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Trauma bleeding

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https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#1
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28212854/delayed-radiographic-manifestation-of-renal-pseudoaneurysms-after-blunt-trauma
#2
Michael Froehner, Felix Schaab, Thomas Hofmockel, Ralf-Thorsten Hoffmann, Dirk Fahlenkamp, Manfred P Wirth
Pseudoaneurysms may cause recurrent hematuria after blunt renal trauma. We report on an 18-year old patient with radiographic manifestation of pseudoaneurysm 41 days after blunt renal trauma. Initial and follow-up imaging for recurrent hematuria including angiography was without signs of pseudoaneurysm or active bleeding. This case illustrates that recurrent gross hematuria as a typical symptom of pseudoaneurysm may be present initially in the absence of radiographic signs. Repeat angiography should be taken into consideration if recurrent bleeding persists...
February 14, 2017: Urology
https://www.readbyqxmd.com/read/28210401/zygomatic-intraosseous-hemangioma-case-report-and-literature-review
#3
REVIEW
David B Powers, Elda Fisher, Detlev Erdmann
Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28208933/a-rare-case-report-of-hepatic-subcapsular-pseudocyst-of-pancreas
#4
Noor Topno, Sandeep Ghosh, Arup Baruah
A pancreatic pseudocyst arises as a result of acute or chronic pancreatitis, pancreatic trauma, or obstruction of the pancreatic duct by a neoplasm. Most of the pseudocysts are located within the head and the body of the pancreas but 20% are extra-pancreatic. We report a case of a 33-year-old gentleman presenting with acute on chronic alcoholic pancreatitis with hepatic sub-capsular pseudocyst involving left lobe of liver, with intra-cystic bleed was successfully treated with Ultrasonography (USG) guided drainage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207628/earlier-endpoints-are-required-for-hemorrhagic-shock-trials-among-severely-injured-patients
#5
Erin E Fox, John B Holcomb, Charles E Wade, Eileen M Bulger, Barbara C Tilley
BACKGROUND: Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-h and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints...
February 15, 2017: Shock
https://www.readbyqxmd.com/read/28205078/enoxaparin-dose-reduction-for-thrombocytopenia-in-patients-with-cancer-a-quality-assessment-study
#6
Simon Mantha, Yimei Miao, Jonathan Wills, Rekha Parameswaran, Gerald A Soff
The development of thrombocytopenia in the setting of therapeutic anticoagulation for venous thromboembolic disease (VTE) is common in cancer patients, but guidelines for management are based on limited past data and have not been validated. In 2011, Memorial Sloan Kettering Cancer Center (MSKCC) implemented the following guidelines in this setting: administer full dose enoxaparin for a platelet count > 50,000/mcL, half-dose enoxaparin for a platelet count of 25,000-50,000/mcL, and hold anticoagulation for a platelet count < 25,000/mcL...
February 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28201842/minimally-invasive-aortic-root-replacement-with-valved-conduits-through-partial-upper-sternotomy
#7
Julia Hillebrand, Mosab Alshakaki, Sven Martens, Mirela Scherer
Background Minimally invasive surgical access through limited sternotomy reduces trauma and morbidity in cardiosurgical patients. However, until now, it is not the standard access for aortic root replacement. This study details our clinic's experience with minimally invasive implantation of valved conduits through partial upper sternotomy and the comparison to conventional full median sternotomy. Methods Between January 2012 and March 2016, a total of 187 patients underwent aortic root replacement with valved conduits in our department...
February 15, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#8
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28195889/a-biodegradable-hemostatic-gelatin-polycaprolactone-composite-for-surgical-hemostasis
#9
Niann-Tzyy Dai, Keng-Yen Fu, Pai-Shan Hsieh, Yu-Min Hung, Yun-Lung Fang, Nien-Chi Huang, Tzu-Wei Lu, Lien-Guo Dai, Shyi-Gen Chen, Tim-Mo Chen
Massive bleeding is the leading cause of battlefield-related deaths and the second leading cause of deaths in civilian trauma centers. One of the challenges of managing severe wounds is the need to promote hemostasis as quickly as possible, which can be achieved by using hemostatic dressings. In this study, we fabricated 2 kinds of gelatin/polycaprolactone composites with 2 ratios of gelatin/polycaprolactone, 1:1 and 2:1 (GP11 and GP21, respectively). Scanning electron microscopy revealed that the GP11 composite exhibited rougher and more porous structure than the GP21 composite did...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28194797/clinical-outcome-of-using-gastric-remnant-or-jejunum-or-colon-conduit-in-surgery-for-esophageal-carcinoma-with-previous-gastrectomy
#10
Wang Jun, Wen Wei, Wu Weibing, Xu Jing, Zhen Fuxi, Xi Xiaoxiang, Lu Bihong, Zhou Tong, Chen Liang, Luo Jinhua
BACKGROUND: For esophageal carcinoma patients with early gastrectomy, individualized surgical plans-including selection of replacement conduit and operation route based on patient's new lesion and surgical history-can achieve the desired therapeutic effect and improve postoperative life quality. We investigated the outcomes at our institution. METHODS: The clinical data of 42 esophageal carcinoma patients with early gastrectomy were analyzed retrospectively. RESULTS: Esophagectomy was performed combining replacement with remnant stomach in 16 patients, jejunum in 17, and colon in 9...
February 14, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28188471/visualization-of-vascular-injuries-in-extremity-trauma
#11
Kwitae Chong, Chenfanfu Jiang, Daniel Ram, Anand Santhanam, Demetri Terzopoulos, Peyman Benharash, Erik Dutson, Joseph Teran, Jeff D Eldredge
A tandem of particle-based computational methods is adapted to simulate injury and hemorrhage in the human body. In order to ensure anatomical fidelity, a three-dimensional model of a targeted portion of the human body is reconstructed from a dense sequence of CT scans of an anonymized patient. Skin, bone and muscular tissue are distinguished in the imaging data and assigned with their respective material properties. An injury geometry is then generated by simulating the mechanics of a ballistic projectile passing through the anatomical model with the material point method...
February 11, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28184955/-tranexamic-acid-in-the-german-emergency-medical-service-a%C3%A2-national-survey
#12
V Zickenrott, I Greb, A Henkelmann, F Balzer, S Casu, L Kaufner, C von Heymann, K Zacharowski, C F Weber
BACKGROUND: Trauma-induced coagulopathy, one of the leading causes of trauma-related death, is detected in about one of four trauma patients upon hospital admission. The current European Management of Major Bleeding and Coagulopathy Following Trauma guidelines, published in 2013, recommend that tranexamic acid (TXA) be administered as early as possible to inhibit hyperfibrinolysis (grade of recommendation (GoR 1A)). Furthermore, it is suggested that protocols for the management of patients with bleeding or showing signs of bleeding include the administration of the first dose of TXA at the site of injury or during transportation to hospital (GoR 2C)...
February 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28184357/delayed-splenic-rupture-normal-appearing-spleen-on-the-initial-multidetector-computed-tomography-mdct-can-sometimes-be-misleading
#13
Alireza Hamidian Jahromi, Matias Migliaro, Melisa Romano, Guillermo Sangster
INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of the cases the initial CT imaging revealed some form of damage to the spleen. CASE PRESENTATION: Here we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28181262/descriptive-characteristics-and-in-hospital-mortality-of-critically-bleeding-patients-requiring-massive-transfusion-results-from-the-australian-and-new-zealand-massive-transfusion-registry
#14
R Ruseckaite, Z K McQuilten, J C Oldroyd, T H Richter, P A Cameron, J P Isbister, E M Wood
BACKGROUND AND OBJECTIVES: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). MATERIALS AND METHODS: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015...
February 8, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28176906/comparison-of-outcomes-between-minimally-invasive-transforaminal-lumbar-interbody-fusion-and-traditional-posterior-lumbar-intervertebral-fusion-in-obese-patients-with-lumbar-disk-prolapse
#15
Ya-Peng Wang, Ji-Long An, Ya-Peng Sun, Wen-Yuan Ding, Yong Shen, Wei Zhang
OBJECTIVE: The aim of this study was to compare the curative effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and the posterior lumbar interbody fusion (PLIF) in obese patients with lumbar disk prolapse. PATIENTS AND METHODS: In this study, 72 patients who underwent lumbar disk prolapse therapy in the Third Hospital of Hebei Medical University between March 2011 and 2015 were retrospectively analyzed and were divided into two groups, MIS-TLIF group (n=35) and PLIF group (n=37), according to different surgical procedures...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#16
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28168070/chronic-subdural-hematoma-associated-with-thrombocytopenia-in-a-patient-with-human-immunodeficiency-virus-infection-in-cameroon
#17
Clovis Nkoke, Engelbert Bain Luchuo, Denis Teuwafeu, Ines Nepetsoun, Cyrille Nkouonlack
Hematological abnormalities including thrombocytopenia are common in patients living with HIV infection. Patients with HIV infection related thrombocytopenia present generally with only minor bleeding problems. But cases of subdural hematoma are very rare. A 61-year-old female with a history of HIV infection of 9 years' duration presented with a 3-month history of generalized headache associated with visual blurring and anterograde amnesia. There was no history of trauma or fever. She was treated empirically for cerebral toxoplasmosis for 6 weeks without any improvement of the symptoms...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28165057/a-novel-indication-of-platonin-a-therapeutic-immunomodulating-medicine-on-neuroprotection-against-ischemic-stroke-in-mice
#18
Joen-Rong Sheu, Zhih-Cherng Chen, Thanasekaran Jayakumar, Duen-Suey Chou, Ting-Lin Yen, Hsing-Ni Lee, Szu-Han Pan, Chih-Hsuan Hsia, Chih-Hao Yang, Cheng-Ying Hsieh
Thrombosis and stroke are major causes of disability and death worldwide. However, the regular antithrombotic drugs may have unsatisfactory results and side effects. Platonin, a cyanine photosensitizing dye, has been used to treat trauma, ulcers and some acute inflammation. Here, we explored the neuroprotective effects of platonin against middle cerebral artery occlusion (MCAO)-induced ischemic stroke in mice. Platonin(200 μg/kg) substantially reduced cerebral infarct volume, brain edema, neuronal cell death and neurological deficit scores, and improved the MCAO-reduced locomotor activity and rotarod performance...
February 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28164000/spinal-dural-arteriovenous-fistula-and-cecal-arteriovenous-malformation-in-a-boy
#19
Vimlesh Soni, Pankaj C Vaidya, Jitendra Kumar Sahu, Mukesh Yadav, Pratibha Singhi
Concurrent spinal dural arteriovenous fistula (AVF) and cecal arteriovenous malformation (AVM) are very rare. A 6-year old boy presented with lower limb paresis after trauma. On imaging work-up spinal dural AVF was found. It was managed with endovascular glue embolization. After two years, the boy presented with severe anemia and occult gastrointestinal tract (GIT) bleed. Cecal AVM was diagnosed and managed with embolization.
January 2017: APSP Journal of Case Reports
https://www.readbyqxmd.com/read/28163460/diode-laser-ear-piercing-a-novel-technique
#20
Bibilash Babu Suseela, Preethitha Babu, Ravi Kumar Chittoria, Devi Prasad Mohapatra
Earlobe piercing is a common office room procedure done by a plastic surgeon. Various methods of ear piercing have been described. In this article, we describe a novel method of laser ear piercing using the diode laser. An 18-year-old female patient underwent an ear piercing using a diode laser with a power of 2.0 W in continuous mode after topical local anaesthetic and pre-cooling. The diode laser was fast, safe, easy to use and highly effective way of ear piercing. The advantages we noticed while using the diode laser over conventional methods were more precision, minimal trauma with less chances of hypertrophy and keloids, no bleeding with coagulation effect of laser, less time taken compared to conventional method and less chance of infection due to thermal heat effect of laser...
October 2016: Journal of Cutaneous and Aesthetic Surgery
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