TY  - CHAP
M1  - Book, Section
TI  - Genomics and Acute Care Surgery
A1  - Brakenridge, Scott C.
A1  - Efron, Philip A.
A1  - Moldawer, Lyle L.
A2  - Feliciano, David V.
A2  - Mattox, Kenneth L.
A2  - Moore, Ernest E.
PY  - 2020
T2  - Trauma, 9e
AB  - KEY  POINTSVariability  in  clinical  phenotypes  results  from  the  following:  differences  in  DNA  sequence  (genomics),  RNA  transcription  (transcriptomics),  and  protein  translation  and  structure  (posttranscriptional  regulation  and  posttranslational  modification).It  is  estimated  that  only  2%  of  total  DNA  includes  the  code  for  the  approximately  20,000  protein-coding  genes  of  the  human  genome.Exons  are  the  regions  of  DNA  that  are  transcribed  to  mRNA  and  then  translated  into  the  amino  acid  structure  of  proteins.Histone  proteins  play  a  key  role  in  the  functional  regulation  of  the  genome.The  most  common  type  of  DNA  sequence  variations  are  single  base  substitutions  termed  single  nucleotide  polymorphisms  (SNPs).SNPs  relevant  to  acute  care  surgery  are  found  within  the  promotor  regions  of  genes  for  Toll-like  receptor  1  and  tumor  necrosis  factor-α,  both  associated  with  increased  mortality  after  trauma  and  sepsis.MicroRNAs  are  short  single-stranded  RNA  fragments  that  downregulate  gene  expression  when  bound  to  messenger  RNA.Postinjury  systemic  inflammatory  response  syndrome–induced  early  multiple  organ  failure  is  related  to  a  “genomic  storm”  at  the  level  of  circulating  leukocyte  gene  transcription  and  occurs  simultaneously  with  a  compensatory  anti-inflammatory  and  immunosuppressive  response.Chronic  critical  illness  is  characterized  by  an  underlying  pathophysiology  of  persistent  inflammation,  immunosuppression,  and  catabolism.A  63-gene  transcriptomic  metric  score  within  24  hours  after  injury  has  been  shown  to  be  associated  with  subsequent  adverse  outcomes  including  multiple  organ  dysfunction,  length  of  mechanical  ventilation  and  hospital  stay,  and  infection  rates.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/17
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1175130719
ER  -