16,747 results match your criteria Shock Hemorrhagic


Assessment of the Cytoprotective Effects of High-Dose Valproic Acid Compared to a Clinically Used Lower Dose.

J Surg Res 2021 May 11;266:125-141. Epub 2021 May 11.

Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan; Department of Surgery, Feinberg School of Medicine/Northwestern University, Chicago, Illinois. Electronic address:

Objective: Valproic acid (VPA) treatment improves survival in animal models of injuries on doses higher than those allowed by Food and Drug Administration (FDA). We investigated the proteomic alterations induced by a single high-dose (140mg/kg) of VPA (VPA140) compared to the FDA-approved dose of 30mg/kg (VPA30) in healthy humans. We also describe the proteomic and transcriptomic changes induced by VPA140 in an injured patient. Read More

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Model for the prediction of mechanical asphyxia as the cause of death based on four biological indexes in human cardiac tissue.

Sci Justice 2021 May 4;61(3):221-226. Epub 2021 Mar 4.

Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China. Electronic address:

Determination of mechanical asphyxia as the cause of death has always been difficult for forensic pathologists, particularly when signs of asphyxia are not obvious on the body. Currently, depending on only physical examination of corpses, pathologists must be cautious when making cause-of-death appraisals. In a previous study, four biomarkers-dual-specificity phosphatase 1 (DUSP1), potassium voltage-gated channel subfamily J member 2 (KCNJ2), miR-122, and miR-3185-were screened in human cardiac tissue from cadavers that died from mechanical asphyxia compared with those that died from craniocerebral injury, hemorrhagic shock, or other causes. Read More

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The effect of perturbations of the glycocalyx on microvascular perfusion in the obese trauma population: an in vitro study.

Trauma Surg Acute Care Open 2021 26;6(1):e000711. Epub 2021 Apr 26.

Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.

Objectives: Patients with morbid obesity have impaired responses to resuscitation following severe injury, which may contribute to adverse outcomes. Obesity is associated with microvascular dysfunction and metabolic changes associated with altered hemorheological profiles. These include decreased red blood cell (RBC) deformity associated with increased aggregation and adhesion. Read More

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Acute hemorrhagic cholecystitis with gallbladder rupture and massive intra-abdominal hemorrhage.

Autops Case Rep 2021 Jan 28;11:e2020232. Epub 2021 Jan 28.

University of Michigan, Michigan Medicine, Department of Surgery, Ann Arbor, Michigan, USA.

Acute hemorrhagic cholecystitis is a rare, life-threatening condition that can be further complicated by perforation of the gallbladder. We describe a patient with clinical and radiologic findings of acute cholecystitis with a gallbladder rupture and massive intra-abdominal bleeding. Our patient is a 67-year-old male who presented with an ischemic stroke and was treated with early tissue plasminogen activator. Read More

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January 2021

Addition of Drag-Reducing Polymers to Colloid Resuscitation Fluid Enhances Cerebral Microcirculation and Tissue Oxygenation After Traumatic Brain Injury Complicated by Hemorrhagic Shock.

Adv Exp Med Biol 2021 ;1269:283-288

Department of Neurosurgery, University of New Mexico, Albuquerque, NM, USA.

Hemorrhagic shock (HS) is a severe complication of traumatic brain injury (TBI) that doubles mortality due to severely compromised microvascular cerebral blood flow (mvCBF) and oxygen delivery reduction, as a result of hypotension. Volume expansion with resuscitation fluids (RF) for HS does not improve microvascular CBF (mvCBF); moreover, it aggravates brain edema. We showed that the addition of drag-reducing polymers (DRP) to crystalloid RF (lactated Ringer's) significantly improves mvCBF, oxygen supply, and neuronal survival in rats suffering TBI+HS. Read More

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A 45-year-old female patient with Sheehan's syndrome presenting with imminent adrenal crisis: a case report.

J Med Case Rep 2021 May 8;15(1):229. Epub 2021 May 8.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Background: Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis.

Case Presentation: We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Read More

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A rare case of sudden death due to aortogastric fistula after endovascular aortic repair of the descending aorta.

Forensic Sci Med Pathol 2021 May 5. Epub 2021 May 5.

Department of Forensic Medicine and Toxicology, Greece M. Asias, School of Medicine, National and Kapodistrian University of Athens, 115 27, Athens, Greece.

Aortogastric fistulas are a rare type of aortoenteric fistula (AEF). Aortoenteric fistulas have been reported as a complication of endovascular aortic repair (EVAR) after the placement of prosthetic materials. Considering the anatomic relationship of the descending thoracic aorta and the stomach, the formation of an aortic fistula involving the stomach is an extremely rare case. Read More

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Fatal hemoperitoneum due to rupture of mesenteric artery in remission state of microscopic polyangiitis, concomitant with severe hypertension and posterior reversible encephalopathy syndrome: an autopsy case report.

CEN Case Rep 2021 May 4. Epub 2021 May 4.

Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan.

Microscopic polyangiitis (MPA) is a type of necrotizing vasculitis associated with high levels of myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA). While generally associated with renal dysfunction, MPA can also cause intraabdominal hemorrhage in rare cases. A 66-year-old man was admitted to our hospital for renal dysfunction, numbness, and weight loss for 3 months. Read More

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Prehospital blood pressure and lactate are early predictors of acute kidney injury after trauma.

J Surg Res 2021 Apr 30;265:180-186. Epub 2021 Apr 30.

Department of Emergency and Critical Care Medicine, Wakayama Medical University, School of Medicine, Wakayama, Japan.

Background: The purpose of this study is to report the prevalence of acute kidney injury (AKI) after trauma in our center, describe the risk factors associated with AKI, and determine whether these risk factors help avoid AKI.

Materials And Methods: We retrospectively analyzed the data which were prospectively collected from a single center trauma registry from January 2017 to December 2018. Patients who were <16 years of age, patients with burns, and patients with chronic kidney disease were excluded from the present study. Read More

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[Aortoesophageal fistula-A rare differential diagnosis of upper gastrointestinal bleeding].

Anaesthesist 2021 Apr 30. Epub 2021 Apr 30.

Klinik für Anästhesiologie, Intensiv‑, Notfall‑, Transfusionsmedizin und Schmerztherapie Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617, Bielefeld, Deutschland.

Approximately 1% of all patients are admitted to an emergency room for upper gastrointestinal hemorrhage. Differential diagnostics reveal an aortoesophageal fistula (AEF) as the cause of the bleeding in very few cases. Despite increasing means of diagnostics and treatment, mortality is high in patients with AEF even under maximum medical care. Read More

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Vagus Nerve Stimulation Protects Enterocyte Glycocalyx After Hemorrhagic Shock Via The Cholinergic Anti-Inflammatory Pathway.

Shock 2021 Apr 22. Epub 2021 Apr 22.

Department of Anesthesiology, General Hospital of Central Theater Command of PLA, Wuhan, China, 430070 The First School of Clinical Medicine, Southern Medical University, Guangzhou, China, 510006.

Introduction: Electrical vagal nerve stimulation is known to decrease gut permeability and alleviate gut injury caused by traumatic hemorrhagic shock. However, the specific mechanism of action remains unclear. Glycocalyx, located on the surface of the intestinal epithelium, is associated with the buildup of the intestinal barrier. Read More

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Therapeutically Targeting Microvascular Leakage In Experimental Hemorrhagic Shock: A Systematic Review and Meta-Analysis.

Shock 2021 Apr 22. Epub 2021 Apr 22.

Departments of Anesthesiology Physiology, Amsterdam UMC, VU University, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Background: Microvascular leakage is proposed as main contributor to disturbed microcirculatory perfusion following hemorrhagic shock and fluid resuscitation, leading to organ dysfunction and unfavorable outcome. Currently, no drugs are available to reduce or prevent microvascular leakage in clinical practice. We therefore aimed to provide an overview of therapeutic agents targeting microvascular leakage following experimental hemorrhagic shock and fluid resuscitation. Read More

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(E)-Guggulsterone Inhibits Dengue Virus Replication by Upregulating Antiviral Interferon Responses through the Induction of Heme Oxygenase-1 Expression.

Viruses 2021 04 20;13(4). Epub 2021 Apr 20.

Department of Biotechnology and PhD Program in Life Sciences, College of Life Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

Dengue virus (DENV) infection, which causes dengue fever, dengue hemorrhagic fever, and dengue shock syndrome, is a severe global health problem in tropical and subtropical areas. There is no effective vaccine or drug against DENV infection. Thus, the development of anti-DENV agents is imperative. Read More

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Melatonin Inhibits Dengue Virus Infection via the Sirtuin 1-Mediated Interferon Pathway.

Viruses 2021 04 11;13(4). Epub 2021 Apr 11.

Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Dengue virus (DENV) is the causative pathogen in the life-threatening dengue hemorrhagic fever and dengue shock syndrome. DENV is transmitted to humans via the bite of an infected mosquito. Approximately 100 million people are infected annually worldwide, and most of those live in tropical and subtropical areas. Read More

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Effect of Earlier Door-to-CT and Door-to-Bleeding Control in Severe Blunt Trauma: A Retrospective Cohort Study.

J Clin Med 2021 Apr 6;10(7). Epub 2021 Apr 6.

Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka 558-8558, Japan.

Blunt trauma is a potentially life-threatening injury that requires prompt diagnostic examination and therapeutic intervention. Nevertheless, how impactful a rapid response time is on mortality or functional outcomes has not been well-investigated. This study aimed to evaluate effects of earlier door-to-computed tomography time (D2CT) and door-to-bleeding control time (D2BC) on clinical outcomes in severe blunt trauma. Read More

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Does Liberal Prehospital and In-Hospital Tranexamic Acid Influence Outcome in Severely Injured Patients? A Prospective Cohort Study.

World J Surg 2021 Apr 29. Epub 2021 Apr 29.

Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

Background: Early hemorrhage control is important in trauma-related death prevention. Tranexamic acid (TXA) has shown to be beneficial in patients in hemorrhagic shock, although widespread adoption might result in incorrect TXA administration leading to increased morbidity and mortality.

Methods: A 7-year prospective cohort study with consecutive trauma patients admitted to a Level-1 Trauma Center ICU was performed to investigate administration of both pre- and in-hospital TXA and its relation to morbidity and mortality. Read More

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Hemosuccus Pancreaticus: Culprit of Life-Threatening Upper Gastrointestinal Bleeding in Acute Pancreatitis.

J Emerg Trauma Shock 2021 Jan-Mar;14(1):48-50. Epub 2021 Mar 23.

Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Hemosuccus pancreaticus (HP), a term used for upper gastrointestinal bleeding (UGIB) from the ampulla of Vater through the pancreatic duct, is most commonly caused by the rupture of aneurysm of the splenic artery associated with acute or chronic pancreatitis. It is a rare cause of UGIB, and estimates of its rate (1/1500) are based on small case series. Because of its rarity, the diagnosis is easily overlooked. Read More

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Rapid evolution and host immunity drive the rise and fall of carbapenem resistance during an acute Pseudomonas aeruginosa infection.

Nat Commun 2021 04 28;12(1):2460. Epub 2021 Apr 28.

University of Oxford, Department of Zoology, Oxford, UK.

It is well established that antibiotic treatment selects for resistance, but the dynamics of this process during infections are poorly understood. Here we map the responses of Pseudomonas aeruginosa to treatment in high definition during a lung infection of a single ICU patient. Host immunity and antibiotic therapy with meropenem suppressed P. Read More

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Vasopressors in Trauma: A Never Event?

Anesth Analg 2021 Apr 28. Epub 2021 Apr 28.

Anesthesia and Critical Care-Réanimation, Hôpital Beaujon, Université de Paris, Paris, France.

Vasopressor use in severely injured trauma patients is discouraged due to concerns that vasoconstriction will worsen organ perfusion and result in increased mortality and organ failure in hypotensive trauma patients. Hypotensive resuscitation is advocated based on limited data that lower systolic blood pressure and mean arterial pressure will result in improved mortality. It is classically taught that hypotension and hypovolemia in trauma are associated with peripheral vasoconstriction. Read More

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Prehospital shock index outperforms hypotension alone in predicting significant injury in trauma patients.

Trauma Surg Acute Care Open 2021 13;6(1):e000712. Epub 2021 Apr 13.

Department of Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.

Background: The American College of Surgeons Resources for Optimal Care of the Injured Patient recommends using hypotension, defined as systolic blood pressure ≤90 mm Hg, as an indicator of a full team trauma activation. We hypothesized that an elevated shock index (SI) predicts significant traumatic injuries better than hypotension alone.

Methods: This is a retrospective cohort study analyzing full team trauma activations between February 2018 and January 2020, excluding transfers and those who had missing values for prehospital blood pressure or heart rate. Read More

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Neuroimaging Patterns in Patients with COVID-19-Associated Neurological Complications: A Review.

Neurol India 2021 Mar-Apr;69(2):260-271

Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.

Background: A variety of neuroimaging abnormalities in COVID-19 have been described.

Objectives: In this article, we reviewed the varied neuroimaging patterns in patients with COVID-19-associated neurological complications.

Methods: We searched PubMed, Google Scholar, Scopus and preprint databases (medRxiv and bioRxiv). Read More

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Sick from what? Trauma during the SARS-CoV-2 pandemic.

Trauma Case Rep 2021 Jun 21;33:100477. Epub 2021 Apr 21.

Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, 800 Meadows Road, Boca Raton, FL 33486, United States of America.

Background: We present the case of two brothers with identical mechanisms of injury presenting simultaneously, one with SARS-Cov-2 respiratory failure and the other in hemorrhagic shock.

Summary: Healthcare globally and in the United States met novel challenges during the unprecedented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) health crisis. The effect of SARS-CoV-2 on hospital and health care delivery systems has been widely reported. Read More

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Endovascular therapies for pulmonary embolism.

Heliyon 2021 Apr 1;7(4):e06574. Epub 2021 Apr 1.

Service d'imagerie CHU Toulouse, Rangueil, France.

Purpose: The aim of this article is to define the place of new endovascular methods for the management of pulmonary embolisms (PE), on the basis of a multidisciplinary consensus.

Method And Results: Briefly, from the recent literature, for high-risk PE presenting with shock or cardiac arrest, systemic thrombolysis or embolectomy is recommended, while for lowrisk PE, anticoagulation alone is proposed. Normo-tense patients with PE but with biological or imaging signs of right heart dysfunction constitute a group known as "at intermediate risk" for which the therapeutic strategy remains controversial. Read More

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Alterations of Phagocytic Activity and Capacity in Granulocytes and Monocytes Depend on the Pathogen Strain in Porcine Polytrauma.

Front Med (Lausanne) 2021 6;8:645589. Epub 2021 Apr 6.

Experimental Radiology, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany.

Polytraumatized patients undergo a strong immunological stress upon insult. Phagocytes (granulocytes and monocytes) play a substantial role in immunological defense against bacteria, fungi and yeast, and in the clearance of cellular debris after tissue injury. We have reported a reduced monocytes phagocytic activity early after porcine polytrauma before. Read More

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A rare iatrogenic mesenteric laceration and hemorrhagic shock after colonoscopy. Case report and literature review.

Ann Ital Chir 2021 Mar 5;10. Epub 2021 Mar 5.

Aim: We report a particular case study of the unexpected death of a 70-year-old caucasian man (affected by crohn's disease) due to the laceration of the ileocolic mesentery and its blood vessels following a colonoscopy procedure carried out only a few hours previously.

Material Of The Study: The autopsy showed that the lacerated blood vessels (i.e. Read More

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The pathophysiology of "happy" hypoglycemia.

Int J Emerg Med 2021 Apr 21;14(1):23. Epub 2021 Apr 21.

SAMU des Hauts-de-Seine, Assistance Publique - Hôpitaux de Paris, Raymond Poincaré Hospital, University of Paris-Saclay, 104 boulevard Raymond Poincaré, 92 380, Garches, France.

Background: Hypoglycemia usually includes various neurological symptoms, which are the consequence of neuroglycopenia. When it is severe, it is associated with altered mental status, even coma.

Case Presentation: We report the case of a patient with severe hypoglycemia, completely asymptomatic, due to the increase of lactate production in response to tissue hypoperfusion following a hemorrhagic shock. Read More

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