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https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#1
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#2
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28626191/hemophagocytic-lymphohistiocytosis-in-a-fatal-case-of-severe-fever-with-thrombocytopenia-syndrome
#3
Ayako Nakano, Hirohisa Ogawa, Yoshinori Nakanishi, Hiromi Fujita, Fumihiko Mahara, Kazuya Shiogama, Yutaka Tsutsumi, Toshiaki Takeichi
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease caused by a novel Bunyavirus with a high mortality rate. We herein report a fatal case of an 86-year-old woman with SFTS complaining of a fever, fatigue, and bicytopenia. Her condition deteriorated with rapid progression of bleeding tendency, disturbance of consciousness, and multiple organ failure leading to death on Day 6 of her illness. The histopathological findings in the autopsy revealed marked infiltration of macrophages with hemophagocytosis in the bone marrow, liver, and spleen leading to a diagnosis of hemophagocytic lymphohistiocytosis (HLH)...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28622739/impact-of-a-collaborative-strategy-to-reduce-the-inappropriate-use-of-acid-suppressive-therapy-in-non-intensive-care-unit-patients
#4
Kristen D Belfield, Arpi G Kuyumjian, Rafael Teran, Mariette Amadi, Melissa Blatt, Keri Bicking
BACKGROUND: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden. OBJECTIVE: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients. METHODS: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28616155/severe-pelvic-fracture-with-profound-hypotension-a-case-report-and-treatment-algorithm
#5
Chadwick J Knight, Igor Wanko Mboumi, Errington C Thompson
Approximately 9% of all blunt trauma patients suffer pelvic fractures. These fractures can range from insignificant and requiring almost no therapy to massive destruction of the pelvic ring with associated with multisystem injury and life-threatening hypotension which mandates the attention of the trauma surgeon, the orthopedic surgeon, the interventional radiologists and possibly other subspecialists. We present a case of a patient who presented to the emergency room in extremis from massive bleeding from a complex pelvic fracture...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28614427/a-new-era-of-thromboelastometry
#6
Tomaz Crochemore, Felipe Maia de Toledo Piza, Roseny Dos Reis Rodrigues, João Carlos de Campos Guerra, Leonardo José Rolim Ferraz, Thiago Domingos Corrêa
Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients...
June 12, 2017: Einstein
https://www.readbyqxmd.com/read/28612224/extrahepatic-portal-venous-obstruction-what-should-be-the-mainstay-of-treatment
#7
Richa Lal, Moinak Sen Sarma, Manish K Gupta
The two cornerstones of management for Extrahepatic portal vein obstruction (EHPVO) are endotherapy and surgery [Porto-systemic shunts (PSS)/Mesorex bypass (MRB)]. Endotherapy is the mainstay of treatment for acute variceal bleed control and has also been used extensively for secondary prophylaxis till variceal eradication is achieved. However, long-term follow-up beyond endoscopic eradication of esophageal varices (EEEV) indicates that there are numerous delayed bleed and non bleed sequelae of EHPVO, which merit surgery as a definitive procedure to decompress the hypertensive portal venous system...
June 14, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28611838/endovascular-embolization-of-intracranial-infectious-aneurysms-in-patients-undergoing-open-heart-surgery-using-n-butyl-cyanoacrylate
#8
Esteban Cheng-Ching, Seby John, Mark Bain, Gabor Toth, Thomas Masaryk, Ferdinand Hui, Muhammad Shazam Hussain
INTRODUCTION: Mycotic aneurysms are a serious complication of infective endocarditis with increased risk of intracranial hemorrhage. Patients undergoing open heart surgery for valve repair or replacement are exposed to anticoagulants, increasing the risk of aneurysm bleeding. These patients may require endovascular or surgical aneurysm treatment prior to heart surgery, but data on this approach are scarce. METHODS: Retrospective review of consecutive patients with infectious endocarditis and mycotic aneurysms treated endovascularly with Trufill n-butyl cyanoacrylate (n-BCA) at the Cleveland Clinic between January 2013 and December 2015...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28608496/stress-ulcer-prophylaxis-in-the-intensive-care-unit-trial-detailed-statistical-analysis-plan
#9
M Krag, A Perner, J Wetterslev, T Lange, M P Wise, M Borthwick, S Bendel, P Pelosi, F Keus, A B Guttormsen, J C Schefold, T S Meyhoff, S Marker, M H Møller
BACKGROUND: In this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The aim of the SUP-ICU trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (ICU). METHODS: The SUP-ICU trial is an investigator-initiated, international, multicentre, randomised, blinded, parallel-group trial of intravenously pantoprazole 40 mg once daily vs...
June 12, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28608268/applicability-of-a-modified-efast-protocol-r-efast-to-evaluate-hemodynamically-unstable-patients-after-percutaneous-cardiac-intervention
#10
José Luis Vázquez Martínez, Kary Leonisa Quiñones Coneo, Tomas Villen Villegas, María Sánchez Porras, Cesar Pérez-Caballero Macarrón, Ana Coca Pérez, Luis Fernandez Pineda
Percutaneous cardiac intervention is an invasive diagnostic and therapeutic technique which carries a significant complication rate. Although the usefulness of EFAST protocol is widely recognised, this paper will attempt to explore a modified approach involving a focused examination on the retroperitoneal (r-EFAST). We have provided examples of 3 cases where r-EFAST was used to detect retroperitoneal bleeding in critical situations.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28604077/-activated-factor-vii-31-years-experience-on-clinical-grounds
#11
Miklós Udvardy
The author provides an overview of the use of recombinant activated FVII (rFVIIa, Novoseven), which is used over 30 years, based upon international publications and also on some modest own experience. Standard, approved indications (inhibitory cases, Glanzmann thrombasthenia, prophylaxis experience) are in the focus of this paper, emphasizing the specially rapid and efficacious way of Novoseven therapy, drawing attention to excellent safety issues regarding very low immunogenicity along with low number of thrombogenic complications...
June 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28598281/design-development-and-characterization-of-act017-a-humanized-fab-that-blocks-platelet-s-glycoprotein-vi-function-without-causing-bleeding-risks
#12
Kristell Lebozec, Martine Jandrot-Perrus, Gilles Avenard, Olivier Favre-Bulle, Philippe Billiald
Glycoprotein VI is a platelet-specific collagen receptor critical for in vivo formation of arterial thrombosis. It is also considered as an attractive target for the development of anti-thrombotic drugs because blocking glycoprotein (GP)VI inhibits platelet aggregation without inducing detrimental effects on physiological hemostasis. Here, we present data on the identification, in vitro and ex vivo pharmacology of a humanized Fab fragment designated as ACT017. ACT017 was selected out of 15 humanized variants based upon structural and functional properties...
June 9, 2017: MAbs
https://www.readbyqxmd.com/read/28595858/risk-of-postoperative-venous-thromboembolism-among-pregnant-women
#13
Yasunori Suematsu, Yoshitsugu Obi, Akihiro Shimomura, Reza Fazl Alizadeh, Nosratola D Vaziri, Ninh T Nguyen, Michael J Stamos, Hirohito Ichii
Venous thromboembolism (VTE) is a critical complication after surgery. Although pregnancy is a known risk factor of VTE, available data on the risk of postoperative VTE are scarce. Using the American College of Surgeons National Surgical Quality Improvement Program database between 2006 and 2012, we matched 2,582 pregnant women to 103,640 nonpregnant women based on age, race, body mass index, and modified Rogers score. Pregnant women, compared with matched nonpregnant women, experienced higher incidence of VTE (0...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28576878/the-disulfide-isomerase-erp72-supports-arterial-thrombosis-in-mice
#14
Junsong Zhou, Yi Wu, Fengwu Chen, Lu Wang, Lubica Rauova, Vincent M Hayes, Mortimer Poncz, Hong Li, Tong Liu, Junling Liu, David W Essex
Several CGHC motif-containing disulfide isomerases support thrombosis. We here report that ERp72, with three CGHC redox-active sites (a(o), a, and a'), supports thrombosis. We generated a new conditional knockout mouse model, and found that Tie2-Cre/ERp72(fl/fl) mice with blood and endothelial cells lacking ERp72 had prolonged tail bleeding times, and decreased platelet accumulation in laser-induced cremaster arteriole injury and FeCl3-induced mesenteric arterial injury. Fibrin deposition was decreased in the laser injury model...
June 2, 2017: Blood
https://www.readbyqxmd.com/read/28572098/prophylactic-acid-suppressive-therapy-in-hospitalized-adults-indications-benefits-and-infectious-complications
#15
Andrew C Faust, Kelly L Echevarria, Rebecca L Attridge, Lyndsay Sheperd, Marcos I Restrepo
Acid-suppressive therapy for prophylaxis of stress ulcer bleeding is commonly prescribed for hospitalized patients. Although its use in select, at-risk patients may reduce clinically significant gastrointestinal bleeding, the alteration in gastric pH and composition may place these patients at a higher risk of infection. Although any pharmacologic alteration of the gastric pH and composition is associated with an increased risk of infection, the risk appears to be highest with proton pump inhibitors, perhaps owing to the potency of this class of drugs in increasing the gastric pH...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28569619/effects-of-point-massage-of-liver-and-stomach-channel-combined-with-pith-and-trotter-soup-on-postpartum-lactation-start-time
#16
Qiong Luo, Yin Hu, Hui Zhang
Delay in lactation initiation causes maternal anxiety and subsequent adverse impact on maternal exclusive breast feeding. It is important to explore a safe and convenient way to promote lactation initiation. The feasibility of point massage of liver and stomach channel combined with pith and trotter soup on prevention of delayed lactation initiation was investigated in the present study. 320 women were enrolled and randomly divided into four groups, control group (80 women), point massage group (80 women), pith and trotter soup group (80 women), and massage + soup group (80 women) to compare the lactation initiation time...
June 1, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28565729/combined-endoscopic-and-surgical-treatment-of-severe-gastrointestinal-bleeding-in-a-patient-with-heart-assist-device-under-therapeutic-anticoagulation
#17
Edris Wedi, Mohamed Bounnah, Riccardo Memeo, Carlo Jung
Gastrointestinal (GI) bleeding is a common complication after heart assist device placement. Reasons for bleeding are multifactorial. Endoscopic therapy is the treatment of choice, whereas invasive procedures are avoided in these critically ill patients. We present the case of a 65-year-old male patient experiencing severe GI bleeding after left ventricular assist device (LVAD) and right ventricular assist device (RVAD) placement with therapeutic anticoagulation. Endoscopically, multiple gastric bleeding sources were found but could not be treated effectively due to a large blood clot...
June 1, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28559097/von-willebrand-disease-type-2-in-pregnancy-a-critical-clinical-association
#18
REVIEW
Anca A Simionescu, Natalia F Buinoiu, Nicoleta Berbec
Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Its association with pregnancy is infrequent. Here we report three cases of vWD associated with pregnancy. The clinical features of this combination are very suggestive. However, difficulties are still encountered during the diagnosis process. The first case was diagnosed for the first time during the patient's second pregnancy despite several episodes of vaginal bleeding and suggestive clinical symptomatology. The second case was diagnosed during childhood and the patient was properly managed during this pregnancy...
May 18, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#19
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3. Device implantation criteria were persistent low output syndrome despite optimal medical treatment. The primary end-point of the study was survival or transplantation to 90 days on the device...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28555443/-extracorporeal-lung-support
#20
REVIEW
S Braune, A Sieweke, D Jarczak, S Kluge
Systems for extracorporeal lung support have recently undergone significant technological improvements leading to more effective and safe treatment. Despite limited scientific evidence these systems are increasingly used in the intensive care unit for treatment of different types of acute respiratory failure. In general two types of systems can be differentiated: devices for extracorporeal carbon dioxide removal (ECCO2R) for ventilatory insufficiency and devices for extracorporeal membrane oxygenation (ECMO) for severe hypoxemic failure...
June 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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