Thromboelastogram does not detect pre-injury anticoagulation in acute trauma patients

Purpose

Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC.

短期的脱氢表雄酮治疗增加中年男性受试者的血小板cGMP产生

目的临床和人群研究提示,脱氢表雄酮和它的硫酸盐在抗动脉粥样硬化和冠心病中起保护作用。然而,这种作用的机制仍不清楚。最近报道,硫酸脱氢表雄酮通过增加一氧化氮的生成来延缓动脉粥样硬化的形成。方法24岁的男性受试者(年龄65.4±0.7岁;范围58.2~67.6岁)经盲法安慰剂对照研究,使用脱氢表雄酮(每天50 mg睡前口服)或安慰剂2个月。2个月前和2个月后评价血小板环一磷酸鸟苷(cGMP)浓度(作为一氧化氮产生的标记)和血清中硫酸脱氢表雄酮钠、脱氢表雄酮、胰岛素样生长因子1、胰岛素、葡萄糖、雌二醇、睾酮、纤溶酶原激活物抑制剂1抗原、高半胱…     

Double-blind, randomized, placebo-controlled trial of a cream containing the Stryphnodendron adstringens (Martius) Coville bark extract for suppressing terminal hair growth

Background  Excess of terminal hair can be defined as excessive hair that appears in male-like pattern in women. Some experts consider this condition as a result of an atypical relationship between levels of circulating androgens and sensitivity of androgen receptors in hair follicles to circulating androgens.
Aims  The aim of this research work was to evaluate the efficacy of a topical treatment for suppressing terminal hair growth of a cream containing 6.0% of the Stryphnodendron adstringens bark extract.
Study design and subjects  Study was randomized, double-blind and placebo-controlled. Subjects with excess of terminal hair were randomized to placebo and to the active treatment (cream with 6.0% of the extract). Evaluation was performed before and after 6 months, and subjects were photographed in each time. Clinical examination was carried out with the same physicians and in accordance with the Ferriman-Gallwey (FG) score.
Results  Benefits of the cream containing S. adstringens bark extract was observed in 60.98% ( P <  0.001) of the subjects. FG score changed from 4 to 3 in the placebo group compared to 4–2 in the active. The cream suppressed the terminal hair growth and diminished the number of terminal hair. Subjects also described the reduction of skin hyperpigmentation, folliculitis and acne. Adverse events were not verified by physicians or patients.
Conclusions  The cream with 6.0% of the S. adstringens bark extract was effective on the reduction and on the reversion of the terminal hair excess, being considered a new promissory product for such finality .     

Experimental use of polyamide bands as an extra-articular repair of the cranial cruciate ligament rupture in dogs

To evaluate the use of polyamide bands, manufactured for securing electrical cables for repair of the cranial cruciate ligament rupture in dogs, the present study was undertaken. Five mixed-breed dogs were used in the study. Lateral and anterioposterior radiography were carried out to confirm the soundness of both stifle joints in all dogs. One pelvic lime was randomly chosen for aseptic stifle surgery. Under general anesthesia and lateral recumbency with the limb rotated externally, the cranial cruciate ligament was found and transected via arthrotomy. Polyamide band was used as an imbrications suture for extra-articular repair of the cranial cruciate ligament. On days 2, 4, 6, 9, 17, 21, 25, 32, 46, 83, and 120 after surgery, lameness was scored. Radiographic examination was performed before and on days 45, 75, and 120 after surgery, and osteoarthritis changes in stifle joint were scored. There were no significant differences on lameness score during study and also between score at each time and score before surgery (grade 0; P > 0.05). There were no significant differences on radiographic examination score during study and also between score at each time and score before surgery (grade 0; P > 0.05). The present study showed that commercially available nylon bands may be successfully applied as cerclage to stabilize the stifle joint for treatment of the cranial cruciate ligament rupture.     

Long-term outcomes of liver transplant patients with human immunodeficiency virus infection and end-stage-liver-disease: single center experience

Objective

Orthotopic-liver-transplantation (OLT) in patients with Human-Immunodeficiency-Virus infection (HIV) and end-stage-liver-disease (ESDL) is rarely reported. The purpose of this study is to describe our institutional experience on OLT for HIV positive patients.

Material and methods

This is a retrospective study of all HIV-infected patients who underwent OLT at the University Hospital of Essen, from January 1996 to December 2009. Age, sex, HIV transmission-way, CDC-stage, etiology of ESDL, concomitant liver disease, last CD4cell count and HIV-viral load prior to OLT were collected and analysed. Standard calcineurin-inhibitors-based immunosuppression was applied. All patients received anti-fungal and anti-pneumocystis carinii pneumonia prophylaxis post-OLT.

Results

Eight transplanted HIV-infected patients with a median age of 46 years (range 35-61 years) were included. OLT indications were HCV (n = 5), HBV (n = 2), HCV/HBV/HDV-related cirrhosis (n = 1) and acute liver-failure (n = 1). At OLT, CD4 cell-counts ranged from 113-621 cells/μl, and HIV viral-loads from < 50-175,000 copies/ml. Seven of eight patients were exposed to HAART before OLT. Patients were followed-up between 1-145 months. Five died 1, 3, 10, 31 and 34 months after OLT due to sepsis and graftfailure respectively. Graft-failure causes were recurrent hepatic-artery thrombosis, HCV-associated hepatitis, and chemotherapy-induced liver damage due to Hodgkin-disease. One survivor is relisted for OLT due to recurrent chronic HCV-disease but non-progredient HIV-infection 145 months post-OLT. Two other survivors show stable liver function and non-progredient HIV-disease under HAART 21 and 58 months post-OLT.

Conclusions

OLT in HIV-infected patients and ESLD is an acceptable therapeutic option in selected patients. Long-term survival can be achieved without HIV disease-progression under antiretroviral therapy and management of the viral hepatitis co-infection.