J Trauma
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Apoptosis (A O) is a pathological process by which cells undergo a form of inducible nonnecrotic cellular suicide. In vitro studies suggest that changes in the rate of macrophage (Mo) A O may be associated with elevated proinflammatory cytokine secretory capacity, such as interleukin-1 beta (IL-1 beta) (via IL-1 converting enzyme activation). Furthermore, it has been reported that Mo are activated during early (0-4 hours) experimental septic insult to act as sources of proinflammatory cytokines, such as IL-1. ⋯ At 24 hours (late) after the onset of sepsis, the ex vivo extent of A O in PMo was increased but it was decreased in KMo. However, the addition of LPS in vitro results in a marked increase in both septic PMo and KMo A O. This latter result suggests that the inability of Mo to release cytokines in response to stiumulants, such as LPS during late sesis (24 hours), may be because of induciton of accelerated A O in these Mo populations.
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To determine if immediate decompression is required for all high voltage injuries to the upper extremity. ⋯ We conclude that the need for amputation and multiple operations is determined by the injury itself and that immediate decompression is only required for the usual clinical signs of compartment syndrome. Selective decompression may actually preserve tissue and decrease the need for eventual amputation because fasciotomy can lead to soft tissue dessication by exposing viable tissue.
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To determine useful predictors of successful organ donation in patients who die within 24 hours of injury (early deaths). ⋯ Decisions regarding the resuscitation of trauma patients who have characteristics associated with a recognized low rate of organ donation should be made exclusive of the potential for organ recovery.
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Review Case Reports
Renal artery pseudoaneurysm after blunt abdominal trauma: case report and literature review.
Renal vascular injuries such as transection, thrombosis, dissection, and arteriovenous fistula formation are unusual but well-recognized consequences of blunt abdominal trauma. We discuss a rare case of renal artery pseudoaneurysm presenting 6 weeks after blunt abdominal trauma that was successfully treated with selective embolization.
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Case Reports
Computed tomography detection of active mesenteric hemorrhage following blunt abdominal trauma.
Following blunt abdominal trauma, patients still may be actively bleed ing, despite seeming hemodynamically stable. By detecting extravasation of contrast-enhanced blood in the absence of any other evidence to support solid visceral injury as the source, computed tomography (CT) scanning was able to indicate ongoing hemorrhage in two patients, thought most likely of mesenteric origin. This information influenced the decision for intervention, which in these two cases was laparotomy, where bleeding torn mesenteric vessels were confirmed.