Трансфузия свежезамороженной плазмы у пациентов в остром периоде изолированной черепно-мозговой травмы

Coagulopathy associated with traumatic brain injury (TBI) is recognized as one of the risk factors for poor outcome in patients with TBI, however, the safety of using fresh frozen plasma (FFP) is not fully understood.The objective of the study: to identify the indications for FFP transfusion in the acute period of TBI.Subjects and methods: a retrospective-prospective observational study included 160 patients aged 18-59 years with isolated TBI in the first 48 hours after injury. Patients were assessed by Glasgow Coma Scale (GCS); patients were divided into two study groups: Group 1 – GCS ≤ 8 points, Group 2 – GCS ≥ 9 points. All patients underwent hemostatic assessment with standard clotting tests (activated partial thromboplastin time, prothrombin ratio, fibrinogen blood level). In 42 patients, additional thromboelastometry was performed. Specific parameters of FFP transfusion and trauma outcomes were assessed.Results: according to clotting tests, hypocoagulation was detected in 50.6% of patients; according to thromboelastometry – in 22.7%. FFP was used more often in severe TBI (83%) with a decrease in prothrombin ratio (PR). However, FFP transfusion is associated with an unfavorable outcome: in the case of transfusion, a greater number of deaths and vegetative states were recorded in patients with severe TBI.Conclusion: in patients in the acute period of isolated TBI, it is preferable to minimize the use of FFP; an isolated decrease in PR should not be a trigger for FFP transfusion.Коагулопатия, ассоциированная с черепно-мозговой травмой (ЧМТ), признана одним из факторов риска неблагоприятного исхода у пациентов с ЧМТ.Цель исследования: уточнение показаний к переливанию свежезамороженной плазмы (СЗП) в остром периоде ЧМТ.Материалы и методы: в ретроспективно-проспективное обсервационное исследование включено 160 пациентов 18‒59 лет c изолированной ЧМТ в первые 48 ч после травмы. Пациенты оценены по шкале комы Глазго (ШКГ), выделены две исследуемые группы: первая ШКГ ≤ 8 баллов, вторая – ШКГ ≥ 9 баллов. Всем пациентам проведены анализы стандартной коагулограммы (активированное частичное тромбопластиновое время, протромбиновый индекс, концентрация фибриногена). У 42 – дополнительно выполнялась тромбоэластометрия. Оценены особенности трансфузии СЗП и исходы травмы.Результаты: согласно стандартной коагулограмме, гипокоагуляция выявлена у 50,6% пациентов, согласно тромбоэластометрии – в 22,7% случаев. Чаще СЗП использовали при тяжелой ЧМТ (83%) при снижении протромбинового индекса.Заключение: у пациентов в остром периоде изолированной ЧМТ предпочтительна минимизация использования СЗП, изолированное снижение ПТИ не должно являться триггером к трансфузии СЗП

Search for Kaluza-Klein Graviton Emission in ppˉp\bar{p} Collisions at s=1.8\sqrt{s}=1.8 TeV using the Missing Energy Signature

We report on a search for direct Kaluza-Klein graviton production in a data sample of 84 ${pb}^{-1}$ of \ppb collisions at $\sqrt{s}$ = 1.8 TeV, recorded by the Collider Detector at Fermilab. We investigate the final state of large missing transverse energy and one or two high energy jets. We compare the data with the predictions from a $3+1+n$-dimensional Kaluza-Klein scenario in which gravity becomes strong at the TeV scale. At 95% confidence level (C.L.) for $n$=2, 4, and 6 we exclude an effective Planck scale below 1.0, 0.77, and 0.71 TeV, respectively.Comment: Submitted to PRL, 7 pages 4 figures/Revision includes 5 figure

Pathogenetic mechanisms of atherosclerosis development in athletes

Aim of the study was to reveal the relationship between the performance of high-intensity physical activity and the development of endothelial dysfunction in people involved in professional sports. The development of endothelial dysfunction as one of the main markers of atherosclerotic damage to the vascular wall in athletes is an urgent problem in modern medicine in connection with the asymptomatic course and unpredictability of the development of cardiovascular complications. Material and methods. The publications on the topic of the scientific review from 2010 to 2020 were analyzed. The electronic databases of the Google Academy (https://scholar.google.ru/), UpToDate (www.uptodate.com), Oxford Medicine Online (https://oxfordmedicine.com/), PubMed (https://pubmed.ncbi.nlm.nih.gov/), scientific electronic library «Cyberleninka» and foreign journals Springer (https://www.springer.com/gp), Journal of the American College of Cardiology (https://imaging.onlinejacc.org/). Results. Recent foreign and domestic studies show a relatively high relationship between the level of physical activity and the development of coronary atherosclerosis in professional athletes. Conclusion. When performing prolonged and excessive physical exertion, trained athletes often experience oxidative stress, the presence of which causes the development of endothelial dysfunction, which from modern positions is a key link in the pathogenesis of atherosclerosis. Further study of the mechanism of atherogenesis will contribute to the use of new diagnostic methods in predicting the disease at an early stage and treating it, thus preserving the health of an athlete

Fresh frozen plasma transfusion in the acute period of isolated traumatic brain injury

Coagulopathy associated with traumatic brain injury (TBI) is recognized as one of the risk factors for poor outcome in patients with TBI, however, the safety of using fresh frozen plasma (FFP) is not fully understood.The objective of the study: to identify the indications for FFP transfusion in the acute period of TBI.Subjects and methods: a retrospective-prospective observational study included 160 patients aged 18-59 years with isolated TBI in the first 48 hours after injury. Patients were assessed by Glasgow Coma Scale (GCS); patients were divided into two study groups: Group 1 – GCS ≤ 8 points, Group 2 – GCS ≥ 9 points. All patients underwent hemostatic assessment with standard clotting tests (activated partial thromboplastin time, prothrombin ratio, fibrinogen blood level). In 42 patients, additional thromboelastometry was performed. Specific parameters of FFP transfusion and trauma outcomes were assessed.Results: according to clotting tests, hypocoagulation was detected in 50.6% of patients; according to thromboelastometry – in 22.7%. FFP was used more often in severe TBI (83%) with a decrease in prothrombin ratio (PR). However, FFP transfusion is associated with an unfavorable outcome: in the case of transfusion, a greater number of deaths and vegetative states were recorded in patients with severe TBI.Conclusion: in patients in the acute period of isolated TBI, it is preferable to minimize the use of FFP; an isolated decrease in PR should not be a trigger for FFP transfusion