European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Expression of Notch and Wnt/β-catenin signaling pathway in acute phase severe brain injury rats and the effect of exogenous thyroxine on those pathways.
With the rapid development of economy, transportation and industry, the incidence of severe traumatic brain injury (sTBI) is rising rapidly, which is one of the main traumatic diseases threatening human life. It is very difficult for sTBI patients to regenerate and repair the central nervous and recover the brain function. Moreover, no effective neuroprotective drug has been found in the treatment of sTBI patients. Seeking drugs to promote nerve repair has become a hot and difficult problem. It is widely accepted that thyroxine is one of the essential hormones in the human body, which not only promotes the growth and development of the nervous system, but also plays an important role in maintaining adult brain function. There are many reports of modern research on thyroxine, mainly focusing on the changes of thyroid hormone levels and their effects on the prognosis after injury. Besides, most of them are observed in clinical cases. Currently, there are few dynamic experimental studies about observing whether thyroxine can promote the repair of central nervous system at different stages after sTBI. In our previous experiment, we found that Wnt/β-catenin signaling pathway, whose functions are opposite to Notch signaling pathway, can be further activated by exogenous thyroxine in rats with sTBI. As a result, we are interested in the expression of Notch and Wnt/β-catenin signaling pathway in acute phase sTBI rats and the effect of thyroxine on those pathways. ⋯ Exogenous thyroxine has no effect on Notch and Wnt/β-catenin signaling pathway in normal rats. After TBI, exogenous thyroxine can activate Notch and Wnt/β-catenin, and have a synergistic effect on the repair of central nervous system, which may be related to the up-regulation of Notch and Wnt/β-catenin signaling pathway mRNA expression and the increase of BDNF and NGF, and resist apoptosis in the brain of sTBI rats.
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Eur J Trauma Emerg Surg · Dec 2021
Association of resuscitative endovascular balloon occlusion of the aorta (REBOA) and mortality in penetrating trauma patients.
The purpose of this study was to examine the association of REBOA and mortality in a group of patients with penetrating trauma to the torso, treated in a level-I trauma center from Colombia. ⋯ We found that, when compared to no REBOA use, patients treated with REBOA had lower risk-adjusted odds of mortality. These findings should be interpreted with caution and confirmed in future comparative studies, if possible.
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Eur J Trauma Emerg Surg · Dec 2021
Osteosynthesis of proximal humeral fractures: a 1-year analysis of failure in a Belgian level-1 trauma centre.
Proximal humeral fractures are the third most common fractures affecting the elderly. Angular stable osteosynthesis has become indispensable in the operative treatment. However, surgical fixation remains challenging. The aim of this retrospective study was to analyse the failure rate after osteosynthesis of proximal humeral fractures over a year in a level-1 trauma centre. Furthermore, parameters that are presumed to be related to osteosynthesis failure will be investigated and discussed. ⋯ The management of proximal humeral fracture osteosynthesis remains a controversial subject. In this retrospective analysis, a failure rate of 15.7% was calculated. Smoking is a statistically significant parameter related to osteosynthesis failure. The subspecialty of the treating trauma surgeon affected the failure rate significantly. A lower failure rate was noted after osteosynthesis by a shoulder surgeon compared to another trauma surgeon.
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Eur J Trauma Emerg Surg · Dec 2021
Trauma patients eligible for resuscitative endovascular balloon occlusion of the aorta (REBOA), a retrospective cohort study.
Non-compressible torso hemorrhage is a major but potentially preventable cause of trauma-related mortality. REBOA has rapidly emerged as an adjunct for hemorrhage control. However, little is known about the proportion of trauma patients in which REBOA may be indicated. The aim of our study was to determine this proportion. ⋯ The study suggests a potential indication for REBOA (incidence) of 2.5 per one million inhabitants per year according to the used criteria. Local REBOA guidelines may vary but a significant number of trauma centers use similar criteria. Although the total mortality within this group is high, the number of patients that theoretically may benefit from the use of REBOA is low.
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Eur J Trauma Emerg Surg · Dec 2021
Observational StudyBicycle-related injuries in the emergency department: a comparison between E-bikes and conventional bicycles: a prospective observational study.
To investigate the mechanisms and severity of injuries of e-bikers compared with conventional bicycle (CB) users at the emergency department (ED) of a level 2 trauma center in the Netherlands. ⋯ In this cohort of bicycle injuries in the ED of a level 2 trauma center, e-bikers were older and had more comorbidities than CB users. Except for a higher rate of thoracic and soft-tissue trauma in e-bikers, no differences were found in the mechanism and severity of injury. While it is important to note that helmet use and alcohol avoidance have demonstrable health benefits for bicyclists, further studies to quantify these benefits are recommended.