Publications by authors named "Shane Smith"

Background: Bacterial infection of the intervertebral disc is difficult to treat because the tissue is usually not vascularized and systemic antibiotic therapy may not reach optimal antibacterial exposure. Here we characterize the safety, tolerability, and pharmacokinetics of PP353, a suspension of micronized linezolid, formulated for direct intervertebral disc administration.

Methods: The safety, tolerability, and pharmacokinetics of an intradiscal administration of PP353, was assessed in Part A of a Phase 1b study and consisted of a single injection of study drug (3 mL of PP353 and 150 mg linezolid).

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Background: Civilian acute trauma care has advanced in recent decades; however, traumatic injury remains the leading cause of death in individuals aged 15 to 29 years in the United States and worldwide. Uncontrolled hemorrhage is the leading preventable cause of death in trauma patients, with up to half of these deaths occurring before reaching a medical facility. The timely application of hemorrhage control measures is critical to enhance the survivability of trauma patients and is one of the major challenges faced by medical providers in austere environments.

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Traumatic brain injury (TBI) is a leading cause of mortality and morbidity amongst trauma patients. Its treatment is focused on minimizing progression to secondary injury. Administration of propranolol for TBI maydecrease mortality and improve functional outcomes.

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In Canada, trauma patients often present initially to non-trauma hospitals without vascular surgeons on site. Local surgeons need skills and support for damage-control vascular surgery. Canadian training programs in general surgery should equip trainees with skills in this area, including resuscitation, identification of vascular injury, hemorrhage control, and temporizing measures (e.

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Rib fractures in combat casualties are an under-appreciated injury, and their treatment may become more common as more patients survive because of modern body armor and point-ofinjury care. The combat environment has challenges such as equipment availability and sterility. A simple and thoughtful rib fracture treatment algorithm may be useful to reduce the morbidity and mortality of rib fractures in the combat environment.

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Introduction: Blunt cerebrovascular injury (BCVI) occurs in 1-3% of blunt traumas and is associated with stroke, disability, and mortality if unrecognized and untreated. Early detection and treatment are imperative to reduce the risk of stroke, however, there is significant variation amongst centers and trauma care providers in the specific medical management strategy used. This study compares antiplatelets vs.

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Medical leadership must decide how to obtain vascular access in a combat environment. Adequate combat trauma resuscitation requires efficient vascular access. A search of the Medline and EMBASE databases was conducted to find articles on combat vascular access.

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Article Synopsis
  • - Central centrifugal cicatricial alopecia (CCCA) is a type of scarring hair loss that primarily impacts individuals with darker skin tones and often leads to irreversible hair loss.
  • - Genetic research indicates that around 30% of CCCA cases are linked to mutations in the peptidyl arginine deiminase 3 gene, which results in misfolded proteins.
  • - The study suggests that CCCA involves a dominant CD4 T-cell response, shown by changes in inflammatory markers like PDL1 and caspase 3, indicating potential involvement of the PD1/PDL1 immune checkpoint pathway in the disease process.
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Purpose: Fetal tracheal occlusion (TO) reverses the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH), but its mechanism of action remains poorly understood. 'Omic' readouts capture metabolic and lipid processing function, which aid in understanding CDH and TO metabolic mechanisms.

Methods: CDH was created in fetal rabbits at 23 days, TO at 28 days and lung collection at 31 days (Term ∼32 days).

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Medical leadership must decide how prehospital airways will be managed in a combat environment, and airway skills can be complicated and difficult to learn. Evidence informed airway strategies are essential. A search was conducted in Medline and EMBASE databases for prehospital combat airway use.

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Background: Standard dose (≤ 1 g) tranexamic acid (TXA) has established mortality benefit in trauma patients. The role of high dose IV TXA (≥2 g or ≥30 mg/kg as a single bolus) has been evaluated in the surgical setting, however, it has not been studied in trauma. We reviewed the available evidence of high dose IV TXA in any setting with the goal of informing its use in the adult trauma population.

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Article Synopsis
  • The article compares different methods for reviewing literature: systematic reviews, scoping reviews, and narrative reviews, which are essential for navigating the increasing volume of medical literature.
  • Systematic reviews focus on answering specific clinical questions using a structured approach, analyzing literature to reduce bias, often following the PICO format.
  • Scoping reviews explore the breadth of a topic without strict limitations, potentially leading to systematic reviews, while narrative reviews help inform practice when high-quality evidence is lacking.
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Neurothekeoma, a lesion of possible fibrohistiocytic origin, is a rare, benign, superficial soft tissue tumor, histologically subclassified in 3 types: myxoid, cellular, or mixed. It clinically presents as a solitary, pink to brown nodule, ranging from 0.3 to 2.

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Hidradenitis suppurativa (HS) is a chronic inflammatory scarring disease felt to be related to occlusion of the hair follicle unit in intertriginous areas. We perform a systematic review on HS histopathology to evaluate current knowledge and discuss future directions. PubMed and Scopus databases were searched for relevant articles published from January 1985 to January 2021 that discussed the pathology of HS.

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  • * The seventh International RASopathies Symposium focused on sharing research findings to foster new discoveries and potential therapies for RASopathies.
  • * This year's meeting marked a significant advance as some research is now being used clinically, specifically through the use of Ras/MAPK inhibitors for treating patients.
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Coronary sinus injury related to the use of a retrograde cardioplegia catheter is a rare but potentially life-threatening complication with mortality reported as high as 20%. We present a series of iatrogenic coronary sinus injuries as well as an effective method of repair without any ensuing mortality. There were 3,004 cases that utilized retrograde cardioplegia at our institution from 2007 to 2018.

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Article Synopsis
  • The study looked at how serious blood vessel injuries are treated in trauma centers across Canada from 2011 to 2015, focusing on adult patients.
  • Out of 1330 patients, most injuries came from car accidents, stabbings, and falls, with a few gunshot wounds. Many injuries were in the neck and abdomen.
  • Different doctors helped treat these injuries using various methods, including surgery, and about 13% of patients sadly died in the hospital, with some needing amputations.
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Fungi cause disease in nearly one billion individuals worldwide. Only three classes of antifungal agents are currently available in mainstream clinical use. Emerging and drug-resistant fungi, toxicity, and drug-drug interactions compromise their efficacy and applicability.

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Basal cell carcinoma (BCC) is the most commonly diagnosed cutaneous cancer in the United States with more than 2.5 million treated annually. Genetic studies have revealed that approximately 90% of BCCs have a mutation in the hedgehog-signaling pathway.

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