What are your research areas/interests?

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armygas

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Mine:

1) Autism (obviously not anesthesia related but since my son is autistic...)

2) Optimizing placement of resuscitation assets within combat theaters of operation.

3) Continuing military research efforts in the areas of resuscitation, hypotensive resuscitation, and hemostatic resuscitation.
 
Mine:

1) Autism (obviously not anesthesia related but since my son is autistic...)

2) Optimizing placement of resuscitation assets within combat theaters of operation.

3) Continuing military research efforts in the areas of resuscitation, hypotensive resuscitation, and hemostatic resuscitation.

Wouldn't nursing research be discussed on allnurses.com?
 
Wouldn't nursing research be discussed on allnurses.com?

I am a PhDc in Neuroscience............................ (nice attempt at looking for a fight)

I'll make sure I tell Dr. Alam, and Dr. Burris you said that (look 'em up on Pubmed for resuscitation, Dr. Burris is on my committee). Here is an abstract of one piece of their work (in Shock - Impact Factor: 3.122):

Valproic acid prevents hemorrhage-associated lethality and affects the acetylation pattern of cardiac histones.
Gonzales E, Chen H, Munuve R, Mehrani T, Britten-Webb J, Nadel A, Alam HB, Wherry D, Burris D, Koustova E.

Department of Surgery, Trauma Research and Readiness Institute for Surgery, Uniformed Services University of the Health Sciences, Bethesda, , MD 20814, USA.

ABSTRACT: Pharmacological inhibitors of histone deacetylases (HDAC) demonstrate cytoprotective effects both in vitro and in vivo. In this study, we investigated whether valproic acid (VPA), a known mood stabilizer and anticonvulsant with HDAC-inhibiting activity, improves survival following otherwise lethal hemorrhage in rats. We found that preinsult injection of VPA (300 mg/kg, twice) prolonged the survival of severely hypotensive animals up to 5 times. VPA treatment increased the acetylation of nonhistone and histone proteins in the rat heart. The pattern of modifications of individual histones revealed hyperacetylation of histones H2A, H3, and H4, indicating the presence of active genes. Expression of HSP70 and superoxide dismutase, implicated in the modulation of vitality, was increased by VPA. Our results reveal that VPA offers considerable protection in the hemorrhagic shock model and suggest a role for HDAC inhibition in mediating VPA actions.

Here is another (in Resuscitation - Impact Factor 2.314)

Effect of different resuscitation strategies on neutrophil activation in a swine model of hemorrhagic shock.
Alam HB, Stanton K, Koustova E, Burris D, Rich N, Rhee P.

Department of Surgery, Uniformed Services University of the Health Sciences, USUHS, Room A-3021, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.

Activated neutrophils play a pivotal role in resuscitation injury. The strategies used for resuscitation (types of fluids and methods of administration) can affect the degree of neutrophil activation. The aim of this study was to test the commonly available resuscitation fluids in a large animal model of hemorrhagic shock to determine the strategy associated with the least degree of neutrophil activation. Methods: Female swine (n=63, weight 45-60 kg) were anesthetized using isoflurane and catheters were placed for hemodynamic monitoring. After 120 min, they were subjected to a volume controlled hemorrhage (28 ml/kg) over 15 min, kept in shock for 60 min, and then resuscitated. The resuscitation groups were as follows: (1) anesthesia only (n=5); (2) hemorrhage, sham resuscitation (n=5); (3) LR-fast rate 3x blood loss (n=6); (4) LR slow rate-3x blood loss (n=6); (5) LR low volume-1x blood loss (n=6); (6) Dextran 40-1x blood loss (n=6); (7) 6% hetastarch-1x blood loss (n=6); (8) 5% albumin-1x blood loss (n=6); (9) 25% albumin-1/5x blood loss (n=6); (10) whole blood resuscitation-1x blood loss (n=6); (11) 7.5% hypertonic saline (HTS)-0.3x blood loss (n=5). Resuscitation fluids were infused over 1 h in all groups except group 4 (LR slow rate, which was over 3 h). Animals were observed for 180 min following the resuscitation period. Neutrophil oxidative burst activity was determined in whole blood using flow cytometery. Results: Animals resuscitated with dextran and hetastarch showed significantly (P<0.05) higher neutrophil burst activity. Resuscitation with LR also caused neutrophil activation (P<0.05), and the highest degree of activation was seen when a large volume of LR was given at a fast rate (group 8). However, all LR infusion protocols were associated with significant neutrophil activation compared with anesthesia (group 1) or sham resuscitation (group 2). No significant activation was seen in the animals resuscitated with albumin or fresh whole blood. Conclusion: Artificial colloids and LR (independent of rate or volume of infusion) caused significant neutrophil activation, which was not seen with albumin and whole blood resuscitation. These findings suggest that the type of resuscitation fluid and method of infusion can influence neutrophil function.

I don't think I started this thread insulting anyone did I?
 
I am in the process of a research project that involves making people hypoxic and then measuring pulmonary artery pressures and intervening with a drug to see if we can decrease hypoxic pulmonary vasoconstriction. The goal is to help with high altitude pulmonary edema.

One thing I have learned - hypoxia DOES NOT cause hypertension, so we can all take that one of our differential list.
 
Not anesthesia related, but cancer biology, specifically cell cycle regulation.

There has been alot of work recently in this area concerning the [SIZE=-1]phosphatase and tensin homolog (PTEN) protein.[/SIZE]
 
I am in the process of a research project that involves making people hypoxic and then measuring pulmonary artery pressures and intervening with a drug to see if we can decrease hypoxic pulmonary vasoconstriction. The goal is to help with high altitude pulmonary edema.

One thing I have learned - hypoxia DOES NOT cause hypertension, so we can all take that one of our differential list.

Does your group think its related to Nitric Oxide released during hypoxic events?
 
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Mine:

1) Autism (obviously not anesthesia related but since my son is autistic...)

2) Optimizing placement of resuscitation assets within combat theaters of operation.

3) Continuing military research efforts in the areas of resuscitation, hypotensive resuscitation, and hemostatic resuscitation.


What does the military have to aid in coagulation in the field? Some fibrin powder or what? Just curious
 
What does the military have to aid in coagulation in the field? Some fibrin powder or what? Just curious

The army is/was testing Novoseven in Iraq for massive hemorrhage before soldiers made it to the hospital.

This chump is in the army, so he probably thinks he is the main investigator on this.
 
Some fibrin powder or what? Just curious


I just saw on the discovery channel last night - that guy that survives in austrialia and drinks his own urine - anyway, he said that if you have an open wound and if you can find a spiderweb, ball up the web and stuff it in the wound. It apparently clots the blood and helps healing - maybe like fibrin glue or something.
 
What does the military have to aid in coagulation in the field? Some fibrin powder or what? Just curious

Actually, that is an ongoing project here are two abstracts from our university:

[SIZE=+1]Application of a zeolite hemostatic agent achieves 100% survival in a lethal model of complex groin injury in Swine.[/SIZE]

Alam HB, Chen Z, Jaskille A, Querol RI, Koustova E, Inocencio R, Conran R, Seufert A, Ariaban N, Toruno K, Rhee P.

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. [email protected]

BACKGROUND: Techniques for better hemorrhage control after injury could change outcome. We have previously shown that a zeolite mineral hemostatic agent (ZH) can control aggressive bleeding through adsorption of water, which is an exothermic process. Increasing the residual moisture content (RM) of ZH can theoretically decrease heat generation, but its effect on the hemostatic properties is unknown. We tested ZH with increasing RM against controls and other hemostatic agents in a swine model of battlefield injury. METHODS: A complex groin injury was created in 72 swine (37 +/- 0.8 kg). This included semitransection of the proximal thigh and complete division of the femoral artery and vein. After 3 minutes, the animals were randomized to 1 of 10 groups: group 1, no dressing (ND); group 2, standard dressing (SD); group 3, SD + 3.5 oz ZH with 1% RM (1% ZH); group 4, SD + 3.5 oz ZH with 4% RM (4% ZH); group 5, SD + 2 oz ZH with 1% RM (1% ZH 2oz); group 6, SD + 3.5 oz ZH with 8% RM (8% ZH); group 7, SD + chitosan-based hemostat, HemCon (HC); group 8, SD + 3.5 oz nonzeolite mineral hemostat, Quick Relief (NZH); group 9, SD + bovine clotting factors-based hemostat, Fast Act (FA); and group 10, SD + 30 g of starch-based hemostat, TraumaDex (TDex). Resuscitation (500 mL of Hespan over 30 minutes) was started 15 minutes after injury and hemodynamic monitoring was performed for 180 minutes. Primary endpoints were survival for 180 minutes and blood loss. In addition, maximum wound temperatures were recorded, and histologic damage to artery, vein, nerve, and muscle was documented. RESULTS: Use of 1% ZH decreased blood loss and reduced mortality to 0% (p < 0.05). Increasing the RM adversely affected efficacy without any significant decrease in wound temperatures. Minimal histologic tissue damage was seen with ZH independent of the percentage of RM. CONCLUSION: The use of zeolite hemostatic agent (1% residual moisture, 3.5 oz) can control hemorrhage and dramatically reduce mortality from a lethal groin wound.

[SIZE=+1]Comparative analysis of hemostatic agents in a swine model of lethal groin injury.[/SIZE]

Alam HB, Uy GB, Miller D, Koustova E, Hancock T, Inocencio R, Anderson D, Llorente O, Rhee P.

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. [email protected]

BACKGROUND: Techniques for better hemorrhage control after injury could change outcome. A large-animal model of lethal, uncontrolled hemorrhage was developed to test whether the use of various hemostatic agents would decrease bleeding and improve early survival. METHODS: A complex groin injury was created in 30 Yorkshire swine (42-55 kg) to produce uncontrolled hemorrhage. This injury included semitransection of the proximal thigh and complete division of the femoral artery and vein. After 5 minutes, the animals were randomized to (n = 6 animals per group) no dressing (ND), standard dressing (SD), SD and Rapid Deployment Hemostat (RDH) bandage, SD and QuikClot hemostatic agent (QC), or SD and TraumaDEX (TDEX). Limited volume 0.9% saline (1,000 mL over 30 minutes) resuscitation was started 30 minutes after injury. We measured blood loss, early mortality (180 minutes), and physiologic markers of hemorrhagic shock (e.g., cardiac output, blood pressure, hemoglobin, metabolic acidosis). RESULTS: Application of wound dressing decreased mortality in all groups compared with the ND group (83% mortality). However, this difference was significant (p < 0.05) only for the QuikClot hemostatic agent (0% mortality). Before the application of dressing (first 5 minutes), there were no differences in blood loss between the groups. After application of dressings, the QC group had the lowest blood loss (4.4 +/- 1.4 mL/kg). CONCLUSION: Of the hemostatic agents tested, QuikClot improved survival and decreased bleeding in a swine model of lethal vascular and soft tissue injury.


Also, PubMed a JB Holcomb, he is doing alot with this kind of stuff.
 
The army is/was testing Novoseven in Iraq for massive hemorrhage before soldiers made it to the hospital.

This chump is in the army, so he probably thinks he is the main investigator on this.
🙄

Whatever dude, but I have done many an anesthetic in Iraq
 
I know that there is some very very interesting trauma research being done at DARPA, including the development of an anesthetic with no physiological side effects other than pain control.
 
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I know that there is some very very interesting trauma research being done at DARPA, including the development of an anesthetic with no physiological side effects other than pain control.

That will be the end of our job. 🙁
 
Wow, that's cool. How come DARPA is so seemingly secretive? They look at some cool far out stuff.

They look at some incredibly far out stuff. If they are putting this stuff on their website, can you only imagine what they aren't?
 
They look at some incredibly far out stuff. If they are putting this stuff on their website, can you only imagine what they aren't?


good point! I had never heard of them until recently when a staff from my place was asked to come out to a brain storming session they had on a research topic/areas of research. I was blown away at some of the things he was telling me about them, and I don't think he really knew that much, so I totally agree with what you are saying.
 
They look at some incredibly far out stuff. If they are putting this stuff on their website, can you only imagine what they aren't?


Do you think that the secret government agency on the show LOST (i think it was called DARMA - I can't remember since I only watched the 2nd season, got pissed off at the end and decided never to watch again - but I heard the 3rd season was really good.....) was in reference to DARPA?
 
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