Perivascular Adipose Tissue: A Novel Regulator of Vascular Tone in the Rat Pregnancy.

Perivascular adipose tissue (PVAT) contributes to vasoregulation. The role of this adipose tissue bed in pregnancy has not been examined. Here, we tested the hypothesis that PVAT in pregnant rats decreases resistance artery tone.

The impact of premorbid conditions on temporal pattern and location of adult blunt trauma hospital deaths.

Background: This study was designed to show the importance of age, presence of premorbid conditions, and the type of injury on time and location of adult inhospital trauma mortality.

Methods: All acute blunt trauma deaths at a Level I urban trauma center between April 1, 1993 and March 31, 2003 were individually reviewed to collect data on the following variables: age, gender, presence and number of premorbid conditions, mechanisms of trauma, location of death, acute transfer from another hospital, delay to death, initial Glasgow Coma Score (GCS), Abbreviated Injury Score (AIS), Injury Severity Score (ISS), and revised trauma score (RTS). Bivariate analysis using simple logistic regression was used to show the association between each variable and delay to death.

Surgical management of blunt thoracic and abdominal injuries in Quebec: a limited volume.

Background: Trauma care of thoracic and abdominal injuries is currently in turmoil because of both a decrease in the number of these injuries and a concomitant increase in their nonsurgical management. The goal of this study was to evaluate the incidence of thoracic and abdominal injuries in the province of Quebec and the number of associated surgical procedures.

Methods: Patients with blunt thoracic or abdominal injuries taken to a tertiary trauma center in the province of Quebec from April 1, 1998 to March 31, 2002 were identified.

Is the delay to surgery for isolated hip fracture predictive of outcome in efficient systems?

Background: Adverse outcomes for patients with isolated hip fracture have been documented when preoperative delay is longer than 48 hours. An efficient system will have the capacity to repair all hip fractures within 48 hours. We hypothesized that in an efficient system, there would be a medical justification for a delay greater than 48 hours.

Paying the price of excluding patients from a trauma registry.

Background: The goal of this study was to evaluate the impact of different trauma registry exclusion criteria on the assessment of trauma populations and outcome.

Methods: All patients admitted to a Canadian regional trauma center from April 1, 1993 to March 31, 2002 with a diagnosis of trauma (ICD-9 codes 800 to 959) were reviewed. TOTAL included everyone.

A simple fall in the elderly: not so simple.

Background: The goal of this study was to evaluate the burden of falls in the elderly in a Canadian tertiary trauma center.

Methods: Patients admitted to Charles-LeMoyne Hospital with a low velocity fall (LVF) from April 1, 1993 to March 31, 2000 were individually reviewed. Elderly was defined as age 65 years and older.

[The use of head CT scan in adult trauma victims: an algorithm].

Introduction: The purpose of this study was to identify, through recursive partitioning, clinically relevant criteria which predict the need for acute neurosurgical intervention in a group of patients with mild head injury.

Materials And Methods: A retrospective cohort of all adult patients, from April 2000 to March 2001, who sustained a blunt trauma and underwent head CT scan, was reviewed. The following inclusion criteria for mild head injury were used: initial Glasgow Coma Scale (GCS) ranging from 13 to 15; no loss of consciousness lasting more than one hour; no obvious skull fracture; a cranial CT scan performed.

Comorbidity and age are both independent predictors of length of hospitalization in trauma patients.

Background: Length of hospitalization is a good indicator of resource utilization. Older patients are increasingly suffering trauma, and comorbid medical conditions are also increasing. Our objective was to determine the separate and combined effect of these 2 factors on length of hospital stay for trauma patients in a tertiary trauma centre.

Penetrating thoracoabdominal injuries in Quebec: implications for surgical training and maintenance of competence.

Background: The frequency of penetrating trauma is low in Canada. Current recommendations for the care of patients with penetrating injuries originate from inner city trauma centres with a high volume of such injuries and may not apply to Canada. The purpose of this study was to review the incidence and treatment of penetrating thoracoabdominal injuries in the 4 tertiary trauma centres in Quebec.

Should patients with isolated hip fractures be included in trauma registries?

Background: Patients with isolated hip fractures are frequently excluded from trauma registries. The goal of this study was to show that patients with these injuries have higher resource use and poorer outcomes than the rest of the trauma population.

Methods: The Quebec Trauma Registry was used to identify all trauma patients from April 1, 1998, to March 31, 2003.

Preinjury warfarin use among elderly patients with closed head injuries in a trauma center.

Background: This study aimed to determine the impact of warfarin use on the severity of injury among elderly patients presenting with closed head injuries.

Methods: A cohort of patients 55 years of age or older with closed head injuries taken to a tertiary trauma center between April 1993 and March 2001 was retrospectively identified. Patient characteristics, mechanism of injury, type and severity of injury, and hospital survival data were obtained from the trauma registry.

Improving the TRISS methodology by restructuring age categories and adding comorbidities.

Background: The Trauma and Injury Severity Score (TRISS) methodology was developed to predict the probability of survival after trauma. Despite many criticisms, this methodology remains in common use. The purpose of this study was to show that improving the stratification for age and adding an adjustment for comorbidity significantly increases the predictive accuracy of the TRISS model.

Elderly trauma patients with rib fractures are at greater risk of death and pneumonia.

Background: The purpose of this study was to show that elderly patients admitted with rib fractures after blunt trauma have increased mortality.

Methods: Demographic, injury severity, and outcome data on a cohort of consecutive adult trauma admissions with rib fractures to a tertiary care trauma center from April 1, 1993, to March 31, 2000, were extracted from our trauma registry.

Results: Among 4,325 blunt trauma admissions, there were 405 (9.

Impact of deferred treatment of blunt diaphragmatic rupture: a 15-year experience in six trauma centers in Quebec.

Background: The purpose of this study was to show that blunt diaphragmatic rupture does not require immediate emergency operation in the absence of other indications.

Methods: We reviewed all patients with blunt diaphragmatic rupture admitted within 24 hours of injury to one of six university trauma centers providing trauma care for the province of Quebec from April 1, 1984, to March 31, 1999. Multivariate analysis of demographic profiles, severity indices, indications for operation, and preoperative delays was performed.

Hypertonic saline treatment of severe hyperkalemia in nonnephrectomized dogs.

Objectives: To determine whether a hypertonic saline bolus improves cardiac conduction or plasma potassium levels more than normal saline infusion within 15 minutes of treatment for severe hyperkalemia. Previously with this model, 8.4% sodium chloride (NaCl) and 8.

Antagonism of the cardiodepressant effects of adenosine during acute hypoxia.

Objective: To determine whether pharmacologic antagonism of adenosine A1-receptor-mediated cardiovascular changes can improve cardiac function and prolong survival during systemic hypoxia.

Methods: Rats were anesthetized with ketamine, instrumented [including left ventricular (LV) pressure transducing catheters], paralyzed with vecuronium, then ventilated to pCO2 = 35-40 torr. After 10 minutes of equilibration (baseline), treatment commenced with saline (n = 7), NPC-205, an adenosine A1 receptor selective antagonist, at doses of 1 mg/kg (n = 10) or 10 mg/kg (n = 10), or drug vehicle (n = 9).

Evolution in the management of the complex liver injury at a Level I trauma center.

Background: Management of the severe liver injury evolved from mandatory surgical repair to a more selective approach. This paper reviews the changes in management of the severe liver injury at a Level I trauma center.

Methods: We reviewed the records of patients with severe liver injury admitted to a Level I trauma center between January 1984 and December 1995.

Induction of islet cell differentiation and new islet formation in the hamster--further support for a ductular origin.

Partial obstruction of the adult hamster pancreas leads to islet cell differentiation and new islet formation. From morphologic and morphometric observations, we have tentatively identified the source of the new islet tissue to be from cells in the ducts. In this study, in vivo labeling with a single pulse of tritiated thymidine after partial duct obstruction was used to ascertain whether newly formed islet cells were in fact derived from cells in the ductal epithelium.

Minimally invasive surgery in the elderly patient.

Minimal access surgery has been rapidly growing. It is essential that it be carefully evaluated and that quality assurance programs be developed. Indications for surgery should not be changed just because less invasive surgical techniques are available.

Factors determining conversion to laparotomy in patients undergoing laparoscopic cholecystectomy.

Laparoscopic cholecystectomy (LC) has been performed increasingly in an outpatient setting. Conversion from LC to open cholecystectomy (OC) is sometimes required. To predict conversion to OC, a single institutional study of 1,676 consecutive patients in whom LC was attempted was performed.

Zaprinast increases cyclic GMP levels in plasma and in aortic tissue of rats.

The purpose of this study was to determine if significant relationships exist between plasma and aortic cyclic GMP (cGMP) levels and pharmacodynamic effect after the i.v. administration of the cGMP-selective phosphodiesterase inhibitor zaprinast to conscious, spontaneously hypertensive rats.

Comparison of a conscious versus anesthetized canine model in response to milrinone, hydralazine and nitroprusside.

The purpose of this study was to demonstrate, based on previous and new data, that the differences between a conscious and anesthetized canine model in the cardiovascular responses to cardiovasoactive agents were beyond their difference in the sensitivity of the compensatory mechanisms. In both conscious and anesthetized canine models, mean arterial pressure (MAP) was decreased by hydralazine (at 1-3 mg/kg and 0.3-3 mg/kg; by -26.

Hemodynamic and renal effects of the protein kinase inhibitor staurosporine in conscious rats.

To evaluate the pattern of hemodynamic responses produced by an inhibitor of protein kinase C (PKC), staurosporine 0.03-0.55 mg/kg was administered intravenously (i.

Differential hemodynamic responses to selective inhibitors of cyclic nucleotide phosphodiesterases in conscious rats.

Selective inhibition of either the low Km cyclic AMP (cAMP) or low Km cyclic GMP (cGMP) phosphodiesterase (PDE) promotes vasorelaxation and, consequently, produces depressor effects. To evaluate the systemic and regional hemodynamic effects of selective inhibitors of these PDE isozymes, CI-930 (0.1-10 mg/kg), an inhibitor of low Km cAMP PDE, or zaprinast (3-30 mg/kg), an inhibitor of low Km cGMP PDE, was given i.