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  • 1
    Online Resource
    Online Resource
    Broad vs Narrow Spectrum Antibiotics in Common Bile Duct Stones: A Post Hoc Analysis of an Eastern Association for the Surgery of Trauma Multicenter Study
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American College of Surgeons Vol. 235, No. 3 ( 2022-09), p. 411-419
    Details
    In: Journal of the American College of Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 235, No. 3 ( 2022-09), p. 411-419
    Abstract: Antimicrobial guidance for common bile duct stones during the perioperative period is limited. We sought to examine the effect of broad-spectrum (BS) vs narrow-spectrum (NS) antibiotics on surgical site infections (SSIs) in patients with common bile duct stones undergoing same-admission cholecystectomy. STUDY DESIGN: We performed a post hoc analysis of a prospective, observational, multicenter study of patients undergoing same-admission cholecystectomy for choledocholithiasis and/or acute biliary pancreatitis between 2016 and 2019. We excluded patients with cholangitis, perforated cholecystitis, and nonbiliary infections on admission. Patients were divided based on receipt of BS or NS antibiotics. Our primary outcome was the incidence of SSIs, and secondary outcomes included hospital length of stay, acute kidney injury (AKI), and 30-day readmission for SSI. RESULTS: The cohort had 891 patients: 51.7% (n= 461) received BS antibiotics and 48.3% (n = 430) received NS antibiotics. Overall antibiotic duration was longer in the BS group than in the NS group (6 vs 4 d, p = 0.01); however, there was no difference in rates of SSI (0.9% vs 0.5%, p = 0.7) or 30-day readmission for SSI (1.1% vs 1.2%, p = 1.0). Hospital length of stay was significantly longer in the BS group (p 〈 0.001) as were rates of AKI (5% vs 1.4%, p = 0.001). On multivariable regression, BS antibiotic use was a risk factor for AKI (adjusted odds ratio 2.8, 95% CI 1.16 to 7.82, p = 0.02). CONCLUSION: The incidence of SSI and 30-day readmission for SSI was similar between antibiotic groups. However, BS antibiotic use was associated with a longer hospitalization and greater likelihood of AKI.
    Type of Medium: Online Resource
    ISSN: 1072-7515
    URL: Article
    DOI: 10.1097/XCS.0000000000000259
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Platelet dysfunction in injured patients
    River Publishers ; 2014
    In:  Molecular and Cellular Therapies Vol. 2, No. 1 ( 2014-12)
    Details
    In: Molecular and Cellular Therapies, River Publishers, Vol. 2, No. 1 ( 2014-12)
    Type of Medium: Online Resource
    ISSN: 2052-8426
    URL: Article
    DOI: 10.1186/s40591-014-0037-8
    Language: English
    Publisher: River Publishers
    Publication Date: 2014
    detail.hit.zdb_id: 2740988-0
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  • 3
    Online Resource
    Online Resource
    Regulatory challenges in conducting human subjects research in emergency settings: the National Trauma Research Action Plan (NTRAP) scoping review
    BMJ ; 2023
    In:  Trauma Surgery & Acute Care Open Vol. 8, No. 1 ( 2023-03), p. e001044-
    Details
    In: Trauma Surgery & Acute Care Open, BMJ, Vol. 8, No. 1 ( 2023-03), p. e001044-
    Abstract: The complexity of the care environment, the emergent nature, and the severity of patient injury make conducting clinical trauma research challenging. These challenges hamper the ability to investigate potentially life-saving research that aims to deliver pharmacotherapeutics, test medical devices, and develop technologies that may improve patient survival and recovery. Regulations intended to protect research subjects impede scientific advancements needed to treat the critically ill and injured and balancing these regulatory priorities is challenging in the acute setting. This scoping review attempted to systematically identify what regulations are challenging in conducting trauma and emergency research. A systematic search of PubMed was performed to identify studies published between 2007 and 2020, from which 289 articles that address regulatory challenges in conducting research in emergency settings were included. Data were extracted and summarized using descriptive statistics and a narrative synthesis of the results. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Most articles identified were editorial/commentary (31%) and published in the USA (49%). Regulatory factors addressed in the papers were categorized under 15 regulatory challenge areas: informed consent (78%), research ethics (65%), institutional review board (55%), human subjects protection (54%), enrollment (53%), exception from informed consent (51%), legally authorized representative (50%), patient safety (41%), community consultation (40%), waiver of informed consent (40%), recruitment challenges (39%), patient perception (30%), liability (15%), participant incentives (13%), and common rule (11%). We identified several regulatory barriers to conducting trauma and emergency research. This summary will support the development of best practices for investigators and funding agencies.
    Type of Medium: Online Resource
    ISSN: 2397-5776
    URL: Article
    DOI: 10.1136/tsaco-2022-001044
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2856913-1
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  • 4
    Online Resource
    Online Resource
    D-Dimer and Fibrin Degradation Products Impair Platelet Signaling: Plasma D-Dimer Is a Predictor and Mediator of Platelet Dysfunction During Trauma
    Oxford University Press (OUP) ; 2020
    In:  The Journal of Applied Laboratory Medicine Vol. 5, No. 6 ( 2020-11-01), p. 1253-1264
    Details
    In: The Journal of Applied Laboratory Medicine, Oxford University Press (OUP), Vol. 5, No. 6 ( 2020-11-01), p. 1253-1264
    Abstract: Platelet dysfunction often accompanies trauma-induced coagulopathy. Because soluble fibrin impairs platelet glycoprotein VI (GPVI) signaling and platelets of trauma patients can display impaired calcium mobilization, we explored the role of fibrinolysis on platelet dysfunction during trauma. Methods Convulxin-induced GPVI calcium mobilization was investigated in healthy platelet-rich plasma (PRP) pretreated with thrombin and tissue plasminogen activator (tPA). Blood samples from healthy participants (n = 7) and trauma patients (n = 22) were tested for platelet calcium mobilization, plasma D-dimer, platelet D-dimer binding (via flow cytometry), and platelet lumi-aggregometry. Results For healthy platelets, maximal platelet dysfunction was observed when cross-linked soluble fibrin (no tPA) or cross-linked fibrin degradation products (FDPs) were generated in suspension before convulxin stimulation. Lack of fibrin polymerization (inhibited by Gly-Pro-Arg-Pro [GPRP]) or lack of factor XIIIa cross-linking (T101-inhibited) restored GPVI signaling, whereas non–cross-linked FDPs only partially blocked signaling induced by convulxin. In addition, D-dimer added to healthy PRP impaired platelet aggregation and dense granule release induced by various agonists. Plasma D-dimer level was strongly correlated (R = 0.8236) with platelet dysfunction as measured by platelet calcium mobilization induced with various agonists. By 48 to 120 h after trauma, plasma D-dimer levels declined, and platelet function increased significantly but not to healthy levels. Trauma platelets displayed elevated D-dimer binding tha t was only partially reduced by αIIbβ3-inhibitor GR144053. After 60-minute incubation, washed healthy platelets resuspended in plasma from trauma patients captured approximately 10 000 D-dimer equivalents per platelet. Conclusions During trauma, D-dimer and FDPs inhibit platelets, potentially via GPVI and integrin αIIbβ3 engagement, contributing to a fibrinolysis-dependent platelet loss-of-function phenotype.
    Type of Medium: Online Resource
    ISSN: 2576-9456 , 2475-7241
    URL: Article
    DOI: 10.1093/jalm/jfaa047
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    MONITORING SKELETAL MUSCLE AND SUBCUTANEOUS TISSUE ACID-BASE STATUS AND OXYGENATION DURING HEMORRHAGIC SHOCK AND RESUSCITATION
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Shock Vol. 24, No. 3 ( 2005-09), p. 270-275
    Details
    In: Shock, Ovid Technologies (Wolters Kluwer Health), Vol. 24, No. 3 ( 2005-09), p. 270-275
    Type of Medium: Online Resource
    ISSN: 1073-2322
    URL: Article
    DOI: 10.1097/01.shk.0000172364.89128.28
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 2011863-6
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  • 6
    Online Resource
    Online Resource
    Mutualism with sea anemones triggered the adaptive radiation of clownfishes
    Springer Science and Business Media LLC ; 2012
    In:  BMC Evolutionary Biology Vol. 12, No. 1 ( 2012-12)
    Details
    In: BMC Evolutionary Biology, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2012-12)
    Abstract: Adaptive radiation is the process by which a single ancestral species diversifies into many descendants adapted to exploit a wide range of habitats. The appearance of ecological opportunities, or the colonisation or adaptation to novel ecological resources, has been documented to promote adaptive radiation in many classic examples. Mutualistic interactions allow species to access resources untapped by competitors, but evidence shows that the effect of mutualism on species diversification can greatly vary among mutualistic systems. Here, we test whether the development of obligate mutualism with sea anemones allowed the clownfishes to radiate adaptively across the Indian and western Pacific oceans reef habitats. Results We show that clownfishes morphological characters are linked with ecological niches associated with the sea anemones. This pattern is consistent with the ecological speciation hypothesis. Furthermore, the clownfishes show an increase in the rate of species diversification as well as rate of morphological evolution compared to their closest relatives without anemone mutualistic associations. Conclusions The effect of mutualism on species diversification has only been studied in a limited number of groups. We present a case of adaptive radiation where mutualistic interaction is the likely key innovation, providing new insights into the mechanisms involved in the buildup of biodiversity. Due to a lack of barriers to dispersal, ecological speciation is rare in marine environments. Particular life-history characteristics of clownfishes likely reinforced reproductive isolation between populations, allowing rapid species diversification.
    Type of Medium: Online Resource
    ISSN: 1471-2148
    URL: Article
    DOI: 10.1186/1471-2148-12-212
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
    detail.hit.zdb_id: 2041493-6
    detail.hit.zdb_id: 3053924-9
    SSG: 12
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  • 7
    Online Resource
    Online Resource
    Comparing the 2010 and 2019 American Society of Gastrointestinal Endoscopy Guidelines for Predicting Choledocholithiasis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American College of Surgeons Vol. 235, No. 5 ( 2022-11), p. S51-S51
    Details
    In: Journal of the American College of Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 235, No. 5 ( 2022-11), p. S51-S51
    Type of Medium: Online Resource
    ISSN: 1072-7515
    URL: Article
    DOI: 10.1097/01.XCS.0000896104.96312.68
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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