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Experientia Supplementum (2012) 2018Traumatic injury as one of the world's most relevant but neglected health concerns results in modulated inflammasome activity, which is closely linked to the development... (Review)
Review
Traumatic injury as one of the world's most relevant but neglected health concerns results in modulated inflammasome activity, which is closely linked to the development of post-injury complications. Cytokine-producing capacity of cells is important for the appropriate immune response to trauma and requires not only synthesis and transcription of inflammasome components but also their activation. Unfortunately, the precise role of inflammasome in trauma is still largely unknown. However, in the following chapter, we provide an overview on the best described inflammasomes in the various settings of trauma, introducing the recent findings on the up-to-date best described NLRP inflammasomes and underlying cytokines in the inflammatory response to trauma.
Topics: Cytokines; Humans; Inflammasomes; Wounds and Injuries
PubMed: 30536169
DOI: 10.1007/978-3-319-89390-7_5 -
Spine Dec 2011To review findings from recent research in consideration of relevant theoretical models between post-traumatic stress disorder (PTSD) and pain, and to review emerging... (Review)
Review
STUDY DESIGN
To review findings from recent research in consideration of relevant theoretical models between post-traumatic stress disorder (PTSD) and pain, and to review emerging interventions and prevention options for PTSD in individuals with whiplash.
OBJECTIVE
A traumatic accident may lead to whiplash injury, but can also frequently lead to post-traumatic stress. There is concern that this occurrence is more problematic than each disorder separately. Furthermore, it is unclear why this might occur. This review addresses two mechanisms that might explain this, specifically arousal and pain.
SUMMARY OF BACKGROUND DATA
There is a growing body of research revealing relationships between injury, pain and psychological trauma with important implications for the prevention and management of chronic pain and post-traumatic reactions. Intervention for PTSD in the context of whiplash has been shown to be effective, and seems to have a beneficial effect on the whiplash injury. The intervention for traumatic stress in acute whiplash presents further challenges.
METHODS
This chapter will review findings from recent research in consideration of relevant theoretical models between PTSD and pain in general and more specifically in the case of pain resulting from whiplash injury. A review of emerging interventions and prevention options for PTSD in individuals with whiplash will also be discussed to provide a basis for treatment of individuals and future research.
RESULTS
Recent work in this area suggests that stress, pain and arousal interact through the effects of tissue injury and the distress in response to perceived threat. Post-traumatic stress plays an important role in a significant proportion of whiplash sufferers as its presence seems to deleteriously impact recovery.
CONCLUSION
Intervention for PTSD in the context of whiplash has been shown to be effective, and seems to have a beneficial effect on the whiplash injury. The intervention for traumatic stress in acute whiplash presents further challenges.
Topics: Humans; Pain; Stress Disorders, Post-Traumatic; Stress, Psychological; Whiplash Injuries; Wounds and Injuries
PubMed: 22020618
DOI: 10.1097/BRS.0b013e3182387fcd -
The Journal of Surgical Research Mar 2015Acute traumatic injury is a complex disease that has remained a leading cause of death, which affects all ages in our society. Direct mechanical insult to tissues may... (Review)
Review
Acute traumatic injury is a complex disease that has remained a leading cause of death, which affects all ages in our society. Direct mechanical insult to tissues may result in physiological and immunologic disturbances brought about by blood loss, coagulopathy, as well as ischemia and reperfusion insults. This inappropriate response leads to an abnormal release of endogenous mediators of inflammation that synergistically contribute to the incidence of morbidity and mortality. This aberrant activation and suppression of the immune system follows a bimodal pattern, wherein activation of the innate immune responses is followed by an anti-inflammatory response with suppression of the adaptive immunity, which can subsequently lead secondary insults and multiple organ dysfunction. Traumatic injury rodent and swine models have been used to describe many of the underlying pathologic mechanisms, which have led to an improved understanding of the morbidity and mortality associated with critically ill trauma patients. The enigmatic immunopathology of the human immunologic response after severe trauma, however, has never more been apparent and there grows a need for a clinically relevant animal model, which mimics this immune physiology to enhance the care of the most severely injured. This has necessitated preclinical studies in a more closely related model system, the nonhuman primate. In this review article, we summarize animal models of trauma that have provided insight into the clinical response and understanding of cellular mechanisms involved in the onset and progression of ischemia-reperfusion injury as well as describe future treatment options using immunomodulation-based strategies.
Topics: Acute Disease; Animals; Complement Activation; Cytokines; Disease Models, Animal; Humans; Neutrophils; Shock, Hemorrhagic; Wounds and Injuries
PubMed: 25481528
DOI: 10.1016/j.jss.2014.10.025 -
Australasian Emergency Nursing Journal... Feb 2012Injury is a leading cause of mortality, hospitalised morbidity and disability in Australia and New Zealand. Of the many public health challenges facing clinicians on a... (Review)
Review
Injury is a leading cause of mortality, hospitalised morbidity and disability in Australia and New Zealand. Of the many public health challenges facing clinicians on a daily basis, traumatic injury is one of the most significant. A large spectrum of injury severity may result, ranging from minor injuries which require little medical intervention through to severe multisystem trauma, requiring definitive management by an experienced multidisciplinary team. An improved understanding of the incidence and prevalence of trauma can empower clinicians of all levels of experience to contribute to improving the trauma system they work in at a local level. This paper provides an overview of the history and epidemiology of traumatic injury in Australia and New Zealand. The reading of this article and completion of revision questions is equivalent to 2h of self-directed learning.
Topics: Australia; Brain Injuries; Emergency Service, Hospital; Humans; Incidence; Injury Severity Score; Multiple Trauma; New Zealand; Prevalence; Trauma Centers; Wounds and Injuries
PubMed: 22813623
DOI: 10.1016/j.aenj.2011.12.001 -
Stem Cell Reviews and Reports Aug 2021Traumatic injuries are a leading cause of death and disability in both military and civilian populations. Given the complexity and diversity of traumatic injuries, novel... (Review)
Review
Traumatic injuries are a leading cause of death and disability in both military and civilian populations. Given the complexity and diversity of traumatic injuries, novel and individualized treatment strategies are required to optimize outcomes. Cellular therapies have potential benefit for the treatment of acute or chronic injuries, and various cell-based pharmaceuticals are currently being tested in preclinical studies or in clinical trials. Cellular therapeutics may have the ability to complement existing therapies, especially in restoring organ function lost due to tissue disruption, prolonged hypoxia or inflammatory damage. In this article we highlight the current status and discuss future directions of cellular therapies for the treatment of traumatic injury. Both published research and ongoing clinical trials are discussed here.
Topics: Cell- and Tissue-Based Therapy; Humans; Wounds and Injuries
PubMed: 33420590
DOI: 10.1007/s12015-020-10086-7 -
Immunology Apr 2021Traumatic injury initiates a large and complex immune response in the minutes after the initial insult, comprising of simultaneous pro- and anti-inflammatory responses.... (Review)
Review
Traumatic injury initiates a large and complex immune response in the minutes after the initial insult, comprising of simultaneous pro- and anti-inflammatory responses. In patients that survive the initial injury, these immune responses are believed to contribute towards complications such as the development of sepsis and multiple organ dysfunction syndrome. These post-traumatic complications affect a significant proportion of patients and are a major contributing factor for poor outcomes and an increased burden on healthcare systems. Therefore, understanding the immune responses to trauma is crucial for improving patient outcomes through the development of novel therapeutics and refining resuscitation strategies. In order to do this, preclinical animal models must mimic human immune responses as much as possible, and as such, we need to understand the constraints of each species in the context of trauma. A number of species have been used in this field; however, these models are limited by their genetic background and their capacity for recapitulating human immune function. This review provides a brief overview of the immune response in critically injured human patients and discusses the most commonly used species for modelling trauma, focusing on how their immune response to serious injury and haemorrhage compares to that of humans.
Topics: Animals; Disease Models, Animal; Hemorrhage; Humans; Immunity; Multiple Organ Failure; Sepsis; Wounds and Injuries
PubMed: 32986856
DOI: 10.1111/imm.13272 -
Shock (Augusta, Ga.) Dec 2017Trauma is responsible for a large proportion of the world's burden of disease, and is by far the biggest killer of young adults. Hemorrhage is the leading cause of... (Review)
Review
Trauma is responsible for a large proportion of the world's burden of disease, and is by far the biggest killer of young adults. Hemorrhage is the leading cause of preventable death and its effects are directly correlated with the incidence multi-organ failure in survivors. Trauma research is challenging due to patient heterogeneity, limited randomized controlled trials, and in vitro studies that fail to mimic the systemic injury response. Preclinical research remains essential for mechanistic and therapeutic discovery. Yet modeling the multifaceted nature of traumatic injury poses important experimental and welfare challenges associated with the onset of injury and prehospital and intra-operative care, the limited inter-species validation of coagulation profiles, the use of anesthesia/analgesia, and its impact on the systemic response to trauma; and the challenge of sustaining intensive care in recovery models. Proper model selection depends on the purpose of a given model and the criteria by which the experimental readouts will be clinically relevant. Such complexity warrants further refinement of experimental methodology and outcome measures to improve its clinical efficacy, while ensuring animal well-being. We review the experimental methodologies currently used for modeling traumatic hemorrhagic shock and addressing their impact on clinical translation. The aim of the review is to improve transparency and form a consensus when reporting methodology in trauma modeling.
Topics: Animals; Critical Care; Disease Models, Animal; Humans; Practice Guidelines as Topic; Shock, Hemorrhagic; Wounds and Injuries
PubMed: 28509685
DOI: 10.1097/SHK.0000000000000901 -
Transfusion Apr 2019The majority of potentially preventable deaths after trauma are related to hemorrhage and occur early after injury, with the largest number of deaths occurring before... (Review)
Review
The majority of potentially preventable deaths after trauma are related to hemorrhage and occur early after injury, with the largest number of deaths occurring before hospital arrival. Approximately one-fourth of trauma deaths may be potentially preventable through early medical and surgical interventions. Interventions dedicated to bleeding control and hemostatic resuscitation have demonstrated merit in decreasing hemorrhagic injury mortality. Advancing these novel strategies to the casualty in the prehospital phase of care, particularly in tactical or austere environments, may prove beneficial for hemorrhage mitigation to temporize the window of survival to definitive care. Future studies of resuscitation and survival after traumatic injury must include analysis of prehospital deaths to fully understand the outcomes of early interventions.
Topics: Emergency Medical Services; Hemorrhage; Humans; Resuscitation; Wounds and Injuries
PubMed: 30980749
DOI: 10.1111/trf.15161 -
Current Opinion in Hematology Nov 2017To describe how hemostatic resuscitation can be used in the prehospital phase of resuscitation to reduce preventable deaths after traumatic injury. (Review)
Review
PURPOSE OF REVIEW
To describe how hemostatic resuscitation can be used in the prehospital phase of resuscitation to reduce preventable deaths after traumatic injury.
RECENT FINDINGS
Hemorrhagic shock is the leading cause of death that is preventable after injury. The National Academy of Sciences, recently, recommended that achievement of zero preventable deaths after traumatic injury should be the goal of a national trauma system. In the United States, there are an estimated 25 000 preventable deaths per year in the prehospital phase of resuscitation because of traumatic hemorrhagic shock. Therefore, to achieve the goal of zero preventable deaths after injury, both shock and hemostatic dysfunction need to be addressed rapidly in the prehospital phase of resuscitation. This review will highlight the epidemiology and outcomes of traumatic hemorrhagic shock, and explore potential solutions such as group O whole blood and platelets stored at 2-6°C. Trauma research receives the lowest funding relative to the burden of morbidity and mortality it creates when compared with all other diseases. Increased resources are required to achieve zero preventable deaths after injury.
SUMMARY
Prehospital hemostatic resuscitation has the potential to significantly reduce preventable death from hemorrhage.
Topics: Hemostatic Techniques; Humans; Resuscitation; Shock, Hemorrhagic; Wounds and Injuries
PubMed: 28832355
DOI: 10.1097/MOH.0000000000000386 -
Clinical Rheumatology May 2014Traumatic injury as a trigger for the subsequent development of psoriatic arthritis (PsA) has been implicated by several case reports and case series. However, it is... (Review)
Review
Traumatic injury as a trigger for the subsequent development of psoriatic arthritis (PsA) has been implicated by several case reports and case series. However, it is still unclear whether trauma is the inciting event or just an incidental finding. It is thought that the interplay of genetic, immunologic, and environmental factors, such as trauma, may trigger the development of PsA. At least two hypotheses of how trauma may be linked to the development of PsA have surfaced and involve a "deep Koebner effect," the concept of a synovio-entheseal complex and activation of the innate immune system by biomechanical factors. The role of neuropeptides such as substance P and vasoactive intestinal peptide has been highlighted in the synovium after trauma. Better understanding of this phenomenon would shed light into the pathophysiology of Psa and help the development of preventive and therapeutic strategies.
Topics: Adult; Aged; Arthritis, Psoriatic; Female; Humans; Male; Middle Aged; Neuropeptides; Research Design; Substance P; Synovial Membrane; Vasoactive Intestinal Peptide; Wounds and Injuries; Young Adult
PubMed: 24249146
DOI: 10.1007/s10067-013-2436-7