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| 1 | Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury显示文摘AIM: To examine complications associated with the use of therapeutic temperature modulation(mild hypothermia and normothermia) in patients with severe traumatic brain injury(TBI). METHODS: One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale(GCS) < 9, intensive care unit(ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation(TTM) with continuous surface cooling and indwelling bladder temperature probes. The control group received standard treatment with intermittent acetaminophen for fever. Information regarding complications during the time in the ICU was collected as follows: Pneumonia was identified using a combination of clinical and laboratory data. Pulmonary embolism, pneumothorax and deep venous thrombosis were identified based onimaging results. Cardiac arrhythmias and renal failure were extracted from the clinical documentation. acute respiratory distress syndrome and acute lung injury were determined based on chest imaging and arterial blood gas results. A logistic regression was conducted to predict hospital mortality and a multiple regression was used to assess number and type of clinical complications. RESULTS: One hundred and fourteen patients were included in the analysis(mean age = 41.4, SD = 19.1, 93 males), admitted to the Jackson Memorial Hospital Neuroscience ICU and Ryder Trauma Center(mean GCS = 4.67, range 3-9), were identified and included in the analysis. Method of injury included motor vehicle accident(n = 29), motor cycle crash(n = 220), blunt head trauma(n = 212), fall(n = 229), pedestrian hit by car(n = 216), and gunshot wound to the head(n = 27). Ethnicity was primarily Caucasian(n = 260), as well as Hispanic(n = 227) and African American(n = 223); four patients had unknown ethnicity. Patients received either TTM(43) or standard therapy(71). Within the TTM group eight patients were treated with normothermia after TBI and 35 patients were treated with hypothermia. A logistic regression predicting in hospital mortality with age, GCS, and TM demonstrated that GCS(Beta = 0.572, P < 0.01) and age(Beta =-0.029) but not temperature modulation(Beta = 0.797, ns) were significant predictors of in-hospital mortality [χ2(3) = 22.27, P < 0.01] A multiple regression predicting number of complications demonstrated that receiving TTM was the main contributor and was associated with a higher number of pulmonary complications(t =-3.425, P = 0.001). CONCLUSION: Exposure to TTM is associated with an increase in pulmonary complications. These findings support more attention to these complications in studies of TTM in TBI patients. | Kristine H O’Phelan Amedeo Merenda Katherine G Denny Kassandra E Zaila Cynthia Gonzalez | 2015 | World Journal of Critical Care Medicine2015，4，4： | 18 |
| 2 | Hemostasis in liver transplantation:Pathophysiology,monitoring,and treatment显示文摘Recent findings in the pathophysiology and monitoring of hemostasis in patients with end stage liver disease have major impact on coagulation management during liver transplantation. There is increasing evidence, that the changes in both coagulation factors and platelet count regularly observed in patients with liver cirrhosis cannot be interpreted as a reliable indicator of diffuse bleeding risk. Instead, a differentiated view on hemostasis has led to the concept of a rebalanced coagulation system: While it is important to recognize that procoagulant factors are reduced in liver cirrhosis, it is also evident that synthesis of anticoagulant factors and fibrinolytic proteins produced in the liver is also diminished. Similarly, the decreased platelet count may be counterbalanced by increased platelet aggregability caused by highly active von Willebrand multimeres. The coagulation system is therefor stated to be rebalanced. While under normal 'unstressed' conditions diffuse bleeding is rarely observed, however both diffuse bleeding or thrombus formation may occur when compensation mechanisms are exhausted. While most patients presenting for liver transplantation have severe cirrhosis, liver function and thus production of pro- and anticoagulant factors can be preserved especially in cholestatic liver disease. During liver transplantation, profound changes in the hemostasis system can occur. Surgical bleeding can lead to diffuse bleeding as coagulation factors and platelets are already reduced. Ischemia and tissue trauma can lead to alterations of hemostasis comparable to trauma induced coagulopathy. A further common disturbance often starting with the reperfusion of the transplanted organ is hyperfibrinolysis which can eventually precipitate complete consumption of fibrinogen and an endogenous heparinization by glycocalyx shedding. Moreover, thrombotic events inliver transplantations are not uncommon and contribute to increased mortality. Besides conventional laboratory methods, bed-side monitoring of hemostasis(e.g., thrombelastography, thrombelastometry) is often used during liver transplantation to rapidly diagnose decreases in fibrinogen and platelet count as well as hyperfibrinolysis and to guide treatment with blood products, factor concentrates, and antifibrinolytics. There is also evidence which suggests when algorithms based on bed-side hemostasis monitoring are used a reduction of blood loss, blood product use, and eventual mortality are possible. Notably, the bed-side monitoring of anticoagulant pathways and the thrombotic risk is not possible at time and thus a cautious and restrictive use of blood products is recommended. | Matthias Hartmann Cynthia Szalai Fuat H Saner | 2016 | World Journal of Gastroenterology2016，22，4： | 11 |
| 3 | 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis显示文摘 | Jacqueline E Tate Anthony H Burton Cynthia Boschi-Pinto A Duncan Steele Jazmin Duque Umesh D Parashar | 2012 | The Lancet Infectious Diseases2012，，2： | 2 |
| 4 | U- Pb zircon and geochemical evidence for bimodal mid-Paleozoic magmatism and syngenetic base-metal mineralization in the Yukon-Tanana terrane,Alaska显示文摘 | Cynthia D B Joseph L W Melanie J H | | 0，，7： | 1 |
| 5 | Correlation between hydrolysis of the fi-Lactam bond of the cephalosporin nucleus and expulsion of the 3-substituent 显示文摘 | Cynthia H Ocallaghan Susan M Kirby Morris A | 1972 | Journal of Bacteriology1972，110，3： | 1 |
| 6 | The efficacy of spinosad againstthe western flower thrips, Frankliniella occidentalis, and its impact on associated biological control agents on greenhouse cucumbers in southern Ontario显示文摘 | Terri J Cynthia S D Ron H | 2005 | Pest Management Science2005，61，： | 1 |
| 7 | ??Examining Walkability and Social Capital as Indicators of Quality of Life at the Municipal and Neighborhood Scales显示文摘 | Rogers Shannon H John M Halstead Kevin H Gardner Cynthia H Carlson | 2010 | Quality of Life2010，6，2： | 1 |
| 8 | Assessing the performance of biological filtration as pretreatment to low pressure membranes for drinking water显示文摘 | Cynthia H Huck P M Peldszus S | 2009 | Environ Sci Technol2009，43，10： | 1 |
| 9 | Resources, knowl- edge and influence: the organizational effects of inter - organizational collaboration 显示文摘 | Cynthia H Nelson P Thomas B L | 2003 | Journal of Management Studies2003，40，2： | 1 |
| 10 | Atrazine and Cancer Incidence Among Pesticide Applicators in the Agricultural Health Study (1994-2007)显示文摘 | Beane Freeman Laura E Rusiecki Jennifer A Hoppin Jane A Lubin Jay H Koutros Stella Andreotti Gabriella Zahm Sheila Hoar Hines Cynthia J Coble Joseph B Barone-Adesi Francesco Sloan Jennifer Sandler Dale P Blair Aaron Alavanja Michael C R | 2011 | Environmental Health Perspectives2011，，9： | 1 |
| 11 | Soils and global climate change: changes andopportunities显示文摘 | Cynthia R Daniel H | 2000 | Soil Science2000，165，： | 1 |
| 12 | Functional and molecular characterization of the human neutral solute channel aquaporin-9 显示文摘 | Tsukaguchi H Weremowicz S Cynthia C | 1999 | Hediger1999，277，5： | 1 |
| 13 | Functional and molecular characterization of the human neutral solute channel aquaporin-9 显示文摘 | Tsukaguchi H Stanislawa W Cynthia C | 1999 | Am J Physiol Renal Physiol1999，277，： | 1 |
| 14 | Escalating world- wide use of urea a global change contributing to coastal eutroph- ication 显示文摘 | PATRICIA M G JOHN H CYNTHIA H | 2006 | Biogeochemistry2006，77，3： | 1 |
| 15 | Exercise-induced alterations in plasma con- centrations of ghrelin, adiponectin, leptin, glucose, insulin, and cortisol in horses显示文摘 | MARY E GORDON KENNETH H MCKEEVER CYNTHIA L BETROS | 2007 | The Veterinary J2007，173，3： | 1 |
| 16 | A Modification to the NOAH LSM to Simulate Heat Mitigation Strategies in the New York City Metropolitan Area显示文摘 | Lynn Barry H Carlson Toby N Rosenzweig Cynthia Goldberg Richard Druyan Leonard Cox Jennifer Gaffin Stuart Parshall Lily Civerolo Kevin | 2009 | Journal of Applied Meteorology and Climatology2009，，2： | 1 |
| 17 | Exposure to tetrabromobisphenol A (TBBPA) in Wistar rats: neurobehavioral effects in offspring from a one-generation reproduction study 显示文摘 | Lilienthal H Cynthia MV | 2008 | Toxicology2008，246，： | 1 |
| 18 | Signals from the Reproductive Systemregulate the Lifespan of C Elegans显示文摘 | Honor H Cynthia K | 1999 | Nature1999，399，： | 1 |
| 19 | Variations of phytoplankton community structure related to water quality trends in a tropical karstic coastal zone 显示文摘 | CYNTHIA A G JORGE A H | 2006 | Marine Pollution Bulletin2006，52，1： | 1 |
| 20 | Fine mapping of the rice low phytic acid(Lpal) locus显示文摘 | Cynthia B Andaya Thomas H Tai | 2005 | TAG Theoretical and Applied Genetics2005，111，3： | 1 |
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