Articles: treatment.
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Thoracic injuries are directly responsible for 20-30% of deaths in severe trauma patients and represent one of the main regions involved in preventable or potentially preventable deaths. Controlling bleeding in thoracic trauma is a major challenge because intrathoracic hemorrhagic lesions can lead to hemodynamic instability and respiratory failure. ⋯ Thoracic bleeding can result from the diaphragm, intrathoracic vessels (aorta, but also inferior or superior vena cava, and suprahepatic veins), lung, cardiac, or chest wall injuries. Depending on thoracic lesions (such as hemothorax or hemopericardium), hemodynamic instability, and respiratory failure, a pericardial window approach, sternotomy, thoracotomy, or emergency resuscitation thoracotomy may be considered after discussion with the surgeon. Alongside treatment of injuries, managing oxygenation, ventilation, hemodynamic, and coagulopathy are essential for the patient's outcome.
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Critical care medicine · Feb 2025
Host Response Stratification in Malarial and Non-malarial Sepsis: A Prospective, Multicenter Analysis From Uganda.
Globally, the burden of sepsis is highest in malaria endemic areas of sub-Saharan Africa. The influence of malaria on biological heterogeneity inherent to sepsis in this setting is poorly understood. We sought to determine shared and distinct features of the host response in malarial and non-malarial sepsis in sub-Saharan Africa. ⋯ Host responses are largely conserved in malarial and non-malarial sepsis but may be distinguished by a signature of relative immunosuppression in the former. Further investigations are needed to differentiate mechanisms of malarial and non-malarial sepsis, with the goal of informing pathogen-stratified and pathogen-agnostic treatment strategies.
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Eur. J. Clin. Invest. · Feb 2025
Effects of glucagon-like PEPTIDE-1 receptor agonists on incidence of hepatocellular carcinoma and liver decompensation in patients with diabetes: A systematic review and META-analysis.
This systematic review and meta-analysis evaluated the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on hepatocellular carcinoma (HCC) and liver decompensation in patients with type 2 diabetes. Analysing over 641,377 patients, GLP-1RA use was associated with a significant 58% reduction in HCC risk, particularly in patients with cirrhotis. While a trend towards reduced liver decompensation risk was observed, it was not statistically significant. These findings suggest a potential role for GLP-1RAs in HCC risk stratification and prevention strategies.
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This study aimed to investigate the expression of cluster of differentiation 44 (CD44) in prostate adenocarcinoma (PAC) compared to benign prostatic hyperplasia (BPH) to address the need for biomarkers that can aid in grading classification and prognosis. ⋯ This study highlights CD44 expression not only as a potential biomarker for PAC diagnosis but also potential guide to therapeutic decision-making. Patients exhibiting lower CD44 levels may require closer monitoring and more aggressive treatment strategies, while those with higher expression may be candidates for less intensive management. Overall, our findings advocate for further investigation into CD44 as a biomarker for prostate cancer aggressiveness, which could ultimately enhance personalized treatment approaches and improve the patient outcomes.