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Hidden blood loss

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
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...
July 6, 2016: Journal of Arthroplasty
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
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
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
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...
July 6, 2016: Journal of Arthroplasty
Meiyun Tan, Tianhao Wu, Jiang Guo, Caidong Zhang, Zhongwei Fan, Xing Guo
OBJECTIVE: To investigate the hemostasis effect of compression dressing therapy after total hip arthroplasty (THA). METHODS: Thirty-four patients undergding unilateral THA between December 2014 and March 2015 were randomly divided into observation group (compression dressing group, n = 17) and control group (ordinary dressing group, n = 17). There was no significant difference in gender, age, height, weight, lesion hips, pathogeny, disease duration, and preoperative hemoglobin between 2 groups (P > 0...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
Weiguang Yu, Xinchao Zhang, Rongbo Wu, Xingfei Zhu, Jun Hu, Yinfeng Xu, Jianhua Yi, Yunjiang Liu
BACKGROUND: The purpose of this study was to evaluate whether PFNA-II (Asia proximal femoral nail anti-rotation) and DHS (dynamic hip screw) carry substantial post-operative hidden blood loss and to compare PFNA-II with DHS in terms of post-operative hidden blood loss in elderly high-risk patients with intertrochanteric femur fractures(IFFs). METHODS: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively...
2016: BMC Musculoskeletal Disorders
Duan Wang, Jin Xu, Wei-Nan Zeng, Kai Zhou, Tian-Hang Xie, Zhi Chen, Hao-da Yu, Jin-Long Li, Zong-Ke Zhou, Fu-Xing Pei
OBJECTIVE: To evaluate whether closed suction drainage (CSD) is associated with early recovery of knee function in patients undergoing total knee arthroplasty (TKA). METHODS: Between January 2015 and September 2015, 80 consecutive patients were prospectively randomized into two groups: a CSD group (40 cases; average age, 66.9 ± 8.6 years; male, 8; female, 32) and a non-CSD group (40 cases; average age, 66.8 ± 10.1 years; male, 9; female, 31). Local inflammation outcomes (assessed by a visual analog scale [VAS], swelling and skin temperature), calculated total blood loss (CBL), hidden blood loss (HBL), blood transfusion requirements and hemoglobin concentrations were recorded...
May 2016: Orthopaedic Surgery
J Soelberg, O Davis, A K Jäger
ETHNOPHARMACOLOGICAL RELEVANCE: Hidden in the documents of the dark past of the trans-Atlantic slavery are gems of ethnomedicinal observations, supported by herbarium specimens, which tell of the traditional medicine of a by-gone slave society in the Caribbean. In the context of the former Danish West Indies (now US Virgin Islands), we identify pre-1900 medicinal plants and their historical uses, and trace their status in the traditional medicine of St. Croix today (2014). By a combined historical and ethnobotanical approach we assess the scale of loss and preservation of traditional medicinal knowledge on St...
July 1, 2016: Journal of Ethnopharmacology
S Chatzipanagiotou, A Ioannidis, E Trikka-Graphakos, N Charalampaki, C Sereti, R Piccinini, A M Higgins, T Buranda, R Durvasula, A L Hoogesteijn, G P Tegos, Ariel L Rivas
BACKGROUND: To extract more information, the properties of infectious disease data, including hidden relationships, could be considered. Here, blood leukocyte data were explored to elucidate whether hidden information, if uncovered, could forecast mortality. METHODS: Three sets of individuals (n = 132) were investigated, from whom blood leukocyte profiles and microbial tests were conducted (i) cross-sectional analyses performed at admission (before bacteriological tests were completed) from two groups of hospital patients, randomly selected at different time periods, who met septic criteria [confirmed infection and at least three systemic inflammatory response syndrome (SIRS) criteria] but lacked chronic conditions (study I, n = 36; and study II, n = 69); (ii) a similar group, tested over 3 days (n = 7); and (iii) non-infected, SIRS-negative individuals, tested once (n = 20)...
2016: Frontiers in Immunology
Sabine Schnadt, Sylvia Pfaff
Despite improved allergen labelling and careful avoidance strategies, hidden allergens in food remain a substantial risk for unintended reactions for consumers with food allergies. New data from a survey of the German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund - DAAB) shows a slight decrease in the number of consumers that report allergic reactions to prepacked food. Still, 75 % (compared to 85 % in 2008) have experienced at least one allergic reaction after eating a prepacked food...
July 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Jinwei Xie, Jun Ma, Huan Yao, Chen Yue, Fuxing Pei
BACKGROUND: The optimal dosage and timing of tranexamic acid (TXA) in total knee arthroplasty (TKA) are undetermined. The purpose of this study was to explore the effect of multiple boluses of intravenous TXA on hidden blood loss (HBL), inflammatory response, and knee function after primary TKA without tourniquet. METHODS: A total of 151 patients were randomly divided into 3 groups to receive single bolus of 20 mg/kg IV-TXA before skin incision (group A), or another bolus of 10 mg/kg IV-TXA 3 hours later (group B), or another 2 boluses of 10 mg/kg IV-TXA 3 hours and 6 hours later (group C)...
May 6, 2016: Journal of Arthroplasty
Xiaoyong Chen, Xiaorui Cao, Chongfei Yang, Kai Guo, Qingsheng Zhu, Jinyu Zhu
BACKGROUND: Simultaneous bilateral total knee arthroplasty (TKA) can lead to greater blood loss and higher risk of venous thromboembolism. The effectiveness and safety of tranexamic acid (TXA) in simultaneous bilateral TKAs have not been clearly defined. We presumed that a fixed dose of TXA may be a preferable alternative for ease of administration in patients undergoing simultaneous bilateral TKAs. METHODS: We prospectively randomized 120 primary simultaneous bilateral TKAs to a fixed dose of TXA or equivalent volume of normal saline intravenously...
April 13, 2016: Journal of Arthroplasty
Jan Hendrickx, Philip Peyton, Rik Carette, Andre De Wolf
This review re-examines existing pharmacokinetic and pharmacodynamic concepts of inhaled anaesthetics. After showing where uptake is hidden in the classic FA/FI curve, it is argued that target-controlled delivery of inhaled agents warrants a different interpretation of the factors affecting this curve (cardiac output, ventilation and blood/gas partition coefficient). Blood/gas partition coefficients of modern agents may be less important clinically than generally assumed. The partial pressure cascade from delivered to inspired to end-expired is re-examined to better understand the effect of rebreathing during low-flow anaesthesia, including the possibility of developing a hypoxic inspired mixture despite existing machine standards...
September 2016: European Journal of Anaesthesiology
Tao Yuan, Jian-ning Zhao, Jia Meng, Yu Cong, Shuang-shuang Chen, Ni-rong Bao
OBJECTIVE: To study the correlation between arachidonic acid (AA) and acute red blood cells damage in rats, and to build a model with hidden blood loss in vivo, and to explore the pathological mechenism of hidden blood loss. METHODS: A total of 50 male adult Sprague-Dawley rats weighing (200 ± 20) g were randomly divided into five groups (n = 10): control group and four experimental groups. The rats in the experimental groups were given 0.5 ml different concentrations of AA dilu- ents, 5, 10, 20, 40 mmol/L respectively...
February 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Juan C Suarez, Colin A McNamara, Leticia C Barksdale, Cecilia Calvo, Caleb R Szubski, Preetesh D Patel
BACKGROUND: Many studies have challenged routine drain placement in patients undergoing total hip arthroplasty. Some studies suggest increased transfusion rate with the use of closed suction drains. The use of tranexamic acid to control surgical bleeding and aspirin for venous thromboembolism prophylaxis has gained popularity. No study has evaluated the use of drains in patients undergoing direct anterior total hip arthroplasty under these conditions. METHODS: We performed a prospective, randomized study in patients undergoing direct anterior total hip arthroplasty to evaluate whether closed suction drain placement provides any clinical benefit...
September 2016: Journal of Arthroplasty
Marcello De Fine, Francesco Traina, Gianluca Giavaresi, Eugenio Leo, Ilaria Sanzarello, Fabrizio Perna, Roberto Dattola, Cesare Faldini
PURPOSE: A consistent limb position strategy could be an attractive and easier alternative to reduce blood loss and increase range of motion following total knee arthroplasty. The aim of this study was to understand the proper amount of flexion required to improve functional outcomes with limited patients' discomfort. METHODS: Eighty-five patients undergoing total knee arthroplasty were randomly assigned to receive mild (30° of knee flexion) or high-flexion protocol (70° of knee flexion), 48 h after surgery...
April 7, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Guoyin Liu, Dongmei Zhu, Yong Zhang, Mengru Wang, Yuansheng Xu, Lei Bao, Nannan Leng, Zhengqian Yang, Jianmin Chen
OBJECTIVE: To investigate the effects of initiative and passive perioperative function exercises on hidden blood loss (HBL). METHODS: Two hundreds and thirty elderly patients with hip fractures aging from 67 to 87 years (average age of 73.6 years) who underwent total hip replacement were included. By the intensity and the manner of perioperative function exercises, patients were divided into four groups: little initiative function exercises group (group A, n=51), little initiative and passive function exercises group (group B, n=54), normal initiative function exercises group (group C, n=65), normal initiative and passive function exercises group (group D, n=60)...
April 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Bin Li, Guangbin Wang, Yanfang Wang, Lunhao Bai
This study assessed the effects of limb position on venous hemodynamics and blood loss after primary total knee arthroplasty (TKA). First, the venous blood flow velocity was detected by color Doppler flow imaging in seven young volunteers after the leg was elevated 25 cm with the knee in full extension or mild flexion. Next, 108 consecutive TKA patients were randomized into flexion or extension groups. Both groups had the leg elevated 25 cm at the ankle over a specific backing pad for 72 hours postoperatively...
March 28, 2016: Journal of Knee Surgery
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