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Splenic Injury

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101. Embolization in Splenic Trauma

at Birmingham Study Details Study Description Go to Brief Summary: Randomized, prospective, feasibility study to begin evaluating the efficacy, safety, and cost of using either coils or vascular plugs (VPs) for proximal splenic artery embolization in the setting of traumatic splenic injury. Condition or disease Intervention/treatment Phase Trauma to the Spleen Device: Splenic artery embolization with vascular embolic coils Device: Splenic artery embolization with vascular embolic plugs Not Applicable (...) Detailed Description: Splenic preservation rates are improved for participants with high-grade splenic injuries (defined as Grade III-V injuries by the AAST guidelines) when non-operative management is supplemented by image-guided, trans-catheter splenic artery embolization (SAE). SAE is currently the standard of care for hemodynamically stable participants with high-grade splenic injuries. In proximal SAE (pSAE), the mid-splenic artery is embolized between the origins of the dorsal pancreatic artery

2018 Clinical Trials

102. Non-operative management versus operative management in high-grade blunt hepatic injury. (Abstract)

Non-operative management versus operative management in high-grade blunt hepatic injury. Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring (...) about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions. In 1994, the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST) revised the Hepatic Injury Scale to have a range from grade I to VI. Minor injuries (grade I or II) are the most frequent liver injuries (80% to 90% of all cases); severe injuries

2015 Cochrane

103. Surgical versus non-surgical management of abdominal injury. (Abstract)

Surgical versus non-surgical management of abdominal injury. Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries.To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen.We searched the Cochrane Injuries (...) injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating.Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively.Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described

2015 Cochrane

104. Splenic angioembolisation versus non-operative management for splenic injury: a systematic review

Splenic angioembolisation versus non-operative management for splenic injury: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address

2016 PROSPERO

105. Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: An analysis of a National Trauma Registry database. (Abstract)

Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: An analysis of a National Trauma Registry database. Non-operative management has become the standard approach for treating stable patients sustaining blunt hepatic or splenic injuries in the absence of other indications for laparotomy. The liberal use of computed tomography (CT) has reduced the rate of unnecessary immediate laparotomies; however, due to its limited sensitivity in the diagnosis of hollow (...) viscus injuries (HVI), this may be at the expense of a rise in the incidence of missed HVI. The aim of this study was to assess the incidence of concomitant HVI in blunt trauma patients diagnosed with hepatic and/or splenic injuries, and to evaluate whether a correlation exists between this incidence and the severity of hepatic or splenic injuries.A retrospective cohort study involving blunt trauma patients with splenic and/or liver injuries, between the years 1998 and 2012 registered in the Israel

2014 Injury

106. Neutrophils alleviate fibrosis in the CCl4‐induced mouse chronic liver injury model Full Text available with Trip Pro

Neutrophils alleviate fibrosis in the CCl4‐induced mouse chronic liver injury model Tribbles pseudokinase 1 (Trib1) is a negative regulator of CCAAT/enhancer binding protein α (C/EBPα) and is known to induce granulopoiesis while suppressing monocyte differentiation. Loss of Trib1 was previously shown to increase the neutrophil population in the spleen but lead to M2-like macrophage reduction. Because M2 macrophages are anti-inflammatory and promote tissue repair by producing fibrogenic (...) factors, we investigated liver fibrosis in Trib1-deficient mice. Interestingly, loss of Trib1 suppressed fibrosis in the CCl4-induced chronic liver injury model. Trib1 knockout increased neutrophils but had a minimal effect on the macrophage population in the liver. Hepatic expressions of neutrophil matrix metalloproteinases (Mmp)8 and Mmp9 were increased, but the production of fibrogenic factors, including transforming growth factor β1, was not affected by loss of Trib1. These results suggest

2018 Hepatology communications

107. Loss of hypoxia inducible factor‐1α aggravates γδ T‐cell‐mediated inflammation during acetaminophen‐induced liver injury Full Text available with Trip Pro

Loss of hypoxia inducible factor‐1α aggravates γδ T‐cell‐mediated inflammation during acetaminophen‐induced liver injury Acetaminophen (APAP)-induced liver injury is closely associated with acute hepatic inflammation. Hypoxia-inducible factor-1 (HIF-1) is activated during immunological processes and regulates gene expressions in various types of immune cells. Although HIF-1 controls the differentiation and functions of conventional T cells in chronic inflammation, the pathological (...) importance of HIF-1 in innate-like T cells during acute inflammation remains unknown. Here, we investigated the role of HIF-1 in innate-like γδ T cells during APAP-induced acute liver injury. In response to APAP administration, T-cell-specific Hif-1α gene knockout mice sustained severe liver damage compared to wild-type control mice but without any impacts on the initial hepatic insult. This severe liver damage was accompanied by excessive neutrophil infiltration into the liver, increased serum

2018 Hepatology communications

108. Can we predict delayed undesirable events after blunt injury to the torso visceral organs? Full Text available with Trip Pro

Can we predict delayed undesirable events after blunt injury to the torso visceral organs? Blunt injuries to visceral organs have the potential to lead to delayed pseudoaneurysm formation or organ rupture, but current trauma and surgical guidelines do not recommend repetitive imaging. This study examined the incidence and timing of delayed undesirable events and established advisable timing for follow-up imaging and appropriate observational admission.Patients with blunt splenic (S), liver (L (...) ), or kidney (K) injury treated with non-operative management (NOM) in our institution were included and retrospectively reviewed.From January 2013 to January 2017, 57 patients were admitted with documented blunt visceral organ injuries and 22 patients were excluded. Of 35 patients (L, 10; S, 17; K, 6; L & S, 1; S & K, 1) treated with NOM, 14 (L, 4; S, 9; K, 1) patients underwent transcatheter arterial embolization. Delayed undesirable events occurred in four patients: three patients with splenic

2018 Acute medicine & surgery

109. Molecular mechanisms involved in drug-induced liver injury caused by urate-lowering Chinese herbs: A network pharmacology study and biology experiments. Full Text available with Trip Pro

Molecular mechanisms involved in drug-induced liver injury caused by urate-lowering Chinese herbs: A network pharmacology study and biology experiments. As an important part of the comprehensive treatment methods, the urate-lowering Chinese herbs could provide favorable clinical effects on hyperuricemia in its ability to invigorate spleen and remove dampness. Owing to the long-term duration, it brought up the potential adverse reactions (ADRs) and concerns about the drug-induced liver injury (...) from these herbs. To address this problem, the bioinformatics approaches which combined the network pharmacology, computer simulation and molecular biology experiments were undertaken to elucidate the underlying drug-induced liver injury molecular mechanisms of urate-lowering Chinese herbs. Several electronic databases were searched to identify the potential liver injury compounds in published research. Then, the putative target profile of liver injury was predicted, and the interaction network

2019 PLoS ONE

110. Randomised controlled trial: Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Full Text available with Trip Pro

Randomised controlled trial: Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity | BMJ Evidence-Based Medicine We use cookies to improve our service (...) name or password? You are here Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Article Text Therapeutics Randomised controlled trial Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Deepa Manwani

2012 Evidence-Based Medicine

111. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock Full Text available with Trip Pro

Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed (...) by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3

2014 Brazilian Journal of Medical and Biological Research

112. Splenic Laceration and Pulmonary Contusion Injury From Bean Bag Weapon Full Text available with Trip Pro

Splenic Laceration and Pulmonary Contusion Injury From Bean Bag Weapon 24672591 2015 10 30 2018 11 13 1936-900X 15 2 2014 Mar The western journal of emergency medicine West J Emerg Med Splenic laceration and pulmonary contusion injury from bean bag weapon. 118-9 10.5811/westjem.2013.10.19900 Patel Amar A Pennsylvania State University, College of Medicine, Hershey, Pennsylvania. Toohey Shannon S University of California Irvine Medical Center, Department of Emergency Medicine, Orange, California (...) . Boysen-Osborn Megan M University of California Irvine Medical Center, Department of Emergency Medicine, Orange, California. eng Case Reports Journal Article United States West J Emerg Med 101476450 1936-900X IM Contusions diagnosis diagnostic imaging etiology Humans Lacerations diagnosis diagnostic imaging etiology Lung Injury diagnosis diagnostic imaging etiology Male Middle Aged Spleen injuries Tomography, X-Ray Computed Wounds, Gunshot diagnosis diagnostic imaging Original DateCompleted: 20140327

2014 Western Journal of Emergency Medicine

113. Prospective trial of angiography and embolization for all grade III to V blunt splenic injuries: nonoperative management success rate is significantly improved. (Abstract)

. The protocol required all stable patients with grade III to V splenic injuries be referred for angiography and embolization. In historic controls, referral was based on surgeon preference.From January 1, 2010 to December 31, 2012, there were 168 patients with grades III to V spleen injuries admitted; NOM was undertaken in 113 (67%) patients. The protocol was followed in 97 patients, with a failure rate of 5%. Failure rate in the 16 protocol deviations was 25% (p = 0.02). Historic controls from January 1 (...) Prospective trial of angiography and embolization for all grade III to V blunt splenic injuries: nonoperative management success rate is significantly improved. Nonoperative management (NOM) of blunt splenic injury is well accepted. Substantial failure rates in higher injury grades remain common, with one large study reporting rates of 19.6%, 33.3%, and 75% for grades III, IV, and V, respectively. Retrospective data show angiography and embolization can increase salvage rates in these severe

2014 Journal of the American College of Surgeons

114. The contemporary management of penetrating splenic injury. (Abstract)

The contemporary management of penetrating splenic injury. Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury.Trauma registry and medical record review (...) identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined.During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63

2014 Injury

115. Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study. Full Text available with Trip Pro

to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters.First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative (...) rate of embolization was 87.5%. The two-week survival rate in all animal models of splenic injury was 100%.Our findings in the current study demonstrate that the mobile minimally invasive interventional shelter can be adapted to the field perfectly and complete emergency surgical intervention for splenic injury efficiently and safely. Therefore, on-spot emergency interventional TAE for vascular injury of solid organs (e.g. spleen) in mobile minimally invasive interventional shelter is available

2014 Scandinavian journal of trauma, resuscitation and emergency medicine

116. Splenic injury after blunt abdominal trauma during a soccer (football) game. Full Text available with Trip Pro

Splenic injury after blunt abdominal trauma during a soccer (football) game. The spleen is the most commonly injured abdominal organ in children who sustain blunt abdominal trauma, and pediatric splenic injury may result from minor mechanisms of injury, including sports participation. We present 2 cases of splenic injury in soccer goalies because of blunt abdominal trauma sustained during game play. Although abdominal organ injuries are uncommon in soccer, emergency medicine and primary care

2014 Pediatric Emergency Care

117. Pleural effusion following blunt splenic injury in the pediatric trauma population. (Abstract)

Pleural effusion following blunt splenic injury in the pediatric trauma population. Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children.Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury.Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4 (...) ), respectively. In multivariate analysis, high-grade splenic injury (IV-V) (OR 16.5, p=0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III).Pleural effusion following pediatric blunt splenic injury has an incidence of 4.4% and is associated with high-grade splenic injuries and longer lengths of stay. While some symptomatic patients may be successfully managed medically, many require tube thoracostomy for progressive respiratory

2014 Journal of Pediatric Surgery

118. Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? (Abstract)

Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in patients undergoing colectomy procedures are reliably coded (...) 114 patients (1%) who had a concurrent splenic procedure code recorded in either ACS NSQIP or Medicare inpatient claims. There were 7 patients who had a splenic injury diagnosis code recorded in either data source. Agreement of splenic procedure codes between the data sources was substantial (κ statistic 0.72; 95% CI, 0.64-0.79). Medicare inpatient claims identified 81% of the splenic procedure codes recorded in ACS NSQIP, and 99% of the patients without a splenic procedure code.It is feasible

2014 Journal of the American College of Surgeons

119. Role of spleen-derived monocytes/macrophages in acute ischemic brain injury. Full Text available with Trip Pro

Role of spleen-derived monocytes/macrophages in acute ischemic brain injury. Monocytes/macrophages (MMs), mononuclear phagocytes, have been implicated in stroke-induced inflammation and injury. However, the presence of pro-inflammatory Ly-6C(high) and antiinflammatory Ly-6C(low) monocyte subsets raises uncertainty regarding their role in stroke pathologic assessment. With recent identification of the spleen as an immediate reservoir of MMs, this current study addresses whether the spleen (...) -derived MMs are required for stroke pathologic assessment. We observed that the spleen was contracted in poststroke animals and the contraction was accompanied by decreased number of Ly-6C(high) and Ly-6C(low) subsets in the spleen. The deployment of these subsets from the spleen temporally coincided with respective increases in the ischemic brain. Compared to mice with the spleen, mice receiving a splenectomy just before the stroke displayed less accumulation of Ly-6C(high) and Ly-6C(low) MMs

2014 Journal of Cerebral Blood Flow and Metabolism

120. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients

Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02232191 Recruitment Status : Recruiting First Posted : September 5

2014 Clinical Trials

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