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https://www.readbyqxmd.com/read/28100323/-high-risk-factors-and-clinical-characteristics-of-massive-pulmonary-hemorrhage-in-infants-with-extremely-low-birth-weight
#1
Dan Chen, Meng Wang, Xin Wang, Xue-Wei Ding, Rui-Hua Ba, Jian Mao
OBJECTIVE: To explore the high-risk factors and analyze the clinical characteristics of massive pulmonary hemorrhage (MPH) in infants with extremely low birth weight (ELBW). METHODS: Two hundred and eleven ELBW infants were included in this study. Thirty-five ELBW infants who were diagnosed with MPH were labelled as the MPH group, and 176 ELBW infants without pulmonary hemorrhage were labelled as the control group. The differences in clinical characteristics, mortality rate, and incidence of complications between the two groups were analysed...
January 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28098575/obstetric-anesthesia-liability-concerns
#2
Joanna M Davies, Linda S Stephens
Obstetric practice carries a high risk of medical liability and involves both obstetricians and anesthesiologists. Analysis of data from the Anesthesia Closed Claims Project database shows an increase in the proportion of anesthesia claims for maternal death and brain damage between the 1990s and 2000 and later, primarily due to hemorrhage. The proportion of claims for newborn brain damage remained unchanged while those for maternal nerve injury and minor injuries decreased. Use of massive transfusion protocols and clinical drills have been shown to improve outcomes from hemorrhage...
January 16, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28098341/retrospective-cohort-study-of-prophylactic-intraoperative-uterine-artery-embolization-for-abnormally-invasive-placenta
#3
Yi Pan, Xin Zhou, Zhengqiang Yang, Shudong Cui, Wei De, Lizhou Sun
OBJECTIVE: To evaluate the safety and efficacy of prophylactic intraoperative uterine artery embolization (UAE) during cesarean delivery as conservative treatment for patients with abnormally invasive placenta. METHODS: A retrospective cohort study enrolled patients surgically diagnosed with abnormally invasive placenta who underwent cesarean delivery at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China, between February 1, 2012, and February 28, 2015...
December 26, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#4
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28079139/blood-occludin-level-as-a-potential-biomarker-for-early-blood-brain-barrier-damage-following-ischemic-stroke
#5
Rong Pan, Kewei Yu, Theodore Weatherwax, Handong Zheng, Wenlan Liu, Ke Jian Liu
Concern about intracerebral hemorrhage (ICH) is the primary reason for withholding tPA therapy from patients with ischemic stroke. Early blood brain barrier (BBB) damage is the major risk factor for fatal post-thrombolysis ICH, but rapidly assessing BBB damage before tPA administration is highly challenging. We recently reported that ischemia induced rapid degradation of tight junction protein occludin in cerebromicrovessels. The present study investigates whether the cleaved occludin is released into the blood stream and how blood occludin levels correlate to the extent of BBB damage using a rat model of ischemic stroke...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28070235/bevacizumab-and-gastrointestinal-bleeding-in-hereditary-hemorrhagic-telangiectasia
#6
George Ou, Cherry Galorport, Robert Enns
We report a case of severe, refractory gastrointestinal (GI) bleeding in a patient with hereditary hemorrhagic telangiectasia (HHT) whose massive transfusion dependence was lifted shortly after treatment with bevacizumab, an anti-vascular endothelial growth factor. The patient's bleeding had been refractory to repeated endoscopic interventions, tranexamic acid, and tamoxifen. However, following treatment with bevacizumab at 5 mg/kg every other week, nearly 300 units of packed red blood cell transfusions were avoided in one year's time...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28065219/uterine-artery-embolization-for-management-of-primary-postpartum-hemorrhage-associated-with-placenta-accreta
#7
Wang Zhi-Wei, Li Xiao-Guang, Pan Jie, Zhang Xiao-Bo, Shi Hai-Feng, Yang Ning, Jin Zheng-Yu
Objective To evaluate the efficacy and safety of uterine artery embolization (UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women (mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#8
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#9
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28056159/obturator-artery-injury-resulting-in-massive-hemorrhage-from-a-low-energy-pubic-ramus-fracture
#10
Mark K Solarz, Justin M Kistler, Saqib Rehman
Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28050516/high-flow-av-malformation-a-v-shunt-of-mandible-a-rare-life-threatening-entity
#11
Sanat Kumar Bhuyan, Krishna Gopal Birmiwal, Indu Bhusan Kar, Ruchi Bhuyan, Priyanka Debta
Intraosseous Arteriovenous Malformations (AVMs) in the head and neck region are very rare and potentially life threatening entities due to massive hemorrhage. These are the results of an embryonic abnormality of the vascular system. Depending on the blood flow and clinical presentations they are of different types like slow flow and high flow AVM. Here we present a case of high flow AVM involving mandible with a chief complain of gingival bleeding in a four year old girl child.
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28033139/air-medical-administration-of-tranexamic-acid
#12
Brian Cornelius
Traumatic injury is a significant cause of morbidity and mortality in the United States. Massive hemorrhage is responsible for the vast majority of deaths. Evolution in trauma treatment has resulted in major improvements to emergency care. Tranexamic acid (TXA), an antifibrinolytic agent, is synthetically derived from amino acids. The CRASH-2 study demonstrated that the early administration of TXA results in significant decreases in morbidity and mortality. Experiences by coalition forces in Southwest Asia found a substantial increase in survival of trauma patients with early TXA administration...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28032204/gastrointestinal-bleeding-due-to-gastrointestinal-tract-malignancy-natural-history-management-and-outcomes
#13
Richard A Schatz, Don C Rockey
BACKGROUND: Gastrointestinal (GI) tumor bleeding can vary from occult bleeding to massive hemorrhage and can be the presenting sign of malignancy. AIMS: Our primary aims were to: (1) characterize the natural history, treatment, and outcomes in patients with GI tumor bleeding and (2) compare and contrast bleeding in upper GI (UGI)/small bowel (SB) and lower GI malignancies. METHODS: Patients with endoscopically confirmed tumor bleeding were identified through search of consecutive electronic medical records: Bleeding was determined by the presence of melena, hematochezia, hematemesis, or fecal occult blood...
December 28, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28018508/fatal-hemorrhage-from-kidney-after-endovascular-repair-for-chronic-type-b-dissection-complicated-with-disseminated-intravascular-coagulation
#14
Takashi Yamauchi, Suguru Kubota, Kosei Hasegawa, Shinya Shirai
We report lethal hemorrhage from the kidney after thoracic endovascular repair for chronic type B dissection complicated by disseminated intravascular coagulation (DIC). A 70-year-old woman underwent thoracic endovascular repair to treat chronic DIC. Two weeks after surgery, refractory shock suddenly occurred and computed tomography showed a massive hematoma around the left kidney. Emergent renal artery angiography showed multiple bleeding points in the renal cortex. Immediate embolization of the renal artery was performed and her hemodynamic condition recovered...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28013226/disseminated-intravascular-coagulation
#15
Benjamin M Boral, Dennis J Williams, Leonard I Boral
OBJECTIVES: To provide a review of the definition, pathophysiology, differential diagnosis, and treatment of disseminated intravascular coagulation (DIC). METHODS: A case scenario and a review of the literature related to the pertinent facts concerning DIC are provided. RESULTS: DIC is a systemic pathophysiologic process and not a single disease entity, resulting from an overwhelming activation of coagulation that consumes platelets and coagulation factors and causes microvascular fibrin thrombi, which can result in multiorgan dysfunction syndrome from tissue ischemia...
December 24, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27999981/phospholipids-in-mitochondrial-dysfunction-during-hemorrhagic-shock
#16
REVIEW
Galina F Leskova
Energy deficiency plays a key role in the development of irreversible shock conditions. Therefore, identifying mitochondrial functional disturbances during hemorrhagic shock should be considered a prospective direction for studying its pathogenesis. Phospholipid (PL)-dependent mechanisms of mitochondrial dysfunction in the brain (i.e., in the frontal lobes of the cerebral hemispheres and medulla oblongata) and liver, which, when damaged, leads to an encephalopathy, are examined in this review. These mechanisms show strong regional specificity...
December 20, 2016: Journal of Bioenergetics and Biomembranes
https://www.readbyqxmd.com/read/27999650/subclavian-artery-esophageal-fistula-after-placement-of-a-self-expanding-metal-stent-in-a-patient-with-esophagogastric-anastomosis-stenosis
#17
Mohammadreza Seyedmajidi, Maryam Tavassoli, Mojtaba Kianti, Jamshid Vafaeimanesh
BACKGROUND: There have been reports on stent-related vascular erosions about patients with benign or malignant stenosis of the esophagus who received endoscopic stent insertion for palliative intention for oral intake. CASE PRESENTATION: A 61-year-old woman with esophageal cancer located in the middle part of esophagus was treated with esophagectomy. Two years following the surgery, malignant stenosis recurred in the esophagogastric anastomosis. A non-covered self-expanding metal stent (10 cm length with a diameter of 18 mm at expanded state) was inserted...
2016: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#18
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27988252/airway-and-circulatory-collapse-due-to-retropharyngeal-hematoma-after-blunt-vertebral-artery-injury
#19
Shunsuke Kudo, Kazuyuki Fukushima, Motonori Hashimoto, Masayuki Furutake, Keiji Tanaka, Kunihiko Okada
Retropharyngeal hematoma following blunt cervical spine injury is a known cause of airway obstruction, but it is not known to cause hemorrhagic shock. We report the case of a massive retropharyngeal hematoma caused by a blunt vertebral artery transection leading simultaneously to airway obstruction and hemorrhagic shock. An 83-year-old woman was injured in a motorcycle accident. In the field, the patient exhibited paradoxical breathing with no breath sounds, and her blood pressure could not be measured. Therefore, emergency intubation and fluid resuscitation were initiated and the patient was transferred to the emergency department...
December 9, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27964918/optimal-plasma-transfusion-in-patients-undergoing-cardiac-operations-with-massive-transfusion
#20
Michael A Mazzeffi, Evan Chriss, Kathryn Davis, Min Zhan, Anthony Harris, Peter Rock, James S Gammie, Kenichi Tanaka
BACKGROUND: Observational studies suggest that transfusion of high ratios of fresh frozen plasma (FFP) to red blood cells (RBCs) reduces mortality in severe hemorrhage. There are no studies examining the impact of the FFP to RBC transfusion ratio on mortality in massively transfused patients undergoing cardiac operations. METHODS: A single-center retrospective cohort study was performed over an 8.5-year period. Massive transfusion was defined as at least 8 RBC units administered during the operation...
December 10, 2016: Annals of Thoracic Surgery
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