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  1. Article ; Online: Brain Death/Death by Neurologic Criteria: What You Need to Know.

    Larson, Nicholas J / Dries, David J / Blondeau, Benoit / Rogers, Frederick B

    The journal of trauma and acute care surgery

    2024  

    Abstract: Abstract: Since the beginning of time, man has been intrigued with the question of when a person is considered dead. Traditionally, death has been considered the cessation of all cardiorespiratory function. At the end of the last century a new ... ...

    Abstract Abstract: Since the beginning of time, man has been intrigued with the question of when a person is considered dead. Traditionally, death has been considered the cessation of all cardiorespiratory function. At the end of the last century a new definition was introduced into the lexicon surrounding death in addition to cessation of cardiac and respiratory function: Brain Death/Death by Neurologic Criteria (BD/DNC). There are medical, legal, ethical, and even theological controversies that surround this diagnosis. In addition, there is no small amount of confusion among medical practitioners regarding the diagnosis of BD/DNC. For families enduring the devastating development of BD/DNC in their loved one, it is the duty of the principal caregiver to provide a transparent presentation of the clinical situation and clear definitive explanation of what constitutes BD/DNC. In this report, we present a historical outline of the development of BD/DNC as a clinical entity, specifically how one goes about making a determination of BD/DNC, what steps are taken once a diagnosis of BD/DNC is made, a brief discussion of some of the ethical/moral issues surrounding this diagnosis, and finally the caregiver approach to the family of a patient who had been declared with BD/DNC. It is our humble hope that with a greater understanding of the myriad of complicated issues surrounding the diagnosis of BD/DNC that the bedside caregiver can provide needed closure for both the patient and the family enduring this critical time in their life.
    Language English
    Publishing date 2024-01-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000004266
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    Zs.A 127: Show issues Location:
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  2. Article: So You Want to Do Trauma Research? A Practical Guide to Creating a Research Program at Your Home Institution.

    Larson, Nicholas J / Altamirano, Heidi M / Dries, David J / Blondeau, Benoit / Rogers, Frederick B

    Journal of trauma nursing : the official journal of the Society of Trauma Nurses

    2024  Volume 31, Issue 2, Page(s) 57–62

    Abstract: Background: There are 3 pillars upon which the foundation of a teaching program in health care is founded: research, education, and clinical care. However, in a busy academic trauma practice, the unfortunate reality is that research is often a low ... ...

    Abstract Background: There are 3 pillars upon which the foundation of a teaching program in health care is founded: research, education, and clinical care. However, in a busy academic trauma practice, the unfortunate reality is that research is often a low priority in the frenzy of mandates for clinical productivity.
    Objective: The purpose of this report is to advise hospitals on how to create a modest trauma research program that supports research interests without significantly impacting the overall clinical productivity of the department.
    Methods: Relevant literature related to the development of an academic trauma research department was reviewed. Relevant articles were then compared to this manuscript to assess the novelty of the topic.
    Results: There are 4 essential components of a trauma research program: (1) a zealot, (2) institutional commitment and support, (3) a statistician, and (4) registry data access.
    Conclusion: The creation of a trauma research program may seem like a herculean effort, but this work is necessary for institutions hoping to achieve status as a Level I/II trauma center. Following the steps outlined in this report, trauma providers can create a robust research program at their institution without sacrificing clinical productivity.
    MeSH term(s) Humans ; Trauma Centers
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1281159-2
    ISSN 1078-7496
    ISSN 1078-7496
    DOI 10.1097/JTN.0000000000000774
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  3. Article ; Online: Electrolyte Disorders: Causes, Diagnosis, and Initial Care-Part 1.

    Larson, Nicholas James / Rogers, Frederick B / Feeken, Jennifer L / Blondeau, Benoit / Dries, David J

    Air medical journal

    2024  Volume 43, Issue 2, Page(s) 80–83

    MeSH term(s) Humans ; Water-Electrolyte Imbalance/diagnosis ; Water-Electrolyte Imbalance/etiology ; Water-Electrolyte Imbalance/therapy ; Electrolytes
    Chemical Substances Electrolytes
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2072853-0
    ISSN 1532-6497 ; 1067-991X
    ISSN (online) 1532-6497
    ISSN 1067-991X
    DOI 10.1016/j.amj.2024.01.001
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  4. Article ; Online: The State of the Union: Trauma System Development in the United States.

    Rogers, Frederick B / Larson, Nicholas J / Dries, David J / Olson-Bullis, Barbara A / Blondeau, Benoît

    Journal of intensive care medicine

    2023  , Page(s) 8850666231216360

    Abstract: Injury is both a national and international epidemic that affects people of all age, race, religion, and socioeconomic class. Injury was the fourth leading cause of death in the United States (U.S.) in 2021 and results in an incalculable emotional and ... ...

    Abstract Injury is both a national and international epidemic that affects people of all age, race, religion, and socioeconomic class. Injury was the fourth leading cause of death in the United States (U.S.) in 2021 and results in an incalculable emotional and financial burden on our society. Despite this, when prevention fails, trauma centers allow communities to prepare to care for the traumatically injured patient. Using lessons learned from the military, trauma care has grown more sophisticated in the last 50 years. In 1966, the first civilian trauma center was established, bringing management of injury into the new age. Now, the American College of Surgeons recognizes 4 levels of trauma centers (I-IV), with select states recognizing Level V trauma centers. The introduction of trauma centers in the U.S. has been proven to reduce morbidity and mortality for the injured patient. However, despite the proven benefits of trauma centers, the U.S. lacks a single, unified, trauma system and instead operates within a "system of systems" creating vast disparities in the level of care that can be received, especially in rural and economically disadvantaged areas. In this review we present the history of trauma system development in the U.S, define the different levels of trauma centers, present evidence that trauma systems and trauma centers improve outcomes, outline the current state of trauma system development in the U.S, and briefly mention some of the current challenges and opportunities in trauma system development in the U.S. today.
    Language English
    Publishing date 2023-11-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632828-3
    ISSN 1525-1489 ; 0885-0666
    ISSN (online) 1525-1489
    ISSN 0885-0666
    DOI 10.1177/08850666231216360
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    Zs.A 2158: Show issues Location:
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  5. Article ; Online: Evaluation and Management of Malignant Biliary Obstruction.

    Guardado, Nadia V / Llorente, Kaysey / Blondeau, Benoit

    Surgical oncology clinics of North America

    2021  Volume 30, Issue 3, Page(s) 491–503

    Abstract: There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved ... ...

    Abstract There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved significantly. The previous preponderant place of surgical procedures now is replaced by endoluminal and percutaneous techniques for the management of symptoms of MBO. Because quantity of life often is the primary and sole outcome for evaluation of various interventions, the main focus of patient quality of life may be erroneously deemphasized. Lagging behind scientific advances are the availability of palliative care services and studies of patient-related outcomes.
    MeSH term(s) Cholestasis/etiology ; Cholestasis/therapy ; Drainage ; Humans ; Neoplasms ; Palliative Care ; Quality of Life ; Stents
    Language English
    Publishing date 2021-05-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1196919-2
    ISSN 1558-5042 ; 1055-3207
    ISSN (online) 1558-5042
    ISSN 1055-3207
    DOI 10.1016/j.soc.2021.03.001
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  6. Article ; Online: A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.

    Mergoum, Anaas Moncef / Rhone, Abigail Rebecca / Larson, Nicholas James / Dries, David J / Blondeau, Benoit / Rogers, Frederick Bolles

    Journal of intensive care medicine

    2024  , Page(s) 8850666241246230

    Abstract: Shock is a life-threatening circulatory failure that results in inadequate tissue perfusion and oxygenation. Vasopressors and inotropes are vasoactive medications that are vital in increasing systemic vascular resistance and cardiac contractility, ... ...

    Abstract Shock is a life-threatening circulatory failure that results in inadequate tissue perfusion and oxygenation. Vasopressors and inotropes are vasoactive medications that are vital in increasing systemic vascular resistance and cardiac contractility, respectively, in patients presenting with shock. To be well versed in using these agents is an important skill to have in the critical care setting where patients can frequently exhibit symptoms of shock. In this review, we will discuss the pathophysiological mechanisms of shock and evaluate the current evidence behind the management of shock with an emphasis on vasopressors and inotropes.
    Language English
    Publishing date 2024-04-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632828-3
    ISSN 1525-1489 ; 0885-0666
    ISSN (online) 1525-1489
    ISSN 0885-0666
    DOI 10.1177/08850666241246230
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  7. Article ; Online: Molecular Mechanisms of Glucocorticoid-Induced Insulin Resistance.

    Beaupere, Carine / Liboz, Alexandrine / Fève, Bruno / Blondeau, Bertrand / Guillemain, Ghislaine

    International journal of molecular sciences

    2021  Volume 22, Issue 2

    Abstract: Glucocorticoids (GCs) are steroids secreted by the adrenal cortex under the hypothalamic-pituitary-adrenal axis control, one of the major neuro-endocrine systems of the organism. These hormones are involved in tissue repair, immune stability, and ... ...

    Abstract Glucocorticoids (GCs) are steroids secreted by the adrenal cortex under the hypothalamic-pituitary-adrenal axis control, one of the major neuro-endocrine systems of the organism. These hormones are involved in tissue repair, immune stability, and metabolic processes, such as the regulation of carbohydrate, lipid, and protein metabolism. Globally, GCs are presented as 'flight and fight' hormones and, in that purpose, they are catabolic hormones required to mobilize storage to provide energy for the organism. If acute GC secretion allows fast metabolic adaptations to respond to danger, stress, or metabolic imbalance, long-term GC exposure arising from treatment or Cushing's syndrome, progressively leads to insulin resistance and, in fine, cardiometabolic disorders. In this review, we briefly summarize the pharmacological actions of GC and metabolic dysregulations observed in patients exposed to an excess of GCs. Next, we describe in detail the molecular mechanisms underlying GC-induced insulin resistance in adipose tissue, liver, muscle, and to a lesser extent in gut, bone, and brain, mainly identified by numerous studies performed in animal models. Finally, we present the paradoxical effects of GCs on beta cell mass and insulin secretion by the pancreas with a specific focus on the direct and indirect (through insulin-sensitive organs) effects of GCs. Overall, a better knowledge of the specific action of GCs on several organs and their molecular targets may help foster the understanding of GCs' side effects and design new drugs that possess therapeutic benefits without metabolic adverse effects.
    MeSH term(s) Adipose Tissue/drug effects ; Adipose Tissue/metabolism ; Animals ; Glucocorticoids/adverse effects ; Glucocorticoids/metabolism ; Glucocorticoids/therapeutic use ; Humans ; Insulin/metabolism ; Insulin Resistance ; Insulin Secretion/drug effects ; Liver/drug effects ; Liver/metabolism ; Muscle, Skeletal/drug effects ; Muscle, Skeletal/metabolism ; Pancreas/drug effects ; Pancreas/metabolism ; Signal Transduction/drug effects
    Chemical Substances Glucocorticoids ; Insulin
    Language English
    Publishing date 2021-01-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms22020623
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  8. Article ; Online: American Trauma Care: A System of Systems.

    Johnson, Rachel M / Larson, Nicholas J / Brown, Catherine T / Iyegha, Uroghupatei P / Blondeau, Benoit / Dries, David J / Rogers, Frederick B

    Air medical journal

    2023  Volume 42, Issue 5, Page(s) 318–327

    Abstract: Objective: The benefits of organized trauma systems have been well-documented during 50 years of trauma system development in the United States. Unfortunately, despite this evidence, trauma system development has occurred only sporadically in the 50 ... ...

    Abstract Objective: The benefits of organized trauma systems have been well-documented during 50 years of trauma system development in the United States. Unfortunately, despite this evidence, trauma system development has occurred only sporadically in the 50 states.
    Methods: The relevant literature related to trauma system design and development was reviewed based on relevance to the study. Information from these sources was summarized into a SWOT (strengths, weaknesses, opportunities, and threats) analysis.
    Results: Strengths discovered were leadership brought forth by the American College of Surgeons Committee on Trauma and meaningful change generated from The National Academy of Sciences, Engineering, and Medicine report addressing the fractionation of the nation's trauma systems, whereas weaknesses included patient outcome disparities due to the lack of a national governing authority, undertriage, underresourced rural trauma, and underfunded trauma research. Opportunities included the creation of level IV trauma centers; telemedicine; the development of rural trauma management courses; air medical transport to bring high-intensity care to the patient, particularly in rural areas; trauma research; and trauma prevention through outreach and educational programs. The following threats were determined: mass casualty incidents, motor vehicle collisions because of the high rate of motor vehicle collision deaths in the United States relative to other developed countries, and underfunded trauma systems.
    Conclusion: Much work remains to be done in the development of an American trauma system. Recommendations include implementation of trauma care governance at the federal level; national oversight and support of emergency medical services systems, particularly in rural areas with strict reporting processes for emergency medical services programs; national organization of our mass casualty response; increased federal and state funding allocated to trauma centers; a consistent model for trauma system development; and trauma research.
    MeSH term(s) Humans ; United States ; Emergency Medical Services ; Trauma Centers ; Telemedicine
    Language English
    Publishing date 2023-07-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2072853-0
    ISSN 1532-6497 ; 1067-991X
    ISSN (online) 1532-6497
    ISSN 1067-991X
    DOI 10.1016/j.amj.2023.07.002
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    Zs.A 5623: Show issues Location:
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  9. Article ; Online: Glucagon-secretion inhibition using somatostatin: An old hormone for the treatment of diabetes-associated pancreatectomy.

    Riveline, J-P / Boudou, P / Blondeau, B / Gautier, J-F

    Diabetes & metabolism

    2017  Volume 43, Issue 3, Page(s) 269–271

    Language English
    Publishing date 2017-06
    Publishing country France
    Document type Letter
    ZDB-ID 1315751-6
    ISSN 1878-1780 ; 1262-3636 ; 0338-1684
    ISSN (online) 1878-1780
    ISSN 1262-3636 ; 0338-1684
    DOI 10.1016/j.diabet.2016.08.002
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  10. Article: Implementing successful strategic plans: a simple formula.

    Blondeau, Whitney / Blondeau, Benoit

    World hospitals and health services : the official journal of the International Hospital Federation

    2015  Volume 51, Issue 1, Page(s) 4–6

    Abstract: Strategic planning is a process. One way to think of strategic planning is to envision its development and design as a framework that will help your hospital navigate through internal and external changing environments over time. Although the process of ... ...

    Abstract Strategic planning is a process. One way to think of strategic planning is to envision its development and design as a framework that will help your hospital navigate through internal and external changing environments over time. Although the process of strategic planning can feel daunting, following a simple formula involving five steps using the mnemonic B.E.G.I.N. (Begin, Evaluate, Goals & Objectives, Integration, and Next steps) will help the planning process feel more manageable, and lead you to greater success.
    MeSH term(s) Efficiency, Organizational ; Hospital Administration ; Organizational Objectives ; Planning Techniques
    Language English
    Publishing date 2015
    Publishing country England
    Document type Journal Article
    ZDB-ID 1287212-x
    ISSN 1029-0540
    ISSN 1029-0540
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