J Trauma
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Splenic artery embolization (SAE) has been used as an adjunct to the nonsurgical treatment of blunt splenic injuries since 1981. It is imperative to define the role of SAE in the management of splenic trauma and to establish a guideline for its use. ⋯ Judicious use of SAE for patients with blunt splenic injury avoids unnecessary surgery and expands the number of patients who can retain their spleen.
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Tumor necrosis factor alpha as a central mediator of the inflammation cascade is correlated to sepsis outcome. Tumor necrosis factor beta (LT-alpha) binds the same cell receptor and polymorphisms in both genes have been described. To evaluate the importance of the LT-alpha (+250 G/A) polymorphism for the clinical outcome of patients developing postsurgical sepsis, 85 patients were consecutively included into this study. ⋯ There was no correlation between the biallelic LT-alpha (+250 G/A) polymorphism and the outcome of critically ill patients. Genotyping this locus does not seem to be useful in predicting sepsis outcome.
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Left ventricular ejection time (LVET) measured in central arteries is modified during hypovolemia. We compared modifications of the pulse wave in a central artery (carotid) and in a peripheral artery (digital) during central hypovolemia induced by lower body negative pressure (LBNP) in conscious volunteers. ⋯ Peripheral LVET could reflect variation of central LVET during LBNP and be a reliable noninvasive parameter for monitoring hypovolemia.