All news from Trauma and Critical Care Medicine

End-Of-Life Patients Suffering Last Days

In the end, it wasn't easy for Aaron McQ to decide when to die. The 50-year-old Seattle man a former world traveler, triathlete and cyclist learned he had leukemia five years ago, followed by an even grimmer diagnosis in 2016: a rare form of amyotrophic lateral sclerosis, or ALS.

An interior and urban designer who legally changed his given name, McQ had been in pain and physical decline for years. Then the disease threatened to shut down his ability to swallow and breathe. "It's like waking up every morning in quicksand," McQ said. "It's terrifying."

Keeping Kidney Stones At Bay During Spaceflights

A new, painless, non-invasive procedure that harnesses ultrasound technology to reposition kidney stones, in an effort to offer the sufferer quick relief, will undergo testing in emergency patients. The development and assessment of the new technology are led by University of Washington and UW Medicine, in collaboration with other universities and agencies.

Kidney Stones

Kidney stones are an increasingly common condition that affects 1 in 11 Americans during their lifetime. The condition is even more frequently encountered in astronauts during space missions. The hope is that the new technology could benefit astronauts as well as Earth-side patients.

Factors Associated With Phantom Odor Perception Among US Adults

A new study finds that one in 15 Americans (or 6.5%) over the age of 40 experiences phantom odors. The study is the first in the US to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study could inform future research aiming to unlock the mysteries of phantom odors.

Imagine the foul smell of an ashtray or burning hair. Now imagine if these kinds of smells were present in your life, but without a source. A new study finds that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors.

Research examines the prevalence of and risk factors for phantom odor perception. The study could inform future research aiming to unlock the mysteries of phantom odors. The study was published in JAMA Otolaryngology-Head and Neck Surgery.

Prevalence Of Stigmatizing Altitudes Towards Psoriasis Patients

Research examining the common this stigma may be among the general population of the United States as well as among medical students. The study also found false perceptions about psoriasis continue to persist, including the belief that psoriasis is contagious and that it is not a serious illness.

The stigma associated with the autoimmune disease psoriasis may lead people to avoid patients who show signs of the condition, including not wanting to date, shake hands, or have people in their homes if they suffer from the disease. The study was published in the Journal of the American Academy of Dermatology

Immune System Can Regulate Insulin

Scientists have identified a specific insulin signaling pathway that, when activated, revs up the response of T cells in the immune system to divide rapidly and secrete cytokines, chemical messenger proteins that activate the rest of the immune system.

Role Of Insulin

The role of insulin as a boost to the immune system to improve its ability to fight infection has been detailed for the first time by Toronto General Hospital Research Institute (TRI) scientists.  A fast and effective immune response protects us against disease and life-threatening infections by destroying infected cells or microbes, while a wrong or inefficient one can cause immune system disorders to develop.

The research findings are published in a paper called, "Insulin receptor-mediated stimulation boosts T cell immunity during inflammation and infection," in Cell Metabolism. 

Protein Complexes Assemble Before The Subunits

Researchers find that most protein complexes in yeast cells assemble before the subunits have fully formed. This mechanism might prevent the formation of toxic protein aggregates. Most cellular processes are carried out by proteins, which generally assemble into heteromeric complexes those composed of two or more distinct subunits.

Although it was thought for many years that protein subunits diffuse freely in the cell and form complexes through random collisions, this seems unlikely, given that the cellular environment is extremely crowded. The study was published in Nature.

Oral Anticoagulants With Regional Anesthesia In Orthopedic Patients

The use of direct oral anticoagulants including apixaban, rivaroxaban, and dabigatran, which are approved for several therapeutic indications, can simplify perioperative and postoperative management of anticoagulation.

Utilization of regional neuraxial anesthesia in patients receiving anticoagulants carries a relatively small risk of hematoma, the serious complications of which must be acknowledged. Given the extensive use of regional anesthesia in surgery and the increasing number of patients receiving direct oral anticoagulants, it is crucial to understand the current clinical data on the risk of hemorrhagic complications in this setting, particularly for anesthesiologists.

They discuss current data, guideline recommendations, and best practice advice on effective management of the direct oral anticoagulants and regional anesthesia, including in specific clinical situations, such as patients undergoing major orthopedic surgery at high risk of a thromboembolic event, or patients with renal impairment at an increased risk of bleeding.

Point-Of-Care Ultrasound Improved The Safety Of Pediatric Emergency Care

Point-of-care ultrasound (POCUS) has become an important adjunct to clinical diagnosis and procedural guidance in the Pediatric Emergency Department (PED), supported by literature demonstrating that its use can improve patient safety and expedite lifesaving care.

POCUS further helps to reduce costs and children’s exposure to ionizing radiation. Not only is POCUS ideally suited for “rule-in” diagnostic applications for many pediatric indications, but ultrasound guidance can also improve the safety and success of common procedures, including placement of central venous catheters (CVCs) and peripheral intravenous (PIV) catheters, thoracentesis, paracentesis, regional anesthesia, lumbar punctures and other procedures.

New Method For Better Understanding of Circadian Rhythms

Scientists have developed a unified, data-driven computational approach to infer and reveal the connections in biological and chemical oscillatory networks that impact circadian rhythms, based on their time-series data.

Once they establish the topology of these complex networks, they can infer how cells in the network work together in synchrony, an important state for the brain. Abnormal synchrony has been linked to a variety of brain disorders, such as epilepsy, Alzheimer's disease, and Parkinson's disease. The study was published its study (“Inferring dynamic topology for decoding spatiotemporal structures in complex heterogeneous networks”) in PNAS.