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Haemorrhagic management

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https://www.readbyqxmd.com/read/28538190/post-traumatic-inferior-vena-cava-thrombosis-a-case-report-and-review-of-literature
#1
Amine Chakroun, Mohamed Said Nakhli, Mohamed Kahloul, Mohamed Amine Harrathi, Walid Naija
INTRODUCTION: Post traumatic inferior vena cava (IVC) thrombosis is a rare and not well described entity with nonspecific clinical presentation. It remains a therapeutic challenge in traumatic context because of haemorrhagic risk due to anticoagulation. PRESENTATION OF CASE: We report a case of IVC thrombosis in an 18 year-old man who presented with liver injury following a traffic crash. The thrombosis was incidentally diagnosed on admission by computed tomography...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28534552/-perforations-following-endoscopic-retrograde-cholangiopancreatography-ercp
#2
J Mateo Retuerta, C Chaveli Díaz, A Goikoetxea Urdiain, B Sainz Villacampa, M J Sara Ongay, J J Íñigo Noain
Endoscopic retrograde cholangiopancreatography (ERCP) associated with sphincterotomy is a useful procedure that is widely used in cases of choledocholithiasis and bile duct obstruction. In spite of being a safe test, there is a risk of complications like pancreatitis, haemorrhaging or perforation. Post-ERCP duodenal perforation is a rare event but has serious consequences if it is not treated early. The lesion mechanism, the place and extension of the perforation, as well as the clinical picture and radiographic findings will guide patient management, which must be individualised and constantly reevaluated...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28533909/recent-advances-in-the-management-of-variceal-bleeding
#3
Ihteshamul Haq, Dhiraj Tripathi
Acute haemorrhage from ruptured gastroesophageal varices is perhaps the most serious consequence of uncontrolled portal hypertension in cirrhotic patients. It represents a medical emergency and is associated with a high morbidity and mortality. In those who survive the initial bleeding event, the risks of further bleeding and other decompensated events remain high. The past 30 years have seen a slow evolution of management strategies that have greatly improved the chances of surviving a variceal haemorrhage...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28531835/postpartum-acute-colonic-pseudo-obstruction-ogilvie-s-syndrome-a-systematic-review-of-case-reports-and-case-series
#4
REVIEW
Pradeep Jayaram, Manoj Mohan, Stephen Lindow, Justin Konje
INTRODUCTION: Ogilvie's Syndrome or Acute Colonic Pseudo-Obstruction (ACPO) is a rare condition characterized by massive dilatation of the colon in the absence of mechanical obstruction. About 10% of all reported cases are related to Obstetric and Gynaecological procedures, Caesarean section being the commonest associated factor. Acute intestinal dilatation, if not treated, may lead to perforation and faecal peritonitis with consequent high morbidity and mortality. MATERIALS AND METHODS: An electronic literature searches were performed in PubMed, EMBASE, Google scholar and hand searches for relevant references were included without any language restriction...
May 2, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28528767/acute-kidney-injury-after-radial-or-femoral-access-for-invasive-acute-coronary-syndrome-management-aki-matrix
#5
Giuseppe Andò, Bernardo Cortese, Filippo Russo, Martina Rothenbühler, Enrico Frigoli, Giuseppe Gargiulo, Carlo Briguori, Pascal Vranckx, Sergio Leonardi, Vincenzo Guiducci, Flavia Belloni, Fabio Ferrari, Jose Maria de la Torre Hernandez, Salvatore Curello, Francesco Liistro, Andrea Perkan, Stefano De Servi, Gavino Casu, Antonio Dellavalle, Dionigi Fischetti, Antonio Micari, Bruno Loi, Fabio Mangiacapra, Nunzio Russo, Fabio Tarantino, Francesco Saia, Dik Heg, Stephan Windecker, Peter Jüni, Marco Valgimigli
BACKGROUND: It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). OBJECTIVES: The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis...
May 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28526538/trastuzumab-emtansine-versus-treatment-of-physician-s-choice-in-patients-with-previously-treated-her2-positive-metastatic-breast-cancer-th3resa-final-overall-survival-results-from-a-randomised-open-label-phase-3-trial
#6
Ian E Krop, Sung-Bae Kim, Antonio Gonzalez Martin, Patricia M LoRusso, Jean-Marc Ferrero, Tanja Badovinac-Crnjevic, Silke Hoersch, Melanie Smitt, Hans Wildiers
BACKGROUND: In the randomised, parallel assignment, open-label, phase 3 TH3RESA study, progression-free survival was significantly longer with trastuzumab emtansine versus treatment of physician's choice in previously treated patients with HER2-positive advanced breast cancer. We report results from the final overall survival analysis of the TH3RESA trial. METHODS: Eligible patients for the TH3RESA trial were men and women (aged ≥18 years) with centrally confirmed HER2-positive advanced breast cancer previously treated with both trastuzumab and lapatinib (advanced setting) and a taxane (any setting) and with progression on two or more HER2-directed regimens in the advanced setting...
May 16, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28523060/management-options-for-interstitial-ectopic-pregnancies-a-case-series
#7
Ilker Kahramanoglu, Zahid Mammadov, Hasan Turan, Aslihan Urer, Abdullah Tuten
OBJECTIVE: Ectopic pregnancy in the interstitial part of the Fallopian tubes can be life-threatining considering the thin myometrial tissue surrounding the gestational sac and highly vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. The diagnosis and management is challenging. Conservative, medical, and surgical treatment options should be considered based on individual patient factors. METHODS: Four women were diagnosed with interstitial pregnancy in last five years in our tertiary center...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28518415/systematic-review-of-transarterial-embolization-for-hepatocellular-adenomas
#8
REVIEW
B V van Rosmalen, R J S Coelen, M Bieze, O M van Delden, J Verheij, C H C Dejong, T M van Gulik
BACKGROUND: Hepatocellular adenoma (HCA) larger than 5 cm in diameter is considered an indication for elective surgery, because of the risk of haemorrhage and malignant transformation. Transarterial embolization (TAE) is used to manage bleeding HCA and occasionally to reduce tumour size. TAE might have potential as an elective therapy, but its current role in this context is uncertain. This systematic review provides an overview of clinical outcomes after TAE, in bleeding and non-bleeding HCA...
June 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28514959/prevention-of-postpartum-haemorrhage-by-community-based-auxiliary-midwives-in-hard-to-reach-areas-of-myanmar-a-qualitative-inquiry-into-acceptability-and-feasibility-of-task-shifting
#9
Kyu Kyu Than, Yasmin Mohamed, Victoria Oliver, Theingi Myint, Thazin La, James G Beeson, Stanley Luchters
BACKGROUND: In Myanmar, postpartum haemorrhage is the leading cause of maternal mortality and contributes to around 30% of all maternal deaths. The World Health Organization recommends training and supporting auxiliary midwives to administer oral misoprostol for prevention of postpartum haemorrhage in resource-limited settings. However, use of misoprostol by auxiliary midwives has not formally been approved in Myanmar. Our study aimed to explore community and provider perspectives on the roles of auxiliary midwives and community-level provision of oral misoprostol by auxiliary midwives...
May 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28511461/cervical-pregnancy-masquerading-as-an-incomplete-abortion-a-learning-lesson
#10
Namrata Kumar, Smriti Agrawal, Vinita Das, Anjoo Agrawal
Cervical pregnancy is a rare site of ectopic pregnancy compared to tubal. The trophoblast implant into the cervical tissue and become a potentially dangerous site of torrential haemorrhage. The widespread use of Ultrasonography (USG) has led to a dramatic increase in the detection rates of extra uterine pregnancy. We hereby report an interesting case of extra uterine pregnancy with a unique situation where only a high index of suspicion prevented an iatrogenic mishap. The patient was referred as a case of incomplete abortion with a documented report of minimal retained products...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#11
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
May 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28506132/lanreotide-in-the-management-of-small-bowel-angioectasias-seven-year-data-from-a-tertiary-centre
#12
S Chetcuti Zammit, D S Sanders, R Sidhu
BACKGROUND AND AIMS: Haemorrhage from small bowel angioectasias (SBAs) can be debilitating to patients who are very often elderly and have multiple comorbidities. Our aim was to assess the use of lanreotide in addition to endotherapy in patients with SBAs. METHOD: Patients with SBAs on capsule endoscopy (CE) who received lanreotide injections from January 2010 to till the present day at the Royal Hallamshire Hospital in Sheffield were included. Baseline demographics were recorded...
May 16, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28503270/early-management-of-head-injury-in-adults-in-primary-care
#13
B S Liew, K Zainab, A Cecilia, Y Zarina, T Clement
Head injury is common and preventable. Assessment of the head injury patient includes airway, cervical spine protection, breathing, circulation, haemorrhage control and the Glasgow Coma Scale. Hypotension, hypoxia, hypocarbia and hypercarbia should be avoided by continuous monitoring of vital signs and hourly head chart to prevent secondary brain injury. This paper aims to assist primary healthcare providers to select the appropriate patient for transfer and imaging for further management of head injury.
2017: Malaysian Family Physician
https://www.readbyqxmd.com/read/28502692/what-factors-determine-treatment-outcome-in-aneurysmal-subarachnoid-haemorrhage-in-the-modern-era-a-post-hoc-stash-analysis
#14
Mario Teo, Mathew R Guilfoyle, Carole Turner, Peter J Kirkpatrick
INTRODUCTION: The management of aneurysmal SAH has changed dramatically in the last few decades with the publication of a few major studies including The International Cooperative Study on the Timing of Aneurysm Surgery Study, International Subarachnoid Aneurysm Trial (ISAT). The aim of this study is to analyse the outcome of patients with aSAH based on a contemporary series, identify the risk factors for poor outcome, and focusing on patients with good grades aSAH (to match the ISAT cohort)...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499381/experience-in-the-use-of-non-pneumatic-anti-shock-garment-nasg-in-the-management-of-postpartum-haemorrhage-with-hypovolemic-shock-in-the-fundaci%C3%A3-n-valle-del-lili-cali-colombia
#15
María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application...
May 12, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28494920/clinical-efficacy-of-intravitreal-aflibercept-versus-panretinal-photocoagulation-for-best-corrected-visual-acuity-in-patients-with-proliferative-diabetic-retinopathy-at-52-weeks-clarity-a-multicentre-single-blinded-randomised-controlled-phase-2b-non-inferiority
#16
Sobha Sivaprasad, A Toby Prevost, Joana C Vasconcelos, Amy Riddell, Caroline Murphy, Joanna Kelly, James Bainbridge, Rhiannon Tudor-Edwards, David Hopkins, Philip Hykin
BACKGROUND: Proliferative diabetic retinopathy is the most common cause of severe sight impairment in people with diabetes. Proliferative diabetic retinopathy has been managed by panretinal laser photocoagulation (PRP) for the past 40 years. We report the 1 year safety and efficacy of intravitreal aflibercept. METHODS: In this phase 2b, single-blind, non-inferiority trial (CLARITY), adults (aged ≥18 years) with type 1 or 2 diabetes and previously untreated or post-laser treated active proliferative diabetic retinopathy were recruited from 22 UK ophthalmic centres...
May 5, 2017: Lancet
https://www.readbyqxmd.com/read/28492980/-haemostatic-management-in-postpartum-haemorrhage-nationwide-survey-in-germany
#17
L Kaufner, K Ghantus, A Henkelmann, U Friedrichs, K Weizsäcker, A Schiemann, C von Heymann
BACKGROUND: In order to ensure evidence-based haemostatic management of postpartum haemorrhage (PPH, blood loss >500 ml) consistent with guidelines appropriate structural conditions must be fulfilled regardless of different levels (1-3) in perinatal care. The aim of the survey was to identify differences in haemostatic management in PPH under consideration of the different levels of perinatal care in Germany. MATERIALS AND METHODS: An electronic questionnaire assessing the structural and therapeutic preconditions for haemostatic management was sent to 533 anaesthesiology departments serving obstetric units...
May 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28489448/immediate-postoperative-management-and-complications-on-the-intensive-care-unit
#18
Eleanor Bates, Daniel Martin
The postoperative management of patients immediately after liver transplantation requires knowledge of this complex surgery and the physiology that accompanies liver failure. A multidisciplinary approach to the care of these patients is essential in order to reduce postoperative complications and preserve function in the transplanted organ. By their nature, patients undergoing liver transplantation have complicated medical problems before surgery which must be borne in mind when managing them after surgery...
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28480620/management-of-recurrent-bleeding-after-pancreatoduodenectomy
#19
Ralph F Staerkle, Justin S Gundara, Thomas J Hugh, Richard Maher, Brendan Steinfort, Jaswinder S Samra
BACKGROUND: Re-bleeding after management of a first haemorrhage following pancreatic surgery is an ever-present danger and often presents diagnostic and management dilemmas. METHODS: All cases of post-pancreatectomy haemorrhage (PPH) following pancreatoduodenectomy were identified from a tertiary referral, clinical database (April 2004-April 2013). Only those suffering a second re-bleeding episode were included in the final case notes review. RESULTS: A total of 301 patients underwent pancreatoduodenectomy during the study period (most common indication: pancreatic adenocarcinoma; 49...
May 8, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28459999/diagnostic-and-management-challenges-in-goodpasture-s-anti-glomerular-basement-membrane-disease
#20
Scott R Henderson, Alan D Salama
Goodpasture's or anti-glomerular basement membrane (GBM) disease is classically characterized by the presence of circulating autoantibodies directed against the non-collagenous domain of the α3 chain of type IV collagen, targeting glomerular and alveolar basement membranes, and associated with rapidly progressive crescentic glomerulonephritis, with alveolar haemorrhage in over half the patients. However, there are increasing examples of variants or atypical presentations of this disease, and novel therapeutic options have been proposed, which nephrologists should be aware of...
April 28, 2017: Nephrology, Dialysis, Transplantation
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