Early thromboelastography in acute traumatic coagulopathy: an observational study focusing on pre-hospital trauma care

Background: Major brain injury and uncontrolled blood loss remain the primary causes of early trauma-related mortality. One-quarter to one-third of trauma patients exhibit trauma-induced coagulopathy (TIC). Thromboelastometry (ROTEM) and thrombelastography (TEG) are valuable alternatives to standard coagulation testing, providing a more comprehensive overview of the coagulation process. Purpose: Evaluating thromboelastographic profile, the incidence of fibrinolysis (defined as Ly30 > 3%) in severe trauma patients, and factors influencing pathological coagulation pattern. Methods: Prospective observational 2\ua0years cohort study on severe trauma patients assisted by Helicopter Emergency Medical System (HEMS) and Level 1 Trauma Center, in a tertiary referral University Hospital. Results: Eighty three patients were enrolled, mean NISS (new injury severity score) 36 (\ub1 13). Mean R value decreased from 7.25 (\ub1 2.6) to 6.19 (\ub1 2.5) min (p 40 groups, changes in R value increased their significance (p = 0.04 and p < 0.03, respectively). Pathological TEG was found in 71 (88.8%) patients at T0 and 74 (92.5%) at T1. Hypercoagulation was present in 57 (71.3%) patients at T0, and in 66(82.5%) at T1. 9 (11.3%) patients had hyperfibrinolysis at T0, 7 (8.8%) patients at T1. Prevalence of StO2 < 75% at T0 was greater in patients whose TEG worsened (7 patients, 46.7%) against whose TEG remained stable or improved (8 patients, 17.4%) from T0 to T1 (p = 0.02). 48 (57.8%) patients received < 1000\ua0mL of fluids, while 35 (42.2%) received 65 1000\ua0mL. The first group had fewer patients with hypercoagulation (20, 41.6%) than the second (6, 17.6%) at T1 (p < 0.03). No differences were found for same TEG pattern at T0, nor other TEG pattern. Conclusion: Our population is representative of a non-hemorrhagic severe injury subgroup. Almost all of our trauma population had coagulation abnormalities immediately after the trauma; pro-coagulant changes were the most represented regardless of the severity of injury. NISS appears to affect only R parameter on TEG. Hyperfibrinolysis has been found in a low percentage of patients. Hypoperfusion parameters do not help to identify patients with ongoing coagulation impairment. Small volume resuscitation and mild hypotermia does not affect coagulation, at least in the early post-traumatic phase

Methyl orange photo‐degradation by tio2 in a pilot unit under different chemical, physical, and hydraulic conditions

The photo‐catalytic degradation of a textile azo‐dye as Methyl Orange was studied in an innovative unit constituted by a channel over which a layer of titanium dioxide (TiO2) catalyst in anatase form was deposited and activated by UVB irradiation. The degradation kinetics were followed after variation of the chemical, physical, and hydraulic/hydrodynamic parameters of the system. For this purpose, the influence of the TiO2 dosage (g/cm3), dye concentration (mg/L), pH of the solution, flow‐rate (L/s), hydraulic load (cm), and irradiation power (W) were evaluated on the degradation rates. It was observed that the maximum dosage of TiO2 was 0.79 g/cm3 while for higher dosage a reduction of homogeneity of the cement conglomerate occurred. The Langmuir– Hinshelwood (LH) kinetic model was followed up to a dye concentration around 1 mg/L. It was observed that with the increase of the flow rate, an increase of the degradation kinetics was obtained, while the further increase of the flow‐rate associated with the modification of the hydraulic load determined a decrease of the kinetic rates. The results also evidenced an increase of the kinetic rates with the increase of the UVB intensity. A final comparison with other dyes such as Methyl Red and Methylene Blue was carried out in consideration of the pH of the solution, which sensibly affected the removal efficiencies

Removal of benzoylecgonine from water matrices through UV254/H2O2 process: Reaction kinetic modeling, ecotoxicity and genotoxicity assessment

Benzoylecgonine (BE), the main cocaine metabolite, has been detected in numerous surface water and treatment plants effluents in Europe and there is urgent need for effective treatment methods. In this study, the removal of BE by the UV254/H2O2 process from different water matrices was investigated. By means of competition kinetics method, the kinetic constant of reaction between BE and the photogenerated hydroxyl radicals ([rad]OH) was estimated resulting in kOH/BE = 5.13 × 109 M−1 s−1. By-products and water matrices scavengers effects were estimated by numerical modeling of the reaction kinetics for the UV254/H2O2 process and validated in an innovative microcapillary film (MCF) array photoreactor and in a conventional batch photoreactor. The ecotoxicity of the water before and after treatment was evaluated with four organisms Raphidocelis subcapitata, Daphnia magna, Caenorhabditis elegans, and Vicia faba. The results provided evidence that BE and its transformation by-products do not have significant adverse effects on R. subcapitata, while D. magna underwent an increase of lipid droplets. C. elegans was the most sensitive to BE and its by-products. Furthermore, a genotoxicity assay, using V. faba, showed cytogenic damages during the cell mitosis of primary roots

Wheat bran valorisation: Towards photocatalytic nanomaterials for benzyl alcohol photo-oxidation

In this work, we have successfully synthesized a set of titania photocatalytic nanocomposites by the incorporation of different TiO2 content on wheat bran residues. The obtained catalysts were characterized by different techniques including UVeVis spectroscopy, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and Transmission Electron Microscopy (TEM) while their photocatalytic activity was investigated in the oxidation of benzyl alcohol under UV light irradiation. Benzaldehyde yields were ca. 20%, with conversion in the systems of ca. 33% of benzyl alcohol by using 10%Ti-Bran catalyst, as compared to 33% yield to the target product (quantitative conversion of benzyl alcohol) using commercial pure TiO2 (P-25). The photocatalytic activity results indicate that designed waste-derived nanomaterials with low TiO2 content can efficiently photocatalyze the conversion of benzyl alcohol with relative high selectivity towards benzaldehyde

Italian patients with hemoglobinopathies exhibit a 5-fold increase in age-standardized lethality due to SARS-CoV-2 infection.

Since the beginning of the COVID-19 pandemic, concerns have been expressed worldwide for patients with hemoglobinopathies and their vulnerability to SARS-CoV-2 infection. Data from Lebanon confirmed a role of underlying comorbidities on COVID-19 severity, but no deaths among a cohort of thalassemia patients.1 Patients with sickle cell disease (SCD) displayed a broad range of severity after SARS-CoV-2 infection, spanning from a favorable outcome unless pre-existing comorbidities (UK cohort)2 to high case mortality in US.3 History of pain, heart, lung, and renal comorbidities was identified as risk factors of worse COVID-19 outcomes by the US SECURE-SCD Registry.4 While Italy experienced a death rate in the general population among the highest in the world, preliminary data from the first wave of the pandemic showed a lower than expected number of infected thalassemia patients (updated up to April 10, 2020), likely due to earlier and more vigilant self-isolation compared to the general population.

Setting for “normal” serum ferritin levels in patients with transfusion‐dependent thalassemia: Our current strategy

This cross‐sectional study aimed to establish the association between serum ferritin levels and organ iron overload (IO) and overall morbidity in transfusion‐dependent thalassemia (TDT) patients. One hundred and three TDT patients (40.03 ± 9.15 years; 57.3% females) with serum ferritin < 2500 ng/mL were included. IO was assessed by T2* magnetic resonance imaging. Three groups were identified based on mean serum ferritin levels: <500 ng/mL (group 0; N = 32), 500–1000 ng/mL (group 1; N = 43), and 1000–2500 ng/mL (group 2; N = 28). All demographic and biochemical parameters were comparable among the three groups, with the exception of the triglycerides being significantly lower in group 0 than in group 2. No difference was found in the frequency of hepatic, endocrine, and cardiac complications. Hepatic IO was significantly less frequent in group 0 versus both groups 1 and 2. No patient with a serum ferritin level < 500 ng/mL had significant myocardial IO and alterations in the main hematological parameters. No difference in the distribution of the different chelation regimens was found. Serum ferritin < 500 ng/mL appears to be achievable and safe for several TDT patients. This target is associated with the absence of significant cardiac iron and significantly lower hepatic IO and triglycerides that are well‐demonstrated markers for cardiac and liver complications