Direct to OR resuscitation of abdominal trauma: An NTDB propensity matched outcomes study

alexandrossfakianakis shared this article with you from Inoreader Direct to OR resuscitation of abdominal trauma: An NTDB propensity matched outcomes study Via Journal of Trauma and Acute Care Surgery - Current Issue BACKGROUND Direct to operating room resuscitation (DOR) is used by some trauma centers for severely injured trauma patients as an approach to minimize time to hemorrhage control. It is unknown whether this strategy results in favorable outcomes. We hypothesized that utilization of an emergency department operating room (EDOR) for resuscitation of patients with abdominal trauma at an urban Level I trauma center would be associated with decreased time to laparotomy and improved outcomes. METHODS We included patients 15 years or older with abdominal trauma who underwent emergent laparotomy within 120 minutes of arrival both at our institution and within a National Trauma Data Bank sample between 2007 to 2019 and 2013 to 2016, respectively. Our institutional sample was matched 1:1 to an American College of Surgeons National Trauma Databank sample using propensity score matching based on age, sex, mechanism of injury, and abdominal Abbreviated Injury Scale score. The primary outcome was time to laparotomy incision. Secondary outcomes included blood transfusion requirement, intensive care unit (ICU) length of stay (LOS), ventilator days, hospital LOS, and in-hospital mortality. RESULTS Two hundred forty patients were included (120 institutional, 120 national). Both samples were well balanced, and 83.3% sustained penetrating trauma. There were 84.2% young adults between the ages of 15 and 47, 91.7% were male, 47.5% Black/African American, with a median Injury Severity Score of 14 (interquartile range [IQR], 8–29), Glasgow Coma Scale score of 15 (IQR, 13–15), 71.7% had an systolic blood pressure of >90 mm Hg, and had a shock index of 0.9 (IQR, 0.7–1.1) which did not differ between groups (p > 0.05). Treatment in the EDOR was associated with decreased time to incision (25.5 minutes vs. 40 minutes; p ≤ 0.001), ICU LOS (1 vs. 3.1 days; p View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Artificial Enamel – Stronger and Durable finds other uses beyond Medicine

alexandrossfakianakis shared this article with you from Inoreader Artificial Enamel – Stronger and Durable finds other uses beyond Medicine Via Junior Dentist Researchers have successfully designed artificial Enamel in their lab, which might not be used in repairing or replacing lost Enamel on natural teeth but can be used in other areas beyond medicine. Artificial Enamel can be used in creating Body armor, stronger body for Vehicles, hardening surfaces of many appliances and even in building materials which can help in protecting against Earthquakes as wel l. The Artificial or Lab grown Enamel has been found to out perform the natural enamel in six different areas such as Elasticity, absorbing vibrations, strength etc. Scientists Develop Gel which repairs Damaged Enamel Enamel is a Complex structure and to replicate it and mimic all its properties is a big step in the right direction. Natural Enamel is the hardest tissue in the human body which is strong enough to not crack on applying hard forces for lifetime and also elastic enough to bear all types of forces. Natural Enamel has many nested modes of organization like wool fibers spun into yarn and then knitted in to a cable knit sweater, Calcium, phosphorus and oxygen atoms must come together in a complex repeating pattern to form crystalline wires. To achieve artificial enamel structure, researchers used extreme temperature to arrange the wires in an orderly formation to achieve the required arrangement. Earlier scientists unsuccessfully used peptides - short chains of amino acids which help in building proteins to mimic enamel. With the new attempt Researchers used malleable metal based coating to encase the wires to give extra strength According to Nicholas Kotov, a chemical engineer at the University of Michigan, Ann Arbor, said - What makes the artificial Enamel more like Natural Enamel is the coating on the crystalline wires which makes the Artificial Enamel more resilient and less likely to break, the soft material covering the wires can absorb high amount of pressures and shock. The magnesium rich coating of the Natural Enamel has been replaced with Zirconium Oxide giving it more strength and also non toxic. The use of these materials helped in achieving a material which was hard and could be cut into desired shapes using a diamond based saw. The team of Researchers have tested the hardness and elasticity of the new Artificial Enamel material by making a small notch on the surface and applied pressure on it until it gave in and formed a fracture. The toughness of the material was determined by seeing the pressure applied and the length of the crack, it also helped in determining the strain resistance of the enamel. The researchers even tried Artificial Enamel against Natural Enamel where the results where in favor of lab grown enamel outperforming the Natural one. The cells (Ameloblasts) which form Enamel die as soon as the tooth emerges from the gums hence Enamel cannot repair itself. Most dental visits are due to Caries in the Enamel and n neglecting, it might lead to tooth loss as well. To replace damaged Enamel, Dentists use artificial filling materials such as GIC, Composite, Dental Amalgam, etc which do not have the same properties such as Natural Enamel to withstand the Oral forces for decades. Use of this Artificial Enamel in repairing natural Enamel might still take some time as bonding Artificial Enamel to Natural Enamel needs to first heated to 300 degrees C first, Frozen and then cut into the required shape which is not so easy in a Clinical practice. References:  Science.org View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single nucleotide polymorphisms as a predisposing factor for the development of apical periodontitis ‐ an umbrella review

alexandrossfakianakis shared this article with you from Inoreader Single nucleotide polymorphisms as a predisposing factor for the development of apical periodontitis ‐ an umbrella review Via International Endodontic Journal Abstract Background The interaction between heredity and different environmental factors in the modification of apical periodontitis (AP) susceptibility and prediction of its progression remain poorly elucidated. Objectives This umbrella review aimed to (i) analyse the available relevant systematic reviews in an attempt to determine the association between genotype and allelic distribution of different single nucleotide polymorphisms (SNPs) and the development of AP, (ii) report deficiencies and gaps in knowledge in this area, and (iii) present recommendations to conduct future clinical studies and systematic reviews. Methods A literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Database of Systematic Reviews, from inception to October 2021, with no language restrictions, including a grey literature search. Systematic reviews with/without meta-analysis evaluating genotype and allelic distribution of different SNPs between adult patients with/ without AP were included. All other type of studies were excluded. The methodological quality was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) - 2 tool. Two independent reviewers were involved in study selection, data extraction, and appraising the included reviews; disagreements were resolved by a third reviewer. Results The current study includes five systematic reviews. Three reviews performed meta-analysis. Three reviews were graded by AMSTAR 2 as 'critically low' quality, whereas other two were graded as 'low' and 'moderate' quality. Two reviews indicated that carriers of specific genotypes and alleles of tumour necrosis factor – alpha (TNF-α) -308 G>A and interleukin 1-beta (IL-1β) +3954 C/T gene polymorphisms are more susceptible to an acute and persistent form of AP. However, high heterogeneity was observed. Discussion The statistical heterogeneity within included systematic reviews was a consequence of clinical and methodological diversity amongst primary studies. Although some of included reviews suggested that carriers of specific genotype and/or allele of TNF-α -308 G>A and IL-1β +3954 C/T SNPs are more susceptible to AP, their conclusions should be interpreted with caution. Conclusions No candidate genes could be identified as a definitive genetic risk or protective factor for the development and progression of AP, and further high-quality genome-wide association studies are warranted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic and therapeutic significance of XPO1 in T-cell lymphoma

alexandrossfakianakis shared this article with you from Inoreader Prognostic and therapeutic significance of XPO1 in T-cell lymphoma Via ScienceDirect Publication: Experimental Cell Research Publication date: Available online 27 April 2022 Source: Experimental Cell Research Author(s): Danian Nie, Xiaohui Xiao, Jiaoting Chen, Shuangfeng Xie, Jie Xiao, Wenjuan Yang, Hongyun Liu, Jieyu Wang, Liping Ma, Yumo Du, Kezhi Huang, Yiqing Li View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Airflow patterns in double occupancy patient rooms may contribute to roommate-to-roommate transmission of severe acute respiratory syndrome coronavirus 2

alexandrossfakianakis shared this article with you from Inoreader Airflow patterns in double occupancy patient rooms may contribute to roommate-to-roommate transmission of severe acute respiratory syndrome coronavirus 2 Via Clinical Infectious Diseases Advance Access Abstract Background Hospitalized patients are at risk to acquire severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from roommates with unrecognized coronavirus disease 2019 (COVID-19). We hypothesized that airflow patterns might contribute to SARS-CoV-2 transmission in double occupancy patient rooms. Methods A device emitting condensed moisture was used to identify airflow patterns in double occupancy patient rooms. Simulations were conducted to assess transfer of fluorescent microspheres, 5% sodium chloride aerosol, and aerosolized bacteriophage MS2 between patient beds 3 meters apart and to assess the effectiveness of privacy curtains and portable air cleaners in reducing transfer. Results Air flowed from inlet vents in the center of the room to an outlet vent near the door, resulting in air currents flowing toward the bed adjacent to the outlet vent. Fluorescent microspheres (212-250 µm diameter), 5% sodium chlor ide aerosol, and aerosolized bacteriophage MS2 released from the inner bed were carried on air currents toward the bed adjacent to the outlet vent. Closing curtains between the patient beds reduced transfer of each of the particles. Operation of a portable air cleaner reduced aerosol transfer to the bed adjacent to the outlet vent but did not offer a benefit over closing the curtains alone, and in some situations resulted in an increase in aerosol exposure. Conclusion Airflow patterns in double occupancy patient rooms may contribute to risk for transmission of SARS-CoV-2 between roommates. Keeping curtains closed between beds may be beneficial in reducing risk. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

gom1 Mutant Mice as a Model of Otitis Media

alexandrossfakianakis shared this article with you from Inoreader gom1 Mutant Mice as a Model of Otitis Media Via JARO - Journal of the Association for Research in Otolaryngology via MedWorm.com AbstractOtitis media (OM) disease is a common cause of hearing loss that is primarily the result of middle ear infection. At present, our understanding of the mechanisms leading to OM is limited due to the lack of animal models of OM with effusion (OME). Here, we report that the mice withgenetic otitis media one (gom1) mutants are prone to OM.gom1 Mice were produced by theN-ethyl-N-nitrosourea (ENU) mutagenesis program as an animal model to study OM. These mice demonstrate many common features of OM, such as middle ear effusion and hearing impairment. We revealed thatgom1 mice display various signs of middle ear and inner ear dysfunctions, including elevated thresholds of auditory-evoked brainstem response (ABR) and lack of cochlear microphonic responses. Decreased compliance in  tympanom... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Blinatumomab overcomes poor prognostic impact of measurable residual disease in pediatric high‐risk first relapse B‐cell precursor acute lymphoblastic leukemia

alexandrossfakianakis shared this article with you from Inoreader Blinatumomab overcomes poor prognostic impact of measurable residual disease in pediatric high‐risk first relapse B‐cell precursor acute lymphoblastic leukemia Via Pediatric Blood & Cancer Abstract Background Blinatumomab, a CD3/CD19 BiTE® (bispecific T cell engager) molecule, was superior to high-risk third course consolidation chemotherapy (HC3) in prolonging event-free survival (EFS) in children with high-risk first relapse B-cell precursor acute lymphoblastic leukemia (B-ALL). Here, we report results from a post hoc measurable residual disease (MRD) analysis of this phase 3 study (NCT02393859). Procedure Children >28 days and <18 years with high-risk first-relapse B-ALL in cytomorphological complete remission (M1 marrow, <5% blasts) or with M2 marrow (≥5% and <25% blasts) after induction and two cycles of high-risk consolidation chemotherapy (baseline) were enrolled in this trial. Patients received one cycle of blinatumomab (15 μg/m2/day, 4 weeks, continuous intravenous infusion) or HC3. The primary endpoint was EFS. In this post hoc analysis, patients with MRD <10–4 by PCR were grouped as having positive but not quantifiable (pbnq) or undetectable disease. Results A higher proportion of patients with MRD <10–4 had undetectable versus pbnq disease after blinatumomab (day 29) than after HC3 (p = 0.0367). Of the 22 patients with MRD ≥10–4 at baseline who achieved MRD remission after blinatumomab, 20 (91%) achieved MRD <10–4 remission by day 15. Patients treated with blinatumomab had improved EFS and overall survival compared with those treated with HC3 independent of end-of-induction or baseline (end-of-second consolidation) MRD levels. Conclusions Blinatumomab was more efficacious than HC3 regardless of MRD status before treatment. These data support the role of blinatumomab in inducing deep MRD remission, negating the poor prognostic value of MRD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.