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https://www.readbyqxmd.com/read/28338584/spring-assisted-cranioplasty-for-the-correction-of-non-syndromic-scaphocephaly-a-quantitative-analysis-of-100-consecutive-cases
#1
W Rodgers, G E Glass, S Schievano, A Borghi, N Rodriguez-Florez, A Tahim, F Angullia, W Breakey, P Knoops, M Tenhagen, J O'Hara, A Ponniah, G James, D J Dunaway, Nuo Jeelani
BACKGROUND: Spring-assisted cranioplasty has been proposed as an alternative to total calvarial remodelling for sagittal craniosynostosis. Advantages include its minimally invasive nature, reduced morbidity and hospital stay. Potential drawbacks include the need for a second procedure for removal and the lack of published long-term follow-up. We present a single institution experience of 100 consecutive cases using a novel spring design. METHODS: All patients treated at our institution between April 2010 and September 2014 were evaluated retrospectively...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28336258/a-comparison-of-combined-intravenous-and-topical-administration-of-tranexamic-acid-with-intravenous-tranexamic-acid-alone-for-blood-loss-reduction-after-total-hip-arthroplasty-a-meta-analysis
#2
REVIEW
Xiangcheng Liu, Jinglong Liu, Ganghe Sun
BACKGROUND: The optimal dose and protocol of tranexamic acid (TXA) for reducing blood loss in total hip arthroplasty (THA) is controversial. Intravenous TXA (IV-TXA) and combined IV-TXA with topical TXA are the two common protocol after THA. A meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of combined IV and topical TXA with IV-TXA alone in reducing blood loss after THA. METHODS: PubMed, Medline, Embase, Web of Science, the Cochrane Library, China Wanfang database and Google database were searched from the inception to February 2017 to identify RCTs that comparing combined IV and topical TXA with IV-TXA alone for patients prepared for primary THA...
March 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28336035/effect-of-tranexamic-acid-on-transfusion-rates-following-total-joint-arthroplasty-a-cost-and-comparative-effectiveness-analysis
#3
REVIEW
Perry J Evangelista, Michael W Aversano, Emmanuel Koli, Lorraine Hutzler, Ifeoma Inneh, Joseph Bosco, Richard Iorio
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#4
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, S Fein, L A Eidelman, A Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005- 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28328655/vascularized-composite-allotransplantation-an-emerging-concept-for-burn-reconstruction
#5
Zhi Yang Ng, Alexandre G Lellouch, Tessa Drijkoningen, Irene A Chang, David H Sachs, Curtis L Cetrulo
Vascularized composite allotransplantation (VCA) has demonstrated utility in the reconstruction of extensive soft-tissue defects following severe burns. However, pre-VCA events such as multiple transfusions, previous transplantation and pregnancies, the use of skin allografts, and mechanical support devices may result in sensitization and ultimately exclude a burn patient, who may benefit most through VCA, from a hand or face transplant. The authors sought to identify the immunologic challenges involved. All reported VCA cases up to July 2016 were reviewed...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28320216/a-neurologic-dysfunction-scoring-protocol-for-jaundiced-neonates-requiring-exchange-transfusion
#6
Bolajoko O Olusanya, Folashade B Osibanjo, Adeniyi A Ajiboye, Oluwafemi E Ayodele, Adebanke A Odunsi, Serah M Olaifa, Abieyuwa A Emokpae
AIM: To evaluate the performance of a neurologic assessment protocol among jaundiced infants requiring exchange transfusion (ET). METHODS: We identified infants in a referral children's hospital who received ET and those who met the American Academy of Pediatrics (AAP) criteria for ET based on total serum bilirubin (TSB) levels. The performance of a bilirubin-induced neurologic dysfunction (BIND-M) scoring protocol for acute bilirubin encephalopathy (ABE) in detecting infants treated with ET in both groups was investigated by logistic regression analysis and c-statistic...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320041/prevention-of-iron-overload-and-long-term-maintenance-of-normal-iron-stores-in-thalassaemia-major-patients-using-deferiprone-or-deferiprone-deferoxamine-combination
#7
Annita Kolnagou, Christina N Kontoghiorghe, George J Kontoghiorghes
Decrease in mortality and morbidity is observed in thalassaemia major patients with reduced iron load in comparison to heavy iron loaded patients. Effective and complete treatment of transfusional iron overload can be achieved by chelation protocols that can eliminate excess iron and maintain normal iron stores (NIS). The maintenance of NIS, i. e., serum ferritin (350 μg/L >), MRI T2* cardiac (>20 ms) and liver (>6.3 ms) relaxation time levels was monitored in 16 thalassaemia major patients (32-53 years, 12 splenectomized, 10 male, erythrocyte transfusions 120-323 ml/kg/year) for about 90 patient years...
March 20, 2017: Drug Research
https://www.readbyqxmd.com/read/28316839/tranexamic-acid-txa-in-trauma-patients-barriers-to-use-among-trauma-surgeons-and-emergency-physicians
#8
Abdulaziz Alburaih
Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods. This is a cross-sectional study. Results. The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28316439/first-indian-study-to-establish-safety-of-immediate-spin-crossmatch-for-red-blood-cell-transfusion-in-antibody-screen-negative-recipients
#9
Aseem Kumar Tiwari, Geet Aggarwal, Ravi C Dara, Dinesh Arora, Gautam Kumar Gupta, Vimarsh Raina
BACKGROUND AND OBJECTIVES: The US Food and Drug Administration and American Association of Blood Banks approved the type and screen approach in 1980s, long after antibody screen (AS) was introduced in 1950s. The present study omits conventional anti-human globulin (AHG) crossmatch and replaces it with immediate-spin (IS) crossmatch as part of pretransfusion testing in AS-negative patients to study the safety and effectiveness of IS crossmatch in recipients. MATERIALS AND METHODS: This prospective longitudinal study was conducted on over 5000 red cell units transfused to AS-negative patients admitted to the hospital...
January 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#10
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28302286/viscoelastic-hemostatic-assays-in-the-management-of-the-pediatric-trauma-patient
#11
Christine M Leeper, Barbara A Gaines
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28297082/blood-product-utilization-in-human-upper-extremity-transplantation-challenges-complications-considerations-and-transfusion-protocol-conception
#12
Jay S Raval, Vijay S Gorantla, Jaimie T Shores, W P Andrew Lee, Raymond M Planinsic, Marian A Rollins-Raval, Gerald Brandacher, Karen E King, Joseph E Losee, Joseph E Kiss
BACKGROUND: Upper-extremity transplantation (UET) is a reality. Immunologic, functional, and graft survival outcomes have been encouraging. However, these complex reconstructions have unique considerations that pose distinct challenges. Transplant programs have reported morbidity and mortality due to significant intraoperative blood losses, but similar data are scant during other phases of recovery. We report experience from two centers on complete blood component demands and utilization with UET...
March 2017: Transfusion
https://www.readbyqxmd.com/read/28295747/the-impact-of-providing-blood-to-the-scene-of-an-accident-on-transfusion-laboratory-practice
#13
S Wolf, J Morris, K Kennedy, M Lawn, T Mcloughlin, K Feane, J Uprichard, A Weaver, S Allard, L Green
BACKGROUND: Haemorrhage is the leading cause of mortality during trauma. In 2012, London's Air Ambulance introduced Blood on Board (BOB), transfusing group O red cells (RBC) to trauma patients at the scene. OBJECTIVES: This study assessed the impact of BOB on the number of mixed field samples received by the laboratory, the number of group O RBC transfused to non-group O patients and the ratio of RBC to fresh frozen plasma (FFP) transfused in the initial 24 h. METHODS: Three major trauma centres collected data on patients for whom the major haemorrhage protocol was activated between August 2008 and February 2012 pre-BOB and March 2012 and December 2013 post-BOB...
March 12, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#14
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#15
Mostafa Alavi-Moghaddam, Ali Anvari, Reaza Soltani Delgosha, Hamid Kariman
INTRODUCTION: Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans' lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. METHOD: This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28281428/a-review-of-blood-transfusions-in-a-trauma-unit-for-young-children
#16
M Salverda, N Ketharanathan, M Van Dijk, E Beltchev, H Buys, A Numanoglu, A B Van As
BACKGROUND: Trauma is the leading cause of mortality and morbidity worldwide. Blood transfusions play an incremental role in the acute phase, yet practice varies owing to variations in transfusion thresholds and concerns about potential complications, especially in children. OBJECTIVES: To evaluate protocol adherence to blood transfusion thresholds in paediatric trauma patients and determine the degree of blood product wastage, as defined by discarded units. METHODS: A retrospective, descriptive study of trauma patients (age 0 - 13 years) who received a blood transfusion in the trauma unit at Red Cross War Memorial Children's Hospital, Cape Town, South Africa, over a 5...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28266246/maximum-surgical-blood-order-schedule-for-pancreatoduodenectomy-a-long-way-from-uniform-applicability
#17
Savio G Barreto, Amanjeet Singh, Azhar Perwaiz, Tanveer Singh, Manish Kumar Singh, Adarsh Chaudhary
BACKGROUND: Unnecessary preoperative ordering of blood and blood products results in wastage of a valuable life-saving resource and poses a significant financial burden on healthcare systems. AIM: To determine patient-specific factors associated with intra-operative transfusions, and if intra-operative blood transfusions impact postoperative morbidity. PATIENTS & METHODS: Analysis of consecutive patients undergoing pancreatoduodenectomy (PD) for pancreatic tumors...
April 2017: Future Oncology
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#18
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28248803/1-1-transfusion-strategies-are-right-for-the-wrong-reasons
#19
Stephanie A Savage, Ben L Zarzaur, Brian L Brewer, Garrett H Lim, Ali C Martin, Louis J Magnotti, Martin A Croce, Timothy H Pohlman
INTRODUCTION: Early assessment of clot function identifies coagulopathies following injury. Abnormalities include a hypercoagulable state from excess thrombin generation, as well as an acquired coagulopathy. Efforts to address coagulopathy have resulted in earlier, aggressive use of plasma emphasizing 1:1 resuscitation. The purpose of this study was to describe coagulopathies in varying hemorrhagic profiles from a cohort of injured patients. METHODS: All injured patients who received at least one unit of packed red blood cells (PRBC) in the first 24 hours of admission from September 2013 to May 2015 were eligible for inclusion...
February 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28244907/oral-and-intravenous-tranexamic-acid-are-equivalent-at-reducing-blood-loss-following-total-hip-arthroplasty-a-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Erdan Kayupov, Yale A Fillingham, Kamil Okroj, Darren R Plummer, Mario Moric, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Tranexamic acid is an antifibrinolytic that has been shown to reduce blood loss and the need for transfusions when administered intravenously in total hip arthroplasty. Oral formulations of the drug are available at a fraction of the cost of the intravenous preparation. The purpose of this randomized controlled trial was to determine if oral and intravenous formulations of tranexamic acid have equivalent blood-sparing properties. METHODS: In this double-blinded trial, 89 patients undergoing primary total hip arthroplasty were randomized to receive 1...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
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