J Trauma
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Several studies evaluating simulation training in intensive care unit (ICU) physicians have demonstrated improvement in leadership and management skills. No study to date has evaluated whether such training is useful in established ICU advanced practitioners (APs). We hypothesized that human patient simulator-based training would improve surgical ICU APs' skills at managing medical crises. ⋯ Human patient simulator training in established surgical ICU APs improves leadership, teamwork, and self-confidence skills in managing medical emergencies. Such a validated curriculum may be useful as an AP continuing education resource.
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To determine whether there is a benefit to platelet transfusion in mild traumatic brain injury (MTBI) patients with intracranial hemorrhage (ICH), taking antiplatelet therapy before hospitalization. ⋯ Platelet transfusion did not improve short-term outcomes after MTBI. Further randomized controlled trials need to be done to truly assess if there is no benefit in platelet transfusion in patients taking antiplatelet agents suffering an MTBI. Because the overall outcome in MTBI patients is favorable, platelet transfusion in these patients may not be indicated.
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Achieving hemostasis in anticoagulated patients is an increasingly important clinical issue. Poly-N-acetylglucosamine (pGlcNAc) nanofibers activate platelets by β3 subunit (CD61) and the von Willebrand receptor GP1b (CD42b) integrin signaling for generation of a prothrombotic surface membrane. Recombinant coagulation factor VIIa (rFVIIa) functions in hemophilia A and B by catalyzing formation of the Xa/Va complex on the surface of activated platelets. These observations suggest that pGlcNAc nanofibers may amplify the activity of rFVIIa in hemophilic blood. ⋯ The pGlcNAc nanofibers amplify rFVIIa activity in hemophilia B canine blood by activating platelets through integrin-dependent mechanisms.