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Haemorrhagic shock

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https://www.readbyqxmd.com/read/28329116/spontaneous-haemothorax-caused-by-a-ruptured-oesophageal-artery
#1
Wenxiong Zhang, Yongbing Wu, Xiaoqiang Zhang, Han Jiang
Spontaneous haemothorax is a subcategory of haemothorax that occurs in the absence of trauma or other causes. It is a rare emergency that can progress rapidly with massive blood loss leading to haemorrhagic shock and death. We describe a patient with massive spontaneous haemothorax caused by the disruption of an oesophageal artery from the middle segment of descending thoracic aorta. We sutured the bleeding artery in an emergency thoracotomy after the failure of interventional procedure.
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28273991/acute-renal-failure-in-dengue-infection
#2
Girish Pamappa Vakrani, Nambakam Tanuja Subramanyam
INTRODUCTION: Acute Renal Failure (RF) is a rare but well recognized complication of Dengue Infection (DI). There has been paucity of published data regarding renal involvement in DI. AIM: The aim of the present study was to elucidate different clinical presentations, disease outcomes of DI. To study the frequency, severity and predictors of RF in DI. MATERIALS AND METHODS: Patients diagnosed either as Dengue Fever (DF) or Dengue Haemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) respectively were enrolled for this study...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28265454/fluid-resuscitation-in-haemorrhagic-shock-in-combat-casualties
#3
REVIEW
Parli R Ravi, Bipin Puri
This brief update reviews the recent literature available on fluid resuscitation from hemorrhagic shock and considers the applicability of this evidence for use in resuscitation of combat casualties in the combat casualty care (CCC) environment. A number of changes need to be incorporated in the CCC guidelines: (1) dried plasma (DP) is added as an option when other blood components or whole blood are not available; (2) the wording is clarified to emphasize that Hetastarch is a less desirable option than whole blood, blood components, or DP and should be used only when these preferred options are not available; (3) the use of blood products in certain tactical field care settings where this option might be feasible (FSC, GH) is discussed; (4) 1:1:1 damage control resuscitation (DCR) with plasma: packed red blood cells (PRBC): platelets is preferred to 1:1 DCR with plasma: PRBC when platelets are available; and (5) the 30-min wait between increments of resuscitation fluid administered to achieve clinical improvement or target blood pressure has been eliminated...
2017: Disaster Mil Med
https://www.readbyqxmd.com/read/28263166/the-red-cell-storage-lesion-s-of-dogs-and-men
#4
REVIEW
Harvey G Klein
The advent of preservative solutions permitted refrigerated storage of red blood cells. However, the convenience of having red blood cell inventories was accompanied by a disadvantage. Red cells undergo numerous physical and metabolic changes during cold storage, the "storage lesion(s)". Whereas controlled clinical trials have not confirmed the clinical importance of such changes, ethical and operational issues have prevented careful study of the oldest stored red blood cells. Suggestions of toxicity from meta-analyses motivated us to develop pre-clinical canine models to compare the freshest vs the oldest red blood cells...
March 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28248122/-double-homicide-with-a%C3%A2-damning-bite-mark-on-the-offender%C3%A2-s%C3%A2-body-case-report
#5
Markéta Kulvajtová, Jiří Hladík, Lucie Zemančíková
The authors deal with a case of a double homicide, the parental murder made by their older son, which was committed by a combination of stabbing and cutting wounds. The perpetra-tor tried to hide the bodies, so he doused them with gasoline and set fire to them on a lonely forest road. Then he ran over the remains by his car. The cause of death was in both cases open wound of the neck - autopsy findings of the woman´s body testified for a blood aspi-ration, on the man´s body it was not clear for a partial charring, so the possibilities were blood aspiration, air embolism or external bleeding with haemorrhagic shock...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#6
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28220810/dengue-virus-ns1-protein-activates-immune-cells-via-tlr4-but-not-tlr2-or-tlr6
#7
Naphak Modhiran, Daniel Watterson, Antje Blumenthal, Alan G Baxter, Paul R Young, Katryn J Stacey
The secreted hexameric form of the dengue virus (DENV) non-structural protein 1 (NS1) has recently been shown to elicit inflammatory cytokine release and disrupt endothelial cell monolayer integrity. This suggests that circulating NS1 contributes to the vascular leak that plays a major role in the pathology of dengue haemorrhagic fever and shock. Pathways activated by NS1 are thus of great interest as potential therapeutic targets. Recent works have separately implicated both toll-like receptor 4 (TLR4) and the TLR2/6 heterodimer in immune cell activation by NS1...
February 21, 2017: Immunology and Cell Biology
https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#8
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28148540/acute-lower-gi-bleeding-in-the-uk-patient-characteristics-interventions-and-outcomes-in-the-first-nationwide-audit
#9
Kathryn Oakland, Richard Guy, Raman Uberoi, Rachel Hogg, Neil Mortensen, Michael F Murphy, Vipul Jairath
OBJECTIVE: Lower GI bleeding (LGIB) is a common reason for emergency hospital admission, although there is paucity of data on presentations, interventions and outcomes. In this nationwide UK audit, we describe patient characteristics, interventions including endoscopy, radiology and surgery as well as clinical outcomes. DESIGN: Multicentre audit of adults presenting with LGIB to UK hospitals over 2 months in 2015. Consecutive cases were prospectively enrolled by clinical teams and followed for 28 days...
February 1, 2017: Gut
https://www.readbyqxmd.com/read/28148427/nursing-procedures-in-dealing-with-haemorrhagic-shock
#10
Isabelle Clavagnier
Sophie assesses a patient whose condition is deteriorating. She manages the critical situation in conjunction with the doctor on duty.
October 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/28137905/wunderlich-s-syndrome-as-a-manifestation-of-polyarteritis-nodosa
#11
Pedro Beirão, Lídia Teixeira, Patrícia Pereira, Margarida Lopes Coelho
Wunderlich syndrome is a rare clinical entity characterised by spontaneous renal haemorrhage that can be life-threatening and requires emergency attention. The most frequent aetiologies are renal tumours and vascular diseases. The authors report a case of a patient admitted with hypovolaemic shock due to a retroperitoneal haematoma in the context of polyarteritis nodosa (PAN). Prognosis of untreated PAN is very poor with 13% 5-year survival rate. Therefore, early recognition of disease and proper treatment with immunosuppressors will prevent catastrophic complications and improves survival...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28130699/autopsy-after-transcatheter-aortic-valve-implantation
#12
MULTICENTER STUDY
F van Kesteren, E M A Wiegerinck, S Rizzo, J Baan, R N Planken, J H von der Thüsen, H W M Niessen, M F M van Oosterhout, A Pucci, G Thiene, C Basso, M N Sheppard, K Wassilew, A C van der Wal
Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available...
March 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28129766/severe-plasmodium-vivax-infection-in-korea
#13
Jae Hyoung Im, Hea Yoon Kwon, JiHyeon Baek, Seong Wook Park, Areum Durey, Kyung Hee Lee, Moon-Hyun Chung, Jin-Soo Lee
BACKGROUND: Although severe malaria by Plasmodium vivax has been increasingly reported, there are marked variations in the type and rate of the complications by geographic area. This is possibly because of the presence of concurrent falciparum malaria or bacteraemia, and of differences in underlying immune status among the infected subjects. Furthermore, published studies on P. vivax in temperate regions are limited. The present study investigated severe vivax malaria in Korea, where only vivax malaria occurs...
January 28, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28124417/interleukin-8-interleukin-1%C3%AE-and-tumour-necrosis-factor-%C3%AE-in-sequential-units-of-packed-red-blood-cells-collected-from-retired-racing-greyhounds
#14
S L Purcell, M Claus, G Hosgood, L Smart
BACKGROUND: We hypothesised that concentrations of interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) would increase during storage in the third sequential unit (U3) of canine packed red blood cells (PRBC) collected from terminal donors in haemorrhagic shock. We further hypothesised that leucoreduction would prevent cytokine accumulation in U3 and that cytokine concentrations in U3 would be higher than in the first units (U1) collected from the same dogs...
January 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28087117/erythropoietin-attenuates-experimental-haemorrhagic-shock-induced-renal-damage-through-an-inos-dependent-mechanism-in-male-wistar-rats
#15
M Ranjbaran, M Kadkhodaee, B Seifi, M Adelipour, B Azarian
AIM: Erythropoietin (EPO) is shown to exert protective effects on different tissues in haemorrhagic shock (HS) states. Nitric oxide (NO), as a multifunctional signaling molecule, is implicated in diverse physiologic and pathologic processes. In order to understand the exact mechanism of EPO protection, in this study we evaluated the role of different NOS enzymes in the EPO signaling pathway in male rats. METHODS: Rats were randomized to five groups: 1) Sham, 2) HS 3) EPO 4) L-NAME, a non-specific NOS inhibitor 5) 1400W, a specific iNOS inhibitor...
February 2017: Injury
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#16
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28070330/the-approximated-cardiovascular-reserve-index-complies-with-haemorrhage-related-hemodynamic-deterioration-pattern-a-swine-exsanguination-model
#17
Roy Nadler, Elon Glassberg, Itay E Gabbay, Linn Wagnert-Avraham, Gal Yaniv, David Kushnir, Arik Eisenkraft, Ben-Zion Bobrovsky, Uri Gabbay
BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28062078/-coexistence-of-acute-appendicitis-and-dengue-fever-a-case-report
#18
Juan Fidel Osuna-Ramos, Carlos Silva-Gracia, Gerardo Joel Maya-Vacio, Alejandra Romero-Utrilla, Efrén Rafael Ríos-Burgueño, Jesús Salvador Velarde-Félix
BACKGROUND: Dengue is the most important human viral disease transmitted by mosquitoes. It can be asymptomatic or it can present in any of its 3clinical forms: Dengue fever, dengue haemorrhagic fever and dengue shock syndrome. However, some atypical manifestations have been reported in surgical emergencies caused by acute appendicitis in patients with dengue fever. CLINICAL CASE: We report the case of an 18-year-old Mexican male who presented to the emergency department of the General Hospital of Culiacan, Sinaloa, with symptoms of dengue fever, accompanied by crampy abdominal pain with positive Rovsing and Dunphy signs...
January 3, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28050452/primary-abdominal-pregnancy-a-case-report
#19
Sunita Dubey, Mohit Satodiya, Priyanka Garg, Mamta Rani
Abdominal pregnancy is a potentially life threatening form of ectopic gestation with an incidence of 1% of all the ectopic pregnancies. Rarely, it may reach at advanced gestation and a viable fetal outcome is indeed a rare event. Most of them are terminated earlier due to poor fetal prognosis and higher chances of maternal mortality secondary to haemorrhagic shock following spontanous placental separation. A high index of suspicion is important for making a diagnosis of abdominal pregnancy and its timely management after correct diagnosis...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28009388/acute-gastrointestinal-haemorrhage-on-board-a-cruise-ship-in-the-antarctic-peninsula
#20
Mathieu Carron, Peter Globokar, Bruno A Sicard
Antarctic tourism on board cruise ships has expanded since the 1990s, essentially in the Antarctic Peninsula. Due to remoteness, medical cases may evolve into life threatening conditions as emergency medical evacuations are challenging. We discuss the case of a young crew member who suddenly fainted with an epigastric pain and abundant rectal bleeding while on board a cruise ship heading to the Deception Island (62°57.6 South, 60°29.5 West), 44 h away from Ushuaia by sea. A medical evacuation was necessary to save the patient whose haemoglobin level rapidly decreased from 11 g/dL to 8...
2016: International Maritime Health
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