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Complicated Recovery Awaits Victims Injured in Vegas Attack

LAS VEGAS (AP) — Their concert turned into a siege, and now their lives may become a battle. The staggering count of people injured in the shooting at a Las Vegas music festival means their recoveries are likely to be as varied as the victims themselves. Some injuries are as simple as broken bones, others gunshot wounds involving multiple surgeries and potential transplants, and all come with the added emotional scars of enduring the deadliest shooting in modern U.S. history, with 59 killed. At least 130 people remained hospitalized Tuesday, with 48 listed in critical condition. Hospitals said 185 others had already been released. At Sunrise Hospital and Medical Center alone, the count of those treated included 120 people who were struck by gunfire, a glimpse of the amount of ammunition unleashed in the attack. Rehabilitation for the most seriously hurt victims will take far longer than many may realize. "Years," said Dr. Thomas Scalea, physician-in-chief at the University of Maryland's Shock Trauma Center in Baltimore, one of the nation's largest trauma centers. "It's not days or weeks." Edward Leon raced to Las Vegas from Palm Springs, California, after learning his niece was shot in the stomach. He said he cried the whole way there. Although she survived an initial operation, he worries about what will come next. "She's out of surgery," he said, "but it's a long road ahead." At the site of the attack, people fashioned stretcher...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Major Incidents News Mass Casualty Incidents Patient Care Source Type: news

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In conclusion, toxic cytokine and HMGB1 released from failing small-for-size grafts leads to pulmonary adhesion molecule expression, leukocyte infiltration and injury. IP prevents DAMP release and toxic cytokine formation in small-for-size grafts, thereby attenuating ALI. PMID: 29755641 [PubMed]
Source: International Journal of Physiology, Pathophysiology and Pharmacology - Category: Physiology Tags: Int J Physiol Pathophysiol Pharmacol Source Type: research
Abstract Intestinal ischemia-reperfusion (I/R) occurs in various clinical settings, such as transplantation, acute mesenteric arterial occlusion, trauma and shock. I/R injury causes severe systemic inflammation, leading to multiple organ dysfunction associated with high mortality. The ubiquitin proteasome pathway has been indicated in the regulation of inflammation, particularly through NF-κB signaling pathway. PYR-41 is a small molecular compound that selectively inhibits ubiquitin-activating enzyme E1. A mouse model of intestinal I/R injury by clamping the superior mesenteric artery for 45 minutes was perf...
Source: Am J Physiol Gastroi... - Category: Gastroenterology Authors: Tags: Am J Physiol Gastrointest Liver Physiol Source Type: research
I was talking with someone recently about grief when she said that it felt like being on a roller coaster ride. This person is facing the impending death of a loved one even as there is no definitive timeline per the treatment team. We spoke of the dynamic of anticipatory grief and the ways in which it impacts the process of letting go of this person as she plans her future in the face of his eventual absence. I have found both in my therapeutic practice and in my personal life, that anticipatory grief genuinely effects mourners, although a 2006 article published in the Counseling, Psychology, and Health Journal quest...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Aging Family Grief and Loss Health-related Interview Peer Support Personal anticipatory grief Cancer grieving Mourning widow widower Source Type: blogs
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis were negative. She received valganciclovir prophylaxis for 3 months after transplantation. Medications are tacrolimus, prednisone, ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Allergies & Immunology Infectious Disease Source Type: blogs
ová M, Veselá J Abstract The ischemia and reperfusion of a jejunal graft during transplantation triggers the stress of endoplasmic reticulum; thus inducing the synthesis of pro-inflammatory cytokines. Spreading of these signals stimulate immunological reactions in distal tissues i.e. lung, liver and spleen. The aim of this study was to detect the molecular changes in liver and spleen induced by transplanted jejunal graft with one or six hours of reperfusion (group Tx1 and Tx6). Analysis of gene expression changes of inflammatory mediators (TNFalpha, IL-10) and specific chaperones (Gadd153, Grp78) der...
Source: Physiological Research - Category: Physiology Authors: Tags: Physiol Res Source Type: research
Conclusions: In intervention development directed at increasing the level of PA and reducing sedentary time in recipients of solid-organ transplantation, attention should be paid to physical limitations, fear of negative effects, low expectations and self-confidence, health and physical outcomes, and exercise self-efficacy. PMID: 29757444 [PubMed - as supplied by publisher]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
This study assesses the effects of mildly increased RV afterload on long-term outcome after OLT in relation to RV function.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Original Article Source Type: research
Abstract Joint bleeding and resultant arthropathy are major determinants of quality of life in haemophilia patients. We previously developed a mesenchymal stromal cell (MSC)-based treatment approach for haemophilic arthropathy in a mouse model of haemophilia A. Here, we evaluated the long-term safety of intra-articular injection of lentivirally transduced autologous MSCs in non-human primates. Autologous bone-marrow-derived MSCs transduced with a lentiviral vector expressing coagulation factor VIII (FVIII) were injected into the left knee joint of cynomolgus monkeys. We first conducted codon optimization to increa...
Source: International Journal of Hematology - Category: Hematology Authors: Tags: Int J Hematol Source Type: research
CONCLUSIONS: To treat HCV-associated mixed cryoglobulinaemia, it may be beneficial to eliminate HCV infection by using antiviral treatment and to stop the immune response by using rituximab. For skin vasculitis and for some laboratory findings, it may be appropriate to combine antiviral treatment with deletion of B-cell clonal expansions by using of rituximab. The applicability of evidence reviewed here is limited by the absence of any studies with direct-acting antivirals, which are urgently needed to guide therapy. PMID: 29734473 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Erin N, Tanrıöver G, Curry A, Akman M, Duymuş Ö, Gorczynski R Abstract CD200 is a widely expressed cell surface glycoprotein that inhibits excessive inflammation in autoimmunity, transplantation, and viral infections. We previously observed that visceral metastasis of highly aggressive and inflammatory 4THM breast carcinoma cells was markedly decreased in CD200 transgenic mice. The goal of this study was to determine whether exogenous exposure to CD200fc mimics the effects of endogenously over expressed CD200. Female BALB/c mice were injected with CD200fc two times a week for five times. Inject...
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
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