Injury
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Epigenetic changes have been described in trauma patients in the form of histone acetylation events, but whether DNA-methylation occurs remains unknown. We hypothesized that the combination of hemorrhage and saline resuscitation would alter DNA-methylation and associated proteomic profiles in the rat lung. ⋯ We demonstrated an association between DNA-methylation and hemorrhage/saline resuscitation. These results suggest a potential role of DNA-methylation in the host response to injury.
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Ankle sprain lesions are the most common ligament lesions in humans. One particularly dangerous consequence of this pathology is an inability to quickly and sufficiently depress the brake pedal when driving a car. The high incidence of the lesion, in the context of a society that is highly automobile-dependent, makes the question "When can a patient safely drive a car again?" of particular socioeconomic importance. ⋯ Four weeks post injury, patients generally had a sufficient BRT to drive in traffic safely. Some patients could achieve sufficient BRTs at an earlier stage. All patients with sufficient BRTs had an AOFAS-AHS score of ≥81 points. The AOFAS-AHS score can therefore be regarded as an adequate screening tool to evaluate which patients are ready to safely operate motor vehicles earlier.
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Financial relationships between industry and physicians are a key aspect for the advancement of surgical practice and training, but these relationships also result in a conflict of interest with respect to research. Financial payments to physicians are public within the United States in the Open Payments Database, but the rate of accurate financial disclosure of payments has not previously been studied in trauma surgery publications. ⋯ Physician-industry relationships are key for advancing surgical practice and providing training to physicians. These relationships are not inherently unethical, but there is consistently high inaccuracy of financial disclosure across multiple trauma surgery journals which may indicate the need for further education on financial disclosures during surgical training or active obtainment of publicly available financial disclosures by journals.
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Ischemia-reperfusion injury (IRI) is a common postoperative complication of the tourniquet used surgery; low-molecular-weight heparin calcium (LMWH) is frequently used postoperatively to prevent the formation of deep venous thrombosis. However, subcutaneous hemorrhage can usually be seen in patients who underwent lower limb surgery, especially in total knee arthroplasty, the influence of LMWH on IRI remains controversial. In this experiment, we designed an animal model to observe the influence of LMWH on the skeletal muscle injury induced by tourniquets. ⋯ The levels of inflammatory markers in serum, the expression of apoptosis proteins, as well as histological examination of skeletal muscles, were detected at 48-h reperfusion. We found that the injury of skeletal muscle and the systemic inflammatory response was less severe in LMWH-treated animals, indicating that LMWH could attenuate the tourniquet-induced IRI. In conclusion, LMWH given postoperatively after limb surgery may be clinically beneficial.
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Comment Letter Retraction Of Publication
Re Pathways and factors that influence time to definitive trauma care for injured children in New South Wales, Australia by Curtis et al. published in 2021.