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Liver trauma

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https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#1
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#2
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28322249/the-protective-effects-of-shikonin-on-hepatic-ischemia-reperfusion-injury-are-mediated-by-the-activation-of-the-pi3k-akt-pathway
#3
Tong Liu, QingHui Zhang, Wenhui Mo, Qiang Yu, Shizan Xu, Jingjing Li, Sainan Li, Jiao Feng, Liwei Wu, Xiya Lu, Rong Zhang, Linqiang Li, Keran Cheng, Yuqing Zhou, Shunfeng Zhou, Rui Kong, Fan Wang, Weiqi Dai, Kan Chen, Yujing Xia, Jie Lu, Yingqun Zhou, Yan Zhao, Chuanyong Guo
Hepatic ischemia/reperfusion (I/R) injury, which can result in severe liver injury and dysfunction, occurs in a variety of conditions such as liver transplantation, shock, and trauma. Cell death in hepatic I/R injury has been linked to apoptosis and autophagy. Shikonin plays a significant protective role in ischemia/reperfusion injury. The purpose of the present study was to investigate the protective effect of shikonin on hepatic I/R injury and explore the underlying mechanism. Mice were subjected to segmental (70%) hepatic warm ischemia to induce hepatic I/R injury...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28321657/novel-hemostatic-agents-based-on-gelatin-microbial-transglutaminase-mix
#4
Fang Lv, Xiaonan Cong, Wenshu Tang, Yiming Han, Yu Tang, Yongrui Liu, Liqiang Su, Mingyao Liu, Mingfei Jin, Zhengfang Yi
Hemostasis is a major challenge in surgical procedures and traumas. Conventional hemostatic methods have limited efficacy and may cause additional tissue damage. In this study, we designed a novel hemostatic agent based on the in situ gel formation of gelatin cross-linked by a novel microbial transglutaminase (mTGase), in which the amino acid sequences differed from commercial mTGases. The new hemostatic agent showed the same biochemical crosslinking chemistry as the final stages of the blood coagulation cascade while using gelatin as a "structural" protein (rather than fibrin) and a calcium-independent mTGase as the crosslinking catalyst (rather than factor XIIIa)...
March 17, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28317586/strategies-to-improve-local-control-of-resected-pancreas-adenocarcinoma
#5
Paul H Sugarbaker
BACKGROUND: Only approximately one in ten pancreas cancer patients is a candidate for potentially curative resection of this disease. Even this small fraction of patients has a poor prognosis following pancreatico-duodenectomy. The disease has an anatomic location that makes it difficult for the surgeon to maintain adequate margins of resection and prevent tumor spillage at the time of resection. Also, the disease is biologically aggressive and even with a complete visible resection of the disease, micrometastases are likely to remain behind...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28314903/diatoms-in-drowning-cases-in-forensic-veterinary-context-a-preliminary-study
#6
Nadia Fucci, Carlo P Campobasso, L Mastrogiuseppe, C Puccinelli, S Marcheggiani, L Mancini, L Marino, V L Pascali
In this preliminary study, a digestive method used in forensic context to extract diatoms has been applied in organs taken from ten wildlife animals belonging three species of mammals (a deer, a roe and five otters) and one species of birds (two magpies). Only four carcasses were recovered from aquatic environments (bath trough for animals, bathtub irrigation, river) and only in three cases out of ten that the cause of death was ruled out as drowning. In seven cases, the death was due to other causes: gunshot injuries for one otter, blunt trauma for a magpie, and traumatic injuries followed by motor vehicle collision in other four otters and a roe...
March 17, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28303066/cervical-chyloma-after-neck-dissection-a-case-report
#7
Masashi Kimura, Hiroyuki Ohto, Akio Shibata, Hiroki Yamada, Shusuke Nishiwaki, Masahiro Umemura
Cervical chylomas are rare pseudocystic collections that lack an epithelial lining and arise from the thoracic duct or its tributaries; although they typically develop after neck surgery or trauma, they can arise from unknown causes. Treatment options include not only conservative therapy, such as dietary modification, repeated aspirations, and sclerotherapy, but also include surgical excision. We describe a case of a chyloma in a 64-year-old Japanese woman with squamous cell carcinoma of the gingiva. The chyloma developed following left segmental mandibulectomy with radical neck dissection and reconstruction, using a titanium plate and a pectoralis major myocutaneous flap...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28301994/does-preoperative-transarterial-chemoembolization-for-hepatocellular-carcinoma-increase-the-incidence-of-hepatic-artery-thrombosis-after-living-donor-liver-transplant
#8
Volkan Ince, Veysel Ersan, Serdar Karakas, Koray Kutluturk, Nese Karadag, Ramazan Kutlu, Sezai Yilmaz
OBJECTIVES: Transarterial chemoembolization is a potential risk factor for hepatic artery damage, which may lead to severe consequences. We aimed to investigate this controversial issue in our population of liver transplant patients with hepatocellular carcinoma. MATERIALS AND METHODS: Between March 2006 and December 2016, a total of 262 patients with hepatocellular carcinoma underwent liver transplant at our institution. Of these, 22 (8.4%) had preoperative transarterial chemoembolization...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28288070/novel-synthetic-host-defense-peptide-protects-against-organ-injury-dysfunction-in-a-rat-model-of-severe-hemorrhagic-shock
#9
Noriaki Yamada, Lukas B Martin, Elisabeth Zechendorf, Gareth S D Purvis, Fausto Chiazza, Barbara Varrone, Massimo Collino, Joanna Shepherd, Lena Heinbockel, Thomas Gutsmann, Wilmar Correa, Klaus Brandenburg, Gernot Marx, Tobias Schuerholz, Karim Brohi, Christoph Thiemermann
OBJECTIVE: To evaluate (1) levels of the host-defense/antimicrobial peptide LL-37 in patients with trauma and hemorrhagic shock (HS) and (2) the effects of a synthetic host-defense peptide; Pep19-4LF on multiple organ failure (MOF) associated with HS. BACKGROUND: HS is a common cause of death in severely injured patients. There is no specific therapy that reduces HS-associated MOF. METHODS: (1) LL-37 was measured in 47 trauma/HS patients admitted to an urban major trauma center...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28272754/hyperpolarized-%C3%AE-1-13-c-gluconolactone-as-a-probe-of-the-pentose-phosphate-pathway
#10
Karlos X Moreno, Crystal E Harrison, Matthew E Merritt, Zoltan Kovacs, Craig R Malloy, A Dean Sherry
The pentose phosphate pathway (PPP) is thought to be upregulated in trauma (to produce excess NADPH) and in cancer (to provide ribose for nucleotide biosynthesis), but simple methods for detecting changes in flux through this pathway are not available. MRI of hyperpolarized (13) C-enriched metabolites offers considerable potential as a rapid, non-invasive tool for detecting changes in metabolic fluxes. In this study, hyperpolarized δ-[1-(13) C]gluconolactone was used as a probe to detect flux through the oxidative portion of the pentose phosphate pathway (PPPox ) in isolated perfused mouse livers...
March 8, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28270138/hepatocytes-express-the-antimicrobial-peptide-hbd-2-after-multiple-trauma-an-experimental-study-in-human-and-mice
#11
Stefanie Fitschen-Oestern, Matthias Weuster, Sebastian Lippross, Peter Behrendt, Sabine Fuchs, Thomas Pufe, Mersedeh Tohidnezhad, Andreas Bayer, Andreas Seekamp, Deike Varoga, Tim Klüter
BACKGROUND: Human-beta defensins (HBD) belong to the family of acute phase peptides and hold a broad antimicrobial spectrum that includes gram-positive and gram-negative bacteria. HBD are up-regulated after severe injuries but the source of posttraumatic HBD expression has not been focused on before. In the current study we analysed the role of liver tissue in expression of HBD after multiple trauma in human and mice. METHODS: HBD-2 expression has been detected in plasma samples of 32 multiple trauma patients (ISS > 16) over 14 days after trauma by ELISA...
March 7, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28263857/organ-donation-an-unexpected-benefit-of-aggressive-resuscitation-of-trauma-patients-presenting-dead-on-arrival
#12
Abdul Q Alarhayem, Stephen M Cohn, Mark T Muir, John G Myers, James Fuqua, Brian J Eastridge
BACKGROUND: We sought to determine if aggressive resuscitation in trauma patients presenting without vital signs or "dead on arrival" (DOA) was futile. We also sought to determine if organ donation was an unexpected benefit of aggressive resuscitation. STUDY DESIGN: We conducted a review of adults presenting to our Level 1 trauma center with no signs of life (pulse = 0; systolic blood pressure = 0; and no evidence of neurologic activity, GCS = 3). Primary outcome was survival to hospital discharge or major organ donation (heart, lung, kidney, liver or pancreas were harvested)...
March 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28260484/impact-of-a-full-time-donor-management-protocol-on-donors-liver-biopsy-findings-progress-to-date
#13
Meysam Mojtabaee, Alireza Shamsaeefar, Siavash Gholami, Mojtaba Mohsenzadeh, Farahnaz Sadegh Beigee
OBJECTIVES: This study investigated a fixed coordinator-directed donor management strategy's impact on donated liver quality, as determined by definitive biopsy results. MATERIALS AND METHODS: We collected donated liver biopsy results from donations both before and after implementing a fixed coordinator-directed donor management strategy. This strategy involved full-time attendance by a donor coordinator and continued resuscitation of brain-dead donors. All donations took place in a single organ procurement unit...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28258447/time-to-ct-and-surgery-for-hpb-trauma-in-scotland-prior-to-the-introduction-of-major-trauma-centres
#14
P S McKechnie, D A Kerslake, R W Parks
AIMS: To assess the time taken to CT and emergency surgery for trauma patients with an injury to liver, spleen or pancreas prior to the introduction of major trauma centres (MTCs) in Scotland. METHODS: A search was performed of the Scottish Trauma Audit Group database for any patient with relevant injuries over a 2-year period. Primary outcome measures were time to CT and emergency surgery. Patient demographics were also recorded. RESULTS: A total of 211 patients were identified of whom 23 had more than one organ affected...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28255580/clinical-applications-of-contrast-enhanced-ultrasound-in-the-pediatric-work-up-of-focal-liver-lesions-and-blunt-abdominal-trauma-a-systematic-review
#15
REVIEW
Nicolaj Grønbæk Laugesen, Christian Pallson Nolsoe, Jacob Rosenberg
In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28254774/mechanism-of-salutary-effects-of-melatonin-mediated-liver-protection-after-trauma-hemorrhage-p38-mapk-dependent-inos-hif-1%C3%AE-pathway
#16
Jun-Te Hsu, Puo-Hsien Le, Chun-Jung Lin, Tsung-Hsing Chen, Chia-Jung Kuo, Kun-Chun Chiang, Ta-Sen Yeh
Although melatonin attenuates the increases in inflammatory mediators and reduces organ injury during trauma-hemorrhage, the mechanisms remain unclear. This study explored whether melatonin prevents liver injury after trauma-hemorrhage through the p38 mitogen-activated protein kinase (MAPK)-dependent, inducible nitrite oxide (iNOS)/hypoxia-inducible factor (HIF)-1α pathway. After a 5-cm midline laparotomy, male rats underwent hemorrhagic shock (mean blood pressure approximately 40 mmHg for 90 min) followed by fluid resuscitation...
March 2, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28248835/specific-etiologies-associated-with-the-multiple-organ-dysfunction-syndrome-in-children-part-2
#17
Jeffrey S Upperman, John C Bucuvalas, Felicia N Williams, Bruce A Cairns, Charles S Cox, Allan Doctor, Robert F Tamburro
OBJECTIVE: To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26-27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop. DATA SOURCES: Literature review, research data, and expert opinion...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28248762/splenic-rupture-and-liver-laceration-in-an-adolescent-with-autism-spectrum-disorder
#18
Desiree Noel Wagner Neville, Jennifer R Marin
We report a case of a 16-year-old adolescent boy with autism who presented to the pediatric emergency department after falling from a standing position, with a relatively benign examination, who was found to have significant hemoperitoneum on the focused assessment with sonography in trauma examination.
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28243716/contemporary-damage-control-surgery-outcomes-80-patients-with-severe-abdominal-injuries-in-the-right-upper-quadrant-analyzed
#19
M Hommes, S Chowdhury, D Visconti, P H Navsaria, J E J Krige, D Cadosch, A J Nicol
BACKGROUND: Damage control laparotomy (DCL) is a well-established surgical strategy in the management of the severely injured abdominal trauma patients. The selection of patients by intra-abdominal organs involvement for DCL remains controversial. The aim of this study was to assess the injury to the abdominal organs that causing severe metabolic failure, needing DCL. METHODS: Severely injured abdominal trauma patients with a complex pattern of injuries were reviewed over a 52-month period...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28241883/the-number-of-displaced-rib-fractures-is-more-predictive-for-complications-in-chest-trauma-patients
#20
Chih-Ying Chien, Yu-Hsien Chen, Shih-Tsung Han, Gerald N Blaney, Ting-Shuo Huang, Kuan-Fu Chen
BACKGROUND: Traumatic rib fractures can cause chest complications that need further treatment and hospitalization. We hypothesized that an increase in the number of displaced rib fractures will be accompanied by an increase in chest complications. METHODS: We retrospectively reviewed the trauma registry between January 2013 and May 2015 in a teaching hospital in northeastern Taiwan. Patients admitted with chest trauma and rib fractures without concomitant severe brain, splenic, pelvic or liver injuries were included...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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