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massive hemorrhage

Tamer Sekmenli, Metin Gündüz, Hikmet Akbulut, H Haldun Emiroglu, Mustafa Koplay, Ilhan Ciftci
Percutaneous endoscopic gastrostomy (PEG) is used as an alternative to enteral/nasoenteral feeding in situations where long-term oral feeding is ineffective or not tolerated. It is mostly preferred in patients with neurological conditions and also to support nutrition in patients with congenital heart diseases, cystic fibrosis, inflammatory bowel disease, and various oropharyngeal diseases. Although it is easily applicable compared to many invasive procedures, it has complications ranging from wound infection to death...
April 1, 2018: Archivos Argentinos de Pediatría
Thais Fontes de Magalhães, Kathiane Lustosa Augusto, Livia Ponte Mota, Arthur Ribeiro da Costa, Rainardo Antonio Puster, Leonardo Robson Pinheiro Sobreira Bezerra
Endometriosis can have several different presentations, including overt ascites and peritonitis; increased awareness can improve diagnostic accuracy and patient outcomes. We aim to provide a systematic review and report a case of endometriosis with this unusual clinical presentation. The PubMed/MEDLINE database was systematically reviewed until October 2016. Women with histologically-proven endometriosis presenting with clinically significant ascites and/or frozen abdomen and/or encapsulating peritonitis were included; those with potentially confounding conditions were excluded...
March 19, 2018: Revista Brasileira de Ginecologia e Obstetrícia
Ashley C McGinity, Caroline S Zhu, Leslie Greebon, Elly Xenakis, Elizabeth Waltman, Eric Epley, Danielle Cobb, Rachelle Jonas, Susannah E Nicholson, Brian J Eastridge, Ronald M Stewart, Donald H Jenkins
The mortality from hemorrhage in trauma patients remains high. Early balanced resuscitation improves survival. These truths, balanced with the availability of local resources and our goals for positive regional impact, were the foundation for the development of our pre-hospital whole blood initiative-using low titer cold stored O RhD positive whole blood (LTOWB). The main concern with use of RhD positive blood is the potential development of isoimmunization in RhD negative patients. We used our retrospective massive transfusion protocol (MTP) data to analyze the anticipated risk of this change in practice...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Patrick Oellers, Natalie Wolkow, Frederick A Jakobiec, Ivana K Kim
Purpose: To demonstrate the clinical pathologic correlation in a hemorrhagic choroidal melanoma. Observations: A 52 year old patient presented with a large choroidal mass associated with vitreous and retinal hemorrhage. The eye was enucleated and histopathology demonstrated epithelioid-type MART1 positive tumor cells consistent with choroidal melanoma. The tumor had broken through Bruch's membrane, which led to localized vascular compression with bleeding into the subretinal space, retina and vitreous...
June 2018: American Journal of Ophthalmology Case Reports
Thorsten Tjardes, Markus Luecking
Introduction: To achieve the aim of zero preventable deaths on the battlefield a deeper understanding of uncontrolled hemorrhage from junctional or proximal extremity sources is mandatory. While tourniquet application to the extremities has drastically reduced morbidity and mortality, there is still room for improvement regarding the timing of tourniquet placement as the available evidence clearly points out a tight correlation between timing of tourniquet application and outcome. To save as many lives as possible the "point of no return" regarding the circulatory breakdown due to hemorrhage, colloquially addressed as platinum 5 min, needs to be determined...
March 14, 2018: Military Medicine
Yu Meng, FangGen Lu, Lin Shi, MeiChu Cheng, Jie Zhang
RATIONALE: The use of anticoagulants is a contributor to gastrointestinal (GI) bleeding. Most bleeding patients on anticoagulant therapy such as warfarin commonly have basic lesions existing in their GI mucosa. PATIENT CONCERNS: We report a case of major GI bleeding following the use of anticoagulants in a patient with hookworm infection. DIAGNOSES: The patient was diagnosed with nephrotic syndrome with pulmonary embolism. INTERVENTIONS: He was treated with anticoagulants and suffered from acute major GI bleeding during the treatment...
March 2018: Medicine (Baltimore)
Nadim Mahmud, Kirk J Wangensteen
Prostate cancer is commonly diagnosed by using a transrectal ultrasound (TRUS)-guided biopsy. Although this procedure is usually well tolerated, rarely it may be complicated by massive rectal bleeding. We report a case of a 77-year-old male who underwent a TRUS biopsy and subsequently developed recurrent episodes of rectal bleeding with syncope and anemia requiring the transfusion of multiple units of blood. A sigmoidoscopy revealed the source of the bleeding: a large hemorrhoid on the anterior wall of the rectum with an overlying ulceration...
February 2018: Annals of Coloproctology
William Virgil Brown, Ira Goldberg, Barton Duell, Daniel Gaudet
Plasma triglyceride concentrations are normally below 150 mg/dL in the fasting state. However, these lipids can reach values of several thousand mg/dL. Elevations in this range are due to a massive retention of chylomicrons and usually result from multiple genetic variants with superimposed influences such as diabetes and immune disorders. Less commonly, major gene defects in lipoprotein metabolism can be the cause. These may present soon after birth with strong evidence of familial penetrance. The causes of this syndrome have been discussed in a Roundtable published in the most recent issue of this Journal...
March 5, 2018: Journal of Clinical Lipidology
S Gooran, A Javid, G Pourmand
One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor...
2018: International Journal of Organ Transplantation Medicine
Yalan Xu, Lei Li
Cases of squamous cell carcinoma (SCC) arising from ovarian endometriosis have been rarely reported. Most of the patients show a poor prognosis and present with a diminished survival time. We present a SCC case arising from endometriosis, and analyzed the clinical, therapeutic, and pathologic features through a comprehensive literature review. A 43-year premenopausal woman (gravida 2, para 1) presented to our hospital due to sudden pain in lower abdomen. Exploratory laparotomy indicated rupture of left ovarian cyst and intra-abdominal hemorrhage were observed...
February 9, 2018: Current Problems in Cancer
Irem Serifoglu, Balam Er Dedekarginoglu, Ebru Hatice Ayvazoglu Soy, Gaye Ulubay, Mehmet Haberal
OBJECTIVES: Hemoptysis is a symptom that can be caused by airway disease, pulmonary parenchymal disease, or pulmonary vascular disease, or it can be idiopathic. Infection is the most common cause of hemoptysis, accounting for 60% to 70% of cases. Hemoptysis is also an initial symptom of diffuse alveolar hemorrhage syndrome, although it may be absent at presentation in one-third of patients. Diffuse alveolar hemorrhage is characterized by disruption of the alveolar-capillary basement membranes because of either injury or inflammation of the arterioles, venules, or capillaries, resulting in bleeding in alveolar spaces...
March 2018: Experimental and Clinical Transplantation
Nikita Zaborovskii, Dmitrii Ptashnikov, Dmitrii Mikaylov, Sergei Masevnin, Oleg Smekalenkov
BACKGROUND: Intraoperative hemorrhage can sometimes be massive in patients with spinal metastasis of renal cell carcinoma (MRCC). Preoperative embolization and local hemostatic agents are routinely use in spinal tumor surgery, but there have been no comparisons between these methods. This report compares the efficiency of various methods of bleeding control and their influence on outcome and survival after decompression procedures for MRCC. MATERIALS AND METHODS: This was a retrospective case-control study of 54 patients with hypervascular extraosseous MRCC...
March 10, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Brant M Wagener, Parker J Hu, Joo-Yeun Oh, Cilina A Evans, Jillian R Richter, Jaideep Honavar, Angela P Brandon, Judy Creighton, Shannon W Stephens, Charity Morgan, Randal O Dull, Marisa B Marques, Jeffrey D Kerby, Jean-Francois Pittet, Rakesh P Patel
BACKGROUND: Trauma is the leading cause of death and disability in patients aged 1-46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of organ injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood...
March 2018: PLoS Medicine
Shannon Broxton, Regina Medeiros, Adel Abuzeid, Corey Peterson, Autumn Schumacher
Massive transfusion protocols (MTPs) allow practitioners to follow a prescribed algorithm for the rapid replacement of blood products during a massive hemorrhage. They function as an established protocol to provide consistent treatment. Once implemented, the MTP must be evaluated to ensure best practice. The purpose of this clinical improvement project was to formally evaluate the use and efficacy of an MTP during its first year of implementation. The specific aims were to (1) determine whether MTP activations were missed; (2) compare outcomes between those patients managed by the MTP and those who were not; and (3) provide recommendations to the institution's stakeholders...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Xiaobo Peng, Chunyan Wang, Lili Bai, Jianguang Dong, Xiaoxia Lu, Yanqing Liu, Zewu Qiu
OBJECTIVE: To analyze the clinical manifestation and therapeutic method in patients with acute mushroom poisoning. METHODS: A retrospective study was conducted. The clinical data of 48 patients with acute mushroom poisoning admitted to Department of Poisoning Treatment of the 307th Hospital of PLA from January 2016 to May 2017 were analyzed. The clinical data including gender, age, clinical symptoms, onset season, initial symptoms, incubation time, the length of hospital stay, treatment, and prognosis...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Lingchen Kong, Jianzhong Li, Peng Wu, Jianhua Xu, Honglei Li, Haifei Long, Pan Liu, Fangfang Wei, Wenhong Peng
OBJECTIVE: To investigate the curative effect of lateral position ventilation combined with vibration sputum drainage on the patients with acute respiratory distress syndrome (ARDS). METHODS: A prospective randomized controlled trial was conducted. The patients with ARDS undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Linyi Central Hospital from January 2013 to June 2017 were enrolled, and they were divided into simple ventilation group and combined treatment group according to random number table...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Cesar Cilento Ponce
Gastric Dieulafoy's lesion (DL) is a potentially fatal entity that causes upper digestive hemorrhage as a consequence of the erosion of an abnormal large-caliber artery in the submucosa of the gastrointestinal tract. We report the case of a 59-year-old female patient admitted to the emergency facility due to melena without any active sign of bleeding during the esophagogastroduodenoscopy. Unexpectedly, she progressed presenting a massive hematemesis followed by an irreversible cardiorespiratory arrest. The aim of this study is to draw attention to DL as a possible cause of massive and fatal digestive hemorrhage, and to describe the anatomical autopsy findings...
January 2018: Autopsy & Case Reports
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 1, 2018: Revista Brasileira de Terapia Intensiva
Natascha de Lange, Pim Schol, Marcus Lancé, Mallory Woiski, Josje Langenveld, Robbert Rijnders, Luc Smits, Martine Wassen, Yvonne Henskens, Hubertina Scheepers
BACKGROUND: Postpartum hemorrhage (PPH) is associated with maternal morbidity and mortality and has an increasing incidence in high-resource countries, despite dissemination of guidelines, introduction of skills training, and correction for risk factors. Current guidelines advise the administration, as fluid resuscitation, of almost twice the amount of blood lost. This advice is not evidence-based and could potentially harm patients. METHODS: All women attending the outpatient clinic who are eligible will be informed of the study; oral and written informed consent will be obtained...
March 6, 2018: Trials
Larry A Cogburn, Danielle N Smarsh, Xiaofei Wang, Nares Trakooljul, Wilfrid Carré, Harold B White
BACKGROUND: A strain of Leghorn chickens (rd/rd), unable to produce a functional riboflavin-binding protein, lays riboflavin-deficient eggs, in which all embryos suddenly die at mid-incubation (days 13-15). This malady, caused by riboflavin deficiency, leads to excessive lipid accumulation in liver, impaired β-oxidation of lipid, and severe hypoglycemia prior to death. We have used high-density chicken microarrays for time-course transcriptional scans of liver in chicken embryos between days 9-15 during this riboflavin-deficiency-induced metabolic catastrophe...
March 5, 2018: BMC Genomics
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