ABSTRACT
Objective In this study, we investigated the factors related to anemia and platelet reduction in patients with moderate to severe trauma to gain a deeper understanding of these phenomena. Methods Our study spanned the period from April 2021 to September 2023, and it involved a retrospective review of the hospital medical charts of all emergency outpatients of all ages who were transported by a physician-staffed helicopter and treated at our hospital and were diagnosed with an Injury Severity Score (ISS) of >8 by CT on arrival. The following data were analyzed: sex; age; mechanism of injury; vital signs upon arrival at the hospital; ISS; hemoglobin level and platelet count on arrival and day two; fibrin degradation product (FDP) level, lactate dehydrogenase (LDH) level, and diameter of the inferior vena cava (IVC) on arrival; and infusion volume on day one. We then statistically calculated the independent risk factors for differences between hemoglobin levels and platelet counts on arrival and those on day two. Results The study included a total of 209 subjects, with an average age of 58 years and a male predominance. Multivariate analysis showed that the FDP level, IVC diameter, and age were significantly associated with changes in hemoglobin levels on arrival and day two, whereas the IVC diameter, LDH, age, systolic blood pressure, and sex were significantly associated with changes in the platelet count on arrival and day two. Conclusions A noteworthy correlation was found between certain factors and changes in hemoglobin levels and platelet counts between the initial assessment and the second day in our cohort. We recommend further prospective research to determine whether our findings hold true for a larger population of trauma patients.
ABSTRACT
Background There have so far been no reports regarding whether or not the jugular veins remain distended even in cases of cardiac arrest, which is the worst form of shock. We focused on the diameter of the jugular vein in neck computed tomography (CT) in cases of thoracic aortic disease resulting in cardiac arrest to determine whether or not cardiac tamponade increased the diameter. Methodology From January 2014 to December 2021, patients were eligible for inclusion when they were transported to our hospital, judged to be in cardiac arrest at the emergency department, and then diagnosed with thoracic aortic disease as the cause of cardiac arrest according to CT. Patients were divided into two groups according to the presence (tamponade (+)) or absence (tamponade (-)) of cardiac tamponade. Comparisons between the two groups were also conducted after excluding cases in which relief of cardiac tamponade was obtained before CT or that had hemothorax. Results There were 52 cases in the cardiac tamponade (+) group and 16 in the cardiac tamponade (-) group. The diameters of both the right and left internal jugular veins were significantly larger in the cardiac tamponade (+) group than in the cardiac tamponade (-) group. After excluding cases with relief of cardiac tamponade before CT and hemothorax complications, the right and left internal and external jugular vein diameters in the cardiac tamponade (+) group were still significantly greater than those in the cardiac tamponade (-) group. Conclusions The present study showed that the cardiac tamponade induced by thoracic aortic cases tended to display larger internal jugular vein diameters compared to cases without cardiac tamponade, even in patients experiencing cardiac arrest. Additionally, cardiac tamponade consistently presented with larger diameters in the right-sided jugular vein.
ABSTRACT
A simple device structure composed of an interfacial Eu2+/3+ complex on a mesoporous TiO2 film is developed by a solution process and acts as the high-performance photodetector with photomultiplication phenomena. The electron transfer from the photoexcited organic ligand, 2,2':6',2â³-terpyridine (terpy), as a photosensitizer to TiO2 is accelerated by the reduction level of Eu3+/2+ ions chemically bonding among terpy and TiO2, resulting in the generation of a large photocurrent. It is worth noting that its external quantum efficiency is in excess of 105% under applied reverse bias. The corresponding responsivity of the device is also determined to be 464 A/W at an irradiation light intensity of 0.7 mW/cm2 (365 nm), which is more than 3 orders of magnitude larger than those of inorganic photodetectors. A dark current of the device can be reduced to 10-9 A/cm2 by introducing a Eu oxide thin-film layer as a carrier blocking layer at the interface between transparent conducting oxide (TCO) and the TiO2 layer, and the specific detectivity reaches 5.2 × 1015 jones at 365 nm with -3 V. The performance of our organic-inorganic hybrid photodetector surpasses those of existing ultraviolet photodetectors.
