cell Stress & Chaperones
https://www.readbyqxmd.com/read/29101382/deconvolution-of-transcriptional-networks-in-post-traumatic-stress-disorder-uncovers-master-regulators-driving-innate-immune-system-function
#13
Abolfazl Doostparast Torshizi, Kai Wang
Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that develops in individuals experiencing a shocking incident, but the underlying disease susceptibility gene networks remain poorly understood. Breen et al. conducted a Weighted Gene Co-expression Network Analysis on PTSD, and identified a dysregulated innate immune module associated with PTSD development. To further identify the Master Regulators (MRs) driving the network function, here we deconvoluted the transcriptional networks on the same datasets using ARACNe (Algorithm for Reconstruction of Accurate Cellular Networks) followed by protein activity analysis...
November 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29098071/the-use-of-the-clinical-ethnographic-narrative-interview-to-understand-and-support-help-seeking-after-gender-based-violence
#14
Denise M Saint Arnault
Gender-based violence (GBV), characterized by the abduction or rape of women and girls to humiliate, intimidate, and traumatize them and their communities, is a profoundly disturbing tactic in international conflict. Long after armed conflict has ended, survivors continue to experience physical injuries, psychological trauma, and social and cultural stigma. Guilt, shame, and continued interpersonal violence can become a normalized part of daily life, significantly challenging the road to healing and recovery...
September 2017: TPM. Testing, Psychometrics, Methodology in Applied Psychology
https://www.readbyqxmd.com/read/29095714/current-trends-in-the-management-of-hemodynamically-unstable-pelvic-ring-injuries
#15
Philip F Stahel, Clay C Burlew, Ernest E Moore
PURPOSE OF REVIEW: Complex traumatic pelvic ring disruptions are associated with a high mortality rate due to associated retroperitoneal hemorrhage, traumatic-hemorrhagic shock, and postinjury coagulopathy. The present review provides an update on current management strategies to improve survival rates form hemodynamically unstable pelvic ring injuries. RECENT FINDINGS: Recently published international consensus guidelines have attempted to standardize the classification of hemodynamically unstable pelvic ring injuries and provided classification-based management algorithms for acute resuscitation and pelvic ring stabilization...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29095204/improvement-of-blood-brain-barrier-integrity-in-traumatic-brain-injury-and-hemorrhagic-shock-following-treatment-with-valproic-acid-and-fresh-frozen-plasma
#16
Vahagn C Nikolian, Simone E Dekker, Ted Bambakidis, Gerald A Higgins, Isabel S Dennahy, Patrick E Georgoff, Aaron M Williams, Anuska V Andjelkovic, Hasan B Alam
OBJECTIVE: Combined traumatic brain injury and hemorrhagic shock are highly lethal. Following injuries, the integrity of the blood-brain barrier can be impaired, contributing to secondary brain insults. The status of the blood-brain barrier represents a potential factor impacting long-term neurologic outcomes in combined injuries. Treatment strategies involving plasma-based resuscitation and valproic acid therapy have shown efficacy in this setting. We hypothesize that a component of this beneficial effect is related to blood-brain barrier preservation...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29079917/permissive-hypotensive-resuscitation-in-adult-patients-with-traumatic-haemorrhagic-shock-a-systematic-review
#17
REVIEW
Mohammed Albreiki, David Voegeli
BACKGROUND: Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation whilst treating severely injured patients, and its effectiveness on the survival rate remains unexplored. This detailed systematic review aims to critically evaluate the available literature that investigates the effects of PHR on survival rate. METHODS: A systematic review design searched for comparative and non-comparative studies using EMBASE, MEDLINE, PubMed, Web-of-Science and CENTRAL...
October 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29067429/association-of-prehospital-blood-product-transfusion-during-medical-evacuation-of-combat-casualties-in-afghanistan-with-acute-and-30-day-survival
#18
Stacy A Shackelford, Deborah J Del Junco, Nicole Powell-Dunford, Edward L Mazuchowski, Jeffrey T Howard, Russ S Kotwal, Jennifer Gurney, Frank K Butler, Kirby Gross, Zsolt T Stockinger
Importance: Prehospital blood product transfusion in trauma care remains controversial due to poor-quality evidence and cost. Sequential expansion of blood transfusion capability after 2012 to deployed military medical evacuation (MEDEVAC) units enabled a concurrent cohort study to focus on the timing as well as the location of the initial transfusion. Objective: To examine the association of prehospital transfusion and time to initial transfusion with injury survival...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29061477/effect-of-hypothermia-on-apoptosis-in-traumatic-brain-injury-and-hemorrhagic-shock-model
#19
Oğuz Eroğlu, Turgut Deniz, Üçler Kisa, Pınar Atasoy, Kuzey Aydinuraz
INTRODUCTION: The neuroprotective mechanisms of therapeutic hypothermia against trauma-related injury have not been fully understood yet. In this study, we aimed to investigate the effects of therapeutic hypothermia on biochemical and histopathological markers of apoptosis using Traumatic brain injury (TBI) and hemorrhagic shock (HS) model. METHODS: A total of 50 male albino-wistar rats were divided into five groups: Group isolated TBI, Group NT (HT+HS+normothermia), Group MH (HT+HS+mild hypothermia), Group MoH (HT+HS+moderate hypothermia) and Group C (control)...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/29055663/damage-control-concept-and-implementation
#20
B Malgras, B Prunet, X Lesaffre, G Boddaert, S Travers, P-J Cungi, E Hornez, O Barbier, H Lefort, S Beaume, M Bignand, J Cotte, P Esnault, J-L Daban, J Bordes, E Meaudre, J-P Tourtier, S Gaujoux, S Bonnet
The concept of damage control (DC) is based on a sequential therapeutic strategy that favors physiological restoration over anatomical repair in patients presenting acutely with hemorrhagic trauma. Initially described as damage control surgery (DCS) for war-wounded patients with abdominal penetrating hemorrhagic trauma, this concept is articulated in three steps: surgical control of lesions (hemostasis, sealing of intestinal spillage), physiological restoration, then surgery for definitive repair. This concept was quickly adapted for intensive care management under the name damage control resuscitation (DCR), which refers to the modalities of hospital resuscitation carried out in patients suffering from traumatic hemorrhagic shock within the context of DCS...
October 18, 2017: Journal of Visceral Surgery
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