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https://www.readbyqxmd.com/read/29652745/severe-perineal-lacerations-after-vaginal-delivery-are-they-an-anesthesiologist-s-problem
#1
Feyce Peralta, Joseph Bradley Bavaro
PURPOSE OF REVIEW: Perineal tears or lacerations are common occurrences after vaginal delivery. Understanding the degree of severity of these tears and the immediate and long-term complications of severe perineal lacerations can assist anesthesiologists with the management of these patients in the immediate postpartum period. RECENT FINDINGS: Severe perineal lacerations have a high degree of association with postpartum depression. The presence of neuraxial labor analgesia decreases the odds of severe perineal lacerations...
April 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29651864/exogenous-skeletal-muscle-satellite-cells-promote-the-repair-of-levator-palpebrae-superioris-mechanical-damage-in-rat
#2
Lin Ye, Yuanyuan Yao, Hui Guo, Yun Peng
AIM OF THE STUDY: Blepharoptosis is a drooping of the upper eyelid, usually due to dysfunction of the levator palpebrae superioris (LPS). Recently, skeletal muscle satellite cells (SSCs) have been reported to promote the repair of damaged skeletal muscle. This study aims to investigate the potential contribution of exogenous SSCs to the regeneration of mechanically damaged LPS. MATERIALS AND METHODS: Thirty-two rats were randomly divided into four groups, including control group, SSCs-treated group, SSCs-treated injury group and non-treated injury group...
April 13, 2018: Connective Tissue Research
https://www.readbyqxmd.com/read/29629963/health-care-seeking-characteristics-of-women-with-pelvic-floor-disorders-after-obstetric-anal-sphincter-injury
#3
Jon F Pennycuff, Deborah R Karp, Julia Shinnick, Catherine O Hudson, Gina M Northington
OBJECTIVES: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS...
April 6, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29628615/pelvic-artery-embolization-for-treatment-of-postpartum-hemorrhage
#4
REVIEW
Jonathan D Lindquist, Robert L Vogelzang
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29622147/transcatheter-laceration-of-aortic-leaflets-to-prevent-coronary-obstruction-during-transcatheter-aortic-valve-replacement-concept-to-first-in-human
#5
Jaffar M Khan, Danny Dvir, Adam B Greenbaum, Vasilis C Babaliaros, Toby Rogers, Gabriel Aldea, Mark Reisman, G Burkhard Mackensen, Marvin H K Eng, Gaetano Paone, Dee Dee Wang, Robert A Guyton, Chandan M Devireddy, William H Schenke, Robert J Lederman
OBJECTIVES: This study sought to develop a novel technique called bioprosthetic or native aortic scallop intentional laceration to prevent coronary artery obstruction (BASILICA). BACKGROUND: Coronary artery obstruction is a rare but fatal complication of transcatheter aortic valve replacement (TAVR). METHODS: We lacerated pericardial leaflets in vitro using catheter electrosurgery, and tested leaflet splaying after benchtop TAVR. The procedure was tested in swine...
April 9, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29621998/a-factor-xia-activatable-hirudin-albumin-fusion-protein-reduces-thrombosis-in-mice-without-promoting-blood-loss
#6
William P Sheffield, Louise J Eltringham-Smith, Varsha Bhakta
BACKGROUND: Hirudin is a potent thrombin inhibitor but its antithrombotic properties are offset by bleeding side-effects. Because hirudin's N-terminus must engage thrombin's active site for effective inhibition, fusing a cleavable peptide at this site may improve hirudin's risk/benefit ratio as a therapeutic agent. Previously we engineered a plasmin cleavage site (C) between human serum albumin (HSA) and hirudin variant 3 (HV3) in fusion protein HSACHV3. Because coagulation factor XI (FXI) is more involved in thrombosis than hemostasis, we hypothesized that making HV3 activity FXIa-dependent would also improve HV3's potential therapeutic profile...
April 5, 2018: BMC Biotechnology
https://www.readbyqxmd.com/read/29619536/penetrating-femoral-artery-injuries-an-urban-trauma-centre-experience
#7
Shreya Rayamajhi, Nivashini Murugan, Andrew Nicol, Sorin Edu, Juan Klopper, Nadraj Naidoo, Pradeep Navsaria
AIM: This study reviews a single centre experience with penetrating femoral artery injuries. PATIENTS AND METHODS: The records of all patients with femoral artery injuries admitted to the Trauma Centre at Groote Schuur Hospital from January 2002 to December 2012 were reviewed. These were analysed for demographics, injury mechanism, perioperative, and surgical management. Outcome was categorised by limb salvage. RESULTS: One-hundred and fifty-eight (158) patients with femoral artery injuries were identified...
April 4, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29618914/in-depth-analysis-of-pattern-of-occupational-injuries-and-utilization-of-safety-measures-among-workers-of-railway-wagon-repair-workshop-in-jhansi-u-p
#8
Shubhanshu Gupta, Anil K Malhotra, Santosh K Verma, Rashmi Yadav
Context: Occupational injuries constitute a global health challenge, yet they receive comparatively modest scientific attention. Pattern of occupational injuries and its safety precautions among wagon repair workers is an important health issue, especially in developing countries like India. Aims: To assess the pattern of occupational injuries and utilization of safety measures among railway wagon repair workshop workers in Jhansi (U.P.). Settings and Design: Railway wagon repair workshop urban area, Jhansi (U...
September 2017: Indian Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29618191/delayed-massive-hemothorax-requiring-surgery-after-blunt-thoracic-trauma-over-a-5-year-period-complicating-rib-fracture-with-sharp-edge-associated-with-diaphragm-injury
#9
Sung Wook Chang, Kyoung Min Ryu, Jae-Wook Ryu
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29609261/-reliability-and-validity-of-the-simplified-chinese-version-of-the-fecal-incontinence-quality-of-life-questionnaire-in-the-patients-with-fecal-incontinence
#10
X X Gao, L Zhu, S J Yu, J R Ma, T Xu
Objective: To develop the Chinese version of the fecal incontinence quality of life (FIQL) questionnaire, and to validate them in Chinese population. Methods: Our study included 52 cases recruiting from outpatients diagnosed with fecal incontinence in Peking Union Medical College Hospital, fecal incontinence in Beijing City nursing homes for the elderly, and patients received perineal repair surgeries who suffered from perineal laceration and laceration in in Peking Union Medical College Hospital from October 2013 to 2016 December...
March 20, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29605791/use-of-postmortem-computed-tomography-to-retrieve-small-metal-fragments-derived-from-a-weapon-in-the-bodies-of-victims-in-two-homicide-cases
#11
Rie Sano, Yoichiro Takahashi, Akira Hayakawa, Masayuki Murayama, Rieko Kubo, Satoshi Hirasawa, Hiroyuki Tokue, Takehiro Shimada, Sachiko Awata, Hiroyuki Takei, Masahiro Yuasa, Shinji Uetake, Hisashi Akuzawa, Yoshihiko Kominato
Postmortem computed tomography (PMCT) is becoming a commonly used modality in routine forensic investigation. Mechanical injuries including lacerations, incisions, stab wounds and gunshot wounds frequently contain foreign bodies that may have significant value as clues in criminal investigations. CT is a sensitive modality for detection of metal foreign bodies that may be associated with injuries to the victim in cases of homicide or traffic accidents. Here we report two cases in which PMCT was able to act as a guide to forensic pathologists for retrieval of metal fragments in the corpses of the victims, the retrieved fragments then being used to validate the confessions of the assailants through comparison with the knife and the crowbar, respectively, that had been used in the crimes...
March 23, 2018: Legal Medicine
https://www.readbyqxmd.com/read/29605244/transcatheter-mitral-valve-replacement-after-transcatheter-electrosurgical-laceration-of-alfieri-stitch-elastic-first-in-human-report
#12
Jaffar M Khan, Robert J Lederman, Saurabh Sanon, Bradley G Leshnower, Altayyeb Yousef, Patrick Gleason, Stamatios Lerakis, Toby Rogers, Adam B Greenbaum, Vasilis C Babaliaros
No abstract text is available yet for this article.
March 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29602553/surgical-lung-biopsy-in-children-after-hematopoietic-cell-transplantation
#13
Lucia Ortega-Laureano, Teresa Santiago, Gabriela Maron, Andrew M Davidoff, Israel Fernandez-Pineda
BACKGROUND/PURPOSE: Pulmonary complications are some of the leading causes of morbidity and mortality in immunocompromised pediatric patients. We sought to assess the value of surgical lung biopsy (SLB) in hematopoietic cell transplantation (HCT) pediatric patients. METHODS: A retrospective review of patients who underwent SLB within one year of HCT between 1999 and 2015 was performed. RESULTS: Twenty-nine patients (15 females, 14 males) with a median age of 10years (range, 0...
March 6, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29593715/comparative-analysis-of-the-regulatory-t-cells-dynamics-in-peripheral-blood-in-human-and-porcine-polytrauma
#14
Rafael Serve, Ramona Sturm, Lukas Schimunek, Philipp Störmann, David Heftrig, Michel P J Teuben, Elsie Oppermann, Klemens Horst, Roman Pfeifer, Tim P Simon, Yannik Kalbas, Hans-Christoph Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
Background: Severely injured patients experience substantial immunological stress in the aftermath of traumatic insult, which often results in systemic immune dysregulation. Regulatory T cells (Treg) play a key role in the suppression of the immune response and in the maintenance of immunological homeostasis. Little is known about their presence and dynamics in blood after trauma, and nothing is known about Treg in the porcine polytrauma model. Here, we assessed different subsets of Treg in trauma patients (TP) and compared those to either healthy volunteers (HV) or data from porcine polytrauma...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29593199/falls-among-hospitalized-patients-in-an-acute-care-hospital-analyses-of-incident-reports
#15
Nori Sato, Naomi Hase, Akemi Osaka, Koichi Sairyo, Shinsuke Katoh
Falls cause injuries such as fractures, skin lacerations, bleeding, and head injury, and could result in more severe medical conditions in hospitalized patients. We retrospectively investigated the incidence and characteristics of falls among hospitalized patients in an acute care hospital from incident reports by hospital staff between January and June 2013. There were 154 falls in 135 patients, 2 of which resulted in fracture. The average age of patients who fell was 63.9 (range 0 to 91) years. Many falls occurred at the bedside (68...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29592978/hypoglossal-nerve-stimulation-for-obstructive-sleep-apnoea-in-a-patient-with-previous-tongue-laceration
#16
Joel W Jones, Kent Lee, Suzanne Stevens, Chris Larsen
Upper airway stimulation of the tongue using an implantable neurostimulator has recently been approved for select patients with moderate to severe obstructive sleep apnoea (OSA) and intolerance to continuous positive airway pressure therapy. Effective implantation depends on the integrity of the hypoglossal nerve as well as the tongue musculature, notably the genioglossus. Prior trauma to either of these structures may be viewed as a relative contraindication to implantation. We describe a case of successful right hypoglossal nerve implantation in a patient with a history of left cardiac pacemaker placement and severe left penetrating tongue trauma with decreased mobility from contracture and deviation mimicking a hypoglossal nerve palsy...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29584488/functional-outcomes-of-thoracic-injuries-in-pediatric-and-adult-occupants
#17
Ashley A Weaver, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: To develop a disability metric for motor vehicle crash (MVC) thoracic injuries and compare functional outcomes between pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank (NTDB) for the top 95% most frequently occurring AIS 2, 3, 4, and 5 thoracic injuries in NASS-CDS 2000-2011. The NTDB contains a truncated form of the FIM score, including three items (self-feed, locomotion, and verbal expression), each graded from full functional dependence to full functional independence...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29582175/exogenous-surfactant-as-a-bridge-to-prolonged-total-lung-rest-in-severely-injured-patient-during-extracorporeal-membrane-oxygenation
#18
Peter Sklienka, Jan Maca, Filip Bursa, Jan Neiser, Roman Kula, Marcela Kanova, Tomas Danek, Pavel Sevcik
We report a case of a 20-year-old male patient suffering from motorcycle accident complicated by rapid development of severe refractory hypoxemia and hypercapnia due to serious bilateral lung contusions and lacerations. Positive pressure mechanical ventilation induced pressure-dependent massive air leak from disrupted pulmonary tissue. Simultaneous implementation of veno-venous extracorporeal membrane oxygenation together with surfactant application allowed prolonged disconnection of patient from mechanical ventilation ("total lung rest" mode)...
March 27, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29581925/isolated-renal-laceration-on-point-of-care-ultrasound
#19
Madeline M Grade, Cori Poffenberger, Viveta Lobo
We report a renal laceration identified on a point-of-care ultrasound (POCUS) performed in the emergency department on a 58-year-old female presenting after blunt trauma. Emergency workup demonstrated a right flank abrasion with tenderness to palpation, hematuria, and decreasing hematocrit. A Focused Assessment with Sonography in Trauma (FAST) exam, performed as part of the intake trauma protocol, identified positive intraperitoneal fluid in the right upper quadrant. A computed tomography (CT) scan established a diagnosis of isolated right renal hematoma arising from a Grade IV laceration, with no collecting duct involvement...
January 25, 2018: Curēus
https://www.readbyqxmd.com/read/29580357/severe-bleeding-in-pelvic-fractures-considerations-in-planning-damage-control
#20
Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Lydia Lam, Demetrios Demetriades
Severe bleeding due to pelvic fractures may require damage control procedures, such as preperitoneal packing. In many cases, preperitoneal packing is performed without full abdominal exploration. There are concerns that such an approach may miss major iliac vascular injuries or other intraabdominal injuries. This analysis assessed the incidence of iliac vascular and intraabdominal injuries in patients with pelvic fractures. The National Trauma Data Bank was queried for blunt trauma patients. Patients with severe pelvic fractures were observed...
February 1, 2018: American Surgeon
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