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https://www.readbyqxmd.com/read/28301661/treatment-of-ocular-pyogenic-granuloma-with-topical-timolol
#1
Isdin Oke, Maan Alkharashi, Robert A Petersen, Alena Ashenberg, Ankoor S Shah
Importance: Pyogenic granulomas, acquired vascular lesions, form on the ocular or palpebral surface related to inflammation from chalazia, trauma, or surgery. They can be unsightly, spontaneously bleed, and cause irritation to patients. Observations: A case series is presented of 4 consecutive children with acquired ocular surface pyogenic granulomas treated at Boston Children's Hospital from 2014 to 2016 with only topical timolol, 0.5%, twice daily for a minimum of 21 days...
March 16, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#2
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28266293/emergency-pancreatico-duodenectomy-with-superior-mesenteric-and-portal-vein-resection-and-reconstruction-using-a-gore-tex-vascular-graft
#3
Mihai Adrian Eftimie, Vasile Lungu, Marian Tudoroiu, Genady Vatachki, Severina Batca, Leonard David
Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28265453/automated-closed-loop-resuscitation-of-multiple-hemorrhages-a-comparison-between-fuzzy-logic-and-decision-table-controllers-in-a-sheep-model
#4
Nicole Ribeiro Marques, Brent J Ford, Muzna N Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer
BACKGROUND: Hemorrhagic shock is the leading cause of trauma-related death in the military setting. Definitive surgical treatment of a combat casualty can be delayed and life-saving fluid resuscitation might be necessary in the field. Therefore, improved resuscitation strategies are critically needed for prolonged field and en route care. We developed an automated closed-loop control system capable of titrating fluid infusion to a target endpoint. We used the system to compare the performance of a decision table algorithm (DT) and a fuzzy logic controller (FL) to rescue and maintain the mean arterial pressure (MAP) at a target level during hemorrhages...
2017: Disaster Mil Med
https://www.readbyqxmd.com/read/28264245/clinical-course-and-results-of-surgery-for-chronic-subdural-hematomas-in-patients-on-drugs-affecting-hemostasis
#5
Tomasz Andrzej Dziedzic, Przemysław Kunert, Andrzej Marchel
OBJECTIVE: An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). METHODS: This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups: on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%)...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28255506/spinal-epidural-hematoma-related-to-vertebral-fracture-in-an-atypical-rigid-diffuse-idiopathic-skeletal-hyperostosis-a-case-report
#6
José Ramírez Villaescusa, Marcela Restrepo Pérez, David Ruiz Picazo
INTRODUCTION: Spinal epidural hematoma (SEH) is a rare disease that causes cord compression and neurologic deficit. Spontaneous SEH is related to minor trauma, bleeding disorders, and anticoagulant medications. Posttraumatic SEH has been associated with low-energy spine hyperextension injuries in patients with ankylosing spinal disorders such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). A variant named atypical DISH-like with SEH is reported. OBJECTIVE: To describe the management, diagnosis, and treatment of an unusual SEH case in a patient causing delayed neurologic deficit with rigid atypical DISH-like spine...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28243715/volume-replacement-during-trauma-resuscitation-a-brief-synopsis-of-current-guidelines-and-recommendations
#7
REVIEW
M Maegele, M Fröhlich, M Caspers, S Kaske
INTRODUCTION: Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. METHODS: A synopsis of best current knowledge with reference to the following guidelines and recommendations is presented: (1) The European Guideline on Management of Major Bleeding and Coagulopathy following Trauma (fourth edition), (2) S3 Guideline on Treatment of Patients with Severe and Multiple Injuries [English Version of the German Guideline S3 Leitlinie Polytrauma/Schwerverletzten-Behandlung/AWMF Register-Nr...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28242237/transarterial-embolization-in-maxillofacial-intractable-potentially-life-threatening-hemorrhage
#8
Dani Noy, Adi Rachmiel, Omri Emodi, Yaakov Amsalem, Yair Israel, Rafael M Nagler
PURPOSE: Although transarterial embolization (TAE) of vascular lesions with embolizing agents through angiographic catheters has been used for more than 45 years, reports of life-threatening maxillofacial bleeding are relatively rare and have not been updated. The authors review treatment modalities, present their experience of the past 21 years, and suggest a comprehensive algorithm and guidelines for the use of TAE in the treatment of intractable life-threatening maxillofacial hemorrhage...
February 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28241151/outcomes-associated-with-resuming-warfarin-treatment-after-hemorrhagic-stroke-or-traumatic-intracranial-hemorrhage-in-patients-with-atrial-fibrillation
#9
Peter Brønnum Nielsen, Torben Bjerregaard Larsen, Flemming Skjøth, Gregory Y H Lip
Importance: The increase in the risk for bleeding associated with antithrombotic therapy causes a dilemma in patients with atrial fibrillation (AF) who sustain an intracranial hemorrhage (ICH). A thrombotic risk is present; however, a risk for serious harm associated with resumption of anticoagulation therapy also exists. Objective: To investigate the prognosis associated with resuming warfarin treatment stratified by the type of ICH (hemorrhagic stroke or traumatic ICH)...
February 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28230248/effectiveness-of-early-administration-of-tranexamic-acid-in-patients-with-severe-trauma
#10
A Shiraishi, S Kushimoto, Y Otomo, H Matsui, A Hagiwara, K Murata
BACKGROUND: A reduction in mortality with the early use of tranexamic acid has been demonstrated in severely injured patients who are bleeding. However, the modest treatment effect with no reduction in blood transfusion has raised concerns. The aim of the present study was to estimate the effectiveness of regular use of tranexamic acid in severely injured patients. METHODS: This multicentre observational study used retrospectively collected data from consecutive injured patients (Injury Severity Score at least 16) treated in 15 Japanese academic institutions in 2012...
February 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28228201/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#11
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28219084/diagnosis-and-treatment-of-hyperfibrinolysis-in-trauma-a-european-perspective
#12
Lewis S Gall, Karim Brohi, Ross A Davenport
Fibrinolysis activation occurs almost universally after severe trauma. Systemic hyperfibrinolysis is a key component of acute traumatic coagulopathy and associated with poor clinical outcomes, although controversy exists over optimal treatment strategies. The mechanistic drivers and dynamics of fibrinolytic activation in response to injury and trauma resuscitation are currently unclear. Furthermore, therapeutic triggers are compounded by the lack of a sensitive and rapid diagnostic tool, with discrepancy between hyperfibrinolysis diagnosed by viscoelastic hemostatic assays versus biomarkers for fibrinolysis...
March 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#13
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/28176906/comparison-of-outcomes-between-minimally-invasive-transforaminal-lumbar-interbody-fusion-and-traditional-posterior-lumbar-intervertebral-fusion-in-obese-patients-with-lumbar-disk-prolapse
#14
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/28162908/does-bacterial-translocation-influence-the-postoperative-infections-in-splenectomized-patients-after-abdominal-trauma
#15
Mario Schietroma, Beatrice Pessia, Sara Colozzi, Francesco Carlei, Gianfranco Amicucci
BACKGROUND: Some studies suggested that after abdominal trauma, postoperative infections are associated with bacterial translocation, whereas others have not replicated these findings. We have assessed the bacterial translocation and postoperative infections in patients undergoing splenectomy after abdominal trauma, using a very homogeneous study population. METHODS: We consecutively studied, in a prospective observational clinical study, 125 patients who required urgent surgical treatment (splenectomy) following blunt abdominal trauma...
February 2, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28149820/comparison-of-the-hemostatic-effects-of-oxidized-cellulose-and-calcium-alginate-in-an-experimental-animal-model-of-hepatic-parenchymal-bleeding
#16
Mustafa Erman Dorterler, Harun Resit Ayangil, Cüneyt Turan, Kemal Deniz
BACKGROUND: Despite all recent developments, bleeding is still one of the main causes of increasing morbidity and mortality following both trauma and elective hepatic surgery. The main goal of treatment is stop the bleeding immediately. In this study, the hemostatic and histopathological effects of Ankaferd blood stopper (ABS), oxidized cellulose (OC), and calcium alginate (CA) were compared in an experimental liver injury. MATERIALS AND METHODS: Forty Wistar albino rats were randomly divided into four groups of ten animals each, receiving 0...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28143564/tranexamic-acid-in-bleeding-trauma-patients-an-exploration-of-benefits-and-harms
#17
Ian Roberts, Phil Edwards, David Prieto, Miland Joshi, Abda Mahmood, Katharine Ker, Haleema Shakur
BACKGROUND: The CRASH-2 trial showed that tranexamic acid (TXA) administration reduces mortality in bleeding trauma patients. However, the effect appeared to depend on how soon after injury TXA treatment was started. Treatment within 3 h reduced bleeding deaths whereas treatment after 3 h increased the risk. We examine how patient characteristics vary by time to treatment and explore whether any such variations explain the time-dependent treatment effect. METHODS: Exploratory analysis were carried out, including per-protocol analyses, of data from the CRASH-2 trial, a randomised placebo-controlled trial of the effect of TXA on mortality in 20,211 trauma patients with, or at risk of, significant bleeding...
January 31, 2017: Trials
https://www.readbyqxmd.com/read/28142178/impact-of-abdominal-follow-up-sonography-in-trauma-patients-without-abdominal-parenchymal-organ-lesion-or%C3%A2-free-intraabdominal-fluid-in-whole-body-computed-tomography
#18
Emmanuel Schneck, Christian Koch, Mara Borgards, Martin Reichert, Andreas Hecker, Christian Heiß, Winfried Padberg, Enrique Alejandre-Lafont, Rainer Röhrig, Gabriele Anja Krombach, Markus Weigand, Michael Bernhard, Fritz Christian Roller
Purpose Patients suffering from severe blunt abdominal trauma are challenging because of their need for accurate diagnostic imaging and fast therapeutic action. Whole-body computed tomography (WBCT) is highly sensitive and represents the gold standard in the trauma room diagnostic setting. The aim of our study was to investigate the impact and therapy relevance of abdominal follow-up sonography (AFS) as part of the tertiary trauma survey (TTS) in patients without abdominal parenchymal organ lesions or free abdominal fluid in initial WBCT...
February 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28079258/combined-effect-of-therapeutic-strategies-for-bleeding-injury-on-early-survival-transfusion-needs-and-correction-of-coagulopathy
#19
K Balvers, S van Dieren, K Baksaas-Aasen, C Gaarder, K Brohi, S Eaglestone, S Stanworth, P I Johansson, S R Ostrowski, J Stensballe, M Maegele, J C Goslings, N P Juffermans
BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. METHODS: A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate)...
February 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28077534/reduced-mortality-by-meeting-guideline-criteria-before-using-recombinant-activated-factor-vii-in-severe-trauma-patients-with-massive-bleeding
#20
J-F Payen, M Berthet, C Genty, P Declety, D Garrigue-Huet, N Morel, P Bouzat, B Riou, J-L Bosson
BACKGROUND: Management of trauma patients with severe bleeding has led to criteria before considering use of recombinant activated factor VII (rFVIIa), including haemoglobin >8 g dl(-1), serum fibrinogen ≥1.0 g l(-1), platelets >50,000 x 10(9) l(-1), arterial pH ≥ 7.20, and body temperature ≥34 °C. We hypothesized that meeting these criteria is associated with improved outcomes. METHODS: In this prospective cohort study of 26 French trauma centres, subjects were included if they received rFVIIa for persistent massive bleeding despite appropriate care after severe blunt and/or penetrating trauma...
October 2016: British Journal of Anaesthesia
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