Advancing the conversation: next steps for lesbian, gay, bisexual, trans, and queer (LGBTQ) health sciences librarianship.

In recent years, librarians in various sectors have been moving forward a conversation on the distinct information needs and information-seeking behavior of our lesbian, gay, bisexual, trans, and queer (LGBTQ) patrons and how well the profession recognizes and meets those needs. Health sciences librarianship has been slower than other areas of the profession in creating an evidence base covering the needs of its LGBTQ patrons, with, until recently, only very limited literature on this subject. LGBTQ health sciences librarianship is now starting to attract new interest, with librarians working together to bring this emerging specialization to the attention of the broader professional community.

High phosphoserine in sepsis: panel of clinical and plasma amino acid correlations.

The determination of plasma phosphoserine concentration in sepsis is uncommon, and the clinical and metabolic correlations of abnormally high phosphoserine are basically unknown. We analyzed 430 determinations of phosphoserine, other amino acid (AA) levels and ancillary variables obtained in 18 septic patients, in order to assess the biochemical and clinical correlations of changes in phosphoserine. Phosphoserine ranged between 5 and 55 micromol/L (n.

What the ancients knew of the fatal anatomic consequences of wounding of the lower thorax.

One of the most important lessons concerning the relevance of human anatomy to surgical diagnosis to be taught to medical students and first-year surgical residents concerns their sometimes poorly understood relationship of the structure of the lower thoracic cavity to the organs within the upper abdominal cavity. To make this indelibly clear, in surgical anatomic and clinical lectures given during the past 20 years, I have chosen to present the earliest Biblical examples of the ancient's knowledge of this critical relationship as regards wounds of the thorax specifically given to injure the liver and thus to produce a rapid and certain death. The first two concern the technique of assassination used by the warring factions of the House of King Saul and the followers of the House of David, which resulted in his succeeding to the kingship of Israel after the death of King Saul in the 10th century BC.

Finite element aortic injury reconstruction of near side lateral impacts using real world crash data.

Traumatic rupture of the aorta (TRA) remains the second most common cause of death associated with motor vehicle crashes, only less prevalent than brain injury. On average, nearly 8000 people die annually in the United States due to blunt injury to the aorta. It is observed that over 80% of occupants who suffer an aortic injury die at the scene due to exsanguination into the chest cavity.

Characterization of alpha-amino-n-butyric acid correlations in sepsis.

Little information is available on the patterns of changes and significance of plasma alpha-amino-n-butyric acid (ABA, μmol/L) in various conditions, particularly in sepsis. This study has been performed to assess the patterns of correlation among ABA, other amino acids, and other variables in a group of septic patients with various degrees of illness. More than 400 determinations of ABA, other amino acids, and simultaneously collected blood variables were obtained in 17 patients with sepsis.

Analysis of the mechanism of lateral impact aortic isthmus disruption in real-life motor vehicle crashes using a computer-based finite element numeric model: with simulation of prevention strategies.

Introduction: Despite advances in the surgical therapy of aortic injury (AI) using endovascular prostheses, more than 60% of motor vehicle crash (MVC) induced AIs die at the scene. In 80 cases of MVC AI, both change in velocity on impact (Delta V) and impact energy (IE) were correlated with autopsy or surgical findings. Of the 34 AIs due to lateral impact MVCs (LMVC), 91% had an aortic isthmus laceration.

Hypotransferrinemia and changes in plasma lipid and metabolic patterns in sepsis.

This study was performed to obtain a characterization of the changes in plasma transferrin (Tf, g/L) in sepsis. More than four hundred determinations of Tf, and of a large series of simultaneously collected blood and hemodynamic variables, were obtained in 17 patients with post-traumatic sepsis. Tf during sepsis was consistently low (mean +/- SD = 1.

Patterns of correlation of plasma ceruloplasmin in sepsis.

Background: In sepsis, plasma ceruloplasmin (Cp, mg/L) is known to increase as part of the acute phase response. However, there is poor knowledge of the patterns of increase and correlation with changes in other biochemical variables, and our study has been performed to investigate this aspect.

Materials And Methods: A total of 213 simultaneous measurements of Cp and other acute phase proteins, biochemical variables, and amino acids were performed on nine patients with severe sepsis, and processed by regression analysis.

Computer simulation and validation of the Archimedes Lever hypothesis as a mechanism for aortic isthmus disruption in a case of lateral impact motor vehicle crash: a Crash Injury Research Engineering Network (CIREN) study.

Objectives: Can aortic isthmus disruption occurring in a lateral motor vehicle crash (LMVC) be explained by the Archimedes Lever Hypothesis, where the intrathoracic aorta, super-pressurized by the thoracic impact force, functions as a rigid lever system? The long arm of this lever system is the proximal aorta-aortic arch, the short arm is the aortic isthmus fixed distally at the descending aorta, and the fulcrum is at the great vessels, especially the left subclavian artery.

Methods: The theory was tested by a simulation technique using a computer-based finite element numerical model system. This simulation model included the dynamics of the crashed vehicles, the direction of force impact, and the structure of the thorax and intrathoracic viscera, including the entire intrathoracic aorta.

Bench-to-bedside review: oxygen debt and its metabolic correlates as quantifiers of the severity of hemorrhagic and post-traumatic shock.

Evidence is increasing that oxygen debt and its metabolic correlates are important quantifiers of the severity of hemorrhagic and post-traumatic shock and and may serve as useful guides in the treatment of these conditions. The aim of this review is to demonstrate the similarity between experimental oxygen debt in animals and human hemorrhage/post-traumatic conditions, and to examine metabolic oxygen debt correlates, namely base deficit and lactate, as indices of shock severity and adequacy of volume resuscitation. Relevant studies in the medical literature were identified using Medline and Cochrane Library searches.

Spine and spinal cord injury in motor vehicle crashes: a function of change in velocity and energy dissipation on impact with respect to the direction of crash.

Objective: To examine the effect of change in velocity (DeltaV) and energy dissipation (IE) on impact, above and below the test levels for Federal MVC Safety Standards, on the incidence of spine fractures (SF), spinal cord injury (SCI)), SF mortality and the associated injury patterns in Frontal (F) and Lateral (L) MVCs. Comparison of 214 patients with SF or SCI with 938 patients who did not have SF or SCI.

Methods: 1152 MVC adult drivers or front-seat passengers (701 F & 451 L) evaluated at 10 Level I CIREN study Trauma Centers together with vehicle and crash scene engineering reconstruction.

Change in velocity and energy dissipation on impact in motor vehicle crashes as a function of the direction of crash: key factors in the production of thoracic aortic injuries, their pattern of associated injuries and patient survival. A Crash Injury Research Engineering Network (CIREN) study.

Objective: To examine the effect of change in velocity (MV) and energy dissipation (IE) on impact, above and below the test levels for federal motor vehicle crash (MVC) safety standards, on the incidence of aortic injury (AI) and its mortality and associated injury patterns in frontal (F) and lateral (L) MVCs. Comparison of 80 AI and 796 non-AI patients of AIS=3.

Methods: Eight hundred seventy-six MVC adult drivers or front-seat passengers (552 F and 324 L) evaluated by 10 Level I CIREN study Trauma Centers together with vehicle and crash scene engineering reconstruction.

Adipose tissue in myocardial infarction.

Introduction: The histologic evolution of myocardial infarction (MI) has been studied in some detail. However, there is little mention of the presence of adipose tissue in healed MI(HMI). Ninety-one hearts explanted during 1997-2001 were examined to determine the extent of adipose tissue within HMI.

The septic abscess wall: a cytokine-generating organ associated with portal venous cytokinemia, hepatic outflow fibrosis, sinusoidal congestion, inflammatory cell sequestration, hepatocellular lipid deposition, and focal cell death.

An acute septic inflammatory response with access to the portal circulation was created in a rat model using an intra-abdominal abscess composed of a sterile agar pellet, or one contaminated with 102 Escherichia coli (E. coli) and 109 Bacteriodes fragilis (B. fragilis).

Depressed interleukin-12-producing activity by monocytes correlates with adverse clinical course and a shift toward Th2-type lymphocyte pattern in severely injured male trauma patients.

Objective: To determine the effect of major trauma on the cytokine-producing activity of monocytes and CD4+ T cells in a homogeneous cohort of patients as well as to determine the relationship between monocyte and T-lymphocyte responses and clinical outcome.

Settings: Surgical intensive care units of a trauma center and flow cytometry and experimental laboratories at a teaching hospital.

Design: Prospective cohort clinical study with measurements of white cell cytokine-producing activity on days 2, 5, and 10 postinjury.

Oxygen debt criteria quantify the effectiveness of early partial resuscitation after hypovolemic hemorrhagic shock.

Background: The effectiveness of partial resuscitation after hypovolemic hemorrhagic shock with deferment of full resuscitation is critical to successful hypotensive resuscitation.

Methods: To quantitatively address this issue, 40 canines were bled under anesthesia to a mean oxygen debt (O(2)D) of 104 +/- 7.6 mL/kg over 60 minutes (mortality, 40%).

Deceleration energy and change in velocity on impact: key factors in fatal versus potentially survivable motor vehicle crash (mvc) aortic injuries (AI): the role of associated injuries as determinants of outcome.

Objective: To examine the difference in force mechanisms between fatal and potentially survivable MVC aortic injuries (AI) compared to non-AI severe thoracic injuries (ST).

Methods: Of 324 autopsied MVC driver or front seat passenger fatalities (1997-2000), there were 43 fatal AI (36 scene deaths, 7 hospital deaths) and 5 additional AI survivors.

Results: Of the 48 AI, there was only a 42% survival for those reaching hospital alive.

Attenuated monocyte IL-10 production in glucose-6-phosphate dehydrogenase-deficient trauma patients.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the world's most common known human genetic polymorphisms, but the pathophysiology of the defect remains largely unknown. In the present study, we compared hematology parameters and ex vivo monocyte cytokine responses in non-deficient and G6PD-deficient trauma patients. Deficient and non-deficient, moderately injured, trauma patients exhibited similar hematology profiles at the time of hospital admission.