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Trauma bleeding

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https://www.readbyqxmd.com/read/28547840/performance-of-norwegian-civilian-emts-and-army-medics-in-penetrating-trauma-a-controlled-simulation-based-assessment
#1
S W Blix, J Melau, I Lund-Kordahl
BACKGROUND: Penetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was that civilian pre-hospital systems perform at a lower level compared to an expert group, and did not have sufficient focus on education and training in examination and treatment of penetrating injuries...
May 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28545266/-analysis-of-misssed-diagnosis-and-misdiagnosis-of-1-212-cases-with-placental-abruption
#2
D Xu, C Liang, J W Xu, J He
Objective: To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods: A retrospective analysis was conducted in 135 584 women who delivered in Women's Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1 212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups. (1) The diagnosis was consistent prenatally and postnatally in 715 cases(58...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28544698/the-use-of-antifibrinolytics-in-pediatric-patients-with-hypoproliferative-thrombocytopenia
#3
Meghan Delaney, Dana C Matthews, Terry B Gernsheimer
Despite the use of evidence-based platelet transfusion therapy during periods of hypoproliferative thrombocytopenia, a large proportion of pediatric hematology/oncology patients continue to suffer from clinically significant bleeding. Antifibrinolytic (AF) drugs have been shown in certain surgical and trauma settings to decrease bleeding, blood transfusion, and improve survival. We conducted a retrospective assessment of the safety of using AF drugs in pediatric patients with hypoproliferative thrombocytopenia at our center as well as the impact on bleeding occurrence and severity...
May 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#4
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28537413/two-stage-surgical-treatment-of-inferior-vena-cava-traumatic-rupture-including-urgent-transport-to-a-specialized-unit
#5
J Kristek, P Hromádka, M Konarik, J Froněk
Inferior vena cava injury as well as major liver injury remains a formidable treatment challenge. The most imminent danger is life-threatening bleeding. In this report, we present a case of polytrauma (Injury Severity Score 35) with arupture of the juxtahepatic inferior vena cava which was successfully treated using two-stage approach. The first part of the treatment consisted of damage control laparotomy at a level I trauma center. After stabilization, the patient was air-transported to receive the definitive treatment at a tertiary care facility experienced in hepatopancreatobiliary and transplantation surgery...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28536048/cell-free-dna-inflammation-and-the-initiation-of-spontaneous-term-labor
#6
Christina A Herrera, Jay Stoerker, John Carlquist, Gregory J Stoddard, Marc Jackson, Sean Esplin, Nancy C Rose
BACKGROUND: Hypomethylated cell-free DNA (cfDNA) from senescent placental trophoblasts may be involved in the activation of the inflammatory cascade to initiate labor. OBJECTIVE: To determine the changes in cfDNA concentrations, the methylation ratio, and inflammatory markers between women in labor at term versus women without labor. STUDY DESIGN: In this prospective cohort study, eligible participants carried a non- anomalous singleton fetus...
May 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28534332/-efficacy-comparison-of-robotic-and-laparoscopic-radical-surgery-in-the-treatment-of-middle-low-rectal-cancer
#7
Hairong Zhang, Weitang Yuan, Quanbo Zhou, Xiaoming Gu, Fuqi Wang
OBJECTIVE: To compare the clinical efficacy of robotic and laparoscopic radical surgery in the treatment of middle-low rectal cancers. METHODS: From January 2015 to March 2016, intra-operative and postoperative follow-up data of 30 patients with middle-low rectal cancers who underwent robotic radical resection(robot group) and 32 patients with middle-low rectal cancers who underwent laparoscopic radical resection (laparoscopy group)n in our department were retrospectively collected...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28533933/negative-wound-pressure-therapy-is-safe-and-useful-in-pediatric-burn-patients
#8
Yanhan Ren, Philip Chang, Robert L Sheridan
INTRODUCTION: Negative Pressure Wound Therapy (NPWT) has proven to be a powerful tool in facilitating healing of difficult wounds of a variety of etiologies. The pediatric experience with NPWT has been limited due to concerns about vascular compression and pain associated with treatment. METHOD: A retrospective review was performed to evaluate the therapeutic effect of NPWT on children with difficult wounds due to burns or soft-tissue trauma. NPWT was instituted in the operating room under general anesthesia using a commercially available system...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28530778/a-comparison-of-the-treatment-results-of-dpen-reduction-internal-fixation-and-intramedullary-nailing-in-adult-forearm-diaphyseal-fractures
#9
Ahmet Köse, Ali Aydın, Naci Ezirmik, Ömer Selim Yıldırım
BACKGROUND: We compared the union and functional results of intramedullary nailing and open reduction internal fixation treatment applied to adults with a forearm diaphysis fracture (fracture of the radius and/or ulna). METHODS: We retrospectively examined 90 patients with completed skeletal maturation who were surgically treated for a forearm diaphyseal fracture. Patients with a Monteggia Galeazzi and ipsilateral upper extremity fracture and those with an open epiphyseal line, Type 3 open fracture, pathological fracture, or brain trauma were excluded from the study...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28529680/-beyond-saving-lives-current-perspectives-of-interventional-radiology-in-trauma
#10
REVIEW
Anuradha Singh, Atin Kumar, Pawan Kumar, Subodh Kumar, Shivanand Gamanagatti
Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28528487/role-of-medicines-of-unknown-identity-in-adverse-drug-reaction-related-hospitalizations-in-developing-countries-evidence-from-a-cross-sectional-study-in-a-teaching-hospital-in-the-lao-people-s-democratic-republic
#11
Céline Caillet, Chanvilay Sichanh, Gaëtan Assemat, Myriam Malet-Martino, Agnès Sommet, Haleh Bagheri, Noudy Sengxeu, Niphonh Mongkhonmath, Mayfong Mayxay, Lamphone Syhakhang, Maryse Lapeyre-Mestre, Paul N Newton, Anne Roussin
INTRODUCTION: The health dangers of medicines of unknown identity (MUIs) [loose pharmaceutical units repackaged in individual bags without labelling of their identity] have been suspected in L/MICs. Using visual and analytical tools to identify MUIs, we investigated the frequency of, and factors associated with, adverse drug reaction (ADR)-related hospitalizations in a central hospital in Vientiane Capital, Lao People's Democratic Republic (PDR). METHODS: All unplanned admissions, except for acute trauma and intentional overdose, were prospectively recorded during a 7-week period in 2013, leading to include 453 adults hospitalized for ≥24 h...
May 20, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#12
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28523330/hemobilia-by-idiopathic-aneurysm-of-cystic-artery-fistulized-in-the-biliary-ways-clinical-case
#13
Bogdan Dan Totolici, Carmen NeamŢu, Florian Dorel Bodog, Simona Gabriela Bungău, Dan Silviu Goldiş, Marius Matei, Octavian Aurel Andercou, Oana Lucia Amza, Zsolt Gyori, Liliana Coldea
Aneurysm of the cystic artery is not common, and it is a rare cause of hemobilia. Most of reported cases are pseudoaneurysms resulting from either an inflammatory process in the abdomen or abdominal trauma. We report a healthy individual who developed hemobilia associated with cystic artery aneurysm. Visceral artery aneurysms are rare and can rupture with potentially grave outcome due to excessive bleeding. The patient was managed with cholecystectomy and concomitant aneurysm repair.
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523318/hemobilia-through-aneurysm-of-the-right-hepatic-artery-22-months-after-laparoscopic-cholecystectomy-case-presentation
#14
Octavian Marius CreŢu, Radu Gheorghe Dan, Iulian Alexandru Ciprian Blidişel, LaurenŢiu Vasile Sima, Mihnea Munteanu, Ion Păun
Hemobilia is a rare cause of upper digestive bleeding, and it should be suspected when there are traumas of the liver area or surgical or exploratory interventions of the liver-bile-pancreas area in the patient's history. Iatrogenic bleeding occurs, most often, after transcutaneous bile punctures, laparoscopic cholecystectomies, cateterisms of the biliary ways. After such interventions, hemobilia may appear earlier, but also up to a few months later. We present a case of massive hemobilia occurring 22 months after a laparoscopic cholecystectomy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28520687/3-nacl-adenosine-lidocaine-mg2-alm-bolus-and-4-hours-drip-infusion-reduces-noncompressible-hemorrhage-by-60-in-a-rat-model
#15
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine, and Mg (ALM) bolus and 0.9% NaCl/ALM "drip" on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. METHODS: Male Sprague-Dawley rats (428 ± 4 g) were anesthetized and randomly assigned to one of five groups (n = 16): (1) Sham, (2) No treatment, (3) Saline controls, (4) ALM therapy, and (5) Hextend...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#16
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28509781/correction-of-severe-coagulopathy-and-hyperfibrinolysis-by-tranexamic-acid-and-recombinant-factor-viia-in-a-cirrhotic-patient-after-trauma-a-case-report
#17
Jack Louro, Katherine Andersen, Roman Dudaryk
Coagulopathy induced by trauma or cirrhosis is a well-recognized entity. Viscoelastic testing has been used in either condition for goal-directed transfusion and detection of fibrinolysis since conventional coagulation tests do not correlate with clinical risk of bleeding. Hemostatic resuscitation may not be adequate for a trauma patient with liver disease due to complex alterations in coagulation systems and occasionally require adjuvant therapy. We report a case of trauma-induced coagulopathy presenting as severe hyperfibrinolysis in a cirrhotic patient who was refractory to hemostatic resuscitation but was rapidly corrected by the administration of tranexamic acid and recombinant Factor VIIa...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#18
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28507366/over-a-decade-of-changing-trends-in-surgical-mortality-audit-from-a-tertiary-care-hospital
#19
Hassaan Bari, Khawaja Mohammad Inam Pal, Akbar Jaleel Zubairi
OBJECTIVE: A retrospective audit of the trend of mortality in the general surgery service at our hospital over the last decade was conducted to reflect the complexity of cases being seen. METHODS: Mortalities of 8 separate years, a decade apart, namely 1997, 1998, 1999, and 2000 as initial years (Group-I) and 2011, 2012, 2013 and 2014 as recent years (Group-II) were reviewed. RESULTS: Total number of admissions in the service and surgeries performed during these two periods experienced an increase of 50...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#20
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
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