14 results on '"Jessica L. Weaver"'
Search Results
2. Precision targeting of the vagal anti-inflammatory pathway attenuates the systemic inflammatory response to burn injury
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Jessica L. Weaver, Todd W. Costantini, Brian P. Eliceiri, and Raul Coimbra
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Agonist ,Male ,Burn injury ,Physical Injury - Accidents and Adverse Effects ,alpha7 Nicotinic Acetylcholine Receptor ,medicine.drug_class ,Neuroimmunomodulation ,medicine.medical_treatment ,Intraperitoneal injection ,Clinical Sciences ,Vascular permeability ,Nursing ,Lung injury ,Pharmacology ,Cardiorespiratory Medicine and Haematology ,Critical Care and Intensive Care Medicine ,Inbred C57BL ,Permeability ,Oral and gastrointestinal ,Vagus nerve ,lung ,alpha 7 nicotinic acetylcholine ,Mice ,cholinergic anti-inflammatory ,medicine ,Animals ,Intestinal Mucosa ,intestine ,Lung ,Intestinal permeability ,business.industry ,Animal ,Neurosciences ,Dextrans ,Lung Injury ,medicine.disease ,Emergency & Critical Care Medicine ,Systemic Inflammatory Response Syndrome ,medicine.anatomical_structure ,5.1 Pharmaceuticals ,Disease Models ,Surgery ,Development of treatments and therapeutic interventions ,business ,Burns ,Digestive Diseases ,Fluorescein-5-isothiocyanate - Abstract
BACKGROUND The systemic inflammatory response (SIRS) drives late morbidity and mortality after injury. The α7 nicotinic acetylcholine receptor (α7nAchR) expressed on immune cells regulates the vagal anti-inflammatory pathway that prevents an overwhelming SIRS response to injury. Non-specific pharmacologic stimulation of the vagus nerve has been evaluated as a potential therapeutic to limit SIRS. Unfortunately, the results of clinical trials have been underwhelming. We hypothesized that directly targeting the α7nAchR would more precisely stimulate the vagal anti-inflammatory pathway on immune cells and decrease gut and lung injury after severe burn. METHODS C57BL/6 mice underwent 30% total body surface area steam burn. Mice were treated with an intraperitoneal injection of a selective agonist of the α7nAchR (AR-R17779) at 30 minutes post-burn. Intestinal permeability to 4 kDa FITC-Dextran was measured at multiple time-points post-injury. Lung vascular permeability was measured 6 hours after burn injury. Serial behavioral assessments were performed to quantify activity levels. RESULTS Intestinal permeability peaked at 6 hours post-burn. AR-R17779 decreased burn-induced intestinal permeability in a dose-dependent fashion (p < 0.001). There was no difference in gut permeability to 4 kDa FITC-Dextran between sham and burn injured animals treated with 5 mg AR-R17779. While burn injury increased lung permeability 10-fold, AR-R17779 prevented burn-induced lung permeability with no difference compared to sham (p < 0.01). Post-injury activity levels were significantly improved in burned animals treated with AR-R17779. CONCLUSION Directly stimulating the α7nAchR prevents burn-induced gut and lung injury. Directly targeting the α7nAChR that mediates the cholinergic anti-inflammatory response may be an improved strategy compared to non-specific vagal agonists. LEVEL OF EVIDENCE Level IV, Therapeutic.
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- 2022
3. Don't mess with the pancreas! A multicenter analysis of the management of low-grade pancreatic injuries
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Walter L, Biffl, Chad G, Ball, Ernest E, Moore, Jason, Lees, S Rob, Todd, Salina, Wydo, Alicia, Privette, Jessica L, Weaver, Samantha M, Koenig, Ashley, Meagher, Linda, Dultz, Pascal Osi, Udekwu, Kevin, Harrell, Allen K, Chen, Rachael, Callcut, Lucy, Kornblith, Gregory J, Jurkovich, Matthew, Castelo, Kathryn B, Schaffer, and Chance, Spalding
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Wounds, Penetrating ,Critical Care and Intensive Care Medicine ,Logistic regression ,Conservative Treatment ,Wounds, Nonpenetrating ,Young Adult ,Injury Severity Score ,Pancreatectomy ,Postoperative Complications ,Trauma Centers ,Risk Factors ,medicine ,Humans ,Pancreas ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Incidence ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,medicine.anatomical_structure ,Practice Guidelines as Topic ,Drainage ,Female ,business ,Tomography, X-Ray Computed ,Penetrating trauma - Abstract
Introduction Current guidelines recommend nonoperative management (NOM) of low-grade (American Association for the Surgery of Trauma-Organ Injury Scale Grade I-II) pancreatic injuries (LGPIs), and drainage rather than resection for those undergoing operative management, but they are based on low-quality evidence. The purpose of this study was to review the contemporary management and outcomes of LGPIs and identify risk factors for morbidity. Methods Multicenter retrospective review of diagnosis, management, and outcomes of adult pancreatic injuries from 2010 to 2018. The primary outcome was pancreas-related complications (PRCs). Predictors of PRCs were analyzed using multivariate logistic regression. Results Twenty-nine centers submitted data on 728 patients with LGPI (76% men; mean age, 38 years; 37% penetrating; 51% Grade I; median Injury Severity Score, 24). Among 24-hour survivors, definitive management was NOM in 31%, surgical drainage alone in 54%, resection in 10%, and pancreatic debridement or suturing in 5%. The incidence of PRCs was 21% overall and was 42% after resection, 26% after drainage, and 4% after NOM. On multivariate analysis, independent risk factors for PRC were other intra-abdominal injury (odds ratio [OR], 2.30; 95% confidence interval [95% CI], 1.16-15.28), low volume (OR, 2.88; 1.65, 5.06), and penetrating injury (OR, 3.42; 95% CI, 1.80-6.58). Resection was very close to significance (OR, 2.06; 95% CI, 0.97-4.34) (p = 0.0584). Conclusion The incidence of PRCs is significant after LGPIs. Patients who undergo pancreatic resection have PRC rates equivalent to patients resected for high-grade pancreatic injuries. Those who underwent surgical drainage had slightly lower PRC rate, but only 4% of those who underwent NOM had PRCs. In patients with LGPIs, resection should be avoided. The NOM strategy should be used whenever possible and studied prospectively, particularly in penetrating trauma. Level of evidence Therapeutic Study, level IV.
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- 2021
4. Methamphetamine Use is Associated with Increased Surgical Site Infections after Trauma Laparotomy
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Jessica L. Weaver, Todd W. Costantini, Jeanne Lee, Allison E. Berndtson, Leslie Kobayashi, Sara Higginson, Laura N. Godat, and Jay Doucet
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Exploratory laparotomy ,medicine.medical_treatment ,Methamphetamine ,chemistry.chemical_compound ,Injury Severity Score ,Trauma Centers ,Laparotomy ,Diabetes mellitus ,medicine ,Humans ,Surgical Wound Infection ,Retrospective Studies ,Abbreviated Injury Scale ,business.industry ,Trauma center ,Meth ,Length of Stay ,medicine.disease ,Exact test ,chemistry ,Anesthesia ,Surgery ,business - Abstract
Background Methamphetamine (METH) use causes significant vasoconstriction, which can be severe enough to cause bowel ischemia. Methamphetamines have also been shown to alter the immune response. These effects could predispose METH users to poor wound healing, increased infections, and other post-operative complications. We hypothesized that METH users would have longer length of stay and higher rates of complications compared to non–METH users. Methods The trauma registry for our urban Level 1 trauma center was searched for patients that received an exploratory laparotomy from 2016 to 2019. A total 204 patients met criteria and 52 (25.5%) were METH positive. Length of stay (LOS), ventilator days, abbreviated injury scale (AIS), and wound class were compared using nonparametric statistics. Age and injury severity score (ISS) were compared using a Student's t-test. A Chi Square or Fisher's Exact test was used to compare sex, mechanism of injury, and rates of infectious complications. Results Methamphetamine-positive patients had a significantly higher rate of surgical site infections (7.4% versus 0%, P = 0.001). Patients that developed surgical site infection had equivalent rates of smoking and diabetes, as well as equivalent abdominal AIS and wound class compared to those who did not develop surgical site infection. Hospital and ICU LOS, ventilator days, ISS, and mortality were equivalent between METH positive and negative patients. Rates of other infectious complications were the same between groups. Conclusions Methamphetamine use is associated with an increased rate of surgical site infection after trauma laparotomy. Other serious complications and mortality were not affected by METH use.
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- 2021
5. Outcomes in Delayed Drainage of Hemothorax
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Jessica L. Weaver, Elinore J. Kaufman, Andrew J. Young, Madhu Subramanian, Mark J. Seamon, Jane Keating, Adam Shiroff, and Jeremy W. Cannon
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Traumatic hemothorax ,Trapped lung ,Time-to-Treatment ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Fibrinolytic Agents ,Trauma Centers ,medicine ,Odds Ratio ,Humans ,Registries ,Drainage ,Thoracic trauma ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hemothorax ,business.industry ,General Medicine ,Delayed treatment ,Middle Aged ,medicine.disease ,Empyema ,Surgery ,Treatment Outcome ,030228 respiratory system ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Background Prompt drainage of traumatic hemothorax is recommended to prevent empyema and trapped lung. Some patients do not present the day of their trauma, leading to their delayed treatment. Delayed drainage could be challenging as clotted blood may not evacuate through a standard chest tube. We hypothesized that such delays would increase the need for surgery or secondary interventions. Methods Our trauma registry was reviewed for patients with a hemothorax admitted to our level 1 trauma center from 1/1/00 to 4/30/19. Patients were included in the delayed group if they received a drainage procedure >24 hours after injury. These patients were matched 1:1 by chest abbreviated injury score to patients who received drainage Results A total of 19 patients with 22 hemothoraces received delayed drainage. All but 3 patients had a chest tube placed as initial treatment. Four patients received surgery, including 3 who initially had chest tubes placed. Longer time to drainage increased the odds of requiring intrathoracic thrombolytics or surgery. In comparison, 2 patients who received prompt drainage received thrombolytics ( P = .11) and none required surgery ( P = .02). Patients needed surgery when initial drainage was on or after post-injury day 5, but pigtail catheter drainage was effective 26 days after injury. Discussion Longer times from injury to intervention are associated with increased likelihood of needing surgery for hemothorax evacuation, but outcomes were not uniform. A larger, multicenter study will be necessary to provide better characterization of treatment outcomes for these patients.
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- 2020
6. The Kinetics of Intestinal Permeability in a Mouse Model of Traumatic Brain Injury
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Jessica L. Weaver
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Male ,Traumatic brain injury ,Permeability ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Brain Injuries, Traumatic ,Impact model ,medicine ,Terminal ileum ,Permeability measurements ,Animals ,Intestinal Mucosa ,030304 developmental biology ,0303 health sciences ,Intestinal permeability ,business.industry ,Dextrans ,General Medicine ,medicine.disease ,nervous system diseases ,Intestines ,Mice, Inbred C57BL ,Disease Models, Animal ,Kinetics ,medicine.anatomical_structure ,nervous system ,Anesthesia ,business ,030217 neurology & neurosurgery - Abstract
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality among trauma patients. Increased intestinal permeability plays an important role in the inflammatory process that accompanies TBI, and therapies that prevent this permeability change may improve outcomes in TBI patients. Different animal models have been developed to test permeability changes, but there has been no agreement on when permeability should be tested after TBI. Here, we describe a method for creating the TBI mouse model and for measuring intestinal permeability. We also detail our permeability measurements at different time points after TBI to help guide future experimental design. The TBI is made using a controlled cortical impact model with the cortical impactor set to speed 6 m/s, depth 3 mm, dwell time 0.2 s, and tip size 3 mm to produce a severe TBI. Permeability is measured at 2, 4, 6, and 24 hr after TBI by removing a piece of terminal ileum, tying the ends, filling the lumen with FITC-labeled dextran, and then measuring how much of the dextran moves into the surrounding solution bath over time using a fluorescent plate reader. Our results show that peak permeability occurs between 4 and 6 hr after TBI. We recommend that future experiments incorporate permeability measurements 4 to 6 hr after TBI in order to take advantage of this peak permeability. © 2020 Wiley Periodicals LLC. Basic Protocol: Mouse CCI traumatic brain injury model and intestinal permeability measurement.
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- 2020
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7. Domestic Violence and Safe Storage of Firearms in the COVID-19 Era
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Ronald M. Stewart, Thomas K. Duncan, Bellal Joseph, Deborah A. Kuhls, A. Britton Christmas, Brendan T. Campbell, Eileen M. Bulger, Jessica L. Weaver, and Tanya L. Zakrison
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Male ,2019-20 coronavirus outbreak ,Domestic Violence ,Firearms ,Coronavirus disease 2019 (COVID-19) ,Safe storage ,Surgical Perspective ,Pneumonia, Viral ,Betacoronavirus ,Pandemic ,medicine ,Prevalence ,Humans ,Pandemics ,biology ,Viral Epidemiology ,business.industry ,SARS-CoV-2 ,COVID-19 ,biology.organism_classification ,medicine.disease ,United States ,Pneumonia ,gun violence ,Domestic violence ,Surgery ,Female ,Wounds, Gunshot ,Medical emergency ,business ,Coronavirus Infections - Published
- 2020
8. Moped Crashes are Just as Dangerous as Motorcycle Crashes
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Keith R. Miller, Jessica L. Weaver, Matthew V. Benns, and Brian G. Harbrecht
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050210 logistics & transportation ,business.industry ,Mortality rate ,05 social sciences ,030208 emergency & critical care medicine ,Crash ,General Medicine ,Emergency department ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Pneumothorax ,Injury types ,Anesthesia ,0502 economics and business ,Injury prevention ,Extremity injury ,Medicine ,Injury Severity Score ,business - Abstract
Mopeds’ (MP) limited speed gives the impression that they are safer than motorcycles (MCs), but factors other than speed may contribute to crash outcome. Records of patients involved in MC or MP crashes evaluated at the University of Louisville Hospital emergency department between 2010 and 2014 were reviewed. Among patients who required hospital admission, the frequency of rib fractures, hemo- or pneumothorax, abdominal injury, extremity injury, and vertebral body fractures were greater in the MC group, whereas head and facial injuries were more common in the MP group. Positive toxicology screens were equivalent (MC 51.8% vs MP 56.8%, P = 0.25), and fewer MP riders wore helmets (33.8% vs 9.2%, P < 0.01). The injury severity score for MC was higher (15.2 vs 13.9, P = 0.039), but mortality was equivalent between groups (7.5 vs 7.6%, P = 0.98). Among patients discharged from the emergency department with minor injuries, frequency of all injury types were equivalent. Although MC patients had a statistically higher injury severity score, differences were clinically similar with equal mortality rate. Moped riders are just as likely to suffer death or serious injury after a crash compared with MC riders, and injury prevention efforts should be aimed at both groups.
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- 2018
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9. Direct peritoneal resuscitation reduces intestinal permeability after brain death
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Jason W. Smith, Cynthia Downard, Brian G. Harbrecht, R. Neal Garrison, Victoria S Graham, Amy Matheson, Paul J. Matheson, and Jessica L. Weaver
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Male ,Brain Death ,Mean arterial pressure ,Resuscitation ,Pathology ,medicine.medical_specialty ,Lipopolysaccharide ,medicine.medical_treatment ,Intraperitoneal injection ,Inflammation ,Shock, Hemorrhagic ,Critical Care and Intensive Care Medicine ,Proinflammatory cytokine ,Rats, Sprague-Dawley ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Animals ,Intestinal permeability ,business.industry ,medicine.disease ,Rats ,Disease Models, Animal ,chemistry ,030220 oncology & carcinogenesis ,Shock (circulatory) ,Cytokines ,Fluid Therapy ,030211 gastroenterology & hepatology ,Surgery ,Peritoneum ,medicine.symptom ,business ,Peritoneal Dialysis - Abstract
Background The profound inflammatory response associated with brain death is frequently cited as the reason organs procured from brain dead donors are associated with worse graft function. The intestine releases inflammatory mediators in other types of shock, but its role is brain death has not been well-studied. Direct peritoneal resuscitation (DPR) improves visceral organ blood flow and reduces inflammation after hemorrhagic shock. We hypothesized that use of DPR would maintain intestinal integrity and reduce circulating inflammatory mediators after brain death. Methods Brain death was induced in male Sprague-Dawley rats by inserting a 4F Fogarty catheter into the epidural space and slowly inflating it. After herniation, rats were resuscitated with normal saline to maintain a mean arterial pressure of 80 mm Hg and killed with tissue collected immediately (time 0), or 2 hours, 4 hours, or 6 hours after brain death. Randomly selected animals received DPR via an intraperitoneal injection of 30-mL commercial peritoneal dialysis solution. Results Levels of proinflammatory cytokines, including IL-1β and IL-6, as well as high-mobility group box 1 protein and heat shock protein 70, were all increased after brain death and decreased with DPR. Fatty acid binding protein and lipopolysaccharide, both markers of intestinal injury, were increased in the serum after brain death and decreased with DPR. Immunohistochemistry staining for zona occludin-1 showed decreased intestinal tight junction integrity after brain death, which improved with DPR. Conclusions Intestinal permeability increases after brain death, and this contributes to the increased inflammation seen throughout the body. Using DPR prevents intestinal ischemia and helps preserve intestinal integrity. This suggests that using this novel therapy as an adjunct to the resuscitation of brain dead donors has the potential to reduce inflammation and potentially improve the quality of transplanted organs.
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- 2018
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10. Danger on the Farm: A Comparison of Agricultural and Animal-Related Injuries
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Karina Pentecost, Jodi Wojcik, Matthew C. Bozeman, Brian G. Harbrecht, Jessica L. Weaver, Kimberly Broughton-Miller, Michelle Frisbie, Charles W. Kimbrough, and Nicholas A. Nash
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medicine.medical_specialty ,business.industry ,Poison control ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,medicine.disease ,Intensive care unit ,Occupational safety and health ,Surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Injury Site ,Pneumothorax ,law ,Emergency medicine ,Injury prevention ,medicine ,Injury Severity Score ,030212 general & internal medicine ,business - Abstract
Animal-related injuries are common in rural areas. Agricultural workers can suffer severe injuries involving farm machinery or falls. The spectrum of injuries related to rural activities is poorly defined and characterizing these injuries will improve injury prevention efforts. Records for injured patients admitted between 2010 and 2013 were retrospectively reviewed. Patients with a mechanism of injury involving a large animal or with the injury site listed as “farm” were included. Patients with agricultural injuries (n = 85) were older with more multisystem injuries than patients injured by animals (n = 132) but the Injury Severity Score was equivalent. There was no difference in intensive care unit length of stay, ventilator days, or mortality. There was no difference in frequency of solid organ injury, pelvic fractures, rib fractures, or hemo- or pneumothorax between groups. Animal injuries had more frequent traumatic brain injuries (22.4% vs 10.5%, P = 0.03), whereas agricultural injuries had more vertebral fractures (20.5% vs 9.2%). Of toxicology screens performed, 25 per cent (22/88) were positive. No significant differences were found between occupational versus recreational animal injuries. Agricultural and animal-related injuries have different characteristics but Injury Severity Score and mortality were similar. Severe injuries from both mechanisms are common in rural communities and injury prevention activities are needed in both settings.
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- 2017
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11. The brain-gut axis: A prime therapeutic target in traumatic brain injury
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Jessica L. Weaver
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0301 basic medicine ,Traumatic brain injury ,Gut–brain axis ,Anti-Inflammatory Agents ,Inflammation ,Brain tissue ,Bioinformatics ,03 medical and health sciences ,0302 clinical medicine ,Brain Injuries, Traumatic ,Brain-Gut Axis ,medicine ,Animals ,Humans ,Endocrine system ,Microbiome ,Molecular Biology ,Intestinal permeability ,business.industry ,General Neuroscience ,Brain ,Chronic injury ,medicine.disease ,Gastrointestinal Microbiome ,Intestines ,030104 developmental biology ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in trauma patients. The primary focus of treating TBI is to prevent additional injury to the damaged brain tissue, known as secondary brain injury. This treatment can include treating the body’s inflammatory response. Despite promise in animal models, anti-inflammatory therapy has failed to improve outcomes in human patients, suggesting a more targeted and precise approach may be needed. There is a bidirectional axis between the intestine and the brain that contributes to this inflammation in acute and chronic injury. The mechanisms for this interaction are not completely understood, but there is evidence that neural, inflammatory, endocrine, and microbiome signals all participate in this process. Therapies that target the intestine as a source of inflammation have potential to lessen secondary brain injury and improve outcomes in TBI patients, but to develop these treatments we need to better understand the mechanisms behind this intestinal inflammatory response.
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- 2021
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12. Direct Peritoneal Resuscitation: A review
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Jessica L. Weaver and Jason W. Smith
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Pathology ,medicine.medical_specialty ,Resuscitation ,business.industry ,Organ dysfunction ,Ischemia ,030208 emergency & critical care medicine ,Inflammation ,General Medicine ,medicine.disease ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Blood pressure ,030220 oncology & carcinogenesis ,Edema ,Anesthesia ,Intravascular volume status ,Medicine ,Surgery ,medicine.symptom ,business - Abstract
Conventional treatment for hemorrhagic shock includes the infusion of intravenous (IV) fluid and blood products in order to restore intravascular volume. However, even after normal heart rate and blood pressure are restored, the visceral organs often remain ischemic. This leads to organ dysfunction and also releases numerous cytokines and inflammatory mediators which activate the body's inflammatory response. The use of Direct Peritoneal Resuscitation (DPR) helps counteract this response. DPR involves infusion of hypertonic fluid into the abdomen in addition to IV resuscitation. This causes rapid and sustained dilation of the arterioles, especially those in the intestine, which reduces organ ischemia and cellular hypoxia. Studies in animals have demonstrated that use of DPR after hemorrhagic shock can reduce organ edema, improve liver blood flow, and reduce serum levels of inflammatory cytokines. Subsequent human studies have shown that DPR after damage control surgery for hemorrhage or sepsis leads to faster abdominal closure, higher rate of primary fascial closure, and reduced abdominal complications. Peritoneal resuscitation has also shown benefits in the resuscitation after acute brain death, including reduced inflammatory mediators and organ edema. Use of DPR in potential organ donors leads to an increase in the number of organs procured per donor, most frequently by increasing the number of lungs procured.
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- 2016
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13. Large-bowel disease presenting as small-bowel obstruction is associated with a poor prognosis
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Vikram G. Ramjee, Ernesto A. Sepulveda, Eric Riedinger, Rebecca E. Barnett, Jessica L. Weaver, Danielle E. Patterson, Jason Younga, Robert Keskey, and William G. Cheadle
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Adult ,Male ,medicine.medical_specialty ,Hernia ,Adolescent ,Population ,Kentucky ,Medical Records ,03 medical and health sciences ,Ileocecal valve ,Young Adult ,0302 clinical medicine ,Age Distribution ,Intestine, Small ,medicine ,Humans ,Multicenter Studies as Topic ,Hospital Mortality ,Intestine, Large ,Sex Distribution ,education ,Veterans Affairs ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,business.industry ,Mortality rate ,Medical record ,General surgery ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Inflammatory Bowel Diseases ,Prognosis ,Surgery ,Bowel obstruction ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Emergency Medicine ,030211 gastroenterology & hepatology ,Female ,business ,Tomography, X-Ray Computed ,Intestinal Obstruction - Abstract
Introduction Small-bowel obstruction (SBO) is a common cause of admission to the surgical service. On rare occasions, a diagnosed SBO is actually due to large-bowel pathology combined with an incompetent ileocecal valve. The purpose of this study was to investigate this phenomenon. Methods We performed a retrospective medical record review of patients that were admitted with a diagnosis of SBO at University of Louisville hospital and the Veterans Affairs hospitals in Louisville, KY, from 2006 until 2014. Results A total of 498 patients were admitted with SBO during this time period. Forty-one patients were found to have an underlying large-bowel disease. The most common large-bowel pathologies included malignancy (51%), inflammation (15%), and infection (15%). Fifteen (43%) of these patients died during admission; 93% of these were due to either their bowel obstruction or the underlying disease state. This was significantly higher than the general population (9.4% mortality, 6% due to underlying disease). Conclusions Patients that present with SBO due to a large-bowel source have a much higher mortality rate than those that present with other causes. Rapid identification of these patients will allow for more timely and appropriate treatment.
- Published
- 2015
14. Sex chromosome complement affects social interactions in mice
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Lucia D. Tejada, Emilie F. Rissman, Jessica L. Weaver, and Anika A. McPhie-Lalmansingh
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Male ,Elevated plus maze ,medicine.medical_specialty ,Gonad ,Disorders of Sex Development ,Anxiety ,Motor Activity ,Y chromosome ,X-inactivation ,Article ,Developmental psychology ,Behavioral Neuroscience ,Mice ,Endocrinology ,Internal medicine ,Y Chromosome ,medicine ,Animals ,Disorders of sex development ,Genes, sry ,Social Behavior ,Sex Chromosome Aberrations ,Sexual differentiation ,Autosome ,Behavior, Animal ,Endocrine and Autonomic Systems ,Feeding Behavior ,medicine.disease ,Mice, Inbred C57BL ,medicine.anatomical_structure ,Testis determining factor ,Female ,Psychology ,Psychomotor Performance - Abstract
Sex differences in behavior can be attributed to differences in steroid hormones. Sex chromosome complement can also influence behavior, independent of gonadal differentiation. The mice used for this work combined a spontaneous mutation of the Sry gene with a transgene for Sry that is incorporated into an autosome thus disassociating gonad differentiation from sex chromosome complement. The resulting genotypes are XX and XY(-) females (ovary-bearing) along with XXSry and XY(-)Sry males (testes-bearing). Here we report results of basic behavioral phenotyping conducted with these mice. Motor coordination, use of olfactory cues to find a food item, general activity, foot shock threshold, and behavior in an elevated plus maze were not affected by gonadal sex or sex chromosome complement. In a one-way active avoidance learning task females were faster to escape an electric shock than males. In addition, sex chromosome complement differences were noted during social interactions with submissive intruders. Female XY(-) mice were faster to follow an intruder than XX female mice. All XY(-) mice spent more time sniffing and grooming the intruder than the XX mice, with XY(-) females spending the most amount of time in this activity. Finally, XX females were faster to display an asocial behavior, digging, and engaged in more digging than XXSry male mice. All of these behaviors were tested in gonadectomized adults, thus, differences in circulating levels of gonadal steroids cannot account for these effects. Taken together, these data show that sex chromosome complement affects social interaction style in mice.
- Published
- 2008
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