Effectiveness of transcatheter arterial embolization for patients with shock from abdominopelvic trauma: A retrospective cohort study
ANNALS OF MEDICINE AND SURGERY
Authors: Boonsinsukh, Thana; Maroongroge, Panitpong
Abstract
Background: Transcatheter arterial embolization (TAE) is a useful endovascular technique for controlling hemorrhage in blunt abdominopelvic trauma without shock. However, several studies have reported that TAE is safe and effective for controlling hemorrhage in hypovolemic shock. Objective: To evaluate the effectiveness of TAE for patients with shock from abdominopelvic trauma. Method: The medical records of patients with abdominopelvic trauma at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University from January 2014 to January 2019 were ret-rospectively reviewed. We enrolled patients with shock caused by injury to solid organs or pelvic fractures who underwent TAE. Result: Of the 320 patients, 14 patients with shock underwent TAE. A total of 78.6% were male. The mean age was 37.5 years. The average injury severity score was 31.3. The most common mechanism of injury was traffic accidents (85.7%). Embolization was performed for 8 liver injuries, 5 pelvic fractures and 1 splenic injury. The treatment time for TAE was approximately 47.9 +/- 33.2 min. The mean length of hospital stay was 21.3 +/- 15.9 days. Two patients died (14.3%). There were no embolization-related complications. A significant improvement in systolic blood pressure (p = 0.028) and a decrease in heart rate (p = 0.001), lactate concentration (p = 0.011), and crystalloid fluid (p = 0.001) and blood transfusion requirements (p = 0.002) were observed after TAE. Conclusions: TAE is a safe and effective method for treating shock patients with a rapid or transient response to resuscitation. For patients who are nonresponsive to resuscitation, TAE is an additional useful option for arterial hemorrhage control in abdominopelvic trauma.
Multimodal assessment of flax dew retting and its functional impact on fibers and natural fiber composites
INDUSTRIAL CROPS AND PRODUCTS
Authors: Chabbert, Brigitte; Padovani, Justine; Djemiel, Christophe; Ossemond, Jordane; Lemaitre, Alain; Yoshinaga, Arata; Hawkins, Simon; Grec, Sebastien; Beaugrand, Johnny; Kurek, Bernard
Abstract
Flax (Linum usitatissinum L.) is an economically important fiber crop species as it produces long cellulosic fibers with high tensile strength. The first step in flax fiber extraction occurs after harvest via a process known as dew retting in which pulled (uprooted) plants are placed on the soil. During this process microorganisms from the soil and the phyllosphere develop on the plants, leading to partial decomposition of the stem tissues and facilitated mechanical extraction and improved fiber quality. Despite its importance, the management of dew retting is mainly based on empirical knowledge that makes the process difficult to control. In this study the dynamics of flax dew retting were investigated for the first time by combining targeted-metagenomics (metabarcoding), enzymatic activities and chemical and microscopic characterization of the stem. This multimodal approach indicated that intensive microbial colonization and major chemical changes in the stem cell wall composition occurred during the first weeks of retting leading to progressive fiber bundle decohesion in the outer stem tissues. The main changes could be explained by the degradation of pectin-rich and non-lignified thin walls of both the parenchyma cells surrounding fiber bundles, and the differentiating xylem and cambial cells. Field emission scanning electron microscopy suggested that the ultrastructure of the fiber secondary wall is weakly impacted by dew-retting. Analyses indicated that the mechanical properties of extracted technical fibers were improved during the last retting stages. Overall data on thermoplastic composites produced by a twin-screw extrusion and injection molding processes suggested that the retting degree had a small but significant effect on tensile properties.