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https://www.readbyqxmd.com/read/28542050/low-spo2-with-normal-sao2-during-general-anesthesia-a-case-report
#1
Stefan Brugger, Maria-Dolores Santafé-Marti, Malika Lakhal
A 25-year-old Caucasian man with a history of spherocytosis, splenectomy, recurrent blood transfusion, and no cardiopulmonary disease presented for an emergent laparoscopic cholecystectomy with a baseline pulse oximetric saturation (SpO2) of 88% while breathing room air. The SpO2 increased to only 89% during preoxygenation with an FIO2 1.0. Multiple arterial blood samples revealed SaO2 as high as 100% with PaO2 averaging 390 mm Hg. He was subsequently diagnosed with a dyshemoglobin, hemoglobin Köln. The simultaneous presentation of a stable patient from a cardiopulmonary perspective with normal arterial oxygen tension and saturation in the blood gas analyses despite a low SpO2 measurement outlines the importance of integrating the history of present illness and both the importance and the limitation of the pulse oximetry...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28533686/misoprostol-for-miscarriage-management-in-a-woman-with-previous-five-cesarean-deliveries-a-case-report-and-literature-review
#2
Doua AlSaad, Sawsan Alobaidly, Palli Abdulrouf, Binny Thomas, Afif Ahmed, Moza AlHail
BACKGROUND: Misoprostol is an effective medical method for the management of pregnancy loss. However, data on its efficacy and safety in women with previous cesarean deliveries are limited. CASE PRESENTATION: We report a 36-year-old patient, gravida 11 para 6, with a diagnosis of missed miscarriage at 15 weeks of gestation. The patient had a significant obstetric history of previous five cesarean deliveries and uterine rupture. Following patient counseling about the medical and surgical options of managing her miscarriage, the patient opted for medical method...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28533096/transfusion-associated-circulatory-overload-in-a-pediatric-patient-with-neuroblastoma
#3
Ryu Yanagisawa, Ikuko Fujihara, Kazutoshi Komori, Seiki Abe, Takako Ono, Kazuo Sakashita, Tomohiko Nakamura
There have been few reports on pediatric transfusion-associated circulatory overload (TACO). A 5-year-old boy with neuroblastoma underwent resection of the residual tumor. Because anemia progressed at the end of the operation, transfusion of red cell component was initiated. Ten minutes later, he suddenly developed hypoxemia, tachypnea, and tachycardia. Although elevated blood pressure and bilateral infiltrative shadows on chest X-rays were not observed, TACO was diagnosed based on positive balance during operation and N-terminal pro-brain natriuretic peptide elevation...
April 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28526942/development-of-a-new-risk-nomogram-of-perioperative-major-adverse-cardiac-events-for-chinese-patients-undergoing-colorectal-carcinoma-surgery
#4
Juhong Zhang, Ying Xiao, Daya Yang, Xiaodong Zhuang, Ling Wang, Xiuren Gao, Zhibin Huang
PURPOSE: The purpose of this study is to create a new risk nomogram to predict perioperative major adverse cardiac events in patients undergoing colorectal carcinoma surgery. METHODS: A total of 1899 patients who underwent colorectal carcinoma surgery at a tertiary teaching hospital in China between 2007 and 2012 were recruited. Logistic regression analysis was used to define risk factors for major adverse cardiac events. A nomogram-predicting model was built based on the logistic regression model and discrimination was tested by receiver operating characteristic curves...
May 19, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28523361/can-laparoscopic-surgery-prevent-incisional-hernia-in-patients-with-crohn-s-disease-a-comparison-study-of-750-patients-undergoing-open-and-laparoscopic-bowel-resection
#5
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Alexander J Greenstein, Sergey Khaitov, Randolph M Steinhagen, Barry A Salky
BACKGROUND: Incisional hernia (IH) is a frequent occurrence following open surgery for Crohn's disease (CD). This study compares the IH rates of patients with CD undergoing open versus laparoscopic bowel resection. METHODS: Seven hundred and fifty patients with CD operated by the authors at the Mount Sinai Medical Center, New York, USA, were reviewed from a prospectively maintained surgical database. Five hundred patients with Crohn's disease undergoing open surgery were compared to 250 patients undergoing laparoscopic bowel resection...
May 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28514895/outcomes-after-use-of-aortouniiliac-endoprosthesis-versus-modular-or-unibody-bifurcated-endoprostheses-for-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#6
Prateek K Gupta, Kelly Kempe, Reshma Brahmbhatt, Himani Gupta, Jorge Montes, R Armour Forse, Shaun M Stickley, Michael J Rohrer
OBJECTIVES: Outcomes after endovascular repair (EVAR) of ruptured abdominal aortic aneurysms (rAAAs) have been widely published. There is, however, controversy on the role of the use of aortouniiliac endoprosthesis (AUI) versus modular or unibody bifurcated endoprosthesis (MUB) for repair of rAAAs. We study and compare 30-day outcomes after use of AUI and MUB for all rAAAs focusing specifically on patients with instability. MATERIALS AND METHODS: Patients who underwent EVAR for rAAA (n = 425) using AUI (n = 55; 12...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28512100/anaemia-and-respiratory-failure-in-a-child-can-it-be-idiopathic-pulmonary-haemosiderosis
#7
Minhajuddin Ahmed, Dinesh Raj, Ashwini Kumar, Abhay Kumar
We present an 8-year-old male child admitted with cough and high-grade fever for 7 days and respiratory difficulty for 2 days. There was a history of blood transfusion at 2 years of age during a respiratory illness. The child was anaemic, tachycardic, tachypnoeic and hypoxic at presentation. Chest examination revealed equal air entry with fine crackles bilaterally. Blood reports were suggestive of anaemia (haemoglobin 6.5 g/dL), leucocytosis and high C reactive protein levels. Chest radiograph revealed bilateral air space opacities involving diffuse lung fields, right more than left...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28511387/erythrocyte-alloimmunization-and-autoimmunization-among-blood-donors-and-recipients-visiting-a-tertiary-care-hospital
#8
Daljit Kaur, Lovenish Bains, Manoj Kandwal, Indu Parmar
INTRODUCTION: The ultimate aim of pretransfusion testing is the acceptable survival of donor red cells in recipient's body and antibody detection plays a critical role in achieving the same. The cornerstone of antibody detection method is detecting an unexpected antibody as against the expected antibodies of ABO blood group system. Autoantibodies can also interfere with the detection of clinically significant alloantibodies. AIM: To study the frequency of alloantibodies and autoantibodies in the healthy blood donors and patient population visiting our hospital...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508402/risk-factors-for-human-immunodeficiency-virus-among-blood-donors-in-cameroon-evidence-for-the-design-of-an-africa-specific-donor-history-questionnaire
#9
Claude T Tagny, Georges Nguefack-Tsague, Diderot Fopa, Celestin Ashu, Estel Tante, Pauline Ngo Balogog, Olivier Donfack, Dora Mbanya, Syria Laperche, Edward Murphy
BACKGROUND: In sub-Saharan Africa improving the deferral of at-risk blood donors would be a cost-effective approach to reducing transfusion-transmitted human immunodeficiency virus (HIV) infections. We performed a pilot case-control study to identify the risk factors for HIV infection and to develop an adapted donor history questionnaire (DHQ) for sub-Saharan Africa. STUDY DESIGN AND METHODS: We recruited 137 HIV-positive donors (cases) and 256 HIV-negative donors (controls) and gathered risk factor data using audio computer-assisted self-interview...
May 15, 2017: Transfusion
https://www.readbyqxmd.com/read/28500860/interventions-for-preventing-silent-cerebral-infarcts-in-people-with-sickle-cell-disease
#10
REVIEW
Lise J Estcourt, Patricia M Fortin, Sally Hopewell, Marialena Trivella, Carolyn Doree, Miguel R Abboud
BACKGROUND: Sickle cell disease (SCD) is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Silent cerebral infarcts are the commonest neurological complication in children and probably adults with SCD. Silent cerebral infarcts also affect academic performance, increase cognitive deficits and may lower intelligence quotient...
May 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28496021/feasibility-and-safety-of-transulnar-catheterization-in-ipsilateral-radial-artery-occlusion
#11
Shu-Kai Hsueh, Cheng-I Cheng, Hsiu-Yu Fang, Mostafa Mohammad Omran, Wen-Hao Liu, Wen-Jung Chung, Chien-Jen Chen, Cheng-Hsu Yang, Chih-Yuan Fang, Chiung-Jen Wu
To investigate the postprocedural cardiovascular events and vascular outcomes, including hand ischemia and neurological compromise, after transulnar (TU) catheterization in ipsilateral radial artery occlusion.Previous randomized trials have shown that the transulnar (TU) approach for coronary angiogram and intervention has safety and outcomes similar to those of the transradial (TR) approach. However, the safety of the TU procedure when ipsilateral radial artery occlusion occurs is unknown.We retrospectively reviewed 87 TU cases with ipsilateral radial artery occlusion confirmed by a forearm angiogram...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28492980/-haemostatic-management-in-postpartum-haemorrhage-nationwide-survey-in-germany
#12
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/28491138/clinicohematological-and-cytogenetic-profile-of-myelodysplastic-syndromes-in-pakistan-compare-and-contrast
#13
Nida Anwar, Aisha Arshad, Muhammad Nadeem, Sana Khurram, Naveena Fatima, Sumaira Sharif, Saira Shan, Tahir Shamsi
BACKGROUND: Myelodysplastic syndromes (MDS) are clonal stem cell disorders exhibiting cytopenias, ineffective hematopoiesis and morphological dysplasia. Bone marrow cytogenetics, inspite of being incorporated as mandatory tool in diagnosis are done less frequently due to limited availability of this technique in Pakistan. The aim of the study was to study baseline clinicohematological and cytogenetic characteristics of patients presenting with de novo MDS. RESULTS: A retrospective cross sectional study was done at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan from 2010 to 2016...
2017: Molecular Cytogenetics
https://www.readbyqxmd.com/read/28488958/strategies-to-identify-candidates-for-d-variant-genotyping
#14
Xunda Luo, Margaret A Keller, Ian James, Michelle Grant, Shiguang Liu, Kellie Simmons Massey, Andrew Czulewicz, Sandra Nance, Yanhua Li
BACKGROUND: RhD variants have altered D epitopes and/or decreased antigen copies per red cell. Individuals carrying these variants may test antigen negative, weakly positive, or positive by serology, and may or may not be at risk of alloimmunisation after exposure. There have been recommendations to perform RHD genotyping of patients, pregnant women and females of childbearing potential with serological weak D phenotype, to guide prophylactic use of Rh immune globulin (RhIG), and better conserve D-negative blood products...
April 5, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28477360/impact-of-transplant-accessibility-for-sensitized-patients-by-avoiding-unacceptable-antigens
#15
Arnaud Del Bello, Nicolas Congy-Jolivet, Benoit Audry, Corinne Antoine, Laure Esposito, Anne-Laure Hebral, Nassim Kamar
Recent data have confirmed the negative impact of preformed donor-specific antibodies after liver transplantation. In order to reduce the risk of developing lesions associated with acute and chronic antibody-mediated rejection in liver-transplant recipients, we evaluated the consequences in terms of transplant accessibility, associated with avoiding preformed DSAs according to several MFI-titer thresholds that have been previously reported to be relevant in liver transplantation. Among the 484 included LT candidates, 99 (20...
May 6, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28473920/posterior-reversible-encephalopathy-syndrome-pres
#16
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Monica Kumbhat, Aravinda Settikere Nataraju
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by a headache, seizures, altered mental status and visual loss and characterized by white matter vasogenic edema affecting the posterior occipital and parietal lobes of the brain predominantly. This clinical syndrome is increasingly recognized due to improvement and availability of brain imaging specifically magnetic resonance imaging (MRI). A 35-year-old female with the history of unsafe abortion and massive blood transfusion 10 days ago was brought to the emergency room with three episodes of generalized tonic-clonic seizures, urinary incontinence and altered sensorium since 3 hours...
April 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28463670/hereditary-spherocytosis-diagnosis-surgical-treatment-and-outcomes-a-literature-review
#17
Simona Manciu, Emil Matei, Bogdan Trandafir
Hereditary spherocytosis (HS) is a disease affecting the red blood cells membrane and belongs to the congenital hemolytic anemias. The clinical spectrum ranges from asymptomatic patients to severe forms requiring transfusions in early childhood. The diagnosis can be based on the physical examination, complete red blood cell count, reticulocytes count, medical history and specific tests, preferentially the EMA test (eosin-5-maleimide binding) test and AGLT (Acidified Glycerol Lysis Time). Splenectomy is considered the standard surgical treatment in moderate and severe forms of hereditary spherocytosis...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28451050/-tubulopapillary-carcinoma-in-a-17-year-old-female-patient-a-case-report-and-review-of-the-literature
#18
Adil Kallat, Hicham Ouazize, Otheman Fahsi, Hani Abousaleh, Hachem El Sayegh, Ali Iken, Lounis Benslimane, Yassine Nouini
Tubulopapillary carcinomas account for 10% of renal cell carcinomas. They are more frequent in men than in women (sex ratio:8/1). The average period is the sixth decade. There are two anatomopathological types:the 1 corresponding to a proliferation of basophilic cells and type 2 corresponding to a proliferation of eosinophilic cells. We report the case of a 17-year old female patient with no particular past medical history presenting to the emergency department with pain in the right lumbar fossa and in the right flank associated with hematuria evolving for two days before admission, with loss of body weight and deterioration of the general status...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28443948/relapse-of-congenital-thrombotic-thrombocytopenic-purpura-after-spontaneous-remission-in-a-second-trimester-primigravida-case-report-and-review-of-the-literature
#19
Donavan de Souza Lúcio, Jacqueline Foelkel Pignatari, Marcelo Gil Cliquet, Henri Augusto Korkes
CONTEXT: Thrombotic microangiopathy syndrome or thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) describes distinct diseases sharing common pathological features: microangiopathic hemolytic anemia and thrombocytopenia, without any other apparent cause. CASE REPORT: An 18-year-old second-trimester primigravida presented with a history of fifteen days of intense weakness, followed by diarrhea over the past six days. She reported having had low platelets since childhood, but said that she had never had bleeding or menstrual abnormalities...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28436378/outcomes-of-corpectomy-in-patients-with-metastatic-cancer
#20
Grzegorz Guzik
BACKGROUND: The objective of surgical management of spinal metastases is to reduce pain and improve the patient's quality of life. The operation should restore spinal stability and decompress neural structures. One surgical technique is corpectomy followed by vertebral body reconstruction and stabilisation of the spine. The procedure may be performed in patients in overall good health and a good survival prognosis. The aim of this paper is to present the outcomes of surgical management of spinal metastases in patients who underwent corpectomy followed by vertebral body reconstruction and stabilisation of the spine...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
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