scholarly journals Hypothermia in Trauma

2021 ◽  
Vol 18 (16) ◽  
pp. 8719
Author(s):  
Michiel van Veelen ◽  
Monika Brodmann Maeder
Keyword(s):  
Early Stage ◽  
Hypovolemic Shock ◽  
Coagulation Disorder ◽  
Trauma Patients ◽  
Medical Procedures ◽  
Hypoxic Injury ◽  
Traumatic Cardiac Arrest ◽  
Lethal Triad ◽  
The One ◽  
Primary Assessment

Hypothermia in trauma patients is a common condition. It is aggravated by traumatic hemorrhage, which leads to hypovolemic shock. This hypovolemic shock results in a lethal triad of hypothermia, coagulopathy, and acidosis, leading to ongoing bleeding. Additionally, hypothermia in trauma patients can deepen through environmental exposure on the scene or during transport and medical procedures such as infusions and airway management. This vicious circle has a detrimental effect on the outcome of major trauma patients. This narrative review describes the main factors to consider in the co-existing condition of trauma and hypothermia from a prehospital and emergency medical perspective. Early prehospital recognition and staging of hypothermia are crucial to triage to proper care to improve survival. Treatment of hypothermia should start in an early stage, especially the prevention of further cooling in the prehospital setting and during the primary assessment. On the one hand, active rewarming is the treatment of choice of hypothermia-induced coagulation disorder in trauma patients; on the other hand, accidental or clinically induced hypothermia might improve outcomes by protecting against the effects of hypoperfusion and hypoxic injury in selected cases such as patients suffering from traumatic brain injury (TBI) or traumatic cardiac arrest.

The Application of UX Research in New Energy Vehicle Innovation

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Menghan TAO ◽  
Ning XIAO ◽  
Xingfu ZHAO ◽  
Wenbin LIU
Keyword(s):  
Early Stage ◽  
Rapid Expansion ◽  
The Other ◽  
Innovative Product ◽  
Stage Of Development ◽  
New Energy ◽  
New Energy Vehicle ◽  
The One ◽  
New Energy Vehicles ◽  
Degree Of Innovation

New energy vehicles(NEV) as a new thing for sustainable development, in China, on the one hand has faced the rapid expansion of the market; the other hand, for the new NEV users, the current NEVs cannot keep up with the degree of innovation. This paper demonstrates the reasons for the existence of this systematic challenge, and puts forward the method of UX research which is different from the traditional petrol vehicles research in the early stage of development, which studies from the user's essence level, to form the innovative product programs which meet the needs of users and being real attractive.

Socialisation Tactics of the Spectacled Parrotlet (Forpus Conspicillatus)

Behaviour ◽  
1991 ◽  
Vol 119 (1-2) ◽  
pp. 1-29 ◽  
Author(s):  
Kyra Garnetzke-Stollmann ◽  
Dierk Franck
Keyword(s):  
Sexual Behaviour ◽  
Early Stage ◽  
Rank Order ◽  
Host Group ◽  
Pair Bonds ◽  
Group Members ◽  
The One ◽  
And Function ◽  
Sibling Group ◽  
Sibling Groups

AbstractSpectacled parrotlets live in a complex system of individual relationships throughout their lives. The adults form exclusive pair bonds, addressing all friendly and sexual behaviour patterns to each other. Pair mates cooperate in agonistic situations. As long as they stay close together they hold the same rank-order position. In mate-choice experiments females (not males) significantly preferred a mate which formerly held a high social position. There are also non-exclusive pair bonds, which are far less stable than exclusive ones. Only exclusive pairs have a good chance to occupy a breeding cavity. All group members are synchronized in many of their activities, such as foraging, preening or resting. They are keenly interested in unusual activities of other group members. Social learning, including copying sexual techniques, seems to be essential. After fledging the parents keep their offspring at a distance from a very early stage. Instead of a close parent-offspring relationship the fledglings form sibling groups with their nest mates. Over a period of months siblings remain the main interaction partners for all friendly and playful activities. They also support one another in agonistic situations. In the first months of life even courtship feeding and sexual behaviour are addressed predominantly to siblings. Thus a pair-like relationship is established between siblings, anticipating the permanent pair bond of adults. Single fledglings, deprived of the experience of a sibling group, remained poorly integrated into the group. They developed alternative socialisation tactics, namely (1) joining a host group of unrelated siblings, (2) renewing a friendly partnership with the parents, (3) helping to protect and feed younger siblings or even unrelated fledglings and (4) seeking early partnership with unrelated group members. Out of 10 single fledglings only the one that was accepted by a host sibling group immediately after fledging became well integrated into the whole group and reproduced well. It is argued that sibling groups offer good opportunities for learning partnership and function as a safe basis for exploring the social environment. It is tentatively proposed that single fledglings have a decreased probability of reproductive success.

scholarly journals The impact of hypoxic conditions on apoptosis and Toll-like receptor 4 expression in polymorphonuclear neutrophils

2018 ◽  
Vol 16 ◽  
pp. 1721727X1875675
Author(s):  
Jung-Youn Kim ◽  
Sung-Hyuk Choi ◽  
Young-Duck Cho ◽  
Young-Hoon Yoon ◽  
Jong-Hak Park ◽  
...  
Keyword(s):  
Hypovolemic Shock ◽  
Polymorphonuclear Neutrophils ◽  
Trauma Patients ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Inflammatory Reactions ◽  
Treatment Groups ◽  
Hypoxic Conditions ◽  
The Impact ◽  
Hypoxic Group

Many patients are admitted to the emergency department due to trauma. Trauma patients suffer from hypoxia due to massive hemorrhage, respiratory failure, and hypovolemic shock. Further damage is caused by reduced immune function and over-expression of inflammatory response. We conducted an experiment to determine the effects of hyperoxia and hypoxia on apoptosis and expression of Toll-like receptor 4 (TLR4) in polymorphonuclear neutrophils (PMNs). Initially, the PMNs were placed in normoxic and hypoxic conditions, and these PMNs were divided into two groups as stimulated or not stimulated with lipopolysaccharide (LPS). Levels of apoptosis and TLR4 expression were measured under normoxic, hypoxic, and hyperoxic conditions. Apoptosis decreased in the hypoxic group than in the normoxic group. With LPS stimulation, apoptosis was decreased in all three treatment groups and even more reduced in the hypoxic group. TLR4 expression increased in all three treatment groups with LPS stimulation, increased further in the hypoxic group, and to a lesser degree in the hyperoxic group. Unlike the cells exposed to hypoxic conditions, the cells exposed to the hyperoxic condition reacted similarly to the cells in the control (normoxic) group. Therefore, the inflammatory reactions can be stronger in the hypoxic group than in the other two groups.

scholarly journals Pre-hospital CPR and early REBOA in trauma patients - Results from the ABOTrauma Registry.

2020 ◽  
Author(s):  
Peter Hilbert-Carius ◽  
David T McGreevy ◽  
Fikri M. Abu-Zidan ◽  
Tal M. Hörer
Keyword(s):  
Survival Rate ◽  
Hospital Admission ◽  
Injury Severity ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Probability Of Survival ◽  
Traumatic Cardiac Arrest ◽  
Predicted Probability ◽  
Using Data

Abstract Background: Severely injured trauma patients suffering from traumatic cardiac arrest (TCA) and requiring cardiopulmonary resuscitation (CPR) rarely survive. The role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) performed early after hospital admission in patients with TCA is not well-defined. As the use of REBOA increases, there is great interest in knowing if there is a survival benefit related to the early use of REBOA after TCA. Using data from the ABOTrauma Registry, we aimed to study the role of REBOA used early after hospital admission in trauma patients who required pre-hospital CPR. Methods: Retrospective and prospective data on the use of REBOA were collected from the ABOTrauma Registry from 11 centers in seven countries globally between 2014 and 2019. In all patients with pre-hospital TCA, the predicted probability of survival, calculated with the Revised Injury Severity Classification II (RISC II), was compared with the observed survival rate. Results: Of 213 patients in the ABOTrauma Registry, 26 patients (12.2%) who had received pre-hospital CPR were identified. The median (range) Injury Severity Score (ISS) was 45.5 (25-75). Fourteen patients (54%) had been admitted to hospital with ongoing CPR. Nine patients (35%) died within the first 24 hours, while seventeen patients (65%) survived post 24 hours. The survival rate to hospital discharge was 27% (n=7). The predicted mortality using the RISC II was 0.977 (25 out of 26). The observed mortality (19 out of 26) was significantly lower than the predicted mortality (p=0.049). Patients not responding to REBOA were more likely to die. Only one (10%) out of 10 non-responders survived. Survival rate in the 16 patients responding to REBOA was 37.5% (n=6). REBOA with a median (range) duration of 45 (8-70) minutes significantly increases blood pressure from median (range) 56.5 (0-147) to 90 (0-200) mmHg. Conclusions: Mortality in patients suffering from TCA and receiving REBOA early after hospital admission is significantly lower than predicted by the RISC II. REBOA may improve survival after TCA. The use of REBOA in these patients should be further investigated.

scholarly journals Smoking is associated with constant cough which is resistant to oseltamivir therapy for suspected COVID-19

2021 ◽  
Author(s):  
Satoru Chiba
Keyword(s):  
Smoking Cessation ◽  
Risk Factor ◽  
Immune Function ◽  
Antibacterial Therapy ◽  
Respiratory Symptoms ◽  
Lung Diseases ◽  
Early Stage ◽  
Medical Personnel ◽  
Never Smokers ◽  
The One

Abstract Background: Smoking depresses pulmonary immune function and is a risk factor contracting more serious outcomes among people who become infected. The association between smoking and persistent respiratory symptoms which are resistant to oseltamivir for suspected coronavirus disease 2019 (COVID-19) was evaluated.Methods: A total of 22 COVID-19 suspected medical personnel and their cohabitation families without hypoxia and lung diseases, who came to the adult fever clinic from March to September 2020 were studied. All patients received oseltamivir and antibacterial therapy together. And four patients suffering from constant cough were started on inhaled ciclesonide 400 μg twice a day for a week.Results: Most of the infected patients were female [13 (59%)], 2 had diabetes (9%) and 4 hypertension (18%). The median age was 40 years (interquartile range [IQR] 25–47 years). The study patients were divided into 2 groups; individuals who currently smoke in 11 patients (current smokers) and never smoked in 11 (never smokers). Four (36%) of 11 current smokers experienced constant cough even after oseltamivir administration, compared with 0% of never smokers (χ2=4.90; p<0.05). The cough score decreased from 1.5±0.5 at baseline to 0.3±0.5 during the one week after ciclesonide administration (p<0.001) and constant cough disappeared in three cases out of four current smokers. Conclusion: Because current smokers are at a higher risk to develop constant cough which is resistant to oseltamivir therapy for suspected COVID-19 as compared to never smokers, smoking cessation should be recommended at an early stage. Ciclesonide may improve the constant cough in suspected COVID-19.

scholarly journals Application of Different Imaging Methods in the Early Diagnosis of Primary Hepatic Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xin’ai Wu ◽  
Jianbo Li ◽  
Cheng Wang ◽  
Guojian Zhang ◽  
Na Zheng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Stage ◽  
Survival Rates ◽  
Hepatic Carcinoma ◽  
Imaging Methods ◽  
Positron Emission ◽  
Ultrasound Computed Tomography ◽  
Primary Hepatic Carcinoma ◽  
The Common ◽  
The One

Primary hepatic carcinoma (PHC) is the one of the most common tumors and the common cause of cancer death in the world. Detecting PHC in its early stage by imaging methods may greatly increase survival rates of patients. Ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography are common imaging methods in the diagnosis of PHC. In this paper, the application of different imaging methods in diagnosing the primary hepatic carcinoma will be discussed.

scholarly journals A step towards unraveling the paleogeographic attribution of pre-Mesozoic basement complexes in the Western Alps based on U–Pb geochronology of Permian magmatism

2020 ◽  
Vol 113 (1) ◽  
Author(s):  
Michel Ballèvre ◽  
Audrey Camonin ◽  
Paola Manzotti ◽  
Marc Poujol
Keyword(s):  
Early Stage ◽  
Western Alps ◽  
Geochemical Data ◽  
Alkaline Magmatism ◽  
Low Grade ◽  
Calc Alkaline ◽  
Alpine Orogeny ◽  
History Of ◽  
External Part ◽  
The One

Abstract The Briançonnais Domain (Western Alps) represented the thinned continental margin facing the Piemonte-Liguria Ocean, later shortened during the Alpine orogeny. In the external part of the External Briançonnais Domain (Zone Houillère), the Palaeozoic basement displays microdioritic intrusions into Carboniferous sediments and andesitic volcanics resting on top of the Carboniferous sediments. These magmatic rocks are analysed at two well-known localities (Guil volcanics and Combarine sill). Geochemical data show that the two occurrences belong to the same calc-alkaline association. LA-ICP-MS U–Pb ages have been obtained for the Guil volcanics (zircon: 291.3 ± 2.0 Ma and apatite: 287.5 ± 2.6 Ma), and the Combarine sill (zircon: 295.9 ± 2.6 Ma and apatite: 288.0 ± 4.5 Ma). These ages show that the calc-alkaline magmatism is of Early Permian age. During Alpine orogeny, a low-grade metamorphism, best recorded by lawsonite-bearing veins in the Guil andesites, took place at about 0.4 GPa, 350 °C in the External Briançonnais and Alpine metamorphism was not able to reset the U–Pb system in apatite. The Late Palaeozoic history of the Zone Houillère is identical to the one recorded in the Pinerolo Unit, located further East in the Dora-Maira Massif, and having experienced a garnet-blueschist metamorphism during the Alpine orogeny. The comparison of these two units allows for a better understanding of the link between the Palaeozoic basements, mostly subducted during the Alpine convergence, and their Mesozoic covers, generally detached at an early stage of the convergence history.

scholarly journals Comparative Studies of Hyaluronic Acid Concentration in Normal and Osteoarthritic Equine Joints

Fluids ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 193
Author(s):  
Matisioudis ◽  
Rizos ◽  
Tyrnenopoulou ◽  
Papazoglou ◽  
Diakakis ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Early Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Elisa Assay ◽  
Major Contributor ◽  
Preventive Strategies ◽  
Specific Enzyme ◽  
Exploratory Approach ◽  
The One ◽  
Biochemical Features

Osteoarthritis (OA) is the most common major disabling disease in humans and horses. Hyaluronic acid (HA), naturally abundantly present in synovial fluid (SF), is thought to have crucial impact on the functional rheological and biochemical features of SF in healthy and osteoarthritic joints. Here we present comparative measurements of HA concentration in SF from 35 normal and osteoarthritic equine joints, between two different approaches. On the one hand, an established biochemical HA-specific Enzyme–Linked Immunosorbent Assay (ELISA) assay was employed, which determined that SF in healthy and osteoarthritic equine joints is characterized by HA concentration of ca 0.3–2 mg/mL and 0.1–0.7 mg/mL respectively. On the other hand the same SF samples were also examined with a new exploratory approach of finding out HA concentration, which is based on SF rheology. This was done following “calibration” using appropriate model HA solutions. Comparative analysis of the results obtained by both the biochemical and the rheological approaches, revealed that in most cases the rheological approach greatly overestimates HA concentration in SF, by ca 3 to 8 times and 6 to 11 times, in healthy and diseased SF respectively. Overall these findings support the notion that, contrary to the established view, HA may not be the major contributor of equine SF rheology. This should be taken into account for the development of new more effective preventive strategies, as well as more effective early-stage interventions in osteoarthritis.

The influence of temperature on the tension developed in an isometric twitch

1951 ◽  
Vol 138 (892) ◽  
pp. 349-354 ◽  
Keyword(s):  
Early Stage ◽  
Muscular Contraction ◽  
Effect Of Temperature ◽  
Maximum Tension ◽  
Velocity Of Shortening ◽  
Influence Of Temperature On ◽  
Higher Temperature ◽  
The Difference ◽  
Isometric Twitch ◽  
The One

In muscular contraction the development of tension requires that the contractile component should shorten and stretch the series elastic component. In an isometric twitch the maximum tension is reached as a balance between two opposing processes, internal shortening on the one hand and decay of the active state (relaxation) on the other. The fact that the maximum tension in a twitch is considerably less than in a tetanus has been attributed to oncoming relaxation allowing insufficient time for internal shortening to be completed. The maximum tension in a twitch is considerably reduced by a rise of temperature, while that in a tetanus is somewhat increased. This would require that the temperature coefficient of the velocity of shortening should be substantially less than that of the decay of activity. Evidence for this exists. On this view the effect of a quick stretch, applied during the early stage of a twitch, in increasing the tension ratio, stretch/isometric, should be much greater at a higher temperature. This expectation is confirmed on frogs’ muscles over the range 0 to 20°C. The effect of temperature, therefore, on the size of a twitch can be attributed to the difference between the temperature coefficients of velocity of shortening and rate of relaxation.

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