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https://www.readbyqxmd.com/read/29780141/hemorrhagic-stress-induced-gastric-ulcer-in-a-healthy-toddler
#1
Katsunori Matsueda, Tatsuya Toyokawa, Masahiro Sakata, Isao Fujita, Jouichiro Horii, Yoshiko Abe, Toru Araki
A 1-year-old female toddler who was under a great amount of psychological stress presented with acute hematemesis. She had no significant medical history; she displayed lethargy and was anemic. Although blood transfusion and famotidine were administered for upper gastrointestinal bleeding (UGIB), the anemia did not improve. Thus, early endoscopy was performed under general anesthesia, revealing a gastric ulcer with exposed vessels in the supra-angular region. Cauterization via bipolar hemostatic forceps was performed on the exposed vessels, and the bleeding was controlled successfully...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29778606/avatrombopag-before-procedures-reduces-need-for-platelet-transfusion-in-patients-with-chronic-liver-disease-and-thrombocytopenia
#2
Norah Terrault, Yi-Cheng Chen, Namiki Izumi, Zeid Kayali, Paul Mitrut, Won Young Tak, Lee F Allen, Tarek Hassanein
BACKGROUND & AIMS: Patients with thrombocytopenia and chronic liver disease (CLD) may require platelet transfusions before scheduled procedures to decrease risk of bleeding. We performed 2 randomized, placebo-controlled, phase 3 trials in patients with thrombocytopenia and CLD undergoing scheduled procedures to evaluate the safety and efficacy of avatrombopag in increasing platelet counts in this patient population METHODS: In the ADAPT-1 and ADAPT-2 studies, adults with thrombocytopenia and CLD (n=231 and n= 204, respectively) were in 1 of 2 cohorts according to their baseline platelet count (below 40x109 /L or 40-50x109 /L) and within each cohort randomized (2:1) to 5 daily doses of avatrombopag (60 mg if baseline platelet count below 40x109 /L or 40 mg if 40-50x109 /L) or placebo...
May 17, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#3
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29777786/photoselective-vaporisation-of-the-bladder-for-the-management-of-radiation-cystitis-technique-and-initial-outcomes
#4
Claire Pascoe, Daniel Christidis, Todd Manning, Benjamin W Lamb, Declan G Murphy, Nathan Lawrentschuk
Objective To describe our technique utilising photoselective vaporisation of the bladder (PVB) for the management of haemorrhagic cystitis and initial results of 12 patients. Materials and Method An audit of theatre records of a single surgeon was performed to identify patients who had undergone PVB for management of radiation-cystitis. TECHNIQUE: Rigid cystoscopy was performed. Ureteric catheters were placed and active bleeding sites targeted to optimise vision. Ablation was commenced using the vaporize function...
May 16, 2018: Urology
https://www.readbyqxmd.com/read/29776423/minimally-invasive-mitral-valve-repair-via-right-mini-thoracotomy-in-patient-with-myelodysplastic-syndrome
#5
Takura Taguchi, Hiroyuki Nishi, Kimihiro Kurose, Kohei Horikawa, Go Kanazawa, Toshiki Takahashi
BACKGROUND: Cardiac surgery for myelodysplastic syndrome (MDS) patients is challenging because anemia and neutropenia develop as a result of the syndrome, leading to infection and bleeding tendency during surgery. We report the case of minimally invasive mitral valve repair via a right mini-thoracotomy and perioperative use of granulocyte colony-stimulating factor (G-CSF) in a patient with MDS. CASE PRESENTATION: A 77-year-old man with myelodysplastic syndrome (MDS) was referred for surgical treatment for mitral valve regurgitation and underwent a minimally invasive mitral valve repair via a right mini-thoracotomy (MICS mitral procedure)...
May 18, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29775552/right-colon-resection-for-colon-cancer-does-surgical-approach-matter
#6
Ivy N Haskins, Tammy Ju, Matthew Skancke, Xiangyu Kuang, Richard L Amdur, Fred Brody, Vincent Obias, Samir Agarwal
BACKGROUND: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. MATERIALS AND METHODS: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database...
May 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29773572/hemostatic-efficacy-of-pathogen-inactivated-versus-untreated-platelets-a-randomized-controlled-trial
#7
Pieter F van der Meer, Paula F Ypma, Nan van Geloven, Joost A van Hilten, Rinie J van Wordragen-Vlaswinkel, Okke Eissen, Jaap J Zwaginga, MIchael Trus, Erik A M Beckers, Peter Te Boekhorst, Alan Tinmouth, Yulia Lin, Cyrus Hsia, David Lee, Philip J Norris, Raymond P Goodrich, Anneke Brand, Tor Hervig, Nancy M Heddle, Johanna G van der Bom, Jean-Louis H Kerkhoffs
Pathogen inactivation of platelet concentrates reduces the risk of blood-borne infections. However, its effect on platelet function and hemostatic efficacy of transfusion is unclear. We conducted a randomized noninferiority trial comparing the efficacy of pathogen inactivated platelets using riboflavin and ultraviolet B illumination technology (intervention) compared to standard plasma-stored platelets (control) for the prevention of bleeding in patients with hematologic malignancies and thrombocytopenia. The primary outcome parameter was the proportion of transfusion treatment periods in which the patient had grade 2 or higher bleeding as defined by World Health Organization (WHO) criteria...
May 17, 2018: Blood
https://www.readbyqxmd.com/read/29772593/-coagulation-monitoring-and-bleeding-management-in-cardiac-surgery
#8
Berthold Bein, Robert Schiewe
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29771870/hyperfibrinolysis-is-an-important-cause-of-early-hemorrhage-in-patients-with-acute-promyelocytic-leukemia
#9
Yu-Hua Song, Chun Qiao, Li-Chan Xiao, Run Zhang, Hua - Lu
BACKGROUND The objective of the current study was to guide the early clinical treatment strategies by assessing the recovery of abnormal coagulation in acute promyelocytic leukemia (APL) patients during induction therapy. MATERIAL AND METHODS Retrospective analysis was performed in 112 newly-diagnosed patients with APL during induction treatment. RESULTS The early death (ED) rate in our study was 5.36% and the main cause was fetal hemorrhage. The presence of bleeding symptoms was significantly correlated with low platelet and fibrinogen levels...
May 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#10
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29767837/romiplostim-for-the-management-of-perioperative-thrombocytopenia
#11
Hanny Al-Samkari, Ariela L Marshall, Katayoon Goodarzi, David J Kuter
Thrombocytopenic patients requiring invasive surgery have few options to improve their platelet count preoperatively. This is a single-centre, retrospective review of thrombocytopenic patients receiving the thrombopoietin receptor agonist romiplostim perioperatively to allow for surgical interventions. Patient characteristics, romiplostim use, and surgical and safety outcomes (bleeding, thrombosis, transfusions) were collected and analysed. Forty-seven patients underwent 51 surgical procedures (ranging from total hip arthroplasty to open cardiac surgery) with romiplostim support...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29766305/evaluation-of-vte-prophylaxis-and-the-impact-of-alternate-regimens-on-post-operative-bleeding-and-thrombotic-complications-following-bariatric-procedures
#12
Maria S Altieri, Jie Yang, Janos Hajagos, Konstantinos Spaniolas, Jihye Park, Antonios P Gasparis, Andrew T Bates, Salvatore Docimo, Mark Talamini, A Laurie Shroyer, Aurora D Pryor
BACKGROUND: Studies examining utilization and impact of venous thromboembolism (VTE) chemoprophylaxis for patients undergoing bariatric surgery are limited. Determination of the optimal prophylactic regimen to minimize complications is crucial. METHODS: The Cerner Health Facts database from 2003 to 2013 was queried using ICD-9 codes to identify patients undergoing laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). VTE chemoprophylaxis regimens were divided into pre-operative alone (PreP), post-operative alone (PostP), both pre-operative and post-operative (PPP), or no prophylaxis (NP)...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29765296/peripartum-haemorrhage-haemostatic-aspects-of-the-new-german-pph-guideline
#13
REVIEW
Heiko Lier, Christian von Heymann, Wolfgang Korte, Dietmar Schlembach
Summary Peripartum haemorrhage remains one of the main causes of maternal mortality world-wide. The German, Austrian and Swiss Societies of Gynaecology and Obstetrics have updated the current guidelines for the treatment of peripartum haemorrhage together with the German Society of Anaesthesiology and Intensive Care Medicine and the Society of Thrombosis and Haemostasis Research. The recommendations have been the result of a thorough review of the available scientific literature and a consensus process involving all members of the guideline group...
April 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29759670/systemic-octreotide-therapy-in-prevention-of-gastrointestinal-bleeds-related-to-arteriovenous-malformations-and-obscure-etiology-in-atrial-fibrillation
#14
Venkat Vuddanda, Mohammad-Ali Jazayeri, Mohit K Turagam, Madhav Lavu, Valay Parikh, Donita Atkins, Sudharani Bommana, Madhu Reddy Yeruva, Luigi Di Biase, Jie Cheng, Vijay Swarup, Rakesh Gopinathannair, Mojtaba Olyaee, Vijay Ivaturi, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The present study describes the use of octreotide (OCT) in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) who have gastrointestinal (GI) bleeding related to arteriovenous malformations (AVMs), as well as its effect on OAC tolerance and subsequent rebleeding. BACKGROUND: AVMs cause significant GI bleeding, especially in patients with AF who are receiving OAC for stroke prevention. OCT has been shown to minimize recurrent GI bleeds related to AVMs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#15
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29758592/comparison-of-a-therapeutic-only-versus-prophylactic-platelet-transfusion-policy-for-people-with-congenital-or-acquired-bone-marrow-failure-disorders
#16
REVIEW
Reem Malouf, Asma Ashraf, Andreas V Hadjinicolaou, Carolyn Doree, Sally Hopewell, Lise J Estcourt
BACKGROUND: Bone marrow disorders encompass a group of diseases characterised by reduced production of red cells, white cells, and platelets, or defects in their function, or both. The most common bone marrow disorder is myelodysplastic syndrome. Thrombocytopenia, a low platelet count, commonly occurs in people with bone marrow failure. Platetet transfusions are routinely used in people with thrombocytopenia secondary to bone marrow failure disorders to treat or prevent bleeding. Myelodysplastic syndrome is currently the most common reason for receiving a platelet transfusion in some Western countries...
May 14, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29758192/gastric-mucosal-metastasis-of-prostate-cancer
#17
Hayretdin Koklu, Gokhan Gedikoglu, Taylan Kav
A 65-year-old male patient who had been hospitalized in the ıntensive care unit for pneumonia presented with hematemesis and melena. He was diagnosed with metastatic adenocarcinoma of prostate (multiple bone and lung metastases), which was accompanied by diabetes mellitus, hypertension, and coronary heart disease. The hemoglobin levels decreased from 11.4 g/dL to 7.3 g/dL during follow-up. Upper endoscopy revealed widespread distribution of numerous umbilicated nodules with varying sizes (from 0.5 to 2 cm) on gastric mucosa (A, B, C)...
May 11, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29757897/coagulation-defects-in-the-cirrhotic-patient-undergoing-liver-transplantation
#18
Arabesque Parker, Constantine J Karvellas
Patients with cirrhosis undergoing liver transplantation have unique challenges with regard to the prevention and management of thrombosis and hemorrhage. Patients with cirrhosis have an unstable balance of the coagulation system due to defects in both prothrombotic and antithrombotic components. These changes make laboratory monitoring challenging, prophylaxis against bleeding and thrombosis controversial, and therapy for the same uncertain. When cirrhotic patients undergo liver transplantation they frequently have significant transfusion requirements...
May 7, 2018: Transplantation
https://www.readbyqxmd.com/read/29757132/safety-and-efficacy-of-tranexamic-acid-for-prevention-of-obstetric-haemorrhage-an-updated-systematic-review-and-meta-analysis
#19
REVIEW
Massimo Franchini, Carlo Mengoli, Mario Cruciani, Valentino Bergamini, Francesca Presti, Giuseppe Marano, Simonetta Pupella, Stefania Vaglio, Francesca Masiello, Eva Veropalumbo, Vanessa Piccinini, Ilaria Pati, Giancarlo M Liumbruno
BACKGROUND: A number of clinical systematic review and meta-analysis have been published on the use of tranexamic in the obstetric setting. The aim of this meta-analysis was to evaluate the safety and effectiveness of tranexamic acid in reducing blood loss when given prior to caesarean delivery. MATERIALS AND METHODS: We searched the Cochrane Wounds Specialized Register, Cochrane Central, MEDLINE (through PUBMED), Embase, and SCOPUS electronic databases. We also searched clinical trials registries for ongoing and unpublished studies, and checked reference lists to identify additional studies...
April 3, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29756664/patient-blood-management-how-is-implementation-going-a-report-comparing-the-2015-survey-with-the-2013-survey-of-pbm-in-england
#20
L Sherliker, K Pendry, B Hockley
BACKGROUND: Patient blood management (PBM) is an evidence-based approach to optimising the care of patients who might need transfusion. In 2013, all NHS Trusts in England were surveyed about their readiness to implement PBM. National PBM recommendations were launched in 2014. AIMS: The aim of this study was to determine progress of PBM initiatives. METHODS/MATERIALS: A survey was constructed by staff in hospitals and NHS Blood and Transplant (NHSBT)...
April 2018: Transfusion Medicine
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