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Haemorrhagic management

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https://www.readbyqxmd.com/read/29786087/a-comparison-of-23-gauge-and-20-gauge-vitrectomy-for-proliferative-sickle-cell-retinopathy-clinical-outcomes-and-surgical-management
#1
Jason Ho, Anna Grabowska, Marta Ugarte, Mahiul Mk Muqit
AIMS: To report anatomical and functional outcomes in patients with proliferative sickle retinopathy (PSR) who underwent 23-gauge (23G) and 20-gauge (20G) vitrectomy. METHODS: Retrospective consecutive case series of patients who underwent vitreoretinal intervention for complications of PSR between April 2009 and February 2015. Operations were performed at a tertiary referral centre, Moorfields Eye Hospital. Visual acuity and anatomical success rates were evaluated for PSR complicated by retinal detachment, tractional vitreous haemorrhage and macular hole...
May 22, 2018: Eye
https://www.readbyqxmd.com/read/29779622/anticoagulation-during-ecmo-in-neonatal-and-paediatric-patients
#2
Rebecca Barton, Vera Ignjatovic, Paul Monagle
Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#3
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29777786/photoselective-vaporisation-of-the-bladder-for-the-management-of-radiation-cystitis-technique-and-initial-outcomes
#4
Claire Pascoe, Daniel Christidis, Todd Manning, Benjamin W Lamb, Declan G Murphy, Nathan Lawrentschuk
Objective To describe our technique utilising photoselective vaporisation of the bladder (PVB) for the management of haemorrhagic cystitis and initial results of 12 patients. Materials and Method An audit of theatre records of a single surgeon was performed to identify patients who had undergone PVB for management of radiation-cystitis. TECHNIQUE: Rigid cystoscopy was performed. Ureteric catheters were placed and active bleeding sites targeted to optimise vision. Ablation was commenced using the vaporize function...
May 16, 2018: Urology
https://www.readbyqxmd.com/read/29770858/-management-of-anticoagulants-in-ophthalmic-surgery-a-survey-among-ophthalmic-surgeons-in-germany
#5
N Feltgen, B Mele, T Dietlein, C Erb, A Eckstein, A Hager, A Heiligenhaus, H Helbig, H Hoerauf, E Hoffmann, D Pauleikhoff, M Schittkowski, B Seitz, C Sucker, S Suffo, U Schaudig, F Tost, S Thurau, P Walter, J Koscielny
INTRODUCTION: As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS: A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo...
May 16, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29765296/peripartum-haemorrhage-haemostatic-aspects-of-the-new-german-pph-guideline
#6
REVIEW
Heiko Lier, Christian von Heymann, Wolfgang Korte, Dietmar Schlembach
Summary Peripartum haemorrhage remains one of the main causes of maternal mortality world-wide. The German, Austrian and Swiss Societies of Gynaecology and Obstetrics have updated the current guidelines for the treatment of peripartum haemorrhage together with the German Society of Anaesthesiology and Intensive Care Medicine and the Society of Thrombosis and Haemostasis Research. The recommendations have been the result of a thorough review of the available scientific literature and a consensus process involving all members of the guideline group...
April 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29764608/the-endoscopic-endonasal-approach-for-the-treatment-of-juvenile-angiofibromas
#7
José Luis Llorente, Fernando López
BACKGROUND AND OBJECTIVES: Juvenile angiofibroma (JA) is a benign tumour, for which the treatment of choice is surgery. It may be associated with significant morbidity because of its anatomical location and its locally destructive growth pattern. Severe haemorrhage constitutes a high risk in JA and its surgical management can be complex. The management of JA remains a challenge. The objective of this study was to review a series of patients with JA treated via the endonasal/endoscopic approach...
May 12, 2018: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/29761663/a-prospective-pilot-study-on-early-toxicity-from-a-simultaneously-integrated-boost-technique-for-canine-sinonasal-tumours-using-image-guided-intensity-modulated-radiation-therapy
#8
A Soukup, V Meier, S Pot, K Voelter, C Rohrer Bley
In order to overcome the common local treatment failure of canine sinonasal tumours, integrated boost techniques were tried in the cobalt/orthovoltage era, but dismissed because of unacceptable early (acute) toxicity. Intriguingly, a recent calculation study of a simultaneously integrated boost (SIB) technique for sinonasal irradiation using intensity-modulated radiation therapy (IMRT) predicted theoretical feasibility. In this prospective pilot study we applied a commonly used protocol of 10 × 4.2 Gy to the planning target volume (PTV) with a 20%-SIB dose to the gross tumour volume (GTV)...
May 14, 2018: Veterinary and Comparative Oncology
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#9
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29749594/-non-aneurysmal-subarachnoid-haemorrhage-secondary-to-panarteritis-nodosa-at-paediatric-age-a-case-report
#10
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29741208/induction-of-labour-for-improving-birth-outcomes-for-women-at-or-beyond-term
#11
REVIEW
Philippa Middleton, Emily Shepherd, Caroline A Crowther
BACKGROUND: Beyond term, the risks of stillbirth or neonatal death increase. It is unclear whether a policy of labour induction can reduce these risks. This Cochrane review is an update of a review that was originally published in 2006 and subsequently updated in 2012 OBJECTIVES: To assess the effects of a policy of labour induction at or beyond term compared with a policy of awaiting spontaneous labour or until an indication for birth induction of labour is identified) on pregnancy outcomes for infant and mother...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29741099/economic-evaluation-of-prescribing-conventional-and-newer-oral-anticoagulants-in-older-adults
#12
Syed Shahzad Hasan, Chia Siang Kow, Louise E Curley, Darrin L Baines, Zaheer-Ud-Din Babar
Anticoagulants refer to a variety of agents that inhibit one or more steps in the coagulation cascade. Generally, clinical conditions that require the prescribing of an oral anticoagulant increase in frequency with age. However, a major challenge of anticoagulation use among older patients is that this group of patients also experience the highest bleeding risk. To date, economic evaluation of prescribing of anticoagulants that includes the novel or newer oral anticoagulants (NOACs) in older adults has not been conducted and is warranted...
May 9, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29736284/a-case-of-placenta-percreta-managed-with-sequential-embolisation-procedures
#13
Shannon Armstrong-Kempter, Supuni Kapurubandara, Brian Trudinger, Noel Young, Naim Arrage
Background: The incidence of morbidly adherent placenta, including placenta percreta, has increased significantly over recent years due to rising caesarean section rates. Historically, abnormally invasive placenta has been managed with caesarean hysterectomy; however nonsurgical interventions such as uterine artery embolisation (UAE) are emerging as safe alternative management techniques. UAE can be utilised to decrease placental perfusion and encourage placental resorption, thereby reducing the risk of haemorrhage and other morbidities...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29732978/the-effect-of-tranexamic-acid-on-preventing-post-partum-hemorrhage-due-to-uterine-atony-a-triple-blind-randomized-clinical-trial
#14
Mahvash Zargar, Roshan Nikbakht, Mahzad Ahmadi
BACKGROUND: Postpartum haemorrhage (PPH) is an important cause of early maternal death which needs to be controlled. OBJECTIVE: This study was designed to compare the effect of intravenous tranexsmic acid (TXA) and prostaglandin analogue on reducing PPH resulted from uterine atony in women undergoing C section or vaginal delivery. METHOD: A randomized, triple-blind, placebo-controlled study was conducted on 248 pregnant women with PPH due to uterine atony who were randomly assigned into two groups of TXA as the intervention group (n=124) and prostaglandin analogue as the control group (n=124)...
May 6, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29729372/management-of-bleeding-and-emergency-invasive-procedures-in-patients-on-dabigatran-updated-guidelines-from-the-french-working-group-on-perioperative-haemostasis-gihp-september-2016
#15
Pierre Albaladejo, Gilles Pernod, Anne Godier, Emmanuel de Maistre, Nadia Rosencher, Jean Louis Mas, Pierre Fontana, Charles Marc Samama, Annick Steib, Sylvie Schlumberger, Emmanuel Marret, Stéphanie Roullet, Sophie Susen, Samia Madi-Jebara, Philippe Nguyen, Jean François Schved, Fanny Bonhomme, Pierre Sié
In 2013, the GIHP published guidelines for the management of severe haemorrhages and emergency surgery. This update applies to patients treated with dabigatran, with a bleeding complication or undergoing an urgent invasive procedure. It includes how to handle the available specific antidote (idarucizumab), when to measure dabigatran plasmatic concentration, and when to use non-specific measures in these situations. It also includes guidelines on how to perform regional anaesthesia and analgesia procedures.
May 2, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29726966/pattern-of-dengue-virus-infections-in-adult-patients-from-sri-lanka
#16
Umesh Jayarajah, Pradeep K de Silva, Priyankara Jayawardana, Upul Dissanayake, Aruna Kulatunga, Harshini Fernando, Lakshika Perera, Vibhavee Kannangara, Champika Udayangani, Ranga Peiris, Shuaib Faizer, Pamodh Yasawardene, Ishan de Zoysa, Suranjith L Seneviratne
Background: Sri Lanka experienced its largest dengue epidemic in 2017. This study describes the disease pattern of adult dengue patients from two hospitals in Sri Lanka. Methods: Demographic, clinical and investigation findings of adult dengue patients admitted to the two hospitals from June to August 2017 were collected and analysed. Results: A total of 1167 patients (777 males [66.2%], mean age 32.9 y) were studied. There were 775 (66.4%) patients with dengue fever (DF), 334 (28...
May 2, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29726291/management-of-acute-tandem-occlusions-stent-retriever-thrombectomy-with-emergency-stenting-or-angioplasty
#17
Wei Li, Zhonglun Chen, Zheng Dai, Rui Liu, Qin Yin, Huaiming Wang, Yonggang Hao, Yunfei Han, Zhongming Qiu, Yunyun Xiong, Wen Sun, Wenjie Zi, Gelin Xu, Xinfeng Liu
Objective To compare outcomes following intracranial stent retriever-based intracranial thrombectomy (SRT) with emergency extracranial internal carotid artery (EICA) stenting or angioplasty alone in patients presenting with acute stroke due to tandem occlusions of the ICA. Methods Consecutive patients with acute anterior tandem occlusion who received an endovascular intervention within 6h of symptom onset between January 2013 and June 2016 were included in this prospective study. Demographic, radiological, procedural and clinical outcome data were compared between the stenting and the angioplasty alone groups...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29724141/major-obstetric-haemorrhage-of-2000-ml-or-greater-a-clinical-audit
#18
J O'Sullivan, R Mansfield, R Talbot, A E Cairns
Haemorrhage remains a leading cause of maternal death. We conducted an audit to identify strategies to improve the management at our local NHS Trust. A data collection form was based on our local guideline. A coded database search was conducted for all deliveries where the estimated blood loss was ≥2000 ml (from June 1 2015 to December 31 2015), returning 68 search results (13.7/1000 births). Fifty-six records were included. Poor compliance (<75%) was seen in some key areas including the major obstetric haemorrhage (MOH) call activation (52%), the presence of an anaesthetic consultant (63%) and tranexamic acid administration (46%)...
May 4, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29722003/optimal-long-term-antithrombotic-management-of-atrial-fibrillation-life-cycle-management
#19
REVIEW
R Pisters, A Elvan, H J G M Crijns, M E W Hemels
Optimal antithrombotic management of atrial fibrillation equals balancing between prevention of arterial thromboembolism, predominantly ischaemic stroke, and haemorrhagic complications. Over time different antithrombotic agents and strategies have been developed. At present, non-vitamin K antagonist oral anticoagulants (NOACs) are the first-line therapy for stroke prevention in patients with non-valvular atrial fibrillation (i.e. without a mechanical valve prosthesis or rheumatic heart disease). Considering the impact of the suboptimal adoption of recommended oral anticoagulant therapy, as experienced with the previous first-line vitamin K antagonists, this review focuses on adequate use of NOACs...
May 2, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29721002/should-atrial-fibrillation-patients-with-hypertension-as-an-additional-risk-factor-of-the-cha2ds2-vasc-score-receive-oral-anticoagulation
#20
REVIEW
Juan Wang, Da-Peng Zhang, Hong-Bin Liu, Jiu-Chang Zhong, Xin-Chun Yang
Hypertension has been found to be increased a risk of stroke in atrial fibrillation (AF). Both the European and U.S. guidelines advocate the use of the CHA2 DS2 -VASc (congestive heart failure, hypertension, age > 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category) scheme for risk stratification. Although vitamin K antagonists is more effective than acetylsalicylic acid at preventing ischaemic stroke, its benefit is offs by an increased haemorrhage risk...
March 2018: Journal of Geriatric Cardiology: JGC
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