Articles: trauma.
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Occipital condyle fractures are rare, and conservative treatment is sufficient for many cases. Surgical treatment may be required if the condyle fracture is accompanied by atlantooccipital dislocation. Unfortunately, condyle fracture generally cannot be diagnosed with X-ray in the emergency department. ⋯ In this report, we describe a patient who admitted to our emergency department after a major trauma. She complained of neck pain, and maxillofacial trauma was more evident. Her cervical X-rays were normal, but cervical computed tomography revealed unilateral occipital condyle fracture.
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In trauma patients, Enoxaparin (a low molecular weight heparin, LMWH) prophylaxis for venous thromboembolism (VTE) risk reduction is unproven. ⋯ Prophylactic LMWH is associated with reduction of VTE in trauma patients.
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Thrombosis research · May 2014
Review Historical ArticleAcute traumatic coagulopathy: clinical characterization and mechanistic investigation.
Trauma remains the leading cause of death and morbidity worldwide and bleeding is the primary reason for this mortality. Over the past 11 years there has been a paradigm shift in our understanding of coagulopathy after trauma. ⋯ This manuscript will review the history of resuscitation after injury, the discovery and clinical and biological characterization of acute traumatic coagulopathy and the changes in resuscitation practices aimed at combating coagulopathy and inflammatory perturbation after trauma. Finally it will discuss the ongoing state of the science and suggest topics for continued biological and clinical study.
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Critical care medicine · May 2014
Sirtuin 1-Mediated Inhibition of p66shc Expression Alleviates Liver Ischemia/Reperfusion Injury.
Ischemia/reperfusion is a leading cause of liver damage after surgical intervention, trauma, and transplantation. It has been reported that the nicotinamide adenine dinucleotide-dependent deacetylase sirtuin 1 attenuates myocardial, cerebral, and renal ischemia/reperfusion damage. This study aimed to investigate the involvement of sirtuin 1-mediated p66shc inhibition in liver ischemia/reperfusion and explore the effect of carnosic acid and ischemic preconditioning on liver ischemia/reperfusion-induced damage. ⋯ Carnosic acid and ischemic preconditioning protect against ischemia/reperfusion-induced liver injury. Mechanistically, the protective effect involves the sirtuin 1-mediated inhibition of p66shc, suggesting that this pathway is a novel potential therapeutic target for protecting the liver from ischemia/reperfusion injury.
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Thrombosis research · May 2014
The effects of recombinant activated factor VII dose on the incidence of thromboembolic events in patients with coagulopathic bleeding.
Previous studies have suggested the used of off-label recombinant factor VII (rFVIIa) increases the risk of thromboembolic events, but the effect of the dose of rFVIIa is not well described in the literature. ⋯ No significant difference in the incidence of thromboembolic events was seen between low dose versus high dose rFVIIa over a seven year period at our institution. However, due to the relatively low overall incidence and a small sample size, type II error may be present.