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The Intersection of Trauma and Immunity: Immune Dysfunction Following Hemorrhage.

Biomedicines

December 2024

Department of Surgery, Sepsis and Critical Illness Research Center, College of Medicine, University of Florida, 1600 SW Archer Road Box 100108, Gainesville, FL 32610, USA.

Hemorrhagic shock is caused by rapid loss of a significant blood volume, which leads to insufficient blood flow and oxygen delivery to organs and tissues, resulting in severe physiological derangements, organ failure, and death. Physiologic derangements after hemorrhage are due in a large part to the body's strong inflammatory response, which leads to severe immune dysfunction, and secondary complications such as chronic immunosuppression, increased susceptibility to infection, coagulopathy, multiple organ failure, and unregulated inflammation. Immediate management of hemorrhagic shock includes timely control of the source of bleeding, restoring intravascular volume, preferably with whole blood, and prevention of ischemia and organ failure by optimizing tissue oxygenation.

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Intermediate lesions (ILs) present challenges in making therapeutic decisions. This study aimed to determine the practical coronary angiographic predictors for revascularization in patients with ILs who underwent repeated angiograms. This study was a retrospective single-center study.

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Catheterization Techniques for Anomalous Aortic Origin of Coronary Arteries.

Catheter Cardiovasc Interv

January 2025

Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France.

Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital anomaly with a large spectrum of anatomical variations. Selective engagement of an AAOCA can present challenges during cardiac catheterization. A comprehensive understanding of the characteristics of major AAOCA can effectively assist operators for selecting and maneuvering catheters.

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Article Synopsis
  • Recent studies highlight the advantages of using intravascular imaging (IVI) for percutaneous coronary intervention (PCI) compared to traditional angiography, but the relevance of angiography-based physiological assessments during this procedure is not fully understood.
  • The FLAVOUR trial analyzed the impact of angiography-based physiological evaluations, specifically the quantitative flow ratio (μQFR), on treatment decisions for patients undergoing IVI-guided PCI.
  • Results indicated significant reclassification of treatment approaches based on μQFR, with the REFERENCE group experiencing a higher risk of major adverse cardiovascular events, while DEFER and PERFORM groups showed similar outcomes and quality of life after 2 years.*
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The article characterises platelets, pointing out the role and contribution of their numerous receptors determining their specific and broad immune activity. Three types of platelet receptors are described, that is, extracellular and intracellular receptors-TLR (toll-like receptors), NLR (NOD-like receptor), and RLR (RIG-I-like receptor); extracellular receptors-selectins and integrins; and their other extracellular receptors-CLR (C-type lectin receptor), CD (cluster of differentiation), TNF (tumour necrosis factor), among others. Outlining the contribution of these numerous platelet receptors to the intravascular immunity, it has been shown that they are formed by their fusion with pathogen-associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), and lifestyle-associated molecular patterns (LAMPs).

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