The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Apr 2014
Alveolar macrophage depletion increases the severity of acute inflammation following nonlethal unilateral lung contusion in mice.
Lung contusion (LC) is a common injury resulting from blunt thoracic trauma. LC is an important risk factor for the development acute lung injury, adult respiratory distress syndrome, and ventilator-associated pneumonia, all of which increase mortality from trauma. LC produces a nonspecific immune cellular response. Neutrophil recruitment is known to increase the severity of inflammation during LC. However, the exact role of macrophages in modulating the response to LC has not been well described. ⋯ The presence of regulatory alveolar macrophages plays an important role in the pathogenesis of acute inflammation following LC.
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J Trauma Acute Care Surg · Apr 2014
The mesenchymal stem cell-derived microvesicles enhance sciatic nerve regeneration in rat: a novel approach in peripheral nerve cell therapy.
The accomplishment for desired functional peripheral nerve regeneration is still challenging despite various materials and methods. The effects of local application of omental adipose mesenchymal stromal cell-derived microvesicles (MVs) on peripheral nerve regeneration were studied using a rat sciatic nerve transection model. ⋯ The anti-inflammatory stem cell-derived MVs can be used as an alternative for the improvement of rat sciatic nerve regeneration.
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J Trauma Acute Care Surg · Apr 2014
Randomized Controlled Trial Comparative StudyThromboelastogram-guided enoxaparin dosing does not confer protection from deep venous thrombosis: a randomized controlled pilot trial.
The incidence of deep venous thrombosis (DVT) remains high in general surgery and trauma patients despite widespread prophylaxis with enoxaparin. A recent study demonstrated decreased incidence of DVT if patients on enoxaparin had a change in R time (ΔR) of greater than 1 minute when heparinase-activated thromboelastography (TEG) was compared with normal TEG. We hypothesized that using ΔR-guided dosing would result in decreased DVT rates. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Apr 2014
Multicenter Study Comparative StudyEpidemiology and risk factors of multiple-organ failure after multiple trauma: an analysis of 31,154 patients from the TraumaRegister DGU.
In the severely injured who survive the early posttraumatic phase, multiple-organ failure (MOF) is the main cause of morbidity and mortality. An enhanced prediction of MOF might influence individual monitoring and therapy of severely injured patients. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Apr 2014
ReviewPressure ulcers from spinal immobilization in trauma patients: a systematic review.
To protect the (possibly) injured spine, trauma patients are immobilized on backboard or vacuum mattress, with a cervical collar, lateral headblocks, and straps. Several studies identified pressure ulcer (PU) development from these devices. The aim of this literature study was to gain insight into the occurrence and development of PUs, the risk factors, and the possible interventions to prevent PUs related to spinal immobilization with devices in adult trauma patients. ⋯ Systematic review, level III.