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https://www.readbyqxmd.com/read/29351269/bipolar-or-monopolar-transurethral-resection-for-benign-prostatic-hyperplasia
#1
Gabriel Inzunza, Gabriel Rada, Alejandro Majerson
INTRODUCTION: Transurethral resection is currently considered as standard endoscopic treatment for lower urinary tract obstruction due to benign hyperplasia under 80 cc. Monopolar resection loops has been traditionally used but bipolar energy has recently displaced precedent technology. The purpose of this summary is to evaluate the efficacy and safety of both technologies. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
January 17, 2018: Medwave
https://www.readbyqxmd.com/read/29349908/robotic-assisted-coronary-artery-bypass-surgery-an-18-year-single-centre-experience
#2
Vincenzo Giambruno, Michael W Chu, Cristina Cucchietti, Douglas W Boyd, Bob Kiaii
BACKGROUND: Minimally invasive robot-assisted direct coronary artery bypass (RADCAB) has emerged as a feasible minimally invasive surgical technique for revascularization that might offer several potential advantages over conventional approaches. We present our 18-year experience in RADCAB. METHODS: Between February 1998 and February 2016, 605 patients underwent RADCAB. Patients underwent post-procedural selective graft patency assessment using cardiac catheterization...
January 19, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#3
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#4
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29344790/prospective-analysis-of-delayed-colorectal-post-polypectomy-bleeding
#5
Soo-Kyung Park, Jeong Yeon Seo, Min-Gu Lee, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jung, Ho-Kyung Chun, Dong Il Park
BACKGROUNDS/AIMS: Although post-polypectomy bleeding is the most frequent complication after colonoscopic polypectomy, only few studies have investigated the incidence of bleeding prospectively. The aim of this study was to investigate the incidence of delayed post-polypectomy bleeding and its associated risk factors prospectively. METHODS: Patients who underwent colonoscopic polypectomy at Kangbuk Samsung Hospital from January 2013 to December 2014 were prospectively enrolled in this study...
January 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#6
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29338867/validation-of-a-definition-of-excessive-postoperative-bleeding-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#7
Rachel S Bercovitz, Allison C Shewmake, Debra K Newman, Robert A Niebler, John P Scott, Eckehard Stuth, Pippa M Simpson, Ke Yan, Ronald K Woods
OBJECTIVE: To derive and validate an objective definition of postoperative bleeding in neonates and infants undergoing cardiac surgery with cardiopulmonary bypass. METHODS: Using a retrospective cohort of 124 infants and neonates, we included published bleeding definitions and cumulative chest tube output over different postoperative periods (eg, 2, 12, or 24 hours after intensive care unit admission) in a classification and regression tree model to determine chest tube output volumes that were associated with red blood cell transfusions and surgical re-exploration for bleeding in the first 24 hours after intensive care unit admission...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29337665/safety-of-intravenous-tranexamic-acid-in-patients-undergoing-majororthopaedic-surgery-a-meta-analysis-of-randomised-controlled-trials
#8
REVIEW
Massimo Franchini, Carlo Mengoli, Marco Marietta, Giuseppe Marano, Stefania Vaglio, Simonetta Pupella, Pier Mannuccio Mannucci, Giancarlo M Liumbruno
Among the various pharmacological options to decrease peri-operative bleeding, tranexamic acid appears to be one of the most interesting. Several trials have consistently documented the efficacy of this synthetic drug in reducing the risk of blood loss and the need for allogeneic blood transfusion in patients undergoing total hip and knee arthroplasty. The safety of intravenous tranexamic acid in major orthopaedic surgery, particularly regarding the risk of venous thromboembolism, was systematically analysed in this review...
January 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29335914/accuracy-and-trending-of-non-invasive-hemoglobin-measurement-during-different-volume-and-perfusion-statuses
#9
Abdelmoneim Adel, Wael Awada, Bassant Abdelhamid, Heba Omar, Omnia Abd El Dayem, Ahmed Hasanin, Ashraf Rady
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation...
January 15, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29332421/comparison-of-two-weight-based-desmopressin-dosing-strategies-for-spontaneous-bleeding
#10
Miguel J Franquiz, Michelle C Hines, Siu Yan Amy Yeung
BACKGROUND: The pharmacokinetics and pharmacodynamics of desmopressin are appropriate for adjusted body weight-based dosing, particularly in obese patients. OBJECTIVE: The objective of this study was to describe desmopressin dosing strategies, with emphasis on hemostatic outcomes among patients without preexisting bleeding disorders. METHODS: This was a single-center, retrospective cohort study of patients who received intravenous weight-based desmopressin for a hemostatic indication...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29332316/how-do-i-implement-a-whole-blood-program-for-massively-bleeding-patients
#11
Mark H Yazer, Andrew P Cap, Philip C Spinella, Louis Alarcon, Darrell J Triulzi
Building on the successful military experience, interest has been rekindled in transfusing whole blood (WB) early in the resuscitation of traumatically injured civilians, often before their ABO group is known. WB efficiently provides treatment for shock and coagulopathy, as well as platelet hemostatic function, to patients losing large volumes of blood. Unlike group O uncrossmatched red blood cells (RBCs), group O WB contains a substantial amount of plasma, which is incompatible with the RBCs of all non-group O recipients...
January 14, 2018: Transfusion
https://www.readbyqxmd.com/read/29324609/outcomes-of-planned-compared-with-urgent-deliveries-using-a-multidisciplinary-team-approach-for-morbidly-adherent-placenta
#12
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Amir A Shamshirsaz, Ahmed A Nassr, Nathan C Sundgren, Jeffery A Jones, Matthew L Anderson, Elias Kassir, Bahram Salmanian, Alexandra W Buffie, Shiu-Ki Hui, Jimmy Espinoza, Lynda A Tyer-Viola, Martha Rac, Niloofar Karbasian, Jerasimos Ballas, Gary A Dildy, Michael A Belfort
OBJECTIVE: To compare outcomes between planned and urgent cesarean hysterectomy for morbidly adherent placenta managed by a multidisciplinary team. METHODS: This is a retrospective case-control study of women with singleton pregnancies with antenatally suspected and pathologically confirmed morbidly adherent placenta who underwent cesarean hysterectomy between January 1, 2011, and February 30, 2017. Timing of delivery was classified as either planned (delivery at 34-35 weeks of gestation) or urgent (need for urgent delivery as a result of uterine contractions, bleeding, or both)...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#13
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29318636/a-multicentred-study-to-validate-a-consensus-bleeding-assessment-tool-developed-by-the-biomedical-excellence-for-safer-transfusion-collaborative-for-use-in-patients-with-haematological-malignancy
#14
C Dyer, C R Alquist, M Cole-Sinclair, E Curnow, N M Dunbar, L J Estcourt, R Kaufman, J M Kutner, J McCullough, Z McQuilten, L Potiphar, B Rioux-Masse, S Slichter, A Tinmouth, K Webert, A P Yokoyama, S J Stanworth
BACKGROUND: There continues to be uncertainty about the optimal approach to documenting bleeding data in platelet transfusion trials, with a desire to apply a common assessment tool across all trials. With this in mind, a consensus bleeding assessment tool (BAT) has been developed by the Biomedical Excellence for Safer Transfusion (BEST) collaborative, based on review of data collection forms used in published randomized trials and following content validation with a range of healthcare professionals at seven haematology centres through BEST members...
January 10, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#15
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29315622/patient-rescue-and-blood-utilization-in-the-ogasawara-blood-rotation-system
#16
Tomoko Igarashi, Hiroshi Fujita, Hiroyuki Asaka, Yuko Takada, Rieko Ametani, Itsuki Naya, Yasushi Tanaka, Makoto Kamesaki, Asuka Kasai
BACKGROUND: In the past, blood products were not transported to the Ogasawara Islands because of the distance; the islands are approximately 1000 km from the mainland and lack an airport. The Ogasawara Blood Rotation system involves the routine, long-distance transportation of Type O, RhD-positive, irradiated red blood cells to rescue patients with acute hemorrhage and severe anemia and to reduce wastage from the expiration of red blood cell solution. STUDY DESIGN AND METHODS: Blood transfusion and utilization in the Ogasawara blood rotation (BR) system were examined from December 2014 to March 2017...
January 7, 2018: Transfusion
https://www.readbyqxmd.com/read/29313587/hereditary-haemorrhagic-telangiectasia-with-severe-anemia-and-recurrent-cns-infections
#17
Nrushen Peesapati, Pbpr Naidu, S Sunitha, P V Sivaram
Hereditary Haemorrhagic Telangiectasia, also known as Osler-Rendu-Weber disease is a rare autosomal dominant disorder affecting small vessels of multiple systems whose main pathological change is the presence of abnormal arteriovenous communications. Usually presents as skin and mucosal telangiectasias, epistaxis, gastrointestinal bleeding and visceral arteriovenous malformations. Although the epistaxis and gastrointestinal blood loss can result in anaemia, patients with hereditary haemorrhagic telangiectasia rarely presents as severe anaemia1 or CNS infections...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29311398/acute-variceal-bleeding-does-octreotide-improve-outcomes-in-patients-with-different-functional-hepatic-reserve
#18
Roberto Monreal-Robles, Carlos A Cortez-Hernández, José A González-González, Juan G Abraldes, Francisco J Bosques-Padilla, Héctor N Silva-Ramos, Jorge A García-Flores, Héctor J Maldonado-Garza
BACKGROUND: Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. MATERIAL AND METHODS: In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus endoscopic therapy (ET) and 216 patients with ET alone were compared in terms of failure to control bleeding, in-hospital mortality, and transfusion requirements stratifying the results according to liver disease severity by Child-Pugh (CP) score and MELD...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29310411/evaluating-a-magnetic-resonance-imaging-of-the-third-trimester-abdominal-pregnancy-what-the-radiologist-needs-to-know
#19
Mei-Xiang Deng, Yu Zou
INTRODUCTION: A 33-week abdominal pregnancy is an extremely rare type of ectopic pregnancy that is potentially life-threatening for the mother and fetus. Reports of using magnetic resonance imaging (MRI) in the third-trimester abdominal pregnancy are very few. PATIENT CONCERNS: A 24-year-old woman (gravida 2, para 1, living 0) at 33 weeks' gestation presented to local hospital complaining of vaginal bleeding for 2 months and lower abdominal pain for 2 days. Then, the woman was transferred to our hospital for suspected abdominal pregnancy, which was confirmed at our hospital on ultrasonography and further evaluated in detail on MRI...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306228/emergency-coronary-bypass-surgery-in-patients-under-the-influence-of-dualantiplatelet-therapy-effects-of-tranexamic-acid-and-desmopressin-acetate
#20
Gökalp Altun, Doğuş Hemşinli, Zerrin Pulathan, Ali Civelek
Background/aim: Bleeding in patients undergoing coronary artery bypass grafting (CABG) while using dual antiplatelet therapy (DAPT) is a cause of significant morbidity and mortality. The aim of this study is to examine the perioperative hemostatic effects of tranexamic acid (TnX-A) and desmopressin acetate (Des) in these patients. Materials and methods: This clinical study was planned in a prospective and randomized manner. Fifty-four patients were enrolled and classified into 4 different groups. They were compared in terms of various bleeding and transfusion parameters...
December 19, 2017: Turkish Journal of Medical Sciences
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