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Carol L Clark, Thomas A Gibson, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Deborah B Diercks, Judd E Hollander, Bret A Nicks, Daniel K Nishijima, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
OBJECTIVE: An estimated 1.2 million annual emergency department (ED) visits for syncope/ near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED evaluation, but the prognostic value of index high-sensitivity troponin (hscTnT) and Natriuretic Peptide (NT-proBNP) are unclear. The objective of this study was to determine if hscTnT and NT-proBNP drawn in the ED are independently associated with 30-day death/ serious cardiac outcomes in adult patients presenting with syncope...
February 5, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Katherine W Turk, Andrew E Budson
PURPOSE OF REVIEW: This article provides a discussion on the current state of knowledge of chronic traumatic encephalopathy (CTE), with an emphasis on clinical features and emerging biomarkers of the condition. RECENT FINDINGS: The results of several large brain bank case series among subjects with a history of contact sports or repetitive head trauma have indicated that a high frequency of CTE may exist in this population. However, the true prevalence of CTE among individuals with a history of head trauma remains unknown, given that individuals who experienced cognitive, behavioral, and mood symptoms during life are more likely to have their brains donated for autopsy at death and epidemiologic studies of the condition are lacking...
February 2019: Continuum: Lifelong Learning in Neurology
Yan Cheng, Mandy Pereira, Neha Raukar, John L Reagan, Mathew Queseneberry, Laura Goldberg, Theodor Borgovan, W Curt LaFrance, Mark Dooner, Maria Deregibus, Giovanni Camussi, Bharat Ramratnam, Peter Quesenberry
Traumatic brain injury (TBI) is a common cause of death and acquired disability in adults and children. Identifying biomarkers for mild TBI (mTBI) that can predict functional impairments on neuropsychiatric and neurocognitive testing after head trauma is yet to be firmly established. Extracellular vesicles (EVs) are known to traffic from the brain to the oral cavity and can be detected in saliva. We hypothesize the genetic profile of salivary EVs in patients who have suffered head trauma will differ from normal healthy controls, thus constituting a unique expression signature for mTBI...
January 15, 2019: Journal of Cellular Physiology
Abraham Nilsson, Björn Alkner, Patrick Wetterlöv, Stefan Wetterstad, Lars Palm, Jörg Schilcher
BACKGROUND: The intense ischemic pain of acute compartment syndrome can be difficult to discriminate from the pain related to an associated fracture. Lacking objective measures, the decision to perform fasciotomy is often only based on clinical findings and performed at a low threshold. Biomarkers of muscle cell damage might help to identify and monitor patients at risk. In patients with fractures, however, markers of muscle cell damage could be elevated because of other reasons associated with the trauma, which would make interpretation difficult...
January 5, 2019: BMC Musculoskeletal Disorders
I Aydin, A Algin, M K Poyraz, O Yumrutas
Background: Glial fibrillary acidic protein (GFAP) is a brain-specific astroglial protein that is released into the blood soon after traumatic brain injury by mature astrocytes. S100B is rapidly released into the cerebrospinal fluid and bloodstream after brain damage. We compared the serum concentrations of these proteins in patients with severe head trauma (bleeding and/or fracture) or nontraumatic intracerebral hemorrhage and healthy individuals. Materials and Methods: The study included 63 patients (33 males and 30 females) with traumatic cerebral hemorrhage and/or cranial bone fractures or nontraumatic cerebral hemorrhage and 30 healthy control subjects...
December 2018: Nigerian Journal of Clinical Practice
Michael Kellner, Christoph Muhtz, Åsa Weinås, Stjepan Ćurić, Alexander Yassouridis, Klaus Wiedemann
While the impact of childhood trauma on basal and dynamic cortisol regulation has widely been studied, the most abundant steroid hormones dehydroepiandrosterone (DHEA) and its sulphated derivative DHEA-S have received little attention in this context. One-hundred in-door patients suffering from major depression or an anxiety disorder filled in the Childhood Trauma Questionaire. A low dose dexamethasone suppression test (DST) measuring DHEA, DHEA-S and cortisol was performed. Furthermore, various cardiovascular risk parameters were measured...
December 2018: Psychiatry Research
Tie-Jiang Chen, Ming-Xia Ji, Zhi-Qiang Tao, Qing-Yang Fu, Kai Xiong, Bin Cheng
BACKGROUND: Fibrinogen-like protein 2 (FGL2) is an inflammatory procoagulant protein. We discerned the impact of serum FGL2 on trauma severity and 30-day mortality in patients with traumatic brain injury (TBI). METHODS: A total of 114 severe TBI patients were subjected to assessment of trauma severity using the Glasgow coma scale (GCS). Measurement of the serum concentrations of FGL2 was done. 114 matched control subjects for their age and sex were included for comparison of serum concentration of FGL2...
February 2019: Clinica Chimica Acta; International Journal of Clinical Chemistry
Jessica Gill, Lawrence Latour, Ramon Diaz-Arrastia, Vida Motamedi, Christine Turtzo, Pashtun Shahim, Stefania Mondello, Christina DeVoto, Eliseo Veras, David Hanlon, Linan Song, Andreas Jeromin
OBJECTIVES: To determine whether a panel of blood-based biomarkers can discriminate between patients with suspected mild traumatic brain injury (mTBI) with and without neuroimaging findings (CT and MRI). METHODS: Study participants presented to the emergency department with suspected mTBI (n = 277) with a CT and MRI scan and healthy controls (n = 49). Plasma concentrations of tau, glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase L1, and neurofilament light chain (NFL) were measured using the single-molecule array technology...
October 9, 2018: Neurology
Divya Mehta, Joanne Voisey, Dagmar Bruenig, Wendy Harvey, Charles P Morris, Bruce Lawford, Ross McD Young
BACKGROUND: Posttraumatic stress disorder (PTSD) is a serious condition that emerges following trauma exposure and involves long-lasting psychological suffering and health-issues. Uncovering critical genes and molecular networks is essential to understanding the biology of the disorder. We performed a genome-wide scan to identify transcriptome signatures of PTSD. METHODS: Genome-wide peripheral blood transcriptomic data from 380 service personnel were investigated...
September 4, 2018: Brain, Behavior, and Immunity
G M Mandolini, M Lazzaretti, A Pigoni, G Delvecchio, J C Soares, P Brambilla
BACKGROUND: Converging lines of evidence suggest that Brain-Derived Neurotrophic Factor (BDNF) may play a central role in the pathogenesis of Bipolar Disorder (BD), thus representing a valid biomarker of the disease. A common genetic variation in the BDNF gene, the Val66Met, is associated with reduced maturation and secretion of BDNF and therefore it has been related to specific mood, cognitive and neuroanatomical alterations in BD. However, so far, only a handful of studies have investigated the association between Val66Met polymorphism and cognitive functioning in BD...
July 24, 2018: Journal of Affective Disorders
Norman J Galbraith, Stephen J O'Brien, Samuel P Walker, Sarah A Gardner, Hiram C Polk, Stephen L Barnes
BACKGROUND: Severe injury can lead to immune dysfunction and predispose patients to infection and death. Micro-RNAs regulate gene expression and may act as biomarkers for susceptibility to infection. The aim of this study was to examine the temporal and differential expression of previously identified dysregulated micro-RNAs in patients with severe injury. METHODS: Fourteen severely injured patients requiring transfusion were enrolled prospectively in this study approved by our institutional review board...
October 2018: Surgery
Juan P Jiménez, Alberto Botto, Luisa Herrera, Caroline Leighton, José L Rossi, Yamil Quevedo, Jaime R Silva, Felipe Martínez, Rodrigo Assar, Luis A Salazar, Manuel Ortiz, Ulises Ríos, Paulina Barros, Karina Jaramillo, Patrick Luyten
Recent research in psychiatric genetics has led to a move away from simple diathesis-stress models to more complex models of psychopathology incorporating a focus on gene-environment interactions and epigenetics. Our increased understanding of the way biology encodes the impact of life events on organisms has also generated more sophisticated theoretical models concerning the molecular processes at the interface between "nature" and "nurture." There is also increasing consensus that psychotherapy entails a specific type of learning in the context of an emotional relationship (i...
2018: Frontiers in Genetics
Amith Shetty, Sebastian Sparenberg, Kristian Adams, Selwyn Selvedran, Benjamin Tang, Kim Hanna, Jonathan Iredell
OBJECTIVE: The arterial to end-tidal carbon dioxide tension difference (CO2 gap) correlates with physiologic dead space. The prognostic value of increased CO2 gap in trauma and respiratory distress patients is documented. Transpulmonary arteriovenous shunting is identified as a predictor of mortality in non-pulmonary sepsis. We set out to investigate the prognostic value of the CO2 gap in a pilot study of patients with suspected sepsis from non-respiratory causes. METHODS: Patients presenting to tertiary Australian ED with suspected sepsis (n = 215) underwent near-simultaneous end-tidal carbon dioxide and partial pressure of carbon dioxide measurements...
December 2018: Emergency Medicine Australasia: EMA
Alison B Rushton, David W Evans, Nicola Middlebrook, Nicola R Heneghan, Charlotte Small, Janet Lord, Jaimin M Patel, Deborah Falla
INTRODUCTION: Pain is an expected and appropriate experience following traumatic musculoskeletal injury. By contrast, chronic pain and disability are unhelpful yet common sequelae of trauma-related injuries. Presently, the mechanisms that underlie the transition from acute to chronic disabling post-traumatic pain are not fully understood. Such knowledge would facilitate the development and implementation of precision rehabilitation approaches that match interventions to projected risk of recovery, with the aim of preventing poor long-term outcomes...
April 28, 2018: BMJ Open
S He, M Blombäck, F Boström, H Wallen, J Svensson, A Östlund
Acute traumatic coagulopathy (ATC) diagnosed by prolongation of APTT and/or PT/INR involves alterations in platelet activity, coagulation and fibrinolysis. However, data showing the haemostatic situation in injured patients without ATC are scarce. To assess whether haemostatic impairment is also present in injured patients without ATC, ten injured patients without ATC and ten normal individuals were examined. The patients were sampled on arrival at the emergency department 0, 2, 12 h after surgical or other intervention...
May 2018: Journal of Thrombosis and Thrombolysis
Nikolaos P Daskalakis, Allison C Provost, Richard G Hunter, Guia Guffanti
Posttraumatic stress disorder (PTSD) is a pathologic response to trauma that impacts ∼8% of the population and is highly comorbid with other disorders, such as traumatic brain injury. PTSD affects multiple biological systems throughout the body, including the hypothalamic-pituitary-adrenal axis, cortical function, and the immune system, and while the study of the biological underpinnings of PTSD and related disorders are numerous, the roles of noncoding RNAs (ncRNAs) are just emerging. Moreover, deep sequencing has revealed that ncRNAs represent most of the transcribed mammalian genome...
May 15, 2018: Biological Psychiatry
John Eppensteiner, Robert Patrick Davis, Andrew S Barbas, Jean Kwun, Jaewoo Lee
Despite significant improvements in injury prevention and emergency response, injury-related death and morbidity continues to increase in the US and worldwide. Patients with trauma, invasive operations, anti-cancer treatment, and organ transplantation produce a host of danger signals and high levels of pro-inflammatory and pro-thrombotic mediators, such as damage-associated molecular patterns (DAMPs) and extracellular vesicles (EVs). DAMPs (e.g., nucleic acids, histone, high-mobility group box 1 protein, and S100) are molecules released from injured, stressed, or activated cells that act as endogenous ligands of innate immune receptors, whereas EVs (e...
2018: Frontiers in Immunology
Hasan Buyukaslan, Umut Gulacti, Mehmet Tahir Gökdemir, Ramazan Giden, Hakim Celik, Özcan Erel, Erman Mustafa Dörterler
BACKGROUND: Gunshot injuries result in serious traumatic tissue damage due to high velocity of the bullet, deep penetration, and ballistic effect. Trauma is known to be related with oxidative stress. Serum thiol levels and disulphide/thiol homeostasis are novel oxidative stress biomarkers. In this study, we aimed to investigate serum thiol levels and disulphide/thiol homeostasis in injury patterns of patients admitted to the emergency department with a gunshot injury. METHOD: A total of 128 participants were included in the study...
January 11, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Simona I Chisalita, Lee Ti Chong, Maciej Wajda, Lars Adolfsson, Mischa Woisetschläger, Anna Spångeus
OBJECTIVE: Elderly patients suffer fractures through low-energy mechanisms. The distal radius is the most frequent fracture localization. Insulin-like growth factor-1 (IGF1) plays an important role in the maintenance of bone mass and its levels decline with advancing age and in states of malnutrition. Our aim was to investigate the association of IGF1 levels, bone mass, nutritional status, and inflammation to low-energy distal radius fractures and also study if fracture healing is influenced by IGF1, nutritional status, and inflammation...
November 2017: Orthopaedic Surgery
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
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