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Hidden blood loss

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https://www.readbyqxmd.com/read/28231650/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#1
Qunn Jid Lee, Wai Yee Ching, Yiu Chung Wong
Purpose: Tranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA. Materials and Methods: All patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28231649/optimal-timing-for-hemoglobin-concentration-determination-after-total-knee-arthroplasty-day-1-versus-day-2
#2
Mahdi Yacine Khalfaoui, Charles Godavitarne, Michael C P Wilkinson
Purpose: Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods: This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28174415/comparison-of-enoxaparin-and-rivaroxaban-in-balance-of-anti-fibrinolysis-and-anticoagulation-following-primary-total-knee-replacement-a-pilot-study
#3
Jinwei Xie, Jun Ma, Qiang Huang, Chen Yue, Fuxing Pei
BACKGROUND This study aimed to assess whether the efficacy of tranexamic acid (TXA) would be altered when rivaroxaban or enoxaparin was used for thromboprophylaxis in primary total knee replacement (TKR). It was hypothesized that the hemostatic effect of TXA would be better with the use of enoxaparin. MATERIAL AND METHODS A randomized clinical trial was conducted on 194 patients undergoing primary TKR for osteoarthritis. An intravenous dose of 15 mg/kg (TXA) and 1 g topical TXA were used. Patients randomly received enoxaparin or rivaroxaban prophylaxis when the drainage was less than 30 ml/h 6-8 h postoperatively...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28139973/effects-of-five-treatment-regimens-on-blood-loss-and-blood-transfusion-in-total-knee-arthroplasty-a-preliminary-study-in-china%C3%A2
#4
Kong-Zu Hu, He-Yan Sun, Cong Sui
OBJECTIVE: Our study is aimed to explore effects of five treatment regimens on blood loss and blood transfusion rate in total knee arthroplasty (TKA) patients. METHODS: 191 TKA patients were divided into the rivaroxaban, nadroparin, and tranexamic acid groups (n = 37 each) as well as into the affected-limb-position and tourniquet group (n = 40 each). A 3-month follow-up after operation was needed for all patients. The total blood loss, hidden blood loss, and dominant blood loss were recorded, and hemoglobin and red blood cell changes, pain and knee swelling degrees, hospital for special surgery (HSS), and American knee society (KSS) knee scores were observed...
January 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28129744/vitiligo-blood-transcriptomics-provides-new-insights-into-disease-mechanisms-and-identifies-potential-novel-therapeutic-targets
#5
Rama Dey-Rao, Animesh A Sinha
BACKGROUND: Significant gaps remain regarding the pathomechanisms underlying the autoimmune response in vitiligo (VL), where the loss of self-tolerance leads to the targeted killing of melanocytes. Specifically, there is incomplete information regarding alterations in the systemic environment that are relevant to the disease state. METHODS: We undertook a genome-wide profiling approach to examine gene expression in the peripheral blood of VL patients and healthy controls in the context of our previously published VL-skin gene expression profile...
January 28, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28103911/comparison-of-the-effectiveness-and-safety-of-topical-versus-intravenous-tranexamic-acid-in-primary-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#6
Tao-Ping Chen, Yu-Min Chen, Jian-Bao Jiao, Yun-Fei Wang, Li-Gang Qian, Zhao Guo, Zheng Ma, Cui-Yu Han, Tong-Huan Shi
BACKGROUND: This study aims to compare the effectiveness and safety of topical versus intravenous tranexamic acid (TXA) in reducing blood loss in primary total knee arthroplasty (TKA). METHODS: PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database and China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled studies (RCTs) that compared topical versus intravenous TXA in terms of reducing blood loss during TKA from their inception to September 2015...
January 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28102450/hidden-blood-loss-and-the-influential-factors-after-percutaneous-kyphoplasty-surgery
#7
Yao-Sen Wu, Hui Zhang, Wen-Hao Zheng, Zhen-Hua Feng, Ze-Xin Chen, Yan Lin
PURPOSE: Percutaneous kyphoplasty (PKP) is a minimally invasive procedure for the treatment of osteoporotic vertebral compression fractures (OVCFs). It is generally considered that there is little blood loss during the surgery. However, a significant perioperative hidden blood loss (HBL) is neglected. This study was to examine the amount of HBL and determine the influential factors during PKP. METHODS: From January 2015 to January 2016, 115 patients with OVCFs who were scheduled to have a PKP were enrolled in this study...
January 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28064380/perioperative-factors-associated-with-hidden-blood-loss-in-intertrochanteric-fracture-patients
#8
Y Liu, Y Sun, L Fan, J Hao
BACKGROUND: The actual total blood loss after a hip fracture has been found to be considerably larger than that observed during surgery and collected in drainage postoperatively. However, no previous studies have offered reasonable explanations for the deficit between a large hemoglobin drop and a small intraoperative blood loss. The aim was to quantify blood loss associated with hip injuries and surgery, and to identify the relative risk factors for perioperative hidden blood loss. MATERIALS AND METHODS: Eighty-nine patients with a femoral intertrochanteric fracture were operated on between August 2012 and October 2013...
January 7, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28028616/impact-of-flexion-versus-extension-of-knee-position-on-outcomes-after-total-knee-arthroplasty-a-meta-analysis
#9
Chao Jiang, Jieqiong Lou, Wenwei Qian, Canhua Ye, Shibai Zhu
INTRODUCTION: Controversy still exists regarding positioning of the knee in flexion or in extension after total knee arthroplasty (TKA) impacts treatment outcomes. In this meta-analysis, we evaluated if a postoperative knee position regime could positively affect the rehabilitation. METHODS: A comprehensive search for randomized controlled trials (RCTs) assessing the effect of knee positioning after TKA was conducted. The outcomes of interest were blood loss and range of motion (ROM); total calculated blood loss (CBL), drainage volume, hidden blood loss (HBL), decline of hemoglobin level and requirement for blood transfusion...
February 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28026726/-intra-articular-application-of-tranexamic-acid-significantly-reduces-blood-loss-and-transfusion-requirement-in-primary-total-knee-arthroplasty
#10
J Lošťák, J Gallo, J Špička, K Langová
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/27913236/effect-of-different-postoperative-limb-positions-on-blood-loss-and-range-of-motion-in-total-knee-arthroplasty-an-updated-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Yuangang Wu, Timin Yang, Yi Zeng, Haibo Si, Canfeng Li, Bin Shen
BACKGROUND: Postoperative limb positioning has been reported to be an efficient and simple way to reduce blood loss and improve range of motion following total knee arthroplasty (TKA). This meta-analysis was designed to compare the effectiveness of two different limb positions in primary TKA. MATERIALS AND METHODS: A meta-analysis of the PubMed, CENTRAL, Web of Science, EMBASE and Google Search Engine electronic databases was performed. In this meta-analysis, two postoperative limb positions were considered: mild-flexion (flexion less than 60°) and high-flexion (flexion at 60° or more)...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27864725/endoscope-assisted-extracapsular-dissection-of-benign-parotid-tumors-through-a-single-cephaloauricular-furrow-incision-versus-a-conventional-approach
#12
Song Fan, Guo-Kai Pan, Wei-Liang Chen, Zhao-Yu Lin, Fa-Ya Liang, Qun-Xing Li, Da-Ming Zhang, You-Yuan Wang, Han-Qing Zhang, Wei-Xiong Chen, Rui Chen, Xiao-Ming Huang, Jian-Tao Ye, Jin-Song Li
BACKGROUND: A few modified approaches have been reported for performing endoscope-assisted dissections of benign parotid tumors, but none that use incisions totally hidden in a natural furrow. This study evaluated the feasibility of performing endoscope-assisted extracapsular dissections of benign parotid tumors using a single cephaloauricular furrow incision. METHODS: Forty-six patients with benign parotid superficial lobe tumors were randomly divided into two groups: an endoscope-assisted (21 patients) group or a conventional (25 patients) surgery group...
November 18, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27846888/comparison-of-intramedullary-and-extramedullary-fixation-of-stable-intertrochanteric-fractures-in-the-elderly-a-prospective-randomised-controlled-trial-exploring-hidden-perioperative-blood-loss
#13
Leyi Cai, Te Wang, Lu Di, Wei Hu, Jianshun Wang
BACKGROUND: Hip fracture is a severe and common injury that occurs predominantly in the elderly. Blood loss in the perioperative period is associated with a greater risk of dying in anaemic patients. The aim of the study was to explore the best way to treat stable intertrochanteric fractures, taking hidden blood loss into account. METHODS: This prospective, randomised blinded study included patients aged over 65 years with stable intertrochanteric fractures (Evans grades I and II)...
November 15, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27776372/early-removal-of-drainage-tube-after-fast-track-primary-total-knee-arthroplasty
#14
Shaoyun Zhang, Bin Xu, Qiang Huang, Huan Yao, Jinwei Xie, Fuxing Pei
There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
October 24, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27658851/identification-of-disease-states-associated-with-coagulopathy-in-trauma
#15
Yuanyang Zhang, Tie Bo Wu, Bernie J Daigle, Mitchell Cohen, Linda Petzold
BACKGROUND: Trauma is the leading cause of death between the ages of 1 to 44 in the United States. Blood loss is the primary cause of these deaths. The discrimination of states through which patients transition would be helpful in understanding the disease process, and in identification of critical states and appropriate interventions. Even though these states are strongly associated with patients' blood composition data, there has not been a way to directly identify them. Statistical tools such as hidden Markov models can be used to infer the discrete latent states from the blood composition data...
2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27633946/combined-administration-of-iv-and-topical-tranexamic-acid-is-not-superior-to-either-individually-in-primary-navigated-tka
#16
Eun-Kyoo Song, Jong-Keun Seon, Jatin Prakash, Young-Jun Seol, Yong Jin Park, Cheng Jin
BACKGROUND: In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic acid (TXA) administration, which has been shown to be superior in conventional arthroplasty, has similar effect in navigational arthroplasty compared to administration of drug either individually. METHODS: In present randomized control trial, 200 patients were randomly divided in one of the 4 groups using computer-generated tables-control, IV, intraarticular, and combined...
January 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27587787/the-combined-effect-of-administration-of-intravenous-and-topical-tranexamic-acid-on-blood-loss-and-transfusion-rate-in-total-knee-arthroplasty-combined-tranexamic-acid-for-tka
#17
Z F Yuan, H Yin, W P Ma, D L Xing
OBJECTIVES: Tranexamic acid (TXA) is an antifibrinolytic agent used as a blood-sparing technique in total knee arthroplasty (TKA), and is routinely administered by intravenous (IV) or intra-articular (IA) injection. Recently, a novel method of TXA administration, the combined IV and IA application of TXA, has been applied in TKA. However, the scientific evidence of combined administration of TXA in TKA is still meagre. This meta-analysis aimed to investigate the efficacy and safety of combined IV and IA TXA in patients undergoing TKA...
August 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27534077/-comparison-of-anatomical-locking-plate-and-gamma-nail-for-the-treatment-of-intertrochanteric-fracture-with-external-wall-fractures
#18
COMPARATIVE STUDY
Yun-gen Hu, Lei Han, Wei-li Fang, Bo Jin
OBJECTIVE: To compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures. METHODS: From June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27510822/dl-adr-a-novel-deep-learning-model-for-classifying-genomic-variants-into-adverse-drug-reactions
#19
Zhaohui Liang, Jimmy Xiangji Huang, Xing Zeng, Gang Zhang
BACKGROUND: Genomic variations are associated with the metabolism and the occurrence of adverse reactions of many therapeutic agents. The polymorphisms on over 2000 locations of cytochrome P450 enzymes (CYP) due to many factors such as ethnicity, mutations, and inheritance attribute to the diversity of response and side effects of various drugs. The associations of the single nucleotide polymorphisms (SNPs), the internal pharmacokinetic patterns and the vulnerability of specific adverse reactions become one of the research interests of pharmacogenomics...
2016: BMC Medical Genomics
https://www.readbyqxmd.com/read/27498390/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-hip-arthroplasty
#20
Qunn Jid Lee, Wai Yee Esther Chang, Yiu Chung Wong
BACKGROUND: Tranexamic acid (TXA) has been shown to be effective in reducing blood loss, hemoglobin drop, and blood transfusion in primary total hip arthroplasty. Most studies used intravenous form or topical form. This study was to assess the blood-sparing efficacy and safety of oral TXA in total hip arthroplasty. METHODS: Patients with primary total hip arthroplasty from 2012 to 2015 were recruited. Trial group with 1 gm of oral TXA 2 hours preoperatively, and 6 hours and 12 hours postoperatively was compared with the control group without drug...
January 2017: Journal of Arthroplasty
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