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https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#1
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#2
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#3
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#4
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28742506/bioimpedance-analysis-vs-dexa-as-a-screening-tool-for-osteosarcopenia-in-lean-overweight-and-obese-caucasian-postmenopausal-females
#5
Melpomeni Peppa, Charikleia Stefanaki, Athanasios Papaefstathiou, Dario Boschiero, George Dimitriadis, George P Chrousos
BACKGROUND-OBJECTIVES: We aimed at evaluating the efficiency of a newly developed, advanced Bioimpedance Analysis (BIA-ACC®) device as a screening tool for determining the degree of obesity and osteosarcopenia in postmenopausal women with normal or decreased bone density determined by Dual-Energy X-Ray absorptiometry (DEXA) in a representative sample of Greek postmenopausal women. METHODS: This is a single-gate cross-sectional study of body composition measured by BIA-ACC® and DEXA...
April 2017: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28706378/soft-tissue-damage-during-total-knee-arthroplasty-focus-on-tourniquet-induced-metabolic-and-ionic-muscle-impairment
#6
REVIEW
Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens
PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism. CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28705097/transfusion-refusal-and-the-shifting-limits-of-multicultural-accommodation
#7
Carey DeMichelis
The refusal of blood products by Jehovah's Witness patients has provoked court proceedings, social science research, and contemporary fiction, all of which emphasize a seemingly intractable conflict between religious and secular ways of being. This article takes a different approach, focusing instead on the space that Witness patients have carved out for their accommodation in a major pediatric research hospital. Using discourse analysis and interview data, I map the way moralizing discourses surrounding Witness families have shifted over the past 70 years alongside advancements in bloodless medicine...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28688475/adolf-lorenz-the-bloodless-surgeon-of-vienna
#8
Ahmadreza Afshar, Robert A Kyle, David P Steensma
No abstract text is available yet for this article.
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28580218/cryotherapy-as-a-conservative-treatment-modality-for-gingival-enlargement-in-a-patient-with-sturge-weber-syndrome
#9
Vikender Singh Yadav, Souvik Chakraborty, Shikha Tewari, Nitesh Tewari, Tuhina Ghosh
This case report describes a case of Sturge-Weber syndrome reported for unilateral gingival enlargement and bleeding from gingiva in maxillary left region. Initial treatment in the form of scaling and root planing was done but recurrence was observed after one year of follow up. Instead of performing conventional surgery, an alternative conservative treatment was planned in the form of cryotherapy with the help of closed nitrous oxide probe. Seeing the satisfactory results obtained, cryotherapy can be suggested as an atraumatic, bloodless and effective chair side procedure for treating vascular gingival enlargement...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28560111/clonidine-or-remifentanil-for-adequate-surgical-conditions-in-patients-undergoing-endoscopic-sinus-surgery-a-randomized-study
#10
Laurent Bairy, Marie Vanderstichelen, Jacques Jamart, Edith Collard
BACKGROUND: Deliberate hypotension is one way to achieve a bloodless surgical field in endoscopic sinus surgery (ESS). We compared two anaesthesia regimens to induce deliberate hypotension and attempted to determine the most efficient one. METHODS: Fifty-nine patients undergoing ESS were minimized into two groups. In the CLO group, patients received I.V. sufentanil 0.15 µg/kg together with I.V. clonidine 2-3 µg/kg. In the REMI group, patients received remifentanil at a rate of up to 1 µg/kg/min...
2017: PeerJ
https://www.readbyqxmd.com/read/28544979/preoperative-left-hepatic-lobe-devascularisation-to-minimize-perioperative-bleeding-in-a-jehovah-s-witness-undergoing-left-hepatectomy
#11
Laurence Weinberg, Georgina Hanus, Jonathan Banting, Diana Abu-Ssaydeh, Manfred Spanger, Su Kah Goh, Vijayaragavan Muralidharan
INTRODUCTION: Major liver resection in a Jehovah's Witness presents unique clinical challenges requiring multimodal blood minimization strategies to reduce perioperative complications. We report a case where complete left hepatic lobe devascularisation was undertaken to minimize bleeding in a Jehovah's Witness undergoing left hepatectomy. PRESENTATION OF CASE: A 65-year-old male Jehovah's Witness presented for open left hepatectomy for a large left-sided hepatocellular carcinoma involving segment IV of the liver...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28509563/the-adjunctive-soft-tissue-diode-laser-in-orthodontics
#12
Ali Borzabadi-Farahani
Lasers are a relatively new addition to the orthodontist's armamentarium. This article reviews the fundamental basic science of available soft-tissue lasers, with an emphasis on diode lasers, and discusses various adjunct applications of the diode laser for soft-tissue orthodontic procedures. Diode lasers function by cutting with an initiated hot tip and produce minimal to no interaction with healthy dental hard tissue, making them suitable for soft-tissue procedures. The contact cutting mode provides enhanced bloodless site visibility and facility to perform delicate soft tissue procedures, which is important in areas with difficult access...
April 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/28435130/intramyometrial-injection-of-vasopressin-a-novel-method-for-hemostasis-at-laparoscopic-management-of-cornual-ectopic
#13
Ramesh Bettaiah, Shwetha Sudhakar Kamath
STUDY OBJECTIVE: Injection of vasopressin into the uterus , significantly reduces the vascularity of the cornual ectopic, thereby resulting in bloodless surgery. DESIGN: A step by step demonstration of the surgical procedure. Canadian task force classification III SETTING: while all ectopics are associated with risk of hemorrhage, cornual pregnancies are feared for catastrophic hemorrhage and uncontrollable bleeding. The maternal mortality rate can be as high as 2...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28280667/intradermal-infiltration-of-local-anesthetic-rapid-and-bloodless-deepithelialization-of-the-breast-pedicle
#14
Katelyn G Bennett, Robert H Gilman
Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28263419/transoral-ultrasonic-surgery-of-pharyngolaryngeal-giant-hemangioma-after-ethylene-vinyl-alcohol-copolymer-onyx-embolization
#15
Meritxell Valls-Mateus, Luis San Román, Juan Macho, Alfons Nadal, Manuel Bernal-Sprekelsen, Isabel Vilaseca
BACKGROUND: Cervico-mediastinal hemangiomas in adulthood are rare and slow-growing vascular tumors. The optimal treatment for giant hemangiomas is controversial. In asymptomatic cases, clinical observation is generally recommended. METHODS: We report the transoral resection of a pharyngolaryngeal hemangioma (diameters of 44 × 56 × 39 mm) with tracheal involvement and mediastinal extension. Clinically, the patient had throat foreign body sensation, severe dyspnea and stridor...
June 2017: Head & Neck
https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#16
REVIEW
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28197644/routine-application-of-bloodless-priming-in-neonatal-cardiopulmonary-bypass-a-3-year-experience
#17
Wolfgang Boettcher, Nicodème Sinzobahamvya, Oliver Miera, Matthias Redlin, Frank Dehmel, Mi-Young Cho, Peter Murin, Felix Berger, Joachim Photiadis
A restrictive transfusion strategy led us to routinely try to conduct donor-blood free open-heart surgery even in neonates. The cardio-pulmonary bypass (CPB) circuit was minimized by priming volumina at 73 ml for the smallest patients with body weight up to 2.5 kg and 85-95 ml for those with body weight of more than 2.5 kg, and by positioning the console as close as possible to operation table. Measures were applied to save blood during the procedure. Transfusion threshold of 8 g/dl hemoglobin was retained...
April 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#18
M F Gomez, O Aljure, G Ciancio, M Lynn
This case describes a 46-year-old male recipient of a kidney-pancreas transplant who is Jehovah's Witness. Early in the postoperative period, he was found to have splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (hemoglobin <6 g/dL). Standard medical therapy for bloodless surgical patients with severe anemia was instituted. Nevertheless, the patient's hemoglobin concentration continued to decline to critical levels (2 g/dL). Because he was Jehovah's Witness, transfusion of allogeneic blood products was not an option, prompting use of a hemoglobin-based oxygen carrier (HBOC)...
July 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28188434/bloodless-reperfusion-with-the-oxygen-carrier-hboc-201-in-acute-myocardial-infarction-a-novel-platform-for-cardioprotective-probes-delivery
#19
Jose M García-Ruiz, Carlos Galán-Arriola, Rodrigo Fernández-Jiménez, Jaume Aguero, Javier Sánchez-González, Ana García-Alvarez, Mario Nuno-Ayala, Gregory P Dubé, Zafiris Zafirelis, Gonzalo J López-Martín, Juan A Bernal, Enrique Lara-Pezzi, Valentín Fuster, Borja Ibáñez
Reperfusion, despite being required for myocardial salvage, is associated with additional injury. We hypothesize that infarct size (IS) will be reduced by a period of bloodless reperfusion with hemoglobin-based oxygen carriers (HBOC) before blood-flow restoration. In the pig model, we first characterized the impact of intracoronary perfusion with a fixed volume (600 ml) of a pre-oxygenated acellular HBOC, HBOC-201, on the healthy myocardium. HBOC-201 was administered through the lumen of the angioplasty balloon (i...
March 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28163429/modified-closed-chamber-sutureless-technique-for-anomalous-pulmonary-venous-connection
#20
Sabarinath Menon, Thomas Mathew, Jayakumar Karunakaran, Baiju Sashidhar Dharan
Visibility continues to be a major problem during repair of obstructed total anomalous pulmonary venous connection (TAPVC) resulting in frequent use of deep hypothermia and low flow bypass. Sutureless technique for primary repair of anomalous pulmonary venous connection is fast becoming popular. In this described modification of sutureless technique through the lateral approach, the left atrium is marsupialized around the common pulmonary venous chamber, except on the right lateral aspect, providing a bloodless field with minimal retraction of heart facilitating the surgery at mild hypothermia...
January 2017: Annals of Pediatric Cardiology
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