Local Tranexamic Acid for Local Hemostasis in an Animal Liver Injury Model.

BACKGROUND: Hyperfibrinolysis is a state of increased clot resolution often seen in trauma patients with ongoing hemorrhage. Tranexamic acid (TXA) inhibits fibrinolysis preventing clot resolution affecting hemorrhage continuation and is used by intravenous administration. AIMS: The purpose of this study was to evaluate the local tranexamic acid application for hemostatic control in an experimental animal liver injury model. SETTINGS AND DESIGN: This study was an experimental prospective treatment study to check the local TXA effects on liver injury. This study was approved by the Ethics Committee. MATERIALS AND METHODS: Twenty adult male Sprague-Dawley white rats were equally randomized to two groups after a standardized liver injury was conducted under anesthesia. One group were "liver-packed" with gauze (TXA [-]) and the other group with gauze soaked in TXA (TXA [+]). Bleeding from the injured middle liver lobe was measured at 2 and 15 min, and at 48h second-look surgery, with euthanasia conducted at 14 days. The liver was sent for histopathological and stereological analysis. STATISTICAL ANALYSIS AND RESULTS: There was no difference in bleeding at 2 or 15 min after packing; however, larger amount of free blood at 48 h in the TXA (-) group was noticed. Five animals in the TXA (-) were alive at 14 days compared to eight animals in the TXA (+) group. Significantly larger volume density of fibrosis, granulation tissue, and amorphous tissue were seen in the TXA (+) group compared to the TXA (-) group at the stereological analysis. CONCLUSION: Local TXA application on the injured liver surface might offer better hemostatic control than packing alone. Further studies are mandated before the clinical application of our findings.

Effects of the Bam earthquake on employment: a shift-share analysis.

Disasters have potential short-term and long-term impacts on employment and employment structures in affected regions. While measuring the full economic impact of a disaster requires sophisticated econometrics and mathematical simulations, conventional regional economic models such as shift-share analysis can be used to assess some of these effects. This paper applies shift-share analysis to understand potential long-term impacts of disasters on employment using the December 2003 Bam earthquake as a case study. The results provide further evidence that disasters could have significant long-term effects on the employment structure of affected regions.