RESUMO
BACKGROUND: Familial correlations, twin studies and adoption studies have all indicated that human obesity has a substantial genetic component. To date, obesity genes have only been identified using mouse models. METHODS: In an attempt to identify human obesity genes large numbers of multigenerational families, in whom extreme obesity segregates, are currently being collected. RESULTS AND CONCLUSIONS: Relative risk estimates and models of genetic heterogeneity indicate that at least 500 affected sibling pairs will need to be collected to identify major genes.
RESUMO
We have used fibrin glue to control non-arterial hemorrhage from major liver lacerations in two patients with excellent results. It is an ideal biologic hemostatic agent. Fibrin glue uses none of the body's intrinsic clotting factors and can be prepared from commonly available products in minutes.
Assuntos
Adesivo Tecidual de Fibrina/uso terapêutico , Fígado/lesões , Ferimentos Penetrantes/terapia , Adulto , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/terapia , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Masculino , Reação Transfusional , Ferimentos Penetrantes/complicaçõesRESUMO
The report presents three studies of post-traumatic pulmonary insufficiency (PTPI). In the first no significant pulmonary hemodynamic or ventilatory changes in severely shocked baboons resuscitated with shed fresh blood or stored blood were observed over 48 or 84 hours. Second, a post-mortem study of patients receving more than 5 units of blood within 24 hours of death showed sme microemboli in the lungs in about two thirds. Patients with multiple microthrombi had received an average of 20.6 units of blood; patients with some or no microemboli 15.5 and 6.3, respectively. Third in a review of the respiratory complications of 153 multiple-trauma patients, it was shown that the formerly severe problems with PTPI were now well managed clinically, that persistent respiratory failure was now occurring much later after injury, and occurred almost exclusively in patients with sepsis. Relation of the above data to previous reports in the literature led to the conclusion that the clinical significance of microaggregates in stored blood, if any, is low, and that ultrafiltration to remove microemboli only makes sense if it does not impede the rate of blood infusion and does not increase cost.
