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  1 / 62219 MEDLINE  
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[PMID]:29231023
[Au] Autor:Zhang WL; Du YL
[Ad] Endereço:Criminal Technology Branch, Agricultural Areas Public Security Bureau, Harbin 150038, China.
[Ti] Título:[Analysis on the Injury Mechanism and Characteristics of Ox Horn].
[So] Source:Fa Yi Xue Za Zhi;33(2):162-164, 2017 Apr.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To study the morphological characteristics of the injury caused by ox horn on human body and its injury mechanism, and to discuss the rules and characteristics of injury by ox horn and provide forensic evidences for identification of such cases. METHODS: The comparative analysis of position and morphological characteristics were performed by summarizing the data of 100 victims gored by ox accepted by Heilongjiang agricultural areas public security bureau during 2004-2014. RESULTS: The specific injuries only could be found at the contact positions such as thorax and abdomen, lower back and limbs of the victims gored by ox horn. Most of the skin wounds had the characteristics of sharp injuries, the bar-type injury by club which called "rail way bruise" was an obvious characteristic appeared on the soft tissue. CONCLUSIONS: Ox horn can cause non-specific injuries on thorax and abdomen, lower back and limbs of human body, which are similar with the characteristics of sharp injury and injury by club. Careful analyzation and identification should be performed on such injury in daily work.
[Mh] Termos MeSH primário: Traumatismos Abdominais/etiologia
Tórax
Ferimentos e Lesões/etiologia
Ferimentos Penetrantes
[Mh] Termos MeSH secundário: Animais
Bovinos
Feminino
Seres Humanos
Extremidade Inferior
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2017.02.011


  2 / 62219 MEDLINE  
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[PMID]:29205971
[Au] Autor:Wang LX; Zhu GL; Qi LQ; Sheng YY
[Ad] Endereço:Hangzhou Qiuzheng Judicial Identification, Hangzhou 311100, China.
[Ti] Título:[Analysis of the Injury-disease Relationship between Spondylolysis and Trauma in 26 Forensic Identifications].
[So] Source:Fa Yi Xue Za Zhi;32(6):434-437, 2016 Dec.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To expound the injury-disease relationship between spondylolysis and trauma for the points of forensic identification. METHODS: Total 26 cases of spondylolysis were collected and the characteristics of this disease such as age, accompanied symptoms, treatment and injury manner were discussed. RESULTS: The causal relationship existed between trauma and injury consequence in 2 appraised individuals and both of them aged less than 50 years old. The injury manners of both were high-energy injury with combined injury and these 2 patients were treated by operation. CONCLUSIONS: The analysis of injury-disease relationship between spondylolysis and trauma should be paid attention in the middle-young age under 50 years old. More importantly, the injury-disease relationship should be analyzed in the patients who chose operative treatment.
[Mh] Termos MeSH primário: Espondilólise/patologia
Ferimentos e Lesões/patologia
[Mh] Termos MeSH secundário: Patologia Legal
Seres Humanos
Meia-Idade
Espondilólise/cirurgia
Ferimentos e Lesões/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.06.010


  3 / 62219 MEDLINE  
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[PMID]:28742815
[Au] Autor:Xu J; Guardado J; Hoffman R; Xu H; Namas R; Vodovotz Y; Xu L; Ramadan M; Brown J; Turnquist HR; Billiar TR
[Ad] Endereço:Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
[Ti] Título:IL33-mediated ILC2 activation and neutrophil IL5 production in the lung response after severe trauma: A reverse translation study from a human cohort to a mouse trauma model.
[So] Source:PLoS Med;14(7):e1002365, 2017 Jul.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The immunosuppression and immune dysregulation that follows severe injury includes type 2 immune responses manifested by elevations in interleukin (IL) 4, IL5, and IL13 early after injury. We hypothesized that IL33, an alarmin released early after tissue injury and a known regulator of type 2 immunity, contributes to the early type 2 immune responses after systemic injury. METHODS AND FINDINGS: Blunt trauma patients admitted to the trauma intensive care unit of a level I trauma center were enrolled in an observational study that included frequent blood sampling. Dynamic changes in IL33 and soluble suppression of tumorigenicity 2 (sST2) levels were measured in the plasma and correlated with levels of the type 2 cytokines and nosocomial infection. Based on the observations in humans, mechanistic experiments were designed in a mouse model of resuscitated hemorrhagic shock and tissue trauma (HS/T). These experiments utilized wild-type C57BL/6 mice, IL33-/- mice, B6.C3(Cg)-Rorasg/sg mice deficient in group 2 innate lymphoid cells (ILC2), and C57BL/6 wild-type mice treated with anti-IL5 antibody. Severely injured human blunt trauma patients (n = 472, average injury severity score [ISS] = 20.2) exhibited elevations in plasma IL33 levels upon admission and over time that correlated positively with increases in IL4, IL5, and IL13 (P < 0.0001). sST2 levels also increased after injury but in a delayed manner compared with IL33. The increases in IL33 and sST2 were significantly greater in patients that developed nosocomial infection and organ dysfunction than similarly injured patients that did not (P < 0.05). Mechanistic studies were carried out in a mouse model of HS/T that recapitulated the early increase in IL33 and delayed increase in sST2 in the plasma (P < 0.005). These studies identified a pathway where IL33 induces ILC2 activation in the lung within hours of HS/T. ILC2 IL5 up-regulation induces further IL5 expression by CXCR2+ lung neutrophils, culminating in early lung injury. The major limitations of this study are the descriptive nature of the human study component and the impact of the potential differences between human and mouse immune responses to polytrauma. Also, the studies performed did not permit us to make conclusions about the impact of IL33 on pulmonary function. CONCLUSIONS: These results suggest that IL33 may initiate early detrimental type 2 immune responses after trauma through ILC2 regulation of neutrophil IL5 production. This IL33-ILC2-IL5-neutrophil axis defines a novel regulatory role for ILC2 in acute lung injury that could be targeted in trauma patients prone to early lung dysfunction.
[Mh] Termos MeSH primário: Regulação da Expressão Gênica
Imunidade Humoral
Interleucina-33/metabolismo
Interleucina-5/genética
Linfócitos/imunologia
Ferimentos e Lesões/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Animais
Estudos de Coortes
Modelos Animais de Doenças
Feminino
Seres Humanos
Interleucina-33/sangue
Interleucina-5/imunologia
Pulmão/imunologia
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Meia-Idade
Estudos Retrospectivos
Choque Hemorrágico/complicações
Choque Hemorrágico/imunologia
Ferimentos e Lesões/etiologia
Ferimentos e Lesões/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (IL33 protein, human); 0 (Il33 protein, mouse); 0 (Interleukin-33); 0 (Interleukin-5)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002365


  4 / 62219 MEDLINE  
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[PMID]:28464812
[Au] Autor:Murgatroyd D; Harris IA; Chen JS; Adie S; Mittal R; Cameron ID
[Ad] Endereço:John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia. dmur0062@uni.sydney.edu.au.
[Ti] Título:Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries.
[So] Source:BMC Musculoskelet Disord;18(1):177, 2017 05 02.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Compensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers' compensation schemes. METHODS: Participants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months. Analysis involved: descriptive statistics for baseline characteristics; comparison of compensable and non-compensable participants with Analysis of Variance (ANOVA) and chi-squared tests; and logistic regression for predictor models. RESULTS: The cohort consisted of 452 participants with a mean age 40 years; 75% male; 74% working pre-injury; 30% in excellent pre-injury health; 56% sustained serious injuries with an Injury Severity Score (ISS) 9-15; 61% had a low-middle range household income; and 35% self-reported at fault in the crash. There was no significant difference in pre-injury/baseline health between compensable and non-compensable participants. Follow up data was available for 301 (67%) participants. The significant predictor of claiming compensation in the adjusted analysis was higher body mass index (BMI) (overweight Odds Ratio [OR] 3.05, 95% Confidence Interval [CI] 1.63-5.68; obese OR 1.63, 95% CI 0.83-3.20). Participants less likely to claim were: involved in a motorcycle crash (OR 0.47, 95% CI 0.28-0.82); socioeconomically less disadvantaged (OR 0.37, 95% CI 0.17-0.82) or least disadvantaged (OR 0.39, 95% CI 0.17-0.90); at risk for short term harm (injury) due to alcohol consumption (OR 0.56, 95% CI 0.32-0.97); and with fair-poor pre-injury health (OR 0.30, 95% CI 0.09-0.94). The predictors for seeking legal representation were speaking a language other than English at home (OR 2.80, 95% CI 1.2-6.52) and lower household income (OR 3.63, 95% CI 1.22-10.72). Participants less likely to seek legal representation were least socioeconomically disadvantaged (OR 0.15, 95% CI 0.04-0.50). CONCLUSIONS: Seeking financial compensation was associated with a higher pre-injury BMI rather than injury-related factors. Seeking legal representation was solely related to socio-economic factors.
[Mh] Termos MeSH primário: Acidentes de Trânsito/economia
Compensação e Reparação
Sistema Musculoesquelético/lesões
Ferimentos e Lesões/economia
[Mh] Termos MeSH secundário: Acidentes de Trânsito/legislação & jurisprudência
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Automóveis
Índice de Massa Corporal
Compensação e Reparação/legislação & jurisprudência
Grupos Étnicos
Feminino
Seres Humanos
Renda
Serviços Jurídicos
Masculino
Meia-Idade
Motocicletas
New South Wales
Recuperação de Função Fisiológica
Fatores Socioeconômicos
Populações Vulneráveis
Ferimentos e Lesões/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1535-z


  5 / 62219 MEDLINE  
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[PMID]:28455618
[Au] Autor:Vogl TJ; Eichler K; Marzi I; Wutzler S; Zacharowski K; Frellessen C
[Ad] Endereço:Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland. T.Vogl@em.uni-frankfurt.de.
[Ti] Título:[Imaging techniques in modern trauma diagnostics].
[Ti] Título:Bildgebende Verfahren der modernen Schockraumdiagnostik..
[So] Source:Unfallchirurg;120(5):417-431, 2017 May.
[Is] ISSN:1433-044X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Modern trauma room management requires interdisciplinary teamwork and synchronous communication between a team of anaesthesists, surgeons and radiologists. As the length of stay in the trauma room influences morbidity and mortality of a severely injured person, optimizing time is one of the main targets. With the direct involvement of modern imaging techniques the injuries caused by trauma should be detected within a very short period of time in order to enable a priority-orientated treatment. Radiology influences structure and process quality, management and development of trauma room algorithms regarding the use of imaging techniques. For the individual case interventional therapy methods can be added. Based on current data and on the Frankfurt experience the current diagnostic concepts of trauma diagnostics are presented.
[Mh] Termos MeSH primário: Cuidados Críticos/métodos
Aumento da Imagem/métodos
Radiologia/tendências
Traumatologia/tendências
Ferimentos e Lesões/diagnóstico por imagem
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s00113-017-0352-z


  6 / 62219 MEDLINE  
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[PMID]:29489652
[Au] Autor:Cho HJ; Hong TH; Kim M
[Ad] Endereço:Department of Trauma Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
[Ti] Título:Physical and nutrition statuses of geriatric patients after trauma-related hospitalization: Data from the Korean National Health and Nutrition Examination Survey 2013-2015.
[So] Source:Medicine (Baltimore);97(9):e0034, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Population aging is associated with increasing numbers of geriatric trauma patients, and various studies have evaluated their short-term outcomes, assessment, and treatment. However, there is insufficient information regarding their long-term outcomes. This study evaluated the physical and nutritional statuses of geriatric patients after trauma-related hospitalization.Data regarding physical and nutritional status were obtained from the Korean National Health and Nutrition Examination Survey VI (2013-2015).A total of 21,069 individuals participated in the survey, including 5650 geriatric individuals. After excluding individuals with missing data, 3731 cases were included in the analyses. The average age was 68 years, and most individuals were women (n = 2055, 55.08%). There were 94 patients had been hospitalized because of trauma. Trauma-related hospitalization among geriatric patients was significantly associated with reduced strength exercise (23.56% vs 12.99%, P = .043), activity limitations caused by joint pain (0.65% vs 3.31%, P = .028), self-care problems (8.00% vs 16.77%, P = .008), pain or discomfort (29.48% vs 40.51%, P = .024), hypercholesterolemia (27.37% vs 39.36%, P = .037), and mastication discomfort (39.98% vs 57.85% P = .005). The adjusted analyses revealed that trauma-related hospitalization was independently associated with activity limitations caused by joint pain (odds ratio [OR]: 5.04, 95% confidence interval [CI]: 1.29-19.67, P = .020), self-care problems (OR: 2.24, 95% CI: 1.11-4.53, P = .025), pain or discomfort (OR: 1.77, 95% CI: 1.08-2.89, P = .023), and mastication discomfort (OR: 2.06, 95% CI: 1.22-3.46, P = .007).Medical staff should be aware that geriatric patients have relatively poor physical and nutritional statuses after trauma-related hospitalization, and manage these patients accordingly.
[Mh] Termos MeSH primário: Avaliação Geriátrica
Nível de Saúde
Hospitalização
Estado Nutricional
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Estudos Transversais
Feminino
Seres Humanos
Masculino
Inquéritos Nutricionais
Qualidade de Vida
República da Coreia
Autocuidado
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010034


  7 / 62219 MEDLINE  
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[PMID]:29206822
[Au] Autor:Berrones-Sanz LD
[Ad] Endereço:Colegio de Ciencia y Tecnología, Universidad Autónoma de la Ciudad de México, Ciudad de México, México.
[Ti] Título:Analysis of accidents and injuries on motorcycles in Mexico.
[Ti] Título:Análisis de los accidentes y las lesiones de los motociclistas en México..
[So] Source:Gac Med Mex;153(6):662-671, 2017 Nov-Dec.
[Is] ISSN:0016-3813
[Cp] País de publicação:Mexico
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To analyze the type of injuries and the characteristics and geographical distribution of road accidents where motorcycles were involved in Mexico. METHODS: A descriptive analysis of second-hand information sources was conducted, including the number of accidents (N = 41,881), total number of injured people (N = 13,916) and medical expenses (N = 9,111) associated to motorcycle accidents during 2014. RESULTS: Motorcycles represent 13.14% of the total number of deaths in road accidents in Mexico, and the Southeast region of Mexico registers the highest proportion of fatal injuries. Of the total number of motorcycles, 1.84% (95% confidence interval [CI]: 1.83-1.86) were involved in a collision. 3.64 (95% CI: 3.39-3.89) people died and 105.5 (95% CI: 104.1-106.8) were injured in every 10,000. Out of the total number of injuries, 76.6% were male and 53.74% were women. 55.1% of deaths were caused by intracranial trauma. Only 16.6% wore a helmet at the time of the accident, and those not wearing a helmet had a 2.11 (odds ratio [OR]: 2.1; CI 95%: 1.8-2.4) higher chance of head injury. Regarding the severity of the crash, those occurred in suburban areas (OR: 6.58; CI 95%: 5.69-7.60), in unpaved surfaces (OR: 4.13; CI 95%: 3.04-5.61), after low alcohol consumption (OR: 1.89; CI 95%: 1.46-2.44), at night (OR: 2.24; CI 95%: 1.95-2.57) and on weekends (OR: 1.65; CI 95%: 1.44-1.90), had the highest chance of turning into a fatal accident. CONCLUSIONS: In spite of the progress made in terms of road safety, motorcycle accidents are still increasing, and the use of a helmet is still proportionally low. More information on these groups and risk factors needs to be available so people are better informed. Also, regulations need improvements regarding the use of security equipment like helmets in order to reduce injuries and fatal accidents.
[Mh] Termos MeSH primário: Acidentes de Trânsito/estatística & dados numéricos
Traumatismos Craniocerebrais/epidemiologia
Motocicletas/estatística & dados numéricos
Ferimentos e Lesões/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Traumatismos Craniocerebrais/mortalidade
Feminino
Dispositivos de Proteção da Cabeça/utilização
Seres Humanos
Lactente
Masculino
México/epidemiologia
Meia-Idade
Fatores de Risco
Ferimentos e Lesões/mortalidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.24875/GMM.017002812


  8 / 62219 MEDLINE  
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[PMID]:29206821
[Au] Autor:Muro-Báez VA; Mendoza-García ME; Vera-López JD; Pérez-Núñez R
[Ad] Endereço:Estudiante de la Licenciatura en Sociología, Secretariado Técnico del Consejo Nacional para la Prevención de Accidentes, Secretaría de Salud México, Ciudad de México, México.
[Ti] Título:[Analysis of road traffic injuries in Mexican cyclists].
[Ti] Título:Análisis de las lesiones causadas por el tránsito sufridas por ciclistas en México..
[So] Source:Gac Med Mex;153(6):653-661, 2017 Nov-Dec.
[Is] ISSN:0016-3813
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:With the objective of analyzing fatal and non-fatal road traffic injuries in cyclists and to document helmet use in this road user to inform sustainable mobility policies, a descriptive analysis of four secondary official information sources was conducted at the national level: mortality, Ministry of Health's hospital discharges, Unintentional and Violence Registry System (SIS-SS-17-P) and the 2012 National Health and Nutrition Survey (ENSANUT). Only SIS-SS-17-P and ENSANUT document helmet use. Except for ENSANUT information analyzed is of 2014.A total of 190 cyclists died in Mexico during 2014 and 392 were hospitalized; head was the anatomical region most frequently affected (63% and 32%, respectively). Only 0.75% of the 667 cases registered in SIS-17 reported helmet use and 24% suffered head injuries. Of the 165,348 non-fatally injured cyclists from ENSANUT <10% used helmet, 24% had head injuries and more than 16,000 suffered permanent injuries. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle use widespread as a means of transportation providing "safety in numbers".
[Mh] Termos MeSH primário: Acidentes de Trânsito/estatística & dados numéricos
Ciclismo/lesões
Traumatismos Craniocerebrais/epidemiologia
Ferimentos e Lesões/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Ciclismo/estatística & dados numéricos
Criança
Estudos Transversais
Feminino
Dispositivos de Proteção da Cabeça/utilização
Inquéritos Epidemiológicos
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
México
Meia-Idade
Sistema de Registros
Índices de Gravidade do Trauma
Ferimentos e Lesões/mortalidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.24875/GMM.17002632


  9 / 62219 MEDLINE  
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[PMID]:29390356
[Au] Autor:Medam S; Zieleskiewicz L; Duclos G; Baumstarck K; Loundou A; Alingrin J; Hammad E; Vigne C; Antonini F; Leone M
[Ad] Endereço:Aix Marseille Université, Service d'anesthésie et de réanimation, Hôpital Nord, AP-HM.
[Ti] Título:Risk factors for death in septic shock: A retrospective cohort study comparing trauma and non-trauma patients.
[So] Source:Medicine (Baltimore);96(50):e9241, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to compare septic shock directly associated-mortality between severe trauma patients and nontrauma patients to assess the role of comorbidities and age. We conducted a retrospective study in an intensive care unit (ICU) (15 beds) of a university hospital (928 beds). From January 2009 to May 2015, we reviewed 2 anonymized databases including severe trauma patients and nontrauma patients. We selected the patients with a septic shock episode. Among 385 patients (318 nontrauma patients and 67 severe trauma patients), the ICU death rate was 43%. Septic shock was directly responsible for death among 35% of our cohort, representing 123 (39%) nontrauma patients and 10 (15%) trauma patients (P < 0.0). A sequential organ failure assessment score above 12 (odds ratio [OR]: 6.8; 95% confident interval (CI) [1.3-37], P = 0.025) was independently associated with septic shock associated-mortality, whereas severe trauma was a protective factor (OR: 0.26; 95% CI [0.08-0.78], P = 0.01). From these independent risk factors, we determined the probability of septic shock associated-mortality. The receiver-operating characteristics curve has an area under the curve at 0.76 with sensitivity of 55% and specificity of 86%. Trauma appears as a protective factor, whereas the severity of organ failure has a major role in the mortality of septic shock. However, because of the study's design, unmeasured confounding factors should be taken into account in our findings.
[Mh] Termos MeSH primário: Choque Séptico/etiologia
Choque Séptico/mortalidade
Ferimentos e Lesões/complicações
[Mh] Termos MeSH secundário: Adulto
Feminino
França
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Ferimentos e Lesões/mortalidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009241


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[PMID]:29465571
[Au] Autor:Wang YC; Liu QX; Liu T; Xu XE; Gao W; Bai XJ; Li ZF
[Ad] Endereço:Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, P.R. China.
[Ti] Título:Caspase-1-dependent pyroptosis of peripheral blood mononuclear cells predicts the development of sepsis in severe trauma patients: A prospective observational study.
[So] Source:Medicine (Baltimore);97(8):e9859, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pyroptosis plays a pivotal role in sepsis and septic shock in animal studies. However, its clinical significance in pathological conditions has not been well elucidated. This study aimed to evaluate the correlation between the percentage of pyroptotic peripheral blood mononuclear cells (PBMCs) and the clinical index and to investigate the relationship between PBMCs pyroptosis and the development of sepsis in trauma patients.This prospective study was conducted from October 2016 to May 2017 in a comprehensive trauma center. Sixty trauma patients and 10 healthy controls were enrolled. Peripheral blood samples were collected from the patients within 24 hours after injury. The percentages of pyroptotic and apoptotic PBMCs were measured using flow cytometry, and plasma levels of cytokines were evaluated using flow cytometric analysis with a human inflammation 13-plex panel.Trauma patients who developed sepsis had higher percentages of pyroptotic and apoptotic PBMCs at admission. Patients who developed sepsis (n = 33) had higher interleukin (IL)-6, IL-18, and monocyte chemotactic protein-1 (MCP-1) concentrations at admission than patients (n = 27) who did not develop sepsis. The percentage of PBMCs pyroptosis was significantly correlated with injury severity score (ISS), acute physiology and chronic health evaluation (APACHE) II score, IL-10, IL-18, and MCP-1 levels in trauma patients. PBMCs pyroptosis is a better biomarker in predicting the development of sepsis after trauma.This study indicates that the percentage of pyroptotic PBMCs increases during the early phase of trauma and that this increase is significantly correlated with the severity and state of inflammation in trauma patients. PBMCs pyroptosis is a potential marker for predicting the development of sepsis after trauma.
[Mh] Termos MeSH primário: Caspase 1/metabolismo
Leucócitos Mononucleares/citologia
Piroptose/fisiologia
Sepse/sangue
Sepse/etiologia
Ferimentos e Lesões/complicações
[Mh] Termos MeSH secundário: Adulto
Citocinas/sangue
Feminino
Seres Humanos
Escala de Gravidade do Ferimento
Leucócitos Mononucleares/enzimologia
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Cytokines); EC 3.4.22.36 (Caspase 1)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009859



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