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Splenic Injury

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101. Splenic responses play an important role in remote ischemic preconditioning-mediated neuroprotection against stroke Full Text available with Trip Pro

volume with an expansion of splenic lymphocytes 3 days after MCAO. Furthermore, the removal of the spleen 1 day or 2 weeks before RIPC and MCAO reduced the protective effect of RIPC on ischemic brain injury and reversed the effects of RIPC on circulating immune cell composition. RIPC significantly reduced brain infiltration of Tc and NKT cells. Prior splenectomy showed no effect on immune cell infiltration after RIPC and stroke.These results reveal an immunomodulatory effect of the spleen, effecting (...) Splenic responses play an important role in remote ischemic preconditioning-mediated neuroprotection against stroke Remote ischemic preconditioning (RIPC) of a limb has been reported to protect against ischemic stroke. Our previous results demonstrated that the RIPC-mediated neuroprotection is associated with alterations in circulating immune cell populations. Here, we evaluated the effect of the spleen, the largest reservoir of immune cells, on RIPC-mediated neuroprotection against

2018 Journal of neuroinflammation

102. Assessment of blunt splenic trauma: Which imaging scoring system is superior? Full Text available with Trip Pro

Assessment of blunt splenic trauma: Which imaging scoring system is superior? Spleen is the most common viscera that may be hurt in blunt abdominal trauma. Operative or nonoperative management of splenic injury is a dilemma. The American Association for the Surgery of Trauma (AAST) is the most common grading system which has been used for the management of blunt splenic injuries. The new recommended grading system assesses other aspects of splenic injury such as contrast extravasation (...) , pseudoaneurysm, arteriovenous fistula, and severity of hemoperitoneum, as well. The aim of this study is to compare and prioritize the cutoff of AAST grading system with the new recommended one.This is a cross-sectional study on patients with splenic injury caused by abdominal blunt trauma referred to Isfahan University of Medical Sciences affiliated Hospitals, Iran, in 2013-2016. All patients underwent abdominopelvic computed tomography scanning with intravenous (IV) contrast. All images were reported

2018 Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

103. To save a child's spleen: 50 years from Toronto to ATOMAC. Full Text available with Trip Pro

To save a child's spleen: 50 years from Toronto to ATOMAC. Pediatric surgeons brought forth non-operative treatment for children with blunt spleen injury more than 50 years ago. At the time, this proposal was deemed reckless by many adult surgeons, and debate ensued for decades. Despite criticisms, pediatric surgeons refined the clinical pathways for children with spleen injury leading to current safe and efficient outcomes. These outcomes are defined by rare splenectomies, few blood (...) transfusions, and short length of hospital stay. This review will address the role of the spleen through historical perceptions and scientific evidence. In addition, evolution of contemporary clinical pathways will be outlined.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Journal of Pediatric Surgery

104. Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report. Full Text available with Trip Pro

Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report. Splenic artery embolization (SAE) is a common procedure in trauma patients with blunt splenic injuries. We report a case of acute ischemic stroke following orthopedic surgery in a patient with post-SAE reactive thrombocytosis.A 37-year-old woman with idiopathic thrombocytopenic purpura (ITP) suffered from multiple trauma scheduled for open

2018 Medicine

105. Biological Effects of Ultrasound Insonification of the Spleen

or exhibiting any of the following: surgery in the past 90 days previous surgery of the spleen or splenectomy, esophagus, lungs, stomach, duodenum, or liver recent traumatic injury, including intracerebral hemorrhage and visceral injury end stage renal disease and/or uremia active malignancy previous leukemia and/or lymphoma human immunodeficiency virus infection or AIDS rheumatoid arthritis or other immune-mediated diseases (e.g. inflammatory bowel disease) arrhythmias, including but not limited to, atrial (...) Biological Effects of Ultrasound Insonification of the Spleen Biological Effects of Ultrasound Insonification of the Spleen - 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. Biological Effects of Ultrasound

2018 Clinical Trials

106. 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

107. 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

108. 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

109. 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

110. 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

111. 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

112. 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

113. 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

114. 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

115. Alternatively activated macrophages promote resolution of necrosis following acute liver injury. Full Text available with Trip Pro

Alternatively activated macrophages promote resolution of necrosis following acute liver injury. Following acetaminophen (APAP) overdose, acute liver injury (ALI) can occur in patients that present too late for N-acetylcysteine treatment, potentially leading to acute liver failure, systemic inflammation, and death. Macrophages influence the progression and resolution of ALI due to their innate immunological function and paracrine activity. Syngeneic primary bone marrow-derived macrophages (...) (BMDMs) were tested as a cell-based therapy in a mouse model of APAP-induced ALI (APAP-ALI).Several phenotypically distinct BMDM populations were delivered intravenously to APAP-ALI mice when hepatic necrosis was established, and then evaluated based on their effects on injury, inflammation, immunity, and regeneration. In vivo phagocytosis assays were used to interrogate the phenotype and function of alternatively activated BMDMs (AAMs) post-injection. Finally, primary human AAMs sourced from healthy

2020 Journal of Hepatology

116. 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

117. 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

118. 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

119. 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

120. 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

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