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Blood salvage

Ashok S Gavaskar, Hitesh Gopalan, Bhupesh Karthik, Parthasarathy Srinivasan, Naveen C Tummala
BACKGROUND: Total hip arthroplasty (THA) provides a successful salvage option for failed acetabular fractures. The complexity of arthroplasty for a failed acetabular fracture will depend on the fracture pattern and the initial management of the fracture. Our objective was to compare the midterm outcome of THA between patients who presented with failed acetabular fractures following initial surgical or nonsurgical treatment. METHODS: Forty-seven patients underwent cementless THA ± acetabular reconstruction following failed treatment of acetabular fractures...
September 28, 2016: Journal of Arthroplasty
Taofeek K Owonikoko, Mukesh Kumar, Shu Yang, Alice O Kamphorst, Rathi N Pillai, Rama Akondy, Vivek Nautiyal, Monica S Chatwal, Wendy M Book, Anurag Sahu, Gabriel L Sica, Rafi Ahmed, Suresh S Ramalingam
INTRODUCTION: The increased availability of immunotherapeutic agents for the treatment of a wide array of cancer in the general oncology practice setting will reveal rare and unique toxicities. MATERIALS AND METHODS: The mechanism of cardiac allograft rejection in the context of PD-1 antibody therapy was explored in a patient with cutaneous squamous cell cancer complicating long-standing cardiac allograft. Immune cell infiltrate in the myocardium and peripheral blood lymphocyte repertoire were assessed using myocardial biopsy and temporal analysis of peripheral blood samples...
October 22, 2016: Cancer Immunology, Immunotherapy: CII
Constantinos Miltiadous, Georgios K Dimitriadis, Pavlos Roditis, Christos Kosmas
Salvage high-dose chemotherapy (HDC) and autologous hematopoietic stem cell (HSC) transplantation represents a curative treatment option for patients with relapsed/refractory germ-cell tumors (GCTs). However, an appreciable proportion of these fail to mobilize adequate numbers of hematopoietic progenitors; thus, plerixafor is applied for that purpose. Limited data exist on remobilization of HSCs after previous autografting. Here, we report a unique case that had undergone successful previous tandem HDC for relapsed GCT, and 1 year later required remobilization of HSCs to support two further cycles of HDC after subsequent multiple relapses and refractoriness requiring various salvage regimens...
October 4, 2016: Anti-cancer Drugs
Chad D Watts, Matthew T Houdek, Cody C Wyles, Rafael J Sierra, Robert T Trousdale, Michael J Taunton
We conducted a study to compare 90-day outcomes of patients who underwent simultaneous bilateral total hip arthroplasties (THAs) through the direct anterior (DA) approach (n = 19 patients) or the posterior approach (n = 21) over a 2-year period (2012-2014). Compared with patients in the posterior group, patients in the DA group had longer operative times (153 vs 106 min; P < .001) and longer anesthesia times (257 vs 221 min; P = .007) but were more likely to be discharged home (100.0% vs 71.4%; P = .02)...
September 2016: American Journal of Orthopedics
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
Akiko Ohashi, Yusuke Saeki, Tomonori Harada, Masako Naito, Tomihisa Takahashi, Shin Aizawa, Hiroyuki Hasegawa
Tetrahydrobiopterin (BH4) is an essential cofactor of nitric oxide synthase (NOS) and aromatic amino acid hydroxylases. BH4 and 7,8-dihydrobiopterin (BH2) are metabolically interchangeable at the expense of NADPH. Exogenously administered BH4 can be metabolized by the body, similar to vitamins. At present, synthetic BH4 is used as an orphan drug for patients with inherited diseases requiring BH4 supplementation. BH4 supplementation has also drawn attention as a means of treating certain cardiovascular symptoms, however, its application in human patients remains limited...
2016: PloS One
Yong-Seok Han, Jun Hee Lee, Yeo Min Yoon, Chul Won Yun, Hyunjin Noh, Sang Hun Lee
Mesenchymal stem cells (MSCs) are 'adult' multipotent cells that promote regeneration of injured tissues in vivo. However, differences in oxygenation levels between normoxic culture conditions (21% oxygen) and both the MSC niche (2-8% oxygen) and ischemic injury-induced oxidative stress conditions in vivo have resulted in low efficacy of MSC therapies in both pre-clinical and clinical studies. To address this issue, we examined the effectiveness of hypoxia preconditioning (2% oxygen) for enhancing the bioactivity and tissue-regenerative potential of adipose-derived MSCs...
October 6, 2016: Cell Death & Disease
Zachary T Rivers, Drew R Oostra, James S Westholder, Gregory M Vercellotti
BACKGROUND: Romidepsin is a novel histone deacetylase inhibitor that is approved for the treatment of cutaneous and peripheral T-cell lymphoma in patients who have had at least one prior therapy. Romidepsin is generally well tolerated, though it comes with a risk of cardiac toxicities. OBJECTIVE: We report a case of electrocardiogram changes in a 64-year-old male with enteropathy-associated T-cell lymphoma, type 2, treated with salvage romidepsin therapy who relapsed after non-myeloablative allogeneic sibling peripheral blood stem cell transplant...
October 5, 2016: Journal of Oncology Pharmacy Practice
Ting Yang, Qiaoxian Lin, Jinhua Ren, Ping Chen, Xiaohong Yuan, Xiaofeng Luo, Tingbo Liu, Jing Zheng, Zhihong Zheng, Xiaoyun Zheng, Xinji Chen, Langhui Zhang, Hao Zheng, Zaisheng Chen, Xueling Hua, Shaohua Le, Jian Li, Zhizhe Chen, Jianda Hu
Haplo-HSCT has been used when HLA-matched siblings are not available. Conditioning regimens aim to reduce tumor burden prior to HSCT and provide sufficient immunoablation. We report the outcome of haplo-HSCT in 63 consecutive patients from 2/2013 to 12/2015 (19 females/44 males) with high-risk or relapsed/refractory hematological malignancies (n=29-AML; 8-sAML; 19-ALL; 5-advanced-MDS; 2-CML-BC). Median age was 20 years (range: 1.1-49). Twenty-one patients achieved remission prior to transplant, while 42 did not...
October 1, 2016: Oncotarget
Andra H James, Chad Grotegut, Homa Ahmadzia, Cathleen Peterson-Layne, Evelyn Lockhart
The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood bank, the role of massive transfusion protocols, the role of laboratory monitoring, and the role of anesthesia management. Aspects of patient blood management are discussed. The concept refers to an evidence-based, comprehensive, multidisciplinary approach to optimizing the care of patients who might need transfusion and includes measures to avoid or minimize transfusion such as preoperative anemia management, cell salvage, and the use of hemostatic medication to reduce bleeding...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Jingzhi Yang, Juliane C Finke, Juncong Yang, Andrew J Percy, Uwe von Fritschen, Christoph H Borchers, Michael O Glocker
Although great success of microvascular free-flap transplantation surgery has been achieved in recent years, between 1.5% and 15% of flaps are still lost due to vascular occlusion. The clinical challenge remains to salvage a transplant in the case of vascular complications. Since flap loss is devastating for the patient, it is of utmost importance to detect signs of complications or of conspicuities as soon as possible. Rescue success rates highly depend on early revision. In this study, we collected blood samples during transplantation surgery from either the contributory artery or the effluent vein of the flap and applied a targeted mass spectrometry-based approach to quantify 24 acute phase proteins, cytokines, and growth factors in 63 plasma samples from 21 hospitalized patients, generating a dataset with 9450 protein concentration values...
September 2016: Medicine (Baltimore)
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
June 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Claudia L Côté, Alexandra M Yip, Jeffrey B MacLeod, Bill O'Reilly, Joshua Murray, Maral Ouzounian, Craig D Brown, Rand Forgie, Marc P Pelletier, Ansar Hassan
BACKGROUND: Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery. METHODS: We conducted a retrospective analysis of patients who underwent nonemergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS. Perioperative transfusion rates, postoperative bleeding, clinical and hematological outcomes, and overall cost were examined...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Frédéric Selle, Joseph Gligorov, Daniele G Soares, Jean-Pierre Lotz
The concept of high-doses chemotherapy was developed in the 1980s based on in vitro scientific observations. Exposure of tumor cells to increasing concentrations of alkylating agents resulted in increased cell death in a strong dose-response manner. Moreover, the acquired resistance of tumor cells could be overcome by dose intensification. In clinic, dose intensification of alkylating agents resulted in increased therapeutic responses, however associated with significant hematological toxicity. Following the development of autologous stem cells transplantation harvesting from peripheral blood, the high-doses of chemotherapy, initially associated with marked toxic effects, could be more easily tolerated...
September 15, 2016: Bulletin du Cancer
Ozge Altintas, Mehmet Ozgen Altintas, Meltem Kumas, Talip Asil
OBJECTIVES: In this study, we aimed to evaluate the effect of the Ischemic preconditioning (IPreC) on the expression profile of cerebral miRNAs against stroke by induced transient middle cerebral artery occlusion (MCAo) in diabetic rats. METHODS: Eighty male Spraque Dawley rats were allocated to eight groups. In order to evaluate the expression profile of miRNAs, we induced transient MCAo seven days after STZ-induced diabetes (DM). Also we performed IPreC 72 h before transient MCAo to assess whether IPreC could have a neuroprotective effect against ischemia-reperfusion injury...
September 16, 2016: Neurological Research
Heiko Lier, Dietmar Schlembach, Wolfgang Korte, Christian von Heymann, Susanne Steppat, Maritta Kühnert, Holger Maul, Wolfgang Henrich, Werner Rath, Jürgen Wacker, Franz Kainer, Daniel Surbek, Hanns Helmer
Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Yuan Zhang, Ting Wang, Ke Yang, Ji Xu, Lijie Ren, Weiping Li, Wenlan Liu
Enolase-phosphatase 1 (ENOPH1), a newly discovered enzyme of the methionine salvage pathway, is emerging as an important molecule regulating stress responses. In this study, we investigated the role of ENOPH1 in blood brain barrier (BBB) injury under ischemic conditions. Focal cerebral ischemia induced ENOPH1 mRNA and protein expression in ischemic hemispheric microvessels in rats. Exposure of cultured brain microvascular endothelial cells (bEND3 cells) to oxygen-glucose deprivation (OGD) also induced ENOPH1 upregulation, which was accompanied by increased cell death and apoptosis reflected by increased 3-(4, 5-Dimethylthiazol-2-yl)-2, 5- diphenyltetrazolium bromide formation, lactate dehydrogenase release and TUNEL staining...
2016: Frontiers in Molecular Neuroscience
Jamil Bashir, Lynn M Fedoruk, John Ofiesh, Shahzad S Karim, G Frank O Tyers
BACKGROUND: Injuries to cardiac and venous structures during pacemaker and defibrillator lead extraction are serious complications that have been studied poorly. The incidence of these injuries is unknown but likely underestimated. No systematic multicenter review of these injuries or their management has been undertaken. METHODS AND RESULTS: We interrogated our mandatory administrative database for all excimer laser extractions that sustained a cardiac or venous injury in the province of British Columbia...
September 2016: Circulation. Arrhythmia and Electrophysiology
Haixia Zhou, Changcheng Zheng, Xiaoyu Zhu, Baolin Tang, Juan Tong, Xuhan Zhang, Lei Zhang, Huilan Liu, Zimin Sun
No clinical studies have investigated the role of decitabine as a part of the myeloablative conditioning regimen prior to UCBT for refractory or relapsed childhood AL in patients in NR status. The aim of this study was to identify the potential benefits of decitabine as a prior therapy before salvaged unrelated UCBT for refractory or relapsed childhood AL. Eight consecutive patients with childhood refractory/relapsed AL were enrolled in our study between 2013 and 2014. All patients were in NR status before the time of transplant and had features associated with poor outcomes, such as CNSL, MDS-AML, high WBC count at diagnosis, and hypodiploid status (FLT3+/ITD+)...
September 12, 2016: Pediatric Transplantation
Diana DeAndrade, Jonathan H Waters, Darrell J Triulzi, Louis Alarcon, Mary Kay Wisniewski, Robert Dyga, Mark H Yazer
BACKGROUND: The rate of patient-related clinical adverse events (AEs) associated with the use of intraoperative cell salvage (ICS) was analyzed. STUDY DESIGN AND METHODS: The perfusion service and electronic risk management databases in a nine-hospital regional health care system were reviewed over an approximately 11-year period. The number of ICS cases performed during this period and basic patient demographics were also extracted. RESULTS: There were 43,198 patients for whom ICS was utilized during the study period...
September 9, 2016: Transfusion
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