J Trauma
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Comparative Study
Addition of an alginate to a modified zeolite improves hemostatic performance in a swine model of lethal groin injury.
QuikClot is a zeolite-based hemostatic agent that can control severe hemorrhage through adsorption of water in an exothermic reaction. Ion exchanging the calcium ions in zeolite type 5A with cations of a reduced hydration enthalpy can reduce heat generation, but its effect on the hemostatic efficacy is not clear. We developed a new compound zeolite hemostat and tested it against controls in a modified swine model of battlefield injury. ⋯ Application of the compound zeolite hemostat can effectively control hemorrhage and dramatically reduce mortality from a lethal groin wound. In addition to its antibacterial properties, Ag- and Zn-substituted zeolite hemostat can decrease the exothermic reaction and greatly attenuate the heat-induced tissue injury.
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To predict the severity of nerve traction injury by skin biopsy with quantification of intraepidermal nerve fibers density (IENFD). ⋯ With the ability to classify the nerve traction injury into a mild, moderate, or severe injury, correlations can be made between skin biopsy with IENFD and the severity of nerve traction injury. However, the extent of nerve injury cannot be differentiated within group of moderate injury with the use of three different traction weights.
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Comparative Study
Effects of different fluid resuscitation speeds on blood glucose and interleukin-1 beta in hemorrhagic shock.
Fluid resuscitation is an important treatment for hemorrhagic shock. However, evidence of guidelines for fluid resuscitation is limited. The expressions of blood glucose and proinflammatory cytokines under different resuscitation rates are still unknown. In this study, the status of blood glucose and interleukin-1beta (IL-1beta) between rapid and slow fluid resuscitation for hemorrhagic shock were compared. ⋯ Rapid fluid resuscitation ameliorates hyperglycemia and inflammatory response after hemorrhagic shock. Knowledge of advanced treatment will facilitate optimal care delivery for patients with hemorrhagic shock.
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The proteasome degrades NF-kappaB blocking protein (I-kappaB) and activates NF-kappaB that plays as a key transcriptional factor to regulate inflammatory factors that are involved in the tissue reperfusion injury. This study was designed to assess whether the proteasome inhibitor can attenuate peripheral nerve ischemia/reperfusion (I/R) injury and consequently promote motor functional recovery after ischemic insult. ⋯ This study indicates that bortezomib; a proteasome inhibitor, is effective at promoting the functional recovery of reperfused peripheral nerve. The proteasome inhibition may play a role as one of the clinical strategy in the peripheral nervous system I/R injury with further understanding its mechanism of action.
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Current data on the association between surgeon and hospital volumes and patient outcomes after hip fracture surgery is inconclusive. We hypothesized that surgeons and hospitals with higher caseloads of hip fracture care have better outcomes as measured by decreased postoperative complications and mortality, shorter length of stay in the hospital, routine disposition of patients on discharge, and decreased cost of care. ⋯ This study provides evidence that surgeon volume, but not hospital volume, is associated with decreased mortality in the treatment of hip fractures. Both surgeon and hospital volume seem to be associated with nonfatal morbidity and length of stay.