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Haemorrhagic management

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https://www.readbyqxmd.com/read/28096228/ingestion-of-cylindrical-batteries-and-its-management
#1
Tony Tien, Sudeep Tanwar
In contrast to the ingestion of coin batteries, the ingestion of cylindrical batteries is an uncommon medical presentation. Owing to their larger size, cylindrical battery ingestion can lead to serious complications including intestinal haemorrhage, bowel obstruction, bowel perforation, peritonitis and even death. We discuss the case of a 17-year-old girl who presented after swallowing three cylindrical batteries. Her medical history included depression and previous battery ingestion that required surgical removal...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28074401/adipsic-diabetes-insipidus-in-adult-patients
#2
REVIEW
Martín Cuesta, Mark J Hannon, Christopher J Thompson
INTRODUCTION: Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI...
January 10, 2017: Pituitary
https://www.readbyqxmd.com/read/28073365/neurophthalmological-conditions-mimicking-glaucomatous-optic-neuropathy-analysis-of-the-most-common-causes-of-misdiagnosis
#3
Diego Torres Dias, Michele Ushida, Roberto Battistella, Syril Dorairaj, Tiago Santos Prata
BACKGROUND: To analyze the most common neurophthalmological conditions that may mimic glaucomatous optic neuropathy and to determine which most often lead to misdiagnosis when evaluated by a glaucoma specialist. METHODS: We reviewed the charts of consecutive patients with optic neuropathies caused by neurophthalmological conditions screened in a single Eye Clinic within a period of 24 months. Within these enrolled patients, we selected the eyes whose fundoscopic appearance could resemble glaucoma based in pre-defined criteria (vertical cup-to-disc ratio ≥0...
January 10, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28065966/implementation-of-warning-tool-to-improve-maternal-newborn-health-outcomes-in-a-developing-country
#4
Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar
OBJECTIVE: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours. METHODS: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#5
REVIEW
Csaba András Dézsi, Balázs Bence Dézsi, Döme András Dézsi
: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28064243/meckel-s-diverticulitis-a-rare-entity-of-meckel-s-diverticulum
#6
Chee S Wong, Leanne Dupley, Haren N Varia, Darek Golka, Thu Linn
Meckel's diverticulum is the most common congenital abnormality of the small intestine that results from incomplete closure of the vitelline (omphalo-mesenteric) duct. This true diverticulum, ~2 ft from the ileocecal valve commonly found on the anti-mesenteric border of the ileum, is benign and majority asymptomatic. Diagnosis challenges arise when it became inflamed or presented in following ways, for example, haemorrhage (caused by ectopic pepsin-and hydrochloric acid-secreting gastric mucosa), intestinal obstruction (secondary to intussusception or volvulus) or the presence of diverticulum in the hernia sac (Littre's hernia)...
January 6, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#7
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28050452/primary-abdominal-pregnancy-a-case-report
#8
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/28043993/safety-and-reproducibility-of-virtual-assisted-lung-mapping-a-multicentre-study-in-japan%C3%A2
#9
Masaaki Sato, Taiji Kuwata, Keiji Yamanashi, Atsushi Kitamura, Kenji Misawa, Kota Imashimizu, Masashi Kobayashi, Masaki Ikeda, Terumoto Koike, Shinji Kosaka, Ryuta Fukai, Yasuo Sekine, Noritaka Isowa, Shin Hirayama, Hiroaki Sakai, Fumiaki Watanabe, Kazuhiro Nagayama, Akihiro Aoyama, Hiroshi Date, Jun Nakajima
OBJECTIVES: Virtual-assisted lung mapping (VAL-MAP) is a preoperative bronchoscopic multispot dye-marking technique using virtual images. The purpose of this study was to evaluate the safety, efficacy and reproducibility of VAL-MAP among multiple centres. METHODS: Selection criteria included patients with pulmonary lesions anticipated to be difficult to identify at thoracoscopy and/or those undergoing sub-lobar lung resections requiring careful determination of resection margins...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28042972/a-conservative-treatment-of-patent-ductus-arteriosus-in-very-low-birth-weight-infants
#10
J B Letshwiti, J Semberova, K Pichova, E M Dempsey, O M Franklin, J Miletin
BACKGROUND: Treatment of the patent ductus arteriosus (PDA) in the preterm infant remains contentious. There are numerous options of the PDA management from early targeted treatment, late (symptomatic) treatment to no treatment at all. AIMS: To evaluate a three different PDA management approaches in very low birth weight (VLBW) infants. STUDY DESIGN: A retrospective observational time series study of three cohorts of VLBW infants born between 2004 and 2011...
December 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/28040528/role-of-diagnostic-endoscopy-in-posterior-segment-evaluation-for-definitive-prognostication-in-eyes-with-corneal-opacification
#11
Rajeev R Reddy Pappuru, Mudit Tyagi, Remya M Paulose, Vivek P Dave, Taraprasad Das, Jay Chhablani, Raja Narayanan, Rushil K Saxena, Divya Balakrishnan, Sayan Basu, Virender S Sangwan
PURPOSE: Direct visualization of the posterior segment is not possible with conventional imaging techniques in eyes with corneal opacification. This study evaluated the efficacy of video-endoscopy in visualising and hence prognosticating the visual outcomes in such eyes . DESIGN: Prospective non-comparative consecutive interventional case series. METHODS: This study included 64 eyes of 64 patients with corneal opacification who underwent diagnostic ophthalmic endoscopy procedure from March 2014 to May 2016...
December 28, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28031087/life-threatening-spontaneous-retroperitoneal-haemorrhage-role-of-multidetector-ct-angiography-for-the-emergency-management
#12
Zhi-Wei Wang, Hua-Dan Xue, Xiao-Guang Li, Jie Pan, Xiao-Bo Zhang, Zheng-Yu Jin
Objective To evaluate the role of multidetector computed tomography-angiography (MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage (SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1, 2005 to November 31, 2014 was performed. SRH was defined as unrelated to invasive procedures, surgery, trauma, abdominal tumor or aortic aneurysm. Life-threatening SRH was defined as hemodynamic instability with hypotension. Sixteen cases met the inclusive criteria...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28009103/experts-perceptions-on-china-s-capacity-to-manage-emerging-and-re-emerging-zoonotic-diseases-in-an-era-of-climate-change
#13
A Hansen, J Xiang, Q Liu, M X Tong, Y Sun, X Liu, K Chen, S Cameron, S Hanson-Easey, G-S Han, P Weinstein, C Williams, P Bi
Zoonotic diseases transmitted by arthropods and rodents are a major public health concern in China. However, interventions in recent decades have helped lower the incidence of several diseases despite the country's large, frequently mobile population and socio-economic challenges. Increasing globalization, rapid urbanization and a warming climate now add to the complexity of disease control and prevention and could challenge China's capacity to respond to threats of emerging and re-emerging zoonoses. To investigate this notion, face-to-face interviews were conducted with 30 infectious disease experts in four cities in China...
December 23, 2016: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28007486/-trends-in-computed-tomography-characteristics-intracranial-pressure-monitoring-and-surgical-management-in-severe-traumatic-brain-injury-analysis-of-a-data-base-of-the-past-25-years-in-a-neurosurgery-department
#14
Pedro A Gómez, Ana M Castaño-León, David Lora, Santiago Cepeda, Alfonso Lagares
OBJECTIVE: To describe the radiological characteristics, surgical indications, procedures, and intracranial pressure monitoring of a representative cohort of severe traumatic brain injury (sTBI) cases collected over the past 25years, and to analyse the changes that have occurred by dividing the period into 3 equal time periods. METHODS: An observational cohort study was conducted on consecutive adult patients (>14years of age) with severe closed TBI (Glasgow Coma Scale score [GCS]≤8) who were admitted during the first 48hours after injury to the Hospital 12 de Octubre from 1987 to 2012...
December 19, 2016: Neurocirugía
https://www.readbyqxmd.com/read/28005984/knowledge-and-skills-of-healthcare-providers-in-sub-saharan-africa-and-asia-before-and-after-competency-based-training-in-emergency-obstetric-and-early-newborn-care
#15
Charles A Ameh, Robert Kerr, Barbara Madaj, Mselenge Mdegela, Terry Kana, Susan Jones, Jaki Lambert, Fiona Dickinson, Sarah White, Nynke van den Broek
BACKGROUND: Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. METHODS: We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan)...
2016: PloS One
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#16
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28004764/sheehan-syndrome
#17
Züleyha Karaca, Bashir A Laway, Hatice S Dokmetas, Hulusi Atmaca, Fahrettin Kelestimur
Sheehan syndrome or postpartum hypopituitarism is a condition characterized by hypopituitarism due to necrosis of the pituitary gland. The initial insult is caused by massive postpartum haemorrhage (PPH), leading to impaired blood supply to the pituitary gland, which has become enlarged during pregnancy. Small sella turcica size, vasospasms (caused by PPH) and/or thrombosis (associated with pregnancy or coagulation disorders) are predisposing factors; autoimmunity might be involved in the progressive worsening of pituitary functions...
December 22, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28003419/47-year-old-female-with-an-apical-mass
#18
Jack Andrews, Christopher Ce Lang, Marc Dweck
CLINICAL INTRODUCTION: A 47-year-old female with no medical history presented with a sudden collapse. Physical examination, chest X-ray and high-sensitivity cardiac troponin I were normal, however ECG demonstrated anterior T-wave inversion. CT pulmonary angiography was performed which ruled out pulmonary embolism but revealed a non-calcified, homogenous mass at the left ventricular (LV) apex. It was not clear whether this mass was intramyocardial or pericardial. Transthoracic echocardiography confirmed the apical mass but was unable to establish its aetiology...
December 21, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#19
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27993911/the-management-of-the-third-stage-of-labour-in-women-with-heart-disease
#20
Matthew Cauldwell, Philip J Steer, Lorna Swan, Anselm Uebing, Michael A Gatzoulis, Mark R Johnson
OBJECTIVE: In women with heart disease (HD), the third stage of labour is managed with a reduced dose of oxytocin because it can have significant adverse cardiovascular effects. However, women with HD have high rates of postpartum haemorrhage (PPH); consequently, we designed a prospective study to investigate whether higher doses of oxytocin can be given safely and would reduce rates of PPH. METHODS: We performed a single centre, prospective, cohort study comparing the standard 'low-dose' oxytocin infusion (10 U of oxytocin in 500 mL of normal saline given intravenously at 36 mL/hour for 4 hours (12 mU/min), n=29) to the low-dose infusion and an additional 2 U of oxytocin given over 10 min immediately after birth (n=30)...
December 19, 2016: Heart: Official Journal of the British Cardiac Society
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