Tactics for hemorrhagic shock: A virtual course and visual aid for improved resuscitation.

Background: Our trauma performance improvement initiative recognized missed treatment opportunities for patients undergoing massive transfusion. To improve patient care, we developed a novel cognitive aid in the form of a poster entitled "TACTICS for Hemorrhagic Shock." We hypothesized that this reference and corresponding course would improve the performance of trauma leaders caring for simulated patients requiring massive transfusion.

Infection and Antibiotic Agents in Bleeding Trauma Patients: A Review of Available Literature.

Antibiotic prophylaxis is a common, established practice at trauma centers worldwide for patients presenting with various forms of serious injury. Many patients simultaneously present with hemorrhage. The current guidelines by the Eastern Association for the Surgery of Trauma recommend re-dosing prophylactic antibiotic agents for every 10 units of blood products administered.

Integrated traffic conflict model for estimating crash modification factors.

Crash modification factors (CMFs) for road safety treatments are usually obtained through observational models based on reported crashes. Observational Bayesian before-and-after methods have been applied to obtain more precise estimates of CMFs by accounting for the regression-to-the-mean bias inherent in naive methods. However, sufficient crash data reported over an extended period of time are needed to provide reliable estimates of treatment effects, a requirement that can be a challenge for certain types of treatment.

Reducing the threat of in-transit derailments involving dangerous goods through effective placement along the train consist.

Train derailments are important safety concerns, and they become increasingly so when dangerous goods (DG) are involved. One way to reduce the risk of DG derailments is through effective DG railway car placement along the train consist. This paper investigates the relationship between DG railway car placement and derailment for different route attributes and DG shipments.

Effects of pioglitazone versus metformin on circulating endothelial microparticles and progenitor cells in patients with newly diagnosed type 2 diabetes--a randomized controlled trial.

Aim: Endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) are markers of endothelial injury and repair. We compared the effects of pioglitazone versus metformin on the circulating numbers of EMPs and EPCs in patients with newly diagnosed type 2 diabetes.

Methods: This was a randomized, double-blind, comparator-controlled, 24-week single-centre trial conducted in a Teaching Hospital in Naples, Italy.

Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial.

Background: Low-carbohydrate and low-fat calorie-restricted diets are recommended for weight loss in overweight and obese people with type 2 diabetes.

Objective: To compare the effects of a low-carbohydrate Mediterranean-style or a low-fat diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes.

Design: Single-center, randomized trial.

Hyperlipidemia and sexual function in premenopausal women.

Introduction: No reported studies exist assessing the relationship between sexual function and hyperlipidemia in women.

Aim: In this study, we assessed the domains of sexual function in a representative sample of sexually active premenopausal women with hyperlipidemia, but without cardiovascular disease, as compared with an age-matched female population without hyperlipidemia.

Methods: To be enrolled in the study, women had to meet at least one of the following criteria for the diagnosis of hyperlipidemia: low-density lipoprotein (LDL) cholesterol levels >160 mg/dL; high-density lipoprotein (HDL) cholesterol levels <50 mg/dL; or triglyceride levels >150 mg/dL.

Calibration and validation of simulated vehicle safety performance at signalized intersections.

A systematic procedure is presented for calibrating and validating a microscopic model of safety performance. The context in the model application is the potential for rear-end crashes at signalized intersections. VISSIM v.

Post-meal glucose peaks at home associate with carotid intima-media thickness in type 2 diabetes.

Context: Two-hour postprandial hyperglycemia is related to chronic complications of diabetes and is currently used in the international guidelines to drive the therapy.

Objective: Our objective was to assess the size and timing of post-meal glucose peaks in the everyday life of type 2 diabetic patients and the relationship with carotid atherosclerosis.

Design, Setting, And Patients: This was an observational study performed in 644 outpatients with type 2 diabetes attending diabetes clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized carotid intima-media thickness (CIMT) assessment.

Effect of a single high-fat meal on endothelial function in patients with the metabolic syndrome: role of tumor necrosis factor-alpha.

Background And Aims: A single high-fat meal may induce endothelial activation and dysfunction in both normal subjects and in patients with type 2 diabetes. The aim of this study was to assess the effect of a high-fat meal on endothelial function in patients with the metabolic syndrome.

Methods And Results: Twenty-five patients with the metabolic syndrome (ATP III criteria) were matched for sex, age and body mass index with 25 subjects without the metabolic syndrome.

Estimating countermeasure effects for reducing collisions at highway-railway grade crossings.

Frequently transportation engineers are required to make difficult safety investment decisions in the face of uncertainty concerning the cost-effectiveness of different countermeasures. For certain types of highway-railway grade crossings, this problem is further aggravated due to the lack of observed before and after collision data that reflects the impact of specific countermeasures. This study proposes a Bayesian data fusion method as an attempt to overcome these challenges.

Effect of rosiglitazone on endothelial function and inflammatory markers in patients with the metabolic syndrome.

Objective: The aim of this study was to assess the effect of rosiglitazone on endothelial function and inflammatory markers in patients with the metabolic syndrome.

Research Design And Methods: This was a randomized, double-blind, controlled clinical trial. One hundred subjects (54 men and 46 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III, were followed for 12 months after random assignment to rosiglitazone (4 mg/day) or placebo.

Influence of safety measures on the risks of transporting dangerous goods through road tunnels.

Quantitative risk assessment (QRA) models are used to estimate the risks of transporting dangerous goods and to assess the merits of introducing alternative risk reduction measures for different transportation scenarios and assumptions. A comprehensive QRA model recently was developed in Europe for application to road tunnels. This model can assess the merits of a limited number of "native safety measures.

Lowering fatty acids potentiates acute insulin response in first degree relatives of people with type II diabetes.

Studies have shown that a high plasma non-esterified fatty acid concentration may inhibit glucose induced insulin secretion in vitro and in vivo. The effect of lowering the fatty acid concentration on the acute insulin response was investigated in first degree relatives of people with Type II diabetes in a double-blind, randomised, placebo-controlled trial. Fifty first degree relatives of people with Type II diabetes volunteered for the study.

Late Klebsiella pneumoniae infection following breast augmentation: case report.

A case is reported of late infection in a breast implant, in a 35-year-old female who underwent breast augmentation with a double-lumen silicone prosthesis combined with abdominoplasty. After 8 uneventful postoperative months, untoward and poorly defined symptoms occurred and further exploratory surgery became necessary. Due to a subacute inflammatory process in the entire pocket of the left breast, the implants were removed.

The expanded polytetrafluoroethylene (ePTFE) in the surgical treatment of Parry-Romberg syndrome: case report.

Expanded polytetrafluoroethylene (ePTFE) was used in conjunction with autologous fat and silicone prosthesis to reshape the facial contour in a patient with mild Parry-Romberg syndrome (PRS). Patches of ePTFE were implanted in the temporo-malar and parotidean areas, fat was injected into the genian area and lower lip, and a middle-density solid silicone device was implanted in the chin. No complications were observed.

Does free fatty acid infusion impair insulin action also through an increase in oxidative stress?

In vitro studies have demonstrated that free fatty acids (FFA) may enhance oxidative stress. In contrast, no in vivo studies have addressed such a relationship. This four-part study aims at investigating the association between FFA and oxidative stress in healthy volunteers.

Equatorial breast reduction: a new technique for the correction of moderate-to-large mammary hypertrophy.

The author describes a personal technique for moderate-to-large breast hypertrophy, regardless of the degree of ptosis, based upon a personal experience of more than 200 breast reductions. It is a superior monopedicle nipple-areola flap procedure, which leaves an inverted-T scar. It was used in 35 cases over the last 3 years involving tissue reductions ranging from 500 to 1950 g per gland.

Metabolic benefits deriving from chronic vitamin C supplementation in aged non-insulin dependent diabetics.

Objective: Our study investigated the metabolic benefits deriving from chronic pharmacological vitamin C administration in aged non-insulin dependent (Type II) diabetic patients.

Methods: Forty type II diabetic patients (age: 72 +/- 0.5 years) underwent placebo and vitamin C (0.

Lisinopril administration improves insulin action in aged patients with hypertension.

Thirty elderly, mildly hypertensive patients were enrolled for a single-blind, randomised cross-over placebo controlled trial in which placebo and lisinopril (20 mg/day before breakfast) were given for 4 and 8 weeks, respectively. A wash-out period of 3 weeks between placebo and lisinopril was observed. In each patient a euglycaemic glucose clamp with simultaneous indirect calorimetry allowed us to determine whole body glucose disposal and substrate oxidation.

Left ventricular hypertrophy is associated with a stronger impairment of non-oxidative glucose metabolism in hypertensive patients.

Hypertensive patients with left ventricular hypertrophy (LVH) have a higher degree of hyperinsulinaemia than hypertensive patients without LVH. Obese patients with LVH have also been demonstrated to have a very low glucose disappearance rate after an intravenous glucose bolus. No studies have investigated the difference in insulin action and substrate oxidation in hypertensive patients with and without LVH.

Low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients.

Fourteen hypertensive (174.3/98.3 mmHg) non-diabetic patients were given a euglyceamic glucose clamp along with infusion of 0.

Evidence for a relationship between oxidative stress and insulin action in non-insulin-dependent (type II) diabetic patients.

Ten healthy subjects and 30 non-insulin-dependent (type II) diabetic patients matched for age, gender ratio, body mass index, lean body mass (LBM), waist to hip ratio, and arterial blood pressure volunteered for the study. In all subjects, fasting plasma free radical (O2-) levels and basal membrane lipid fluidity (MLF) and protein mobility (MPM) were determined. The whole group of subjects underwent a euglycemic hyperinsulinemic glucose clamp with simultaneous indirect calorimetry for substrate oxidation determination.

Is a family history of diabetes associated with an increased level of cardiovascular risk factors? Studies in healthy people and in subjects with different degree of glucose intolerance.

In order to evaluate whether the presence of a positive family history of diabetes (PFH) may have a negative impact on both glucose metabolism and cardiovascular risk factors, we studied parameters of carbohydrate metabolism (fasting and 2h-plasma glucose, HbA1c) and beta-cell function (fasting insulin and C-peptide), as well as the levels of some established cardiovascular risk factors (total cholesterol and triglycerides, HDL-cholesterol, blood pressure) in 729 subjects who were seen within the frame of a Regional Health Program in Taranto, South Italy. According to the NDDG criteria, 147 men and 235 women had normal glucose tolerance, 54 men and 66 women non-diagnostic OGTT, 65 men and 79 women impaired glucose tolerance, and 45 men and 58 women newly-diagnosed Type 2 diabetes. There was a continuous increase of PFH across the categories of glucose intolerance (p < 0.