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https://www.readbyqxmd.com/read/28509685/modelling-acute-traumatic-haemorrhagic-shock-injury-challenges-and-guidelines-for-preclinical-studies
#1
Jordi L Tremoleda, Sarah A Watts, Penny S Reynolds, Christoph Thiemermann, Karim Brohi
Trauma is responsible for a large proportion of the world's burden of disease, and is by far the biggest killer of young adults. Haemorrhage is the leading cause of preventable death and its effects are directly correlated with the incidence multi-organ failure in survivors. Trauma research is challenging due to patient heterogeneity, limited randomised controlled trials, and in vitro studies that fail to mimic the systemic injury response. Preclinical research remains essential for mechanistic and therapeutic discovery...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28495952/deep-and-profound-hypothermia-in-haemorrhagic-shock-friend-or-foe-a-systematic-review
#2
REVIEW
Samuel E Moffatt, S J B Mitchell, J L Walke
INTRODUCTION: Survival in exsanguinating cardiac arrest patients is poor, as is neurological outcome in survivors. Hypothermia has traditionally been seen as harmful to trauma patients and associated with increased mortality; however, there has been speculation that cooling to very low temperatures (≤20°C) could be used to treat haemorrhagic trauma patients by the induction of a suspended animation period through extreme cooling, which improves survival and preserves neurological function...
May 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28464541/accuracy-of-dual-bolus-single-acquisition-computed-tomography-in-the-diagnosis-and-grading-of-adult-traumatic-splenic-parenchymal-and-vascular-injury
#3
Paul Marovic, Paul Anthony Beech, Jim Koukounaras, Helen Kavnoudias, Gerard S Goh
INTRODUCTION: Dual Bolus Single Acquisition Computed Tomography (DBSA-CT) has been advocated for use in trauma imaging through its ability to concurrently optimise abdominal arterial and visceral parenchymal enhancement while minimising scan times and radiation dose. However, concerns have been raised regarding excessive splenic parenchymal heterogeneity using this technique. The purpose of this study is to establish and compare the accuracy of DBSA-CT to traditional sequential multiphase scanning techniques in the diagnosis and grading of traumatic adult splenic injury...
May 2, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28460079/postpartum-complications-in-new-mothers-with-juvenile-idiopathic-arthritis-a-population-based-cohort-study
#4
Debbie Ehrmann Feldman, Évelyne Vinet, Marie-Pierre Sylvestre, Beth Hazel, Ciarán Duffy, Anick Bérard, Garbis Meshefedjian, Sasha Bernatsky
Objective.: The aim was to evaluate the prevalence of postpartum complications, including depression, in new mothers who had juvenile idiopathic arthritis (JIA) and to assess whether these differ from mothers who never had JIA. Methods.: Our cohort study used data from physician billing and hospitalizations covering Quebec, Canada. We identified females with JIA with a first-time birth between 1 January 1983 and 31 December 2010 and assembled a control cohort of first-time mothers without JIA from the same administrative data, matching 4:1 for date of first birth, maternal age and area of residence...
April 27, 2017: Rheumatology
https://www.readbyqxmd.com/read/28456509/effect-of-early-tranexamic-acid-administration-on-mortality-hysterectomy-and-other-morbidities-in-women-with-post-partum-haemorrhage-woman-an-international-randomised-double-blind-placebo-controlled-trial
#5
(no author information available yet)
BACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries...
April 26, 2017: Lancet
https://www.readbyqxmd.com/read/28439168/ocular-injuries-in-patients-of-zygomatico-complex-zmc-fractures
#6
Altaf Hussain Malik, Aijaz A Shah, Irshad Ahmad, Babar Ai Shah
PURPOSE: Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures. PATIENTS AND METHODS: A study of 67 patients, who had sustained facial trauma sufficient to lead to a facial bone fracture, was undertaken in the department of Oral and Maxillofacial Surgery, Govt Dental College, Srinagar from 2008 to 2014 and the patients received a comprehensive examination by an ophthalmologist within 1 week of injury...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#7
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28422768/mechanisms-involved-in-secondary-cardiac-dysfunction-in-animal-models-of-trauma-and-haemorrhagic-shock
#8
Nick M Wilson, Johanna Wall, Veena Naganathar, Karim Brohi, Henry D De'Ath
Clinical evidence reveals the existence of a trauma induced secondary cardiac injury (TISCI) which is associated with poor patient outcomes. The mechanisms leading to TISCI in injured patients are uncertain. Conversely, animal models of trauma haemorrhage have repeatedly demonstrated significant cardiac dysfunction following injury, and highlighted mechanisms through which this might occur. The aim of this review was to provide an overview of the animal studies describing TISCI and its pathophysiology.Basic science models of trauma show evidence of innate immune system activation via Toll-Iike receptors (TLRs), the exact protagonists of which remain unclear...
April 18, 2017: Shock
https://www.readbyqxmd.com/read/28389927/post-mortem-imaging-of-the-infant-and-perinatal-dura-mater-and-superior-sagittal-sinus-using-optical-coherence-tomography
#9
Emma C Cheshire, Roger D G Malcomson, Shiju Joseph, Asif Adnan, David Adlam, Guy N Rutty
Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus. As post-mortem examination of the bridging veins and dura is challenging, and imaging modalities such as magnetic resonance and computed tomography do not have the resolution capabilities to image small blood vessels, we have trialled the use of intravascular and benchtop optical coherence tomography (OCT) systems for imaging from within the superior sagittal sinus (SSS) and through the dura during five infant/perinatal autopsies...
April 7, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28386315/protective-benefits-of-amp-activated-protein-kinase-in-hepatic-ischemia-reperfusion-injury
#10
REVIEW
Min Zhang, Dan Yang, Xianqiong Gong, Pu Ge, Jie Dai, Ling Lin, Li Zhang
Hepatic ischemia-reperfusion injury (HIRI) is a major cause of hepatic failure and death after liver trauma, haemorrhagic shock, resection surgery and liver transplantation. AMP-activated protein kinase (AMPK) is an energy sensitive kinase that plays crucial roles in the regulation of metabolic homeostasis. In HIRI, ischemia induces the decline of ATP and the increased ratio of AMP/ATP, which promotes the phosphorylation and activation of AMPK. Three AMPK kinases, liver kinase B1 (LKB1), Ca(2+)/calmodulin-depedent protein kinase kinase β (CaMKKβ) and TGF-β-activated kinase-1 (TAK1), are main upstream kinases for the phosphorylation of AMPK...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#11
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28329116/spontaneous-haemothorax-caused-by-a-ruptured-oesophageal-artery
#12
Wenxiong Zhang, Yongbing Wu, Xiaoqiang Zhang, Han Jiang
Spontaneous haemothorax is a subcategory of haemothorax that occurs in the absence of trauma or other causes. It is a rare emergency that can progress rapidly with massive blood loss leading to haemorrhagic shock and death. We describe a patient with massive spontaneous haemothorax caused by the disruption of an oesophageal artery from the middle segment of descending thoracic aorta. We sutured the bleeding artery in an emergency thoracotomy after the failure of interventional procedure.
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#13
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28295747/the-impact-of-providing-blood-to-the-scene-of-an-accident-on-transfusion-laboratory-practice
#14
S Wolf, J Morris, K Kennedy, M Lawn, T Mcloughlin, K Feane, J Uprichard, A Weaver, S Allard, L Green
BACKGROUND: Haemorrhage is the leading cause of mortality during trauma. In 2012, London's Air Ambulance introduced Blood on Board (BOB), transfusing group O red cells (RBC) to trauma patients at the scene. OBJECTIVES: This study assessed the impact of BOB on the number of mixed field samples received by the laboratory, the number of group O RBC transfused to non-group O patients and the ratio of RBC to fresh frozen plasma (FFP) transfused in the initial 24 h. METHODS: Three major trauma centres collected data on patients for whom the major haemorrhage protocol was activated between August 2008 and February 2012 pre-BOB and March 2012 and December 2013 post-BOB...
March 12, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28259377/intra-pelvic-pressure-changes-after-pelvic-fracture-a-cadaveric-study-quantifying-the-effect-of-a-pelvic-binder-and-limb-bandaging-over-a-bolster
#15
Rhys Morris, Andrew Loftus, Yasmin Friedmann, Paul Parker, Ian Pallister
INTRODUCTION: Unstable pelvic fractures can be life-threatening due to catastrophic haemorrhage. Non-invasive methods of reducing and stabilising these injuries include pelvic binder application and also lower limb bandaging over a knee-flexion bolster. Both of these methods help close the pelvic ring and should tamponade bleeding. This study aimed to quantify the intra-pelvic pressure changes that occurred with 3 different manoeuvres: lower limb bandaging over a bolster; a Trauma Pelvic Orthotic Device (T-POD) pelvic binder, and a combination of both...
April 2017: Injury
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#16
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#17
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28190583/fibrinogen-is-an-independent-predictor-of-mortality-in-major-trauma-patients-a-five-year-statewide-cohort-study
#18
Zoe K McQuilten, Erica M Wood, Michael Bailey, Peter A Cameron, David J Cooper
INTRODUCTION: Fibrinogen may be reduced following traumatic injury due to loss from haemorrhage, increased consumption and reduced synthesis. In the absence of clinical trials, guidelines for fibrinogen replacement are based on expert opinion and vary internationally. We aimed to determine prevalence and predictors of low fibrinogen on admission in major trauma patients and investigate association of fibrinogen levels with patient outcomes. PATIENTS AND METHODS: Data on all major trauma patients (January 2007-July 2011) identified through a prospective statewide trauma registry in Victoria, Australia were linked with laboratory and transfusion data...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/28183347/application-of-incident-command-structure-to-clinical-trial-management-in-the-academic-setting-principles-and-lessons-learned
#19
Penny S Reynolds, Mary J Michael, Bruce D Spiess
BACKGROUND: Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28160241/retinal-haemorrhages-in-a-university-hospital-not-always-abusive-head-injury
#20
M Mattheij, C Venstermans, I de Veuster, I Vanderstraete, T Menovsky, P Jorens, B Ceulemans
Retinal haemorrhages (RH) and subdural haematomas (SDH) are frequently seen in abusive head trauma (AHT). The aim of our study is to show that they are suggestive, but not pathognomonic for AHT. We performed an observational retrospective study on children, aged 1-18 months old, admitted to the Antwerp University Hospital with RH. History, physical examination, medical course, coagulation and metabolic tests, skeletal survey, head circumference, retinal findings, cerebral imaging, and evaluation reports by social services or civil/criminal courts were collected...
February 3, 2017: Acta Neurologica Belgica
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