Browsing by Subject "injury"

Now showing 1 - 4 of 4

Open Access
CXCL10 is Upregulated in Synovium and Cartilage following Articular Fracture.
(J Orthop Res, 2017-09-14) Furman, Bridgette D; Kent, Collin L; Huebner, Janet L; Kraus, Virginia B; McNulty, Amy L; Guilak, Farshid; Olson, Steven A
The objective of this study was to investigate the expression of the chemokine CXCL10 and its role in joint tissues following articular fracture. We hypothesized that CXCL10 is upregulated following articular fracture and contributes to cartilage degradation associated with post-traumatic arthritis (PTA). To evaluate CXCL10 expression following articular fracture, gene expression was quantified in synovial tissue from knee joints of C57BL/6 mice that develop PTA following articular fracture, and MRL/MpJ mice that are protected from PTA. CXCL10 protein expression was assessed in human cartilage in normal, osteoarthritic (OA), and post-traumatic tissue using immunohistochemistry. The effects of exogenous CXCL10, alone and in combination with IL-1, on porcine cartilage explants were assessed by quantifying the release of catabolic mediators. Synovial tissue gene expression of CXCL10 was upregulated by joint trauma, peaking one day in C57BL/6 mice (25-fold) vs. three days post-fracture in MRL/MpJ mice (15-fold). CXCL10 protein in articular cartilage was most highly expressed following trauma compared with normal and OA tissue. In a dose dependent manner, exogenous CXCL10 significantly reduced total matrix metalloproteinase (MMP) and aggrecanase activity of culture media from cartilage explants. CXCL10 also trended toward a reduction in IL-1α-stimulated total MMP activity (p=0.09) and S-GAG (p=0.09), but not NO release. In conclusion, CXCL10 was upregulated in synovium and chondrocytes following trauma. However, exogenous CXCL10 did not induce a catabolic response in cartilage. CXCL10 may play a role in modulating the chondrocyte response to inflammatory stimuli associated with joint injury and the progression of PTA. This article is protected by copyright. All rights reserved.
Open Access
Regional anesthesia for the trauma patient: improving patient outcomes.
(Local Reg Anesth, 2015) Gadsden, Jeff; Warlick, Alicia
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform. Specific populations that have shown benefits (including morbidity and mortality advantages) with regional analgesic techniques include those with fractured ribs, femur and hip fractures, and patients undergoing digital replantation. Acute compartment syndrome is a potentially devastating sequela of soft-tissue injury that complicates high-energy injuries such as proximal tibia fractures. The use of regional anesthesia in patients at risk for compartment syndrome is controversial; although the data is sparse, there is no evidence that peripheral nerve blocks delay the diagnosis, and these techniques may in fact facilitate the recognition of pathologic breakthrough pain. The benefits of regional analgesia are likely most influential when it is initiated as early as possible, and the performance of nerve blocks both in the emergency room and in the field has been shown to provide quality pain relief with an excellent safety profile.
Open Access
Stable condition: Traumatic injury, coma, and vital traffic in a Mumbai hospital ward
(American Anthropologist, 2023-06-01) Solomon, H
Based on five years of research in a public-hospital trauma ward in Mumbai, this article examines the fraught case study of comatose states that result from traffic-accident injuries. It focuses on a relationship between two brothers, one injured in a motorcycle accident and in a coma, and the other caring for him. The article asks: How do people navigate life-and-death situations through both stillness and motion? Addressing this question requires recasting traumatic injury from a wound that lodges in a single body to an intersubjective problem of discontinuous and relational traffic. In moments of transfer to the hospital, prognosis about vital signs, and reflections on death, the embodiment of and care for traumatic injury materializes through uneven relationships of intermittent motion. The article develops the analytic of vital traffic to describe these relationships and analyzes the temporal and spatial discontinuities that shape and undermine stability after injury occurs. Differences in vital traffic matter to patients, families, providers, and to the very possibility of survival. The implication of this finding is a better understanding of the sociality of injury and its care. Beyond the case of medicine, attention to vital traffic can illuminate the flux of ethnography itself.
Open Access
Wound Culture
(Annual Review of Anthropology, 2022) Solomon, Harris
This review offers new perspectives on the anthropology of injuries and wounds. It maps how theories, methods, and ethnographic sensibilities converge on wounds, on the act of wounding, and on the wounded as instructive objects. The review assesses how anthropologists understand social forces to cause wounds and how they accord wounds the power to generate meaning about sociality. Organized across two themes, quot breach quot and quot repair, quot the review tests concepts of embodiment across clinical boundaries, manifestations of harm, and formations of justice. It examines how anthropological thought connects to wound culture and assesses links between embodiment and politics that develop in the domains of critical theory and medical anthropology. Ultimately, it aims to shed light on the connections between body politics and ethnography and to ask what wounds might generate as an anthropological concern.