Shock : molecular, cellular, and systemic pathobiological aspects and therapeutic approaches : the official journal the Shock Society, the European Shock Society, the Brazilian Shock Society, the International Federation of Shock Societies
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The development of clinically meaningful biomarkers for CNS traumatic injury is a major area in neurotrauma modelling. Neuroimaging is evolving as a major approach to characterize pathophysiology, improve diagnosis and test new therapies. Imaging the microglial response by targeting the up- regulation of the 18 kDa translocator protein (TSPO) following CNS injury, is a main diagnostic approach for investigating the neuroinflammatory (NI) response after CNS injury in vivo. ⋯ : This study shows the significant potential of these imaging tracers as sensitive clinical tools for non- invasive monitoring of the NI response and, potentially, of the response of NI to new therapies.
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Different transfusion ratio concepts of red blood cells (pRBCs), fresh frozen plasma (FFPs) and platelets (PLTs) have been implemented in trauma care, but the optimal ratios are still discussed. In this study the hemostatic potential of two predefined ratios was assessed by using an in vitro thrombelastometric approach. Furthermore, age effects of reconstituted blood were analyzed. ⋯ Under standardized in vitro conditions the higher amount of pRBCs in the 3:1:1 ratio diluted coagulation factors significantly on the expense of its functional coagulation capacity. Thus, the coagulation functionality of the 1:1:1 ratio predominated. It might be considered as the standard transfusion strategy particularly in trauma care.
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Trauma injury and hemorrhagic shock frequently leads to the imbalance of immune system known as Systemic Inflammatory Response syndrome (SIRS) and is connected to the morbidity or mortality. Pro and Anti- inflammatory, which play a significant role in the development of multiple organ failure (MOF). This study investigates the serum cytokines levels in patients with trauma hemorrhagic shock and the association of these cytokines with clinical outcome. ⋯ In trauma hemorrhagic shock, increased IL-6, IL-10, IL-8, IL-12 are detected while compared to normal healthy control. In these patients, increased IL-8 value in nonsurvivors as compared to survivors. This study suggests a much higher degree of activation of immune-inflammatory in T/HS than in normal healthy control. Increased IL-8 values were found to be reliable markers of mortality following T/HS.
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Sepsis is an enormous public health issue and the leading cause of death in critically ill patients in intensive care units. Overwhelming inflammation, characterized by cytokine storm, oxidative threats, and neutrophil sequestration, is an underlying component of sepsis-associated organ failure. Despite recent advances in sepsis research, there is still no effective treatment available beyond the standard of care and supportive therapy. ⋯ Although the detrimental role of ER stress during infections has been demonstrated, there is growing evidence that ER stress participates in the pathogenesis of sepsis. In this review, we summarize current research in the context of ER stress and UPR signaling associated with sepsis and its related clinical conditions, such as trauma-hemorrhage and ischemia/reperfusion injury. We also discuss the potential implications of ER stress as a novel therapeutic target and prognostic marker in patients with sepsis.
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To evaluate the significance of GDNF protein expression for developing a neuronal death after ischemia-reperfusion. ⋯ The results demonstrated association between the changes in GDNF protein level and the development of neuronal death process in the post-resuscitation period. Initial rise of GDNF expression in neuronal populations may prevent neuronal loss. The decrease of GDNF expression was accompanied by the neuronal death. GDNF protein level was shown to be an important factor influencing the resistance of neurons to ischemia- reperfusion.