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https://www.readbyqxmd.com/read/28093566/estrogen-dependent-association-of-hdac4-with-fear-in-female-mice-and-women-with-ptsd
#1
S A Maddox, V Kilaru, J Shin, T Jovanovic, L M Almli, B G Dias, S D Norrholm, N Fani, V Michopoulos, Z Ding, K N Conneely, E B Binder, K J Ressler, A K Smith
Women are at increased risk of developing post-traumatic stress disorder (PTSD) following a traumatic event. Recent studies suggest that this may be mediated, in part, by circulating estrogen levels. This study evaluated the hypothesis that individual variation in response to estrogen levels contributes to fear regulation and PTSD risk in women. We evaluated DNA methylation from blood of female participants in the Grady Trauma Project and found that serum estradiol levels associates with DNA methylation across the genome...
January 17, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28088945/clinical-analysis-of-thoracoscopic-surgery-combined-with-intraoperative-autologous-blood-transfusion-in-the-treatment-of-traumatic-hemothorax
#2
Hu-Sai Ma, Ju-Hua Ma, Feng-Lai Xue, Xiang-Ning Fu, Ni Zhang
From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood trans- fusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088937/traumatic-cardiac-injury-experience-from-a-level-1-trauma-centre
#3
Biplab Mishra, Amit Gupta, Sushma Sagar, Maneesh Singhal, Subodh Kumar
PURPOSE: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. METHODS: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28079681/internal-jugular-vein-compression-a-novel-approach-to-mitigate-blast-induced-hearing-injury
#4
Brian Sindelar, Michael Shinners, Sydney Sherman, Kevin Novak, Kristine Erickson, Vimal Patel, Paul Kubilis, David Smith, John Finan, Julian E Bailes
HYPOTHESIS: Internal jugular vein (IJV) compression before blast injury will lead to reduced risk of traumatic hearing injury following exposure to a blast injury. BACKGROUND: IJV compression and its effects on not only intracranial, but also intracochlear pressure may potentiate blast induced hearing injury, therefore, precluding its use as a prophylactic therapy for blast induced traumatic brain injury. METHODS: Twenty Sprague Dawley rats were exposed to a 17...
January 10, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28053156/targeted-clinical-control-of-trauma-patient-coagulation-through-a-thrombin-dynamics-model
#5
Amor A Menezes, Ryan F Vilardi, Adam P Arkin, Mitchell J Cohen
We present a methodology for personalizing the clinical treatment of severely injured patients with acute traumatic coagulopathy (ATC), an endogenous biological response of impaired coagulation that occurs early after trauma and shock and that is associated with increased bleeding, morbidity, and mortality. Despite biological characterization of ATC, it is not easily or rapidly diagnosed, not always captured by slow laboratory testing, and not accurately represented by coagulation models. This lack of knowledge, combined with the inherent time pressures of trauma treatment, forces surgeons to treat ATC patients according to empirical resuscitation protocols...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#6
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤ 18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030486/non-human-primate-model-of-poly-traumatic-hemorrhagic-shock-recapitulates-early-platelet-dysfunction-observed-following-severe-injury-in-humans
#7
Leasha J Schaub, Hunter B Moore, Andrew P Cap, Jacob J Glaser, Ernest E Moore, Forest R Sheppard
BACKGROUND: Platelet dysfunction has been described as an early component of trauma induced coagulopathy (TIC). The platelet component of TIC remains to be fully elucidated and translatable animal models are required to facilitate mechanistic investigations. We sought to determine if the early platelet dysfunction described in trauma patients could be recapitulated in an non-human primate (NHP) model of poly-traumatic hemorrhagic shock. METHODS: Twenty-four male Rhesus Macaques weighting 7-14 kilograms were subjected to 60 minutes (min) severe pressure-targeted controlled hemorrhagic shock (HS) with and without other injuries...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28012882/out-of-hospital-cardiac-arrest-without-return-of-spontaneous-circulation-in-the-field-who-are-the-survivors
#8
Yan Xiong, Hong Zhan, Yuanzheng Lu, Kaipan Guan, Ngozi Okoro, Denise Mitchell, Megan Dwyer, Auna Leatham, Gilberto Salazar, Xiaoxing Liao, Ahamed Idris
BACKGROUND: Return of spontaneous circulation (ROSC) in the field is a vital determinant contributing to survival from out-of-hospital cardiac arrest (OHCA). However, nearly one third of survivors at the Dallas-Fort Worth (DFW) Resuscitation Outcomes Consortium (ROC) site did not obtain ROSC in the field. METHODS: A retrospective, observational analysis was performed on all adult patients with non-traumatic OHCA treated on scene and transported to hospital, who did not gain ROSC in the field at DFW ROC site between 2006 through 2011...
December 21, 2016: Resuscitation
https://www.readbyqxmd.com/read/28011703/optogenetic-termination-of-ventricular-arrhythmias-in-the-whole-heart-towards-biological-cardiac-rhythm-management
#9
Emile C A Nyns, Annemarie Kip, Cindy I Bart, Jaap J Plomp, Katja Zeppenfeld, Martin J Schalij, Antoine A F de Vries, Daniël A Pijnappels
AIMS: Current treatments of ventricular arrhythmias rely on modulation of cardiac electrical function through drugs, ablation or electroshocks, which are all non-biological and rather unspecific, irreversible or traumatizing interventions. Optogenetics, however, is a novel, biological technique allowing electrical modulation in a specific, reversible and trauma-free manner using light-gated ion channels. The aim of our study was to investigate optogenetic termination of ventricular arrhythmias in the whole heart...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28004325/remarkable-ct-features-of-shock-thyroid-in-traumatic-and-non-traumatic-patients
#10
Dae Hee Han, Eun Ju Ha, Joo Sung Sun, So Lyung Jung
Shock thyroid is a part of the hypovolemic shock complex, which is a constellation of secondary computed tomographic (CT) findings that are observed in patients with hypovolemic shock. However, to the best of our knowledge, there has only been a single report on this condition, which described three cases associated with significant thoracoabdominal trauma. Here, we report four patients with profound hypotension who exhibited similar CT findings as those described in the initial report on shock thyroid, but with a more diverse clinical spectrum...
December 21, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#11
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/28002634/fkbp5-polymorphisms-influence-pre-learning-stress-induced-alterations-of-learning-and-memory
#12
Phillip R Zoladz, Alison M Dailey, Hannah E Nagle, Miranda K Fiely, Brianne E Mosley, Callie M Brown, Tessa J Duffy, Amanda R Scharf, McKenna B Earley, Boyd R Rorabaugh
FK506 binding protein 51(FKBP5) is a co-chaperone of heat shock protein 90 and significantly influences glucocorticoid receptor sensitivity. Single nucleotide polymorphisms (SNPs) in the FKBP5 gene are associated with altered hypothalamus-pituitary-adrenal (HPA) axis function, changes in the structure and function of several cognitive brain areas, and increased susceptibility to post-traumatic stress disorder, major depression, bipolar disorder, and suicidal events. The mechanisms underlying these associations are largely unknown, but it has been speculated that the influence of these SNPs on emotional memory systems may play a role...
December 21, 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/28000769/characterization-of-blunt-chest-trauma-in-a-long-term-porcine-model-of-severe-multiple-trauma
#13
K Horst, T P Simon, R Pfeifer, M Teuben, K Almahmoud, Q Zhi, S Aguiar Santos, C Castelar Wembers, S Leonhardt, N Heussen, P Störmann, B Auner, B Relja, I Marzi, A T Haug, M van Griensven, M Kalbitz, M Huber-Lang, R Tolba, L K Reiss, S Uhlig, G Marx, H C Pape, F Hildebrand
Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock)...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/28000134/takotsubo-cardiomyopathy-in-traumatic-brain-injury
#14
Chun Fai Cheah, Mario Kofler, Alois Josef Schiefecker, Ronny Beer, Gert Klug, Bettina Pfausler, Raimund Helbok
BACKGROUND: Takotsubo cardiomyopathy (TC) is a well-known complication after aneurysmal subarachnoid hemorrhage and has been rarely described in patients with traumatic brain injury (TBI). METHODS: Case report and review of literature. RESULTS: Here, we report a 73-year-old woman with mild traumatic brain injury (TBI) presenting in cardiogenic shock. Takotsubo cardiomyopathy (TC) was diagnosed by repeated echocardiography. Cardiovascular support by inotropic agents led to hemodynamic stabilization after initiation of levosimendan...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27999410/effects-of-quercetin-in-a-rat-model-of-hemorrhagic-traumatic-shock-and-reperfusion
#15
Virginia Chamorro, Rachele Pandolfi, Laura Moreno, Bianca Barreira, Andrea Martínez-Ramas, Daniel Morales-Cano, Jesús Ruiz-Cabello, José Angel Lorente, Juan Duarte, Ángel Cogolludo, José Luis Alvarez-Sala, Francisco Perez-Vizcaino
BACKGROUND: We hypothesized that treatment with quercetin could result in improved hemodynamics, lung inflammatory parameters and mortality in a rat model of hemorrhagic shock. METHODS: Rats were anesthetized (80 mg/kg ketamine plus 8 mg/kg xylazine i.p.). The protocol included laparotomy for 15 min (trauma), hemorrhagic shock (blood withdrawal to reduce the mean arterial pressure to 35 mmHg) for 75 min and resuscitation by re-infusion of all the shed blood plus lactate Ringer for 90 min...
December 20, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/27994152/disrupting-the-blood-brain-barrier-by-focused-ultrasound-induces-sterile-inflammation
#16
Zsofia I Kovacs, Saejeong Kim, Neekita Jikaria, Farhan Qureshi, Blerta Milo, Bobbi K Lewis, Michele Bresler, Scott R Burks, Joseph A Frank
MRI-guided pulsed focused ultrasound (pFUS) combined with systemic infusion of ultrasound contrast agent microbubbles (MB) causes localized blood-brain barrier (BBB) disruption that is currently being advocated for increasing drug or gene delivery in neurological diseases. The mechanical acoustic cavitation effects of opening the BBB by low-intensity pFUS+MB, as evidenced by contrast-enhanced MRI, resulted in an immediate damage-associated molecular pattern (DAMP) response including elevations in heat-shock protein 70, IL-1, IL-18, and TNFα indicative of a sterile inflammatory response (SIR) in the parenchyma...
January 3, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27986330/making-the-quick-diagnosis-a-case-of-neonatal-shock
#17
Mike Gardiner, Timothy K Ruttan, Andrew J Kienstra, Matthew Wilkinson
BACKGROUND: The work-up and initial management of a critically ill neonate is challenging and anxiety provoking for the Emergency Physician. While sepsis and critical congenital heart disease represent a large proportion of neonates presenting to the Emergency Department (ED) in shock, there are several additional etiologies to consider. Underlying metabolic, endocrinologic, gastrointestinal, neurologic, and traumatic disorders must be considered in a critically ill infant. Several potential etiologies will present with nonspecific and overlapping signs and symptoms, and the diagnosis often is not evident at the time of ED assessment...
December 13, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27955692/is-the-shock-index-based-classification-of-hypovolemic-shock-applicable-in-multiple-injured-patients-with-severe-traumatic-brain-injury-an-analysis-of-the-traumaregister-dgu-%C3%A2
#18
Matthias Fröhlich, Arne Driessen, Andreas Böhmer, Ulrike Nienaber, Alhadi Igressa, Christian Probst, Bertil Bouillon, Marc Maegele, Manuel Mutschler
BACKGROUND: A new classification of hypovolemic shock based on the shock index (SI) was proposed in 2013. This classification contains four classes of shock and shows good correlation with acidosis, blood product need and mortality. Since their applicability was questioned, the aim of this study was to verify the validity of the new classification in multiple injured patients with traumatic brain injury. METHODS: Between 2002 and 2013, data from 40 888 patients from the TraumaRegister DGU(®) were analysed...
December 12, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#19
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27938373/pre-hospital-transfusion-of-plasma-in-hemorrhaging-trauma-patients-independently-improves-hemostatic-competence-and-acidosis
#20
Hanne H Henriksen, Elaheh Rahbar, Lisa A Baer, John B Holcomb, Bryan A Cotton, Jacob Steinmetz, Sisse R Ostrowski, Jakob Stensballe, Pär I Johansson, Charles E Wade
BACKGROUND: The early use of blood products has been associated with improved patient outcomes following severe hemorrhage or traumatic injury. We aimed to investigate the influence of pre-hospital blood products (i.e. plasma and/or RBCs) on admission hemostatic properties and patient outcomes. We hypothesized that pre-hospital plasma would improve hemostatic function as evaluated by rapid thrombelastography (rTEG). METHODS: We conducted a prospective observational study recruiting 257 trauma patients admitted to a Level I trauma center having received either blood products pre-hospital or in-hospital within 6 hours of admission...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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