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https://www.readbyqxmd.com/read/29458216/institution-of-a-comprehensive-postpartum-hemorrhage-bundle-at-a-large-academic-center-does-not-immediately-reduce-maternal-morbidity
#1
Rebecca Feldman Hamm, Eileen Wang, Kathleen O'Rourke, April Romanos, Sindhu K Srinivas
OBJECTIVE: Obstetric hemorrhage is a leading cause of morbidity and mortality. We sought to assess whether institution of a postpartum hemorrhage (PPH) bundle could improve maternal morbidity in our population. STUDY DESIGN: Preintervention data (PRE) was collected on all deliveries at Hospital of the University of Pennsylvania between October 15, 2013 and December 15, 2013. A two-pronged, multidisciplinary educational and procedural intervention related to PPH was instituted from March 2015 to June 2015...
February 19, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29443507/three-dimensional-directionality-is-a-pivotal-structural-feature-for-the-bioactivity-of-azabisphosphonate-capped-poly-phosphorhydrazone-nanodrug-dendrimers
#2
Myriam Hayder, Matteo Garzoni, Davide Bochicchio, Anne-Marie Caminade, François Couderc, Varravaddheay Ong-Meang, Jean-Luc Davignon, Cédric-Olivier Turrin, Giovanni M Pavan, Remy Poupot
Dendrimers are nanosized, non-linear, hyperbranched polymers whose overall three-dimensional shape is key for their biological activity. Poly(PhosphorHydrazone) (PPH) dendrimers capped with aza-bisphosphonate (ABP) end groups are known to have anti-inflammatory properties enabling the control of inflammatory diseases in different mouse models. Here we screen the anti-inflammatory activity of a series of PPH bearing between 2 and 16 ABP end groups in a mouse model of arthritis, and confront the biological results with atomistic simulations of the dendrimers...
February 14, 2018: Biomacromolecules
https://www.readbyqxmd.com/read/29427752/diagnosis-and-treatment-efficacy-of-digital-subtraction-angiography-and-transcatheter-arterial-embolization-in-post-pancreatectomy-hemorrhage-a-single-center-retrospective-cohort-study
#3
Yuan Fang, Xu Han, Lingxiao Liu, Wenhui Lou
BACKGROUND: To evaluate the diagnostic and treatment efficacy of digital subtraction angiography (DSA), transcatheter arterial embolization (TAE) in post-pancreatectomy hemorrhage (PPH). MATERIALS AND METHODS: This is a single-center retrospective cohort study. Clinicopathological data of 23 patients with PPH from August 2009 to November 2016 were collected. We observed (1) DSA procedures and hemorrhagic sites (2) TAE: successful rate and complications (3) Follow-up...
February 7, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29422014/development-of-a-tailored-strategy-to-improve-postpartum-hemorrhage-guideline-adherence
#4
Suzan M de Visser, Mallory D Woiski, Richard P Grol, Frank P H A Vandenbussche, Marlies E J L Hulscher, Hubertina C J Scheepers, Rosella P M G Hermens
BACKGROUND: Despite the introduction of evidence based guidelines and practical courses, the incidence of postpartum hemorrhage shows an increasing trend in developed countries. Substandard care is often found, which implies an inadequate implementation in high resource countries. We aimed to reduce the gap between evidence-based guidelines and clinical application, by developing a strategy, tailored to current barriers for implementation. METHODS: The development of the implementation strategy consisted of three phases, supervised by a multidisciplinary expert panel...
February 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29417353/perioperative-management-with-phosphodiesterase-type-5-inhibitor-and-prostaglandin-e1-for-moderate-portopulmonary-hypertension-following-adult-to-adult-living-donor-liver-transplantation-a-case-report
#5
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29412439/new-simplified-screening-method-for-postprandial-hypotension-in-older-people
#6
R Abbas, A Tanguy, D Bonnet-Zamponi, R Djedid, A Lounis, M-L Gaubert-Dahan
BACKGROUND: Postprandial hypotension (PPH) is an important disorder in the older people that remain underdiagnosed. The reference PPH diagnostic method is too demanding, because blood pressure (BP) needs to be measured 8 times in 2 hours. OBJECTIVES: Our primary objective was to define a new simplified PPH diagnostic method and to evaluate its performances. DESIGN: We conducted a cross-sectional study. SETTING: Two geriatric rehabilitation units in France...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29409456/task-shifting-in-active-management-of-the-third-stage-of-labor-a-systematic-review
#7
Tessa M Raams, Joyce L Browne, Verena J M M Festen-Schrier, Kerstin Klipstein-Grobusch, Marcus J Rijken
BACKGROUND: Active management of the third stage of labor (AMTSL) describes interventions with the common goal to prevent postpartum hemorrhage (PPH). In low- and middle-income countries, implementation of AMTSL is hampered by shortage of skilled birth attendants and a high percentage of home deliveries. Task shifting of specific AMTSL components to unskilled birth attendants or self-administration could be a strategy to increase access to potentially life-saving interventions. This study was designed to evaluate the effect, acceptance and safety of task shifting of specific aspects of AMTSL to unskilled birth attendants...
February 6, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29393607/blood-flow-changes-in-pelvic-vessels-associated-with-the-application-of-an-abdominal-compression-belt-in-healthy-postpartum-women
#8
T Dias, M Patabendige,, R P Herath, T I Garvik, F Liland, S Arulkumaran
Introduction: Postpartum haemorrhage (PPH) accounts for a high proportion of maternal mortality and morbidity throughout the world. A uterine compression belt which has been developed recently represents a very low tech, low cost solution in managing postpartum haemorrhage. Objectives: To evaluate the blood flow changes in pelvic vessels following application of the postpartum haemorrhage compression belt (Laerdal Global Health, Stavanger, Norway). Methods: The sample included healthy postpartum women within 6 hours of vaginal delivery...
December 26, 2017: Ceylon Medical Journal
https://www.readbyqxmd.com/read/29393567/acute-kidney-injury-but-not-sepsis-is-associated-with-higher-procedure-related-bleeding-in-patients-with-decompensated-cirrhosis
#9
Adelina Hung, Guadalupe Garcia-Tsao
BACKGROUND: Bleeding after low-risk invasive procedures can be life-threatening or can lead to further complications in decompensated cirrhosis patients. In unstratified cohorts of hospitalized patients with cirrhosis, the rate of procedure-related bleeding is low despite abnormal coagulation parameters. Our objective was to identify patients with decompensated cirrhosis at a high risk of developing procedure-related bleeding in whom the value of pre-procedure transfusions could be assessed...
February 2, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29392798/intraluminal-pressure-of-uterine-balloon-tamponade-in-the-management-of-severe-post-partum-hemorrhage
#10
Choi Wah Kong, William W K To
AIM: Intrauterine balloon tamponade has been increasingly used for the management of post-partum hemorrhage (PPH) in recent years. However, data on the precise mechanisms and pressure required for the balloon tamponade are scanty in the literature. This study aims to review the intraluminal pressure (ILP) generated by the Bakri intrauterine balloon that is necessary to produce a 'positive tamponade test' during severe PPH. METHODS: This was a prospective cohort study...
February 1, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29391291/can-hospital-discharge-data-be-used-for-monitoring-indicators-associated-with-postpartum-hemorrhages-the-hera-multicenter-observational-study
#11
Catherine Crenn-Hébert, Chloé Barasinski, Anne Debost-Legrand, Caroline Da Costa Correia, Olivier Rivière, Jeanne Fresson, Françoise Vendittelli
OBJECTIVES: The principal objective of this study was to assess the reliability of measuring the incidence of postpartum hemorrhages (PPH) from the national hospital discharge summary database (PMSI). The secondary objectives were to assess this reliability according to the maternity unit level and status and to assess the measurement of second-line procedures for PPH. MATERIALS AND METHODS: This study compared PPH incidence rates from February through July 2011 in 131 maternity units, as measured in the PMSI and the prospective HERA study cohort, considered as the reference standard...
January 29, 2018: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/29386641/a-naturally-occurring-epiallele-associates-with-leaf-senescence-and-local-climate-adaptation-in-arabidopsis-accessions
#12
Li He, Wenwu Wu, Gaurav Zinta, Lan Yang, Dong Wang, Renyi Liu, Huiming Zhang, Zhimin Zheng, Huan Huang, Qingzhu Zhang, Jian-Kang Zhu
Epigenetic variation has been proposed to facilitate adaptation to changing environments, but evidence that natural epialleles contribute to adaptive evolution has been lacking. Here we identify a retrotransposon, named "NMR19" (naturally occurring DNA methylation variation region 19), whose methylation and genomic location vary among Arabidopsis thaliana accessions. We classify NMR19 as NMR19-4 and NMR19-16 based on its location, and uncover NMR19-4 as an epiallele that controls leaf senescence by regulating the expression of PHEOPHYTIN PHEOPHORBIDE HYDROLASE (PPH)...
January 31, 2018: Nature Communications
https://www.readbyqxmd.com/read/29383061/training-in-emergency-obstetrics-a-needs-assessment-of-u-s-emergency-medicine-program-directors
#13
Daniel W Robinson, Michael Anana, Mary A Edens, Marc Kanter, Sorabh Khandelwal, Kaushal Shah, Todd Peterson
Introduction: Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods: We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH), shoulder dystocia, and breech presentation) through email invitations to all program directors (PD) of U...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29380357/the-association-between-ragged-or-incomplete-membranes-and-postpartum-haemorrhage-a-retrospective-cohort-study
#14
Julia Keating, Malcolm Barnett, Vanessa Watkins, Stella May Gwini
BACKGROUND: The association between an incomplete placenta and postpartum haemorrhage (PPH) is well documented; however, the significance of ragged or incomplete membranes has not been explored as an independent risk factor for PPH. AIMS: To explore the association between the completeness of the amniotic and chorionic membranes and the risk of PPH, independent to placental status. MATERIALS AND METHODS: 37 176 birth records were retrospectively extracted from the period 1 July, 2008 to 30 June, 2016 from the databases of two public hospitals in Melbourne, Australia...
January 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29379246/endovascular-uterine-artery-interventions
#15
Chandan J Das, Deepak Rathinam, Smita Manchanda, D N Srivastava
Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs), as well as intractable bleeding due to inoperable advanced-stage malignancies...
October 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29377131/accuracy-of-international-classification-of-diseases-ninth-revision-codes-for-postpartum-hemorrhage-among-women-undergoing-cesarean-delivery
#16
Alexander J Butwick, Eileen M Walsh, Michael Kuzniewicz, Sherian X Li, Gabriel J Escobar
BACKGROUND: Determining the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) codes for postpartum hemorrhage (PPH) is vital for reaching valid conclusions about the epidemiology of PPH. Our primary objectives were to assess the performance characteristics of ICD-9 PPH codes against a reference standard using estimated blood loss (EBL) among a cohort undergoing Cesarean delivery. STUDY DESIGN AND METHODS: We analyzed maternal discharge and EBL data from women who underwent Cesarean delivery at Kaiser Permanente Northern California facilities between 2010 and 2013...
January 26, 2018: Transfusion
https://www.readbyqxmd.com/read/29368267/-prophylactic-use-of-tranexamic-acid-in-noncardiac-surgery-update-2017
#17
REVIEW
J Waskowski, J C Schefold, F Stueber
BACKGROUND: Minimising perioperative bleeding is a key goal of "patient blood management" programs. One component of respective strategies includes preventive inhibition of fibrinolysis using protease inhibitors, such as tranexamic acid (TXA). TXA inhibits plasminogen activation and plasmin-induced fibrin degradation. OBJECTIVES: The present article provides an overview of the existing literature and TXA applications in the prophylaxis of perioperative bleeding...
January 24, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29366816/robotic-pancreatoduodenectomy-at-an-experienced-institution-is-not-associated-with-an-increased-risk-of-post-pancreatic-hemorrhage
#18
Deepa Magge, Mazen Zenati, Waseem Lutfi, Ahmad Hamad, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Postpancreatectomy hemorrhage (PPH) is a serious and life threatening complication following pancreaticoduodenectomy. The objective was to determine whether PPH incidence is elevated in a series of robotic pancreatoduodenectomy (RPD) from a high-volume institution and if video review can identify technical factors associated with PPH. METHODS: A retrospective review of RPDs from October 2008 to March 2016 was performed. PPH was classified by established international criteria...
January 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29348050/do-estimates-of-blood-loss-differ-between-student-midwives-and-midwives-a-multicenter-cross-sectional-study
#19
Marine Pranal, Aline Guttmann, Lemlih Ouchchane, Ines Parayre, Olivier Rivière, Sylvie Leroux, Sylvie Bonnefont, Anne Debost-Legrand, Françoise Vendittelli
OBJECTIVE: the principal objective of this study was to assess the quality of blood loss estimates by midwives and student midwives. The secondary objectives were: to assess the intraobserver agreement of visual blood estimates and the rate of underestimation of blood loss by participants, and to estimate the sensitivity, specificity, and negative likelihood ratio of these estimates for clinically pertinent blood losses (≥ 500mL and ≥ 1000mL). DESIGN: multicenter cross-sectional study...
December 24, 2017: Midwifery
https://www.readbyqxmd.com/read/29342833/structural-determination-of-ruthenium-complexes-containing-bi-dentate-pyrrole-ketone-ligands
#20
Ya-Wen Tsai, Yun-Fan Chen, Yong-Jie Li, Kuan-Hung Chen, Chia-Her Lin, Jui-Hsien Huang
A series of ruthenium compounds containing a pyrrole-ketone bidentate ligand, 2-(2'-methoxybenzoyl)pyrrole (1), have been synthesized and characterized. Reacting 1 with [(η⁶-cymene)RuCl₂]₂ and RuHCl(CO)(PPh₃)₃ generated Ru(η⁶-cymene)[C₄H₃N-2-(CO-C₆H₄-2-OMe)]Cl (2) and {RuCl(CO)(PPh₃)₂[C₄H₃N-2-(COC₆H₄-2-OMe)]} (3), respectively, in moderate yields. Successively reacting 2 with sodium cyanate and sodium azide gave {Ru(η⁶-cymene)[C₄H₃N-2-(CO-C₆H₄-2-OMe)]X} (4, X=OCN; 5, X=N₃) with the elimination of sodium chloride...
January 13, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
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