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Haemorrhagic management

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https://www.readbyqxmd.com/read/28218409/development-of-haemostatic-decontaminants-for-treatment-of-wounds-contaminated-with-chemical-warfare-agents-3-evaluation-of-in-vitro-topical-decontamination-efficacy-using-damaged-skin
#1
Helen L Lydon, Charlotte A Hall, Christopher H Dalton, J Kevin Chipman, John S Graham, Robert P Chilcott
Previous studies have demonstrated that haemostatic products with an absorptive mechanism of action retain their clotting efficiency in the presence of toxic materials and are effective in decontaminating chemical warfare (CW) agents when applied to normal, intact skin. The purpose of this in vitro study was to assess three candidate haemostatic products for effectiveness in the decontamination of superficially damaged porcine skin exposed to the radiolabelled CW agents, soman (GD), VX and sulphur mustard (HD)...
February 20, 2017: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/28208950/cerebral-venous-thrombosis-in-pregnancy-a-poignant-allegory-of-an-unusual-case
#2
Sheeba Marwah, Gaikwad Harsha Shailesh, Sumedha Gupta, Manjula Sharma, Pratima Mittal
Cerebral Venous Thrombosis (CVT), also known as cortical venous, cerebral sinus, cerebral venous sinus, or dural sinus thrombosis, is an infrequent grave condition affecting pregnant females, resulting from clot formation in one of the many outflow tracts of the brain. Although pregnancy-associated stroke or CVT is uncommon, the risk of stroke is greatly increased above the low baseline rate in young patients during late pregnancy and, even more so, during the puerperium. Haemorrhagic infarction can occur in the acute stage of CVT...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208940/neurological-disorders-complicating-pregnancy-focus-on-obstetric-outcome
#3
Sandya Renukesh, Lavanya Rai
INTRODUCTION: Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre-existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task due to varied symptomatology and risks to the fetus. The evaluation and management should be performed in a stepwise fashion and requires multidisciplinary approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28201864/recurrent-contrast-induced-encephalopathy-following-coronary-angiography
#4
Roberto Spina, Neil Simon, Romesh Markus, David W M Muller, Krishna Kathir
Contrast-induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra-arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood-brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24-48 h...
February 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28198598/coblation-%C3%A2-intracapsular-tonsillectomy-tonsillotomy-in-children-a-prospective-study-of-500-consecutive-cases-with-long-term-follow-up
#5
A W Hoey, N M Foden, S Hadjisymeou Andreou, F Noonan, A K Chowdhury, Greig S R, E L Sproson, D Allin, N Amin, K M Wouters, N E Jonas, D J Tweedie
OBJECTIVES: Intracapsular tonsillectomy (tonsillotomy) has been used internationally, mainly in the management of obstructive sleep apnoea, rather than recurrent tonsillitis, with little published data evaluating its use for this latter indication. We present long-term prospective data from 500 paediatric cases undergoing Coblation(®) intracapsular tonsillectomy, for both obstructive and infective indications. DESIGN: Prospective case series, March 2013-January 2016, all with completed follow up...
February 15, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#6
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
February 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28195653/duration-of-second-stage-of-labour-at-term-and-pushing-time-risk-factors-for-postpartum-haemorrhage
#7
Emelie Looft, Marija Simic, Mia Ahlberg, Jonathan M Snowden, Yvonne W Cheng, Olof Stephansson
BACKGROUND: Prolonged labour is associated with increased risk of postpartum haemorrhage (PPH), but the role of active pushing time and the relation with management during labour remains poorly understood. METHODS: A population-based cohort study from electronic medical record data in the Stockholm-Gotland Region, Sweden. We included 57 267 primiparous women with singleton, term gestation, livebirths delivered vaginally in cephalic presentation in 2008-14. We performed multivariable Poisson regression to estimate the association between length of second stage, pushing time, and PPH (estimated blood loss >500 mL during delivery), adjusting for maternal, delivery, and fetal characteristics as potential confounders...
February 14, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28193628/management-of-endocrine-disease-neuroendocrine-surveillance-and-management-of-neurosurgical-patients-non-pituitary
#8
Aoife Garrahy, Mark Sherlock, Chris J Thompson
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognized acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life-threatening. While hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation...
February 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28183347/application-of-incident-command-structure-to-clinical-trial-management-in-the-academic-setting-principles-and-lessons-learned
#9
Penny S Reynolds, Mary J Michael, Bruce D Spiess
BACKGROUND: Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28179389/homonymous-hemianopia-in-the-primary-antiphospholipid-syndrome
#10
Derek Kwun-Hong Ho, Rishi Ramessur, Mradul Gupta, John P Mathews
A woman aged 26 years was referred by her GP to the eye casualty department with sudden-onset left homonymous hemianopia and right-sided headache. Full ophthalmic examination was normal with the exception of a left homonymous hemianopia confirmed with automated perimetry. Urgent CT imaging revealed a non-haemorrhagic cerebral infarct in the right parieto-occipital region. Subsequent blood tests confirmed a diagnosis of antiphospholipid syndrome with positivity in IgG anticardiolipin antibody, IgG anti-β2-GP1 antibody and the Lupus anticoagulant screen...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28177097/-spontaneous-rupture-of-a-simple-renal-cyst-clinical-management
#11
Luca Estienne, Maria Valentina Domenech, Elena Caramella, Marta Calatroni, Alessandro Avella, Ilaria Massa, Stefania Bianzina, Nicoletta Serpieri, Pasquale Esposito
Spontaneous renal bleeding mainly occurs in patients with polycystic kidney diseases or cancer. Indeed, despite the high prevalence of simple cysts, their spontaneous atraumatic rupture is a rare event. Underlying mechanisms may involve the increase of intracystic pressure and/or the development of a haemorrhage into the cyst. Management of this condition includes surgery, interventional radiology or conservative strategies. Here, we report a case of spontaneous rupture of a simple renal cyst, successfully managed with conservative treatment...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28174188/cervical-spine-arteriovenous-fistula-associated-with-hereditary-haemorrhagic-telangiectasia
#12
Iain John McGurgan, Roisin Lonergan, Ronan Killeen, Christopher McGuigan
Reported is a case of a man aged 55 years who presented with progressive spastic paraparesis. Examination demonstrated multiple cutaneous telangiectases. Subsequent development of upper limb weakness, acute urinary retention and eventual respiratory compromise resulted in the requirement for intensive care unit admission and mechanical ventilation. MRI spine revealed diffuse T2 hyperintensity in the cervical cord with enhancement and cord expansion. Immunomodulatory therapy for a presumed diagnosis of transverse myelitis yielded no response, so a vascular aetiology was suspected...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28155296/paraquat-intoxication-and-associated-pathological-findings-in-three-dogs-in-south-africa
#13
June H Williams, Zandri Whitehead, Erna Van Wilpe
Paraquat is a bipyridylium non-selective contact herbicide commonly used worldwide. When ingestion occurs by humans and animals either accidentally, intentionally or maliciously, paraquat selectively accumulates in the lungs resulting in the production of oxygen-free radicals, causing membrane damage and cell death. Intoxicated subjects typically show progressive and fatal pulmonary haemorrhage, collapse and oedema. In individuals surviving the acute phase, pulmonary fibrosis develops. Gastrointestinal-, renal- and central nervous system clinical signs may also occur...
November 9, 2016: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28151829/haemotherapy-algorithm-for-the-management-of-trauma-induced-coagulopathy-an-australian-perspective
#14
James Winearls, Biswadev Mitra, Michael C Reade
PURPOSE OF REVIEW: Recent advances in the understanding of the pathophysiological processes associated with traumatic haemorrhage and trauma-induced coagulopathy have resulted in improved outcomes for seriously injured trauma patients. However, a significant number of trauma patients still die from haemorrhage. This article reviews the various transfusion strategies utilized in the management of traumatic haemorrhage and describes the major haemorrhage protocol (MHP) strategy employed by an Australian trauma centre...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28150348/management-of-acute-ischaemic-stroke-in-patients-with-dementia
#15
REVIEW
A Subic, P Cermakova, B Norrving, B Winblad, M von Euler, M G Kramberger, M Eriksdotter, S Garcia-Ptacek
An estimated 10% of stroke patients have an underlying dementia. As a consequence, health professionals often face the challenge of managing patients with dementia presenting with an acute stroke. Patients with dementia are less likely to receive thrombolysis (0.56-10% vs. 1-16% thrombolysis rates in the general population), be admitted to a stroke unit or receive some types of care. Anticoagulation for secondary stroke prevention is sometimes withheld, despite dementia not being listed as an exclusion criterion in current guidelines...
February 2, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28148427/nursing-procedures-in-dealing-with-haemorrhagic-shock
#16
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/28141954/successful-management-of-intraoperative-haemorrhage-during-emergency-cervical-cerclage-using-balloon-tamponade
#17
Shota Kanbayashi, Eiji Kondoh, Koh Suginami, Shingo Io, Junzo Hamanishi, Ikuo Konishi
No abstract text is available yet for this article.
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28138763/-haemoptysis-intensive-care-management-of-pulmonary-hemorrhage
#18
J H Ficker, W M Brückl, J Suc, A Geise
There is a wide spectrum of severities in patients with pulmonary bleeding with a range from mild haemoptysis to severe bleeding with an acute risk of asphyxiation. For the management of acute pulmonary haemorrhage, it is essential to identify the underlying cause in order to initiate a target-oriented or causal therapy. The most common causes of localized pulmonary bleeding are lung cancer as well as infections, anticoagulant therapy or bronchiectasis. Diffuse alveolar haemorrhage is mostly due to pulmonary vasculitis or connective tissue disease, but may also occur in pulmonary metastasis, congestive heart failure, coagulation disorders and from many other causes...
January 30, 2017: Der Internist
https://www.readbyqxmd.com/read/28118993/soft-tissue-evidence-of-head-injury-in-infants-and-young-children-is-ct-head-examination-justified
#19
S Zaman, P H Logan, C Landes, S Harave
AIM: To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature...
January 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28111840/laboratory-monitoring-of-replacement-therapy-for-major-surgery-in-von-willebrand-disease
#20
REVIEW
P M Mannucci, M Franchini
Von Willebrand disease (VWD) is an inherited haemorrhagic disorder caused by a quantitative or qualitative defect of von Willebrand factor (VWF), a multimeric plasma glycoprotein that plays a key role in platelet adhesion to the subendothelium and acts as a carrier of factor VIII (FVIII) in blood. Patients with VWD experience bleeding symptoms that are mainly localized in mucous membranes and soft tissues, and their severity depends on the degree of the primary reduction in VWF and the secondary deficiency of FVIII in plasma...
January 22, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
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