Myocardial Dysfunction in Acute Traumatic Brain Injury Relieved by Surgical Decompression

Traumatic brain injury (TBI) is a major public health issue and is a leading cause of death in North America. After a primary TBI, secondary brain insults can predispose patients to a worse outcome. One of the earliest secondary insults encountered during the perioperative period is hypotension, which has been directly linked to both mortality and poor disposition after TBI. Despite this, it has been shown that hypotension commonly occurs during surgery for TBI. We present a case of intraoperative hypotension during surgery for TBI, where the use of transthoracic echocardiography had significant diagnostic and therapeutic implications for the management of our patient. We then discuss the issue of cardiac dysfunction after brain injury and the implications that echocardiography may have in the management of this vulnerable patient population

Coastal and estuarine blue carbon stocks in the greater Southeast Asia region: seagrasses and mangroves per nation and sum of total

Climate Change solutions include CO2 extraction from atmosphere and water with burial by living habitats insediment/soil. Nowhere on the planet are blue carbon plants which carry out massive carbon extraction andpermanent burial more intensely concentrated than in SE Asia. For the first time we make a national and totalinventory of data to date for “blue carbon” buried from mangroves and seagrass and delineate the constraints.For an area across Southeast Asia of approximately 12,000,000 km2, supporting mangrove forests (5,116,032 ha)and seagrass meadows ( 6,744,529 ha), we analyzed the region's current blue carbon stocks. This estimate wasachieved by integrating the sum of estuarine in situ carbon stock measurements with the extent of mangroves andseagrass across each nation, then summed for the region. We found that mangroves ecosystems regionallysupported the greater amount of organic carbon (3094.69Tg Corg in 1st meter) over that of seagrass (1683.97 TgCorg in 1st meter), with corresponding stock densities ranging from 15 to 2205 Mg ha−1 and 31.3 to2450 Mg ha−1 respectively, a likely underestimate for entire carbon including sediment depths. The largestcarbon stocks are found within Indonesia, followed by the Philippines, Papua New Guinea, Myanmar, Malaysia,Thailand, Tropical China, Viet-Nam, and Cambodia. Compared to the blue carbon hotspot of tropical/subtropicalGulf of Mexico's total carbon stock (480.48 Tg Corg), Southeast Asia's greater mangrove–seagrass stock densityappears a more intense Blue Carbon hotspot (4779.16 Tg Corg). All regional Southeast Asian nation states shouldassist in superior preservation and habitat restoration plus similar measures in the USA & Mexico for the Gulf ofMexico, as apparently these form two of the largest tropical carbon sinks within coastal waters. We hypothesizeit is SE Asia's regionally unique oceanic–geologic conditions, placed squarely within the tropics, which arelargely responsible for this blue carbon hotspot, that is, consistently high ambient light levels and year-longwarm temperatures, together with consistently strong inflow of dissolved carbon dioxide and upwelling ofnutrients across the shallow geological plates

Case Report Myocardial Dysfunction in Acute Traumatic Brain Injury Relieved by Surgical Decompression

Traumatic brain injury (TBI) is a major public health issue and is a leading cause of death in North America. After a primary TBI, secondary brain insults can predispose patients to a worse outcome. One of the earliest secondary insults encountered during the perioperative period is hypotension, which has been directly linked to both mortality and poor disposition after TBI. Despite this, it has been shown that hypotension commonly occurs during surgery for TBI. We present a case of intraoperative hypotension during surgery for TBI, where the use of transthoracic echocardiography had significant diagnostic and therapeutic implications for the management of our patient. We then discuss the issue of cardiac dysfunction after brain injury and the implications that echocardiography may have in the management of this vulnerable patient population