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https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#1
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29149974/liver-transplantation-with-old-grafts-a-ten-year-experience
#2
S Roullet, M Defaye, A Quinart, J-P Adam, L Chiche, C Laurent, M Neau-Cransac
BACKGROUND: The persistent scarcity of donors has prompted liver transplantation teams to find solutions for increasing graft availability. We report our experience of liver transplantations performed with grafts from older donors, specifically over 70 and 80 years old. PATIENTS AND METHODS: We analyzed our prospectively maintained single-center database from January 1, 2005, to December 31, 2014, with 380 liver transplantations performed in 354 patients. Six groups were composed according to donor age: <40 (n = 84), 40 to 49 (n = 67), from 50 to 59 (n = 62), from 60 to 69 (n = 76), from 70 to 79 (n = 64), and ≥80 years (n = 27)...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#3
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29131053/an-experimental-study-to-measure-the-mechanical-properties-of-the-human-liver
#4
Alireza Karimi, Ahmad Shojaei
BACKGROUND: Since the liver is one of the most important organs of the body that can be injured during trauma, that is, during accidents like car crashes, understanding its mechanical properties is of great interest. Experimental data is needed to address the mechanical properties of the liver to be used for a variety of applications, such as the numerical simulations for medical purposes, including the virtual reality simulators, trauma research, diagnosis objectives, as well as injury biomechanics...
October 31, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#5
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29123547/quercetin-pretreatment-attenuates-hepatic-ischemia-reperfusion-induced-apoptosis-and-autophagy-by-inhibiting-erk-nf-%C3%AE%C2%BAb-pathway
#6
Liwei Wu, Qinghui Zhang, Weiqi Dai, Sainan Li, Jiao Feng, Jingjing Li, Tong Liu, Shizan Xu, Wenwen Wang, Xiya Lu, Qiang Yu, Kan Chen, Yujing Xia, Jie Lu, Yingqun Zhou, Xiaoming Fan, Chuanyong Guo
Background: Hepatic ischemia reperfusion (IR) injury is a common phenomenon in transplantation or trauma. The aim of the present study was to determine the protective effect of quercetin (QE) on hepatic IR injury via the ERK/NF-κB pathway. Methods: Mice were randomized into the sham, IR, QE100 + IR, and QE200 + IR groups. Quercetin was administered intragastrically daily at two doses (100 mg/kg and 200 mg/kg) for 5 days prior to IR injury. The expression levels of liver enzymes, inflammatory cytokines, and other marker proteins were determined at 2, 8, and 24 hours after IR...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29118676/host-responses-to-concurrent-combined-injuries-in-non-human-primates
#7
Matthew J Bradley, Diego A Vicente, Benjamin A Bograd, Erin M Sanders, Crystal L Leonhardt, Eric A Elster, Thomas A Davis
Background: Multi-organ failure (MOF) following trauma remains a significant cause of morbidity and mortality related to a poorly understood abnormal inflammatory response. We characterized the inflammatory response in a non-human primate soft tissue injury and closed abdomen hemorrhage and sepsis model developed to assess realistic injury patterns and induce MOF. Methods: Adult male Mauritan Cynomolgus Macaques underwent laparoscopy to create a cecal perforation and non-anatomic liver resection along with a full-thickness flank soft tissue injury...
2017: Journal of Inflammation
https://www.readbyqxmd.com/read/29099334/viscoelastic-monitoring-to-guide-hemostatic-resuscitation-in-liver-transplantation-surgery
#8
Kevin P Blaine, Tetsuro Sakai
Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29097861/biliary-complications-after-hepatic-trauma-in-children
#9
Riccardo Guanà, Carbonaro Giulia, Andrea Brunati, Salvatore Garofalo, Jurgen Schleef
Aim of the Study: In pediatric patients with liver trauma and hemodynamic stability, conservative treatment is acknowledged as the gold standard. Patients and Methods: We conducted a retrospective analysis of 116 consecutive pediatric patients (<14-year-old) observed at our institution for closed abdominal trauma from January 2010 to January 2016. Among these, 16 patients (13%) had hepatic trauma Grade II or more, according to Moore liver trauma injury score...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29094801/photoluminescence-intensity-ratio-of-eu-conjugated-lactates-a-simple-optical-imaging-technique-for-biomarker-analysis-for-critical-diseases
#10
Tarun Kakkar, Nikita Thomas, Eric Kumi Barimah, Gin Jose, Sikha Saha
Instant measurement of elevated biomarker such as lactic acid offers the most promising approaches for early treatment and prevention of many critical diseases including cardiac arrest, stroke, septic shock, trauma, liver dysfunction, and as well as for monitoring lactic acid level during intense exercise. In the present study a unique dependence of visible photoluminescence of Eu(3+) ions resulting from (5) D0 to (7) FJ(J=0,1,2,3,4) transitions, which can be exploited for rapid detection of biomarkers both in vitro and ex vivo has been reported...
November 2, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#11
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29052835/role-of-percutaneous-transhepatic-biliary-drainage-in-the-management-of-blunt-liver-trauma-a-case-report
#12
Şükrü Oğuz, Reyyan Yıldırım, Serdar Topaloğlu
The liver is the most commonly injured intra-abdominal organ after blunt trauma. The management of massive liver injury is complex. Percutaneous transhepatic biliary drainage is the first approach considered, particularly for proximal bile duct strictures after liver surgery. A 27-year-old female patient was transferred to our emergency department with grade V blunt injury. Regarding the patient's unresponsive hemodynamic instability, right hepatectomy was performed. The patient presented with benign biliary duct stricture after surgery that were treated via the percutaneous approach...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29042927/novel-type-of-peritoneocentesis-trocar-assisted-distal-ventriculoperitoneal-shunt-placement-with-supervision-via-a-one-port-laparoscope
#13
Guangming Wang, Jinlu Yu, Yongxin Luan, Yanwu Han, Shuanglin Fu
Ventriculoperitoneal shunts (VPS) are the primary treatment for hydrocephalus and are associated with a high risk of complications, specifically in patients who are obese or have abdominal adhesions or shunt revisions. The present study describes the use of a novel type of peritoneal catheter peritoneocentesis trocar insertion with the assistance of a one-port laparoscope. A total of 36 patients with hydrocephalus underwent this novel type of peritoneocentesis trocar-assisted VPS. The distal shunt catheter was placed into the right subdiaphragmatic space and the catheter was traversed through a single hole drilled through the liver falciform ligament...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29033772/intraparenchymal-hemorrhage-due-to-brain-metastasis-of-hepatocellular-carcinoma
#14
Rafael Sartori Balbinot, Ana Laura Facco Muscope, Mateus Dal Castel, Silvana Sartori Balbinot, Raul Angelo Balbinot, Jonathan Soldera
Although extrahepatic metastases from hepatocellular carcinoma (HCC) are present in only 5-15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29033682/usefulness-of-tc99m-mebrofenin-hepatobiliary-scintigraphy-and-single-photon-emission-computed-tomography-computed-tomography-in-the-diagnosis-of-bronchobiliary-fistula
#15
Rahul Vithalrao Parghane, Rohit Kumar Phulsunga, Rajesh Gupta, Rajender Kumar Basher, Anish Bhattacharya, Bhagwant Rai Mittal
Bronchobiliary fistula (BBF), a rare complication of liver disease, is an abnormal communication between the biliary tract and bronchial tree. BBF may occur as a consequence of local liver infections such as hydatid or amebic disease, pyogenic liver abscess or trauma to the liver, obstruction of biliary tract, and tumor. As such management of liver disease with BBF is very difficult and often associated with a high rate of morbidity and mortality. Therefore, timely diagnosis of BBF is imperative. Hepatobiliary scintigraphy along with hybrid single photon emission computed tomography/computed tomography using Tc99m-mebrofenin is a very useful noninvasive imaging modality, in the diagnosis of BBF...
October 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28987552/is-infection-an-independent-risk-factor-for-venous-thromboembolism-a-population-based-case-control-study
#16
Kevin P Cohoon, Aneel A Ashrani, Daniel J Crusan, Tanya M Petterson, Kent R Bailey, John A Heit
BACKGROUND: The independent association of recent infection with venous thromboembolism is uncertain. The purpose of the study was to test both overall infection (site unspecified) and specific infection sites as potential risk factors for deep vein thrombosis and pulmonary embolism adjusting for other known venous thromboembolism factors. METHODS: Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County, MN residents with objectively-diagnosed incident deep vein thrombosis or pulmonary embolism over the 13-year period, 1988-2000 (cases; n=1303), and 1-2 residents without venous thromboembolism matched to each case on age, sex and incident venous thromboembolism date (controls; n=1494)...
October 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28985866/a-novel-model-of-highly-lethal-uncontrolled-torso-hemorrhage-in-swine
#17
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, John Kevin Grayson, Timothy K Williams, Joseph M Galante, Lucas P Neff
INTRODUCTION: A reproducible, lethal noncompressible torso hemorrhage model is important to civilian and military trauma research. Current large animal models balancing clinical applicability with standardization and internal validity. As such, large animal models of trauma vary widely in the surgical literature, limiting comparisons. Our aim was to create and validate a porcine model of uncontrolled hemorrhage that maximizes reproducibility and standardization. METHODS: Seven Yorkshire-cross swine were anesthetized, instrumented, and splenectomized...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985863/early-declaration-of-death-by-neurologic-criteria-results-in-greater-organ-donor-potential
#18
Shelby Resnick, Mark J Seamon, Daniel Holena, Jose Pascual, Patrick M Reilly, Niels D Martin
BACKGROUND: Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28982391/the-impact-of-early-thromboelastography-directed-therapy-in-trauma-resuscitation
#19
Mohamed Mohamed, Karl Majeske, Gul R Sachwani, Kristin Kennedy, Mina Salib, Michael McCann
BACKGROUND: Conventional coagulation tests do not provide an accurate representation of the complex nature of trauma induced coagulopathy. Thrombelastography provides a prompt global overview of all dynamic sequential aspects of trauma induced coagulopathy. The objective of this study was to evaluate the impact of using thrombelastography on blood products utilization, crystalloids utilization, hospital, and intensive care using length of stay, and cost savings. METHODS: We retrospectively reviewed 134 patients (May of 2012 to February of 2015) meeting Class I trauma activation...
October 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28982020/streptococcus-phocae-in-marine-mammals-of-northeastern-pacific-and-arctic-canada-a-retrospective-analysis-of-85-postmortem-investigations
#20
Nicole D Taurisano, Brian P Butler, Diana Stone, Harry Hariharan, Paul J Fields, Hugh W Ferguson, Martin Haulena, Paul Cotrell, Ole Nielsen, Stephen Raverty
Streptococcus phocae is a pathogen of marine mammals, although its pathogenicity remains poorly understood. Recovery of this bacterium from asymptomatic carriers suggests that it is an opportunistic pathogen. We investigated the role of S. phocae in naturally occurring disease and its significance as a pathogen based on postmortem investigations. Between 2007 and 2012, 1,696 whole carcasses, tissue samples, or both were submitted from the northeastern Pacific and Arctic Canada for diagnostic testing. Streptococcus phocae was cultured from phocids (n=66), otariids (n=12), harbor porpoises (Phocoena phocoena; n=5), and sea otters (Enhydra lutris; n=2)...
October 5, 2017: Journal of Wildlife Diseases
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