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https://www.readbyqxmd.com/read/29664833/effect-of-pre-hospital-red-blood-cell-transfusion-on-mortality-and-time-of-death-in-civilian-trauma-patients
#1
Marius Rehn, Anne Weaver, Karim Brohi, Sarah Eshelby, Laura Green, Jo Røislien, David J Lockey
BACKGROUND: Current management principles of haemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's air ambulance (LAA) was the first UK civilian pre-hospital service to routinely offer pre-hospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before-implementation with after-implementation of phRTx in exsanguinating trauma patients...
April 16, 2018: Shock
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#2
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29662467/multilocus-sequence-typing-and-virulence-associated-gene-profile-analysis-of-staphylococcus-aureus-isolates-from-retail-ready-to-eat-food-in-china
#3
Xiaojuan Yang, Shubo Yu, Qingping Wu, Jumei Zhang, Shi Wu, Dongli Rong
The aim of this study was to characterize the subtypes and virulence profiles of 69 Staphylococcus aureus isolates obtained from retail ready-to-eat food in China. The isolates were analyzed using multilocus sequence typing (MLST) and polymerase chain reaction (PCR) analysis of important virulence factor genes, including the staphylococcal enterotoxin (SE) genes ( sea , seb , sec , sed , see , seg , seh , sei , sej ), the exfoliative toxin genes ( eta and etb ), the toxic shock syndrome toxin-1 gene ( tst ), and the Panton-Valentine leucocidin-encoding gene ( pvl )...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29661236/clinical-analysis-of-50-patients-with-heterotopic-pregnancy-after-ovulation-induction-or-embryo-transfer
#4
Zaigui Wu, Xinmei Zhang, Ping Xu, Xiufeng Huang
OBJECTIVES: The purpose of this study was to evaluate the clinical characteristics, prenatal diagnosis, and management of patients with heterotopic pregnancy after ovulation induction or embryo transfer. METHODS: This was a retrospective study of fifty cases with heterotopic pregnancy, in which the fertilization way, type and number of embryo transferred, gestational age, clinical presentation and outcome of intrauterine, ultrasound presentation and site of ectopic pregnancy, bilateral fallopian tube and treatment were evaluated...
April 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29661170/-people-look-and-ask-lots-of-questions-caregivers-perceptions-of-healthcare-provision-and-support-for-children-born-with-cleft-lip-and-palate
#5
Phumzile Hlongwa, Laetitia C Rispel
BACKGROUND: Clefting of the lip and/or palate (CL/P) is amongst the five most common birth defects reported in South Africa. The emotional impact on parents at the birth of their new-born with CL/P could affect parent-child relationships. In light of insufficient scholarly attention parental experiences and perceptions, this study reports on caregivers' perceptions of health service provision and support for children born with cleft lip and palate in South Africa. METHODS: The study setting consisted of 11 academic hospital centres situated in six of South Africa's nine provinces...
April 16, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#6
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#7
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29655948/outcome-of-catheter-ablation-for-ventricular-tachycardia-in-patients-with-ischemic-cardiomyopathy-a-systematic-review-and-meta-analysis-of-randomized-clinical-trials
#8
Waddah Maskoun, Marwan Saad, Amjad Abualsuod, Ramez Nairooz, John M Miller
BACKGROUND: Current ventricular tachycardia (VT) management in patients with ischemic cardiomyopathy (ICM) includes optimal medical therapy, ICDs device therapy, and antiarrhythmic medications. Data about outcomes of catheter ablation (CA) in these patients is scarce. We aimed to perform a meta-analysis of RCTs to compare outcomes of CA vs conventional management of VT in ICM patients who had ICD. METHODS: A systematic review and meta-analysis of published RCTs between January 1970 and December 2016 were performed...
April 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29655828/venoarterial-extracorporeal-membrane-oxygenation-in-cardiogenic-shock
#9
REVIEW
Mary E Keebler, Elias V Haddad, Chun W Choi, Stuart McGrane, Sandip Zalawadiya, Kelly H Schlendorf, D Marshall Brinkley, Matthew R Danter, Mark Wigger, Jonathan N Menachem, Ashish Shah, JoAnn Lindenfeld
Venoarterial extracorporeal membrane oxygenation has emerged as a viable treatment for patients in cardiogenic shock with biventricular failure and pulmonary dysfunction. Advances in pump and oxygenator technology, cannulation strategies, patient selection and management, and durable mechanical circulatory support have contributed to expanded utilization of this technology. However, challenges remain that require investigation to improve outcomes.
April 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#10
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29649938/preoperative-physiology-imaging-and-management-of-interrupted-aortic-arch
#12
Kevin Friedman
Interrupted aortic arch (IAA) is a rare form of critical neonatal heart disease in which there is lack of continuity between the ascending aorta and the descending thoracic aorta. In the absence of prenatal diagnosis, patients with IAA present in shock when the patent ductus arteriosus closes. Diagnosis can generally be made by echocardiography, and initiation of prostaglandin E1 infusion allows for adequate lower body perfusion prior to surgical repair. Full neonatal repair can be achieved with good outcomes in most cases...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29644505/cardiotoxicity-of-immunotherapy-incidence-diagnosis-and-management
#13
REVIEW
Aarti Asnani
PURPOSE OF REVIEW: This review describes cardiotoxicity associated with adoptive T cell therapy and immune checkpoint blockade. RECENT FINDINGS: Cardiotoxicity is a rare but potentially fatal complication associated with novel immunotherapies. Both affinity-enhanced and chimeric antigen receptor T cells have been reported to cause hypotension, arrhythmia, and left ventricular dysfunction, typically in the setting of cytokine release syndrome. Immune checkpoint inhibitors are generally well-tolerated but have the potential to cause myocarditis, with clinical presentations ranging from asymptomatic cardiac biomarker elevation to heart failure, arrhythmia, and cardiogenic shock...
April 11, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#14
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29629219/novel-endoscopic-stent-for-anastomotic-leaks-after-total-gastrectomy-using-an-anchoring-thread-and-fully-covering-thick-membrane-prevention-of-embedding-and-migration
#15
Gum Mo Jung, Seung Hyun Lee, Dae Seong Myung, Wan Sik Lee, Young Eun Joo, Mi Ran Jung, Seong Yeob Ryu, Young Kyu Park, Sung Bum Cho
Purpose: The endoscopic management of a fully covered self-expandable metal stent (SEMS) has been suggested for the primary treatment of patients with anastomotic leaks after total gastrectomy. Embedded stents due to tissue ingrowth and migration are the main obstacles in endoscopic stent management. Materials and Methods: The effectiveness and safety of endoscopic management were evaluated for anastomotic leaks when using a benign fully covered SEMS with an anchoring thread and thick silicone covering the membrane to prevent stent embedding and migration...
March 2018: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/29628848/wilm-s-tumor-with-intracardiac-extension-causing-dynamic-tricuspid-valve-obstruction-an-anesthetic-challenge
#16
Kamal Kajal, Ganesh Kumar Munirathinam, Banashree Mandal, Komal Gandhi, Harkant Singh, Ravi Kanojia
Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628667/early-predictive-factors-of-hypofibrinogenemia-in-acute-trauma-patients
#17
Shahram Paydar, Behnam Dalfardi, Zahra Shayan, Leila Shayan, Jalal Saem, Shahram Bolandparvaz
Background: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopathy. Aims: The aim of this study is to determine clinical and easily available laboratory variables that are predictive of hypofibrinogenemia in acute trauma patients...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628170/preoperative-assessment-of-the-risk-of-postoperative-death-in-patients-with-oral-squamous-cell-carcinoma-a-consideration-beyond-age-sex-and-stage-of-cancer
#18
A K Bartella, A-K Sander, M Kamal, J Steegmann, A Kloss-Brandstätter, J Teichmann, F Hölzle, B Lethaus
Despite improvements in the management of patients in critical care, about 3% patients who have an operation with curative intent for oral squamous cell carcinoma (SCC) do not survive their stay in hospital. Our aim was to assess the risk factors for postoperative death that were independent of the stage of the cancer, or the age and sex of the patients. We screened 4760 consecutive inpatients at a maxillofacial tertiary care centre from 2011 to 2016, and 34 of them had died within the first three months after operation...
April 5, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29626516/national-trends-and-outcomes-of-endomyocardial-biopsy-for-patients-with-myocarditis-from-the-national-inpatient-sample-database
#19
Ayman Elbadawi, Islam Y Elgendy, Le Dung Ha, Amgad Mentias, Gbolahan O Ogunbayo, Waqas Tahir, Nishit Binwale, Odunayo Olorunfemi, Kirolos Barssoum, Maya Guglin
BACKGROUND: The utility of endomyocardial biopsy (EMB) in the management of myocarditis in the era of advanced cardiac imaging has been challenged. METHODS AND RESULTS: The Nationwide Inpatient Sample Database years (1998-2013) was queried to identify hospitalization records with a primary diagnosis of myocarditis, and underwent EMB procedure. We identified 22,299 hospitalization records with a diagnosis of myocarditis during the study period. Of those, 798 (3.6%) underwent EMB procedure...
April 4, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29626019/diagnosis-and-management-of-sepsis
#20
Tom Evans
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
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