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Haemorrhagic management

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https://www.readbyqxmd.com/read/28329135/low-target-inr-anticoagulation-is-safe-in-selected-aortic-valve-patients-with-the-medtronic-open-pivot-mechanical-prosthesis-long-term-results-of-a-propensity-matched-comparison-with-standard-anticoagulation
#1
Thierry Bové, Yves Van Belleghem, Katrien François, Frank Caes, Michel De Pauw, Yves Taeymans, Guido J Van Nooten
OBJECTIVES: To investigate the long-term results of a low international normalized ratio (INR)-anticoagulation program in selected patients after aortic valve replacement (AVR) with the Medtronic Open Pivot mechanical heart valve (OPMHV). METHODS: From January 1993 to December 2012, 909 OPMHV valves were used for single AVR. Patients with preserved sinus rhythm and left ventricular function (Low-INR, n  = 552), were managed to an INR of 1.5-2.5 and compared to patients (Standard-INR, n  = 357) treated with standard anticoagulation (INR 2...
March 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28324183/multimodality-management-and-outcomes-of-brain-arterio-venous-malformations-avms-in-children-personal-experience-and-review-of-the-literature-with-specific-emphasis-on-age-at-first-avm-bleed
#2
REVIEW
Anan Shtaya, John Millar, Owen Sparrow
PURPOSE: The purpose of this paper is to study the presentation and analyse the results of multimodality treatment of brain arterio-venous malformations (AVMs) in children at our centre and review age at first AVM rupture in the literature. METHODS: Of 52 patients aged <18 years, 47 with brain AVMs (27 males and 20 females) aged 4-17 years (mean 12.2) were retrospectively reviewed. PubMed search revealed five additional studies including 267 patients where the prevalence of age-related AVMs rupture was analysed...
March 21, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#3
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28317421/a-prospective-cohort-study-evaluating-the-cost-effectiveness-of-carbetocin-for-prevention-of-postpartum-haemorrhage-in-caesarean-sections
#4
Yasmin Luni, Aditya Borakati, Arti Matah, Katie Skeats, Padma Eedarapalli
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28304220/high-resolution-magnetic-resonance-imaging-of-carotid-atherosclerotic-plaques-a-correlation-study-with-histopathology
#5
Zhangyong Xia, Hua Yang, Xiaochun Yuan, Jiyue Wang, Shigang Zhang, Liyong Zhang, Yang Qu, Jun Chen, Liqun Jiao, Le-Xin Wang, Yifeng Du
BACKGROUND: This study aimed to utilize high-resolution magnetic resonance imaging (MRI) to investigate the characteristics of stable and vulnerable carotid arteriosclerotic plaques, with correlations to histopathological findings. PATIENTS AND METHODS: High-resolution MRI was performed in 817 patients, using three-dimensional magnetic resonance angiography. Plaque composition was evaluated by measuring the areas occupied by calcification, a lipid-rich necrotic core, intra-plaque haemorrhage, and fibrous cap rupture...
March 17, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#6
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28302657/vascular-challenges-from-pancreatoduodenectomy-in-the-setting-of-coeliac-artery-stenosis
#7
Joal D Beane, Roderich E Schwarz
Coeliac artery stenosis due to median arcuate ligament compression or atherosclerotic disease is a frequently unrecognised challenge to recovery after pancreatoduodenectomy. The described case illustrates management with intraoperative superior mesenteric artery to hepatic artery bypass graft that led to haemorrhagic challenges postoperatively but ultimately a good recovery. Aspects of preoperative diagnosis, preoperative intervention and intraoperative management options are reviewed. Surgeons need to possess these tools to prevent complications from coeliac artery stenosis when pancreatoduodenectomy is required...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28299919/spontaneous-soft-tissue-haemorrhage-in-systemic-lupus-erythematosus
#8
M C Abdulla
Diversity in clinical presentations and complications of systemic lupus erythematosus (SLE) make the diagnosis and management challenging. The mechanisms of haemorrhagic manifestations in SLE have not been well elucidated. A 47-year-old woman with no comorbidities was admitted after suffering fatigue and low grade fever for six months. She had bilateral soft tissue haemorrhage over the forearm and intra retinal haemorrhages. She was assessed and diagnosed as having SLE based on positive antinuclear antibody, strongly positive anti double stranded DNA, thrombocytopenia and low C3 and C4 levels...
December 31, 2016: Reumatismo
https://www.readbyqxmd.com/read/28298378/antepartum-uterine-rupture-at-29%C3%A2-weeks-gestation-following-unilateral-salpingectomy-and-review-of-literature
#9
Yu-Ting Huang, Stephen Li-Yen Yim, Supuni Kapurubandara, Anbu Anpalagan
Antepartum uterine rupture following salpingectomy is a rare condition and is associated with high fetal and maternal mortality and morbidity. We illustrate a 33-year-old primigravida who presented with abdominal pain at 29 weeks of gestation. Her previous obstetric history included a ruptured right ectopic pregnancy for which she underwent laparoscopic salpingectomy with no breach of uterine cavity. Her antenatal care had otherwise been unremarkable. Following admission for undetectable fetal heart, ultrasound and CT demonstrated an extrauterine fetus at the right adnexal region with free fluid consistent with intra-abdominal haemorrhage...
March 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28292361/effectiveness-of-per-rectal-misoprostol-versus-intramuscular-oxytocin-for-prevention-of-primary-postpartum-haemorrhage
#10
Raheela Asmat, Tasneem Ashraf, Fazila Asmat, Shakila Asmat, Nagina Asmat
OBJECTIVE: To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). STUDY DESIGN: Randomised controlled trial study. PLACE AND DURATION OF STUDY: Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. METHODOLOGY: Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28289746/advances-in-anticoagulation-management-of-patients-undergoing-cardioversion-of-nonvalvular-atrial-fibrillation
#11
Georgios Benetos, Maria Bonou, Konstantinos Toutouzas, Panagiotis Diamantopoulos, Nora Viniou, John Barbetseas
Atrial fibrillation (AF) is a major cause of stroke. The restoration of sinus rhythm through cardioversion, either chemical or electrical is a common practice. Interestingly, there is an incremental increase from the baseline risk for embolisation in the immediate post-cardioversion period, with most events occurring within 10 days from cardioversion. Especially patients with recent onset AF show the lowest rates of antithrombotic therapy, while having a high stroke risk. Despite the increased risk for embolisation, anticoagulation in patients undergoing cardioversion of atrial fibrillation is often inadequate...
March 14, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28289598/massive-hemoptysis-in-a-patient-with-pulmonary-embolism-a-real-therapeutic-conundrum
#12
Yiolanda Herodotou, Andriana I Papaioannou, Anna Karakatsani, Lazaros Reppas, Effrosyni D Manali, Vasiliki Apollonatou, Ioannis Tomos, Elias Brountzos, Spyros Papiris
Massive Hemoptysis and pulmonary embolism are two very severe and potentially fatal pulmonary emergencies requiring completely different treatments. We present the case of a 45-year old male transmitted to our Hospital for massive hemoptysis who at the same time was found to suffer from pulmonary embolism. Hemoptysis was treated with bronchial artery embolization which resulted in cessation of haemorrhage and allowed the administration of anticoagulant therapy a few days later. This case report gives an answer on how to manage a real therapeutic conundrum which is the coexistence of a massive hemoptysis and a concomitant pulmonary embolism...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28289516/biochemical-changes-in-the-injured-brain
#13
EDITORIAL
Seelora Sahu, Deb Sanjay Nag, Amlan Swain, Devi Prasad Samaddar
Brain metabolism is an energy intensive phenomenon involving a wide spectrum of chemical intermediaries. Various injury states have a detrimental effect on the biochemical processes involved in the homeostatic and electrophysiological properties of the brain. The biochemical markers of brain injury are a recent addition in the armamentarium of neuro-clinicians and are being increasingly used in the routine management of neuro-pathological entities such as traumatic brain injury, stroke, subarachnoid haemorrhage and intracranial space occupying lesions...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28288206/an-in-vivo-system-for-directed-experimental-evolution-of-rabbit-haemorrhagic-disease-virus
#14
Robyn N Hall, Lorenzo Capucci, Markus Matthaei, Simona Esposito, Peter J Kerr, Michael Frese, Tanja Strive
The calicivirus Rabbit haemorrhagic disease virus (RHDV) is widely used in Australia as a biocontrol agent to manage wild European rabbit (Oryctolagus cuniculus) populations. However, widespread herd immunity limits the effectiveness of the currently used strain, CAPM V-351. To overcome this, we developed an experimental platform for the selection and characterisation of novel RHDV strains. As RHDV does not replicate in cell culture, variant viruses were selected by serially passaging a highly virulent RHDV field isolate in immunologically naïve laboratory rabbits that were passively immunised 18-24 hours post-challenge with a neutralising monoclonal antibody...
2017: PloS One
https://www.readbyqxmd.com/read/28283870/-dirty-coagulation-technique-as-an-alternative-to-microclips-for-control-of-bleeding-from-deep-feeders-during-brain-arteriovenous-malformation-surgery
#15
Danil A Kozyrev, Peeraphong Thiarawat, Behnam Rezai Jahromi, Patcharin Intarakhao, Joham Choque-Velasquez, Ferzat Hijazy, Mario K Teo, Juha Hernesniemi
BACKGROUND: Meticulous haemostasis is one of the most important factors during microneurosurgical resection of brain arteriovenous malformation (AVM). Controlling major arterial feeders and draining veins with clips and bipolar coagulation are well-established techniques, while managing with bleeding from deep tiny vessels still proves to be challenging. This technical note describes a technique used by the senior author in AVM surgery for last 20 years in dealing with the issue highlighted...
March 11, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#16
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28273607/haemorrhagic-gastritis-following-gastrografin-administration-for-adhesive-small-bowel-obstruction-a-case-report-of-a-rare-outcome
#17
Stephen Guy, Mohammed Al Askari
INTRODUCTION: Adhesive small bowel obstruction (ASBO) is common after abdominal surgery. Water soluble contrast agents (WSCA) such as Gastrografin have been demonstrated to be safe and effective in predicting resolution of ASBO with conservative management while decreasing the time to resolution, decreasing the need for surgery and reducing overall length of stay. Few adverse effects have been reported. To the authors knowledge this is the first report of haemorrhagic gastritis following administration of Gastrografin for ASBO...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28272855/a-fifteen-year-experience-of-total-thyroidectomy-for-the-management-of-simple-multinodular-goitres-in-a-low-medium-income-country
#18
A O Afolabi, O O Ayandipo, O O Afuwape, O A Ogundoyin
INTRODUCTION: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. METHOD: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. RESULTS: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28272736/reintroduction-of-anti-thrombotic-therapy-after-a-gastrointestinal-haemorrhage-if-and-when
#19
REVIEW
Martin J Scott, Andrew Veitch, Jecko Thachil
Gastrointestinal haemorrhage is a common clinical scenario and, in those using antithrombotic agents, the risk is significantly increased. Management of these patients, in terms of initial resuscitation is well established and numerous guidelines exist in this area. However, few studies have addressed the subsequent dilemma of if and when antithrombotic agents should be reintroduced. Consequently, practice is variable and not necessarily evidenced-based. Overall, for patients that are either anticoagulated or using antiplatelet drugs for secondary prophylaxis, there is a clear benefit to restarting these agents...
March 8, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28262158/psychosis-as-a-late-manifestation-of-sheehan-s-syndrome
#20
Mukku Shiva Shanker Reddy, Abhinav Nahar, Harish Thippeswamy, Chaturvedi Santosh Kumar
Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most common causes of hypopituitarism in underdeveloped or developing countries. Characteristic manifestations include failure to lactate or to resume menses, genital and axillary hair loss, asthenia and weakness, fine wrinkles around the eyes and lips, signs of premature aging, dry skin, hypopigmentation and other evidence of hypopituitarism. Uncommonly it can present with psychosis. There are only few case reports of psychoses in patients with Sheehan's syndrome...
February 2017: Asian Journal of Psychiatry
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