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https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#1
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29768961/a-rare-case-of-ruptured-aneurysm-of-the-paramedian-artery-of-percheron
#2
Gianvincenzo Sparacia, Francesco Agnello, Massimo Midiri, Alberto Iaia
Introduction The artery of Percheron is a rare anatomic variant supplying bilateral medial thalamic nuclei and a variable portion of the rostral part of midbrain. Case report A 48-year-old female with massive subarachnoid hemorrhage due to a ruptured aneurysm of the paramedian artery of Percheron presented to the emergency room. Because of significant risk of recurrent intracranial hemorrhage, it was decided to proceed with endovascular embolization of the aneurysm. The patient was ultimately sent to a rehabilitation center and her presenting neurologic deficits showed significant improvements in the weeks following endovascular embolization treatment...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29765931/decreased-breg-th17-ratio-improved-the-prognosis-of-patients-with-ulcerative-colitis
#3
Xue Bing, Liang Linlang, Chen Keyan
Objective: To investigate the effects of regulatory B (Breg) cells and T helper 17 (Th17) cells on pathogenesis of ulcerative colitis, explore the clinical significance of Breg/Th17 ratio on the prognosis of ulcerative colitis, and provide the theoretical basis for the targeted therapy, diagnosis, and prognosis of the disease. Methods: Peripheral blood and colonic mucosa were collected from patients with ulcerative colitis. Hematoxylin-eosin staining was used to observe the pathological changes of colonic mucosa...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29765235/fatal-hemoptysis-in-patients-with-advanced-esophageal-cancer-treated-with-apatinib
#4
Wei Wang, Lin Zhang, Yan Xie, Tianchang Zhen, Gongzhang Su, Qi Zang
Targeted therapy is commonly used for treating advanced malignant tumors. Compared with cytotoxic drugs, targeted drugs have the characteristics of good curative results, less adverse effects, and convenient oral administration. Hence, they are especially suitable for patients with cancer who are not able to tolerate chemotherapy. Anti-angiogenic therapy can achieve the objective by inhibiting the formation of new blood vessels in tumors. Apatinib is a novel tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor-2...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29764557/-development-and-application-of-disposable-constant-volume-and-negative-pressure-drainage-device
#5
Dongzhi Liu
The common negative pressure drainage bottle used in the vacuum sealing drainage (VSD) cannot quantitative and automatically cut off. Excessive drainage damages the negative pressure source, causes drainage interruption, so once drainage was continuously performed, medical staff need to closely observe drainage bottle calibration. It was also important to known whether there was a large amount of fresh blood sucked out during continuous drainage because it could lose too much blood. To solve these two problems, we designed a kind of negative pressure drainage device, which volume was constant, with the function of automatic cutting off continuous drainage...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763851/pancreaticoduodenal-arcades-as-salvage-route-for-transarterial-embolization-of-life-threatening-hepatic-hemorrhage-in-patients-with-severe-celiac-axis-stenosis-case-series
#6
Ali Barah, Ahmed Omar, Ayman El-Menyar, Omran Almokdad, Ahmed Sayedin, Ala Alsherbini, Ahmed Almuzrakshi, Hatem Khalaf, Hassan Al-Thani
INTRODUCTION: Various transarterial embolotherapies for different hepatic etiologies are performed through the celiac axis (CA). However, this pathway is not always patent due to the extensive stenosis or occlusion of the origin of CA. In such situations, the pancreaticoduodenal arcades (PDAs) catheterization is the main alternative to gain access to the hepatic arteries as demonstrated in clinical studies. PRESENTATION OF CASE: We report two cases of life-threating hepatic hemorrhage indicated for emergency transarterial embolization (TAE)...
April 11, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29760834/a-case-series-of-two-patients-presenting-with-pericardial-effusion-as-first-manifestation-of-non-small-cell-lung-cancer-with-braf-mutation-and-expression-of-pd-l1
#7
Muhammad Mufti, Steven Ching, Sassan Farjami, Sharareh Shahangian, Serap Sobnosky
Lung cancer is the number one cause of cancer-related deaths in the United States. Involvement of pericardium occurs once cancer has progressed to stage IV which can cause massive effusion in the pericardial sac. This can lead to cardiac tamponade which can be fatal very quickly if untreated. The following is a two patient case series in which both patients presented with large pericardial effusion. The first patient sought medical attention due to new onset palpitations and was found to have hemorrhagic pericardial effusion and pulmonary embolism (PE)...
April 2018: World Journal of Oncology
https://www.readbyqxmd.com/read/29756113/primary-splenic-angiosarcoma-diagnosed-after-splenectomy-for-spontaneous-rupture
#8
Barış Özcan, Metin Çevener, Ayşegül Odabaşı Kargı, Hilmi Dikici, Akın Yıldız, Mustafa Özdoğan, Alihan Gürkan
Primary splenic angiosarcoma is a rare abnormality and has a bad prognosis. It has unknown pathogenesis. This abnormality is usually presented by splenic rupture. Surgery is the most promising treatm Surgery is the most accepted and accurate method for diagnosis and treatment. Surgery before rupture increases the life expectancy. A 65-year-old woman who presented to the emergency room with abdominal pain, abdominal distension, and anemia was found to have a splenic mass and massive ascites. After getting a hemorrhagic sample from the abdomen, the patient was operated with splenic rupture prediagnosis...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29751198/price-to-pay-portal-vein-arterialization-for-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-a-case-report
#9
Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-Iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can't be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son...
May 2, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29742224/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#10
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 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29725977/gastrosplenic-fistula-with-gastrointestinal-bleeding-a-rare-and-potentially-fatal-complication-after-sleeve-gastrectomy
#11
Laura Montana, Laurent Genser, Alexandre Cortes, Eric Poupardin, Christophe Barrat, Sergio Carandina
BACKGROUND: Although the surgical technique is safe and standardized, laparoscopic sleeve gastrectomy (LSG) is associated with serious and potentially life-threatening complications, such as gastric leak and bleeding. METHODS: In this retrospective study, three French university hospitals reviewed their experience with LSG. Between September 2014 and May 2016, three cases of gastrosplenic fistula complicated by massive upper gastrointestinal hemorrhage (UGIH) were recorded...
May 3, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29725569/nontraumatic-acetabular-fracture-sustained-during-convulsive-seizure-following-surgery-for-an-unruptured-intracranial-aneurysm-a-case-report
#12
Hirofumi Iwamoto, Kazuhiro Nakamura, Daisuke Watanabe, Kiyoyuki Yanaka, Takeshi Ainoya, Tetsuya Yamamoto
Acetabular fracture usually is related to high-energy traumatic injury or falls from heights and directly caused by seizures without trauma is extremely rare. We report a 71-years-old man who sustained a left acetabular fracture secondary to generalized seizure after clipping of an unruptured aneurysm without trauma and any risk for fracture. The patient had an aneurysm was arising from the bifurcation of the left internal carotid artery and the posterior communicating artery. After the clipping, the patient had three times tonic-clonic seizures for 1 min and resulted in an acetabular fracture...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725568/tiny-falx-meningioma-causing-massive-interhemispheric-subdural-hematoma-a-case-report
#13
Yume Suzuki, Masashi Fujimoto, Fumihiro Kawakita, Fumio Asakura, Hiroto Murata, Yoshito Morooka, Hidenori Suzuki
Bleeding from meningiomas is well known, but massive subdural hemorrhage from a very small meningioma is rare. A 61-year-old woman presented with a sudden-onset headache and slight right hemiparesis without a history of trauma. Computed tomographic scan showed bilateral acute/subacute interhemispheric subdural hematoma, but contrast-enhanced computed tomography (CT) scan, non-enhanced magnetic resonance imaging (MRI) and digital subtraction angiography failed to detect the cause. The hematoma was conservatively treated...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725550/massive-ovarian-edema-in-a-girl-with-hemoglobin-sc-disease
#14
Eric Johannesen, Van Nguyen
Massive ovarian edema is a benign tumor like lesion of the ovary. The widely accepted mechanism is disruption of vascular drainage resulting in accumulation of fluid within the stroma and enlargement of the ovary. We report a case of massive ovarian edema in a teenage girl with hemoglobin SC disease. A 16-year-old female with hemoglobin SC disease was admitted with right lower quadrant pain. An ultrasound and CT scan showed a large, heterogeneous solid, and cystic pelvic mass. Due to the size and the possibility of malignancy, the patient underwent a salpingo-oophorectomy...
2018: Case Reports in Pathology
https://www.readbyqxmd.com/read/29723281/immunity-to-lulohya-and-lundep-the-salivary-spreading-factors-from-lutzomyia-longipalpis-protects-against-leishmania-major-infection
#15
Ines Martin-Martin, Andrezza Campos Chagas, Anderson B Guimaraes-Costa, Laura Amo, Fabiano Oliveira, Ian N Moore, Thiago S DeSouza-Vieira, Elda E Sanchez, Montamas Suntravat, Jesus G Valenzuela, Jose M C Ribeiro, Eric Calvo
Salivary components from disease vectors help arthropods to acquire blood and have been shown to enhance pathogen transmission in different model systems. Here we show that two salivary enzymes from Lutzomyia longipalpis have a synergist effect that facilitates a more efficient blood meal intake and diffusion of other sialome components. We have previously shown that Lundep, a highly active endonuclease, enhances parasite infection and prevent blood clotting by inhibiting the intrinsic pathway of coagulation...
May 3, 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29721496/the-role-of-plasma-transfusion-in-massive-bleeding-protecting-the-endothelial-glycocalyx
#16
REVIEW
Stefano Barelli, Lorenzo Alberio
Massive hemorrhage is a leading cause of death worldwide. During the last decade several retrospective and some prospective clinical studies have suggested a beneficial effect of early plasma-based resuscitation on survival in trauma patients. The underlying mechanisms are unknown but appear to involve the ability of plasma to preserve the endothelial glycocalyx. In this mini-review, we summarize current knowledge on glycocalyx structure and function, and present data describing the impact of hemorrhagic shock and resuscitation fluids on glycocalyx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29719984/the-usefulness-of-a-trans-illuminated-introducer-during-the-nuss-procedure
#17
In-Hag Song, Seung Jin Lee, Seock Yeol Lee
Background There has been an increase in the number of patients undergoing the Nuss procedure for cosmetic purposes, thus increasing the need for safer surgery. However, there are reports of massive hemorrhage and organ damage during the Nuss procedure which involves dissection of the anterior mediastinum. We have developed the trans-illuminated introducer that allows safe surgery while maintaining a small surgical incision of less than 1 cm. Methods This study was a retrospective review of 306 patients aged 3-40 years who underwent the Nuss procedure using the trans-illuminated introducer at our hospital between April 2006 and December 2014...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29717340/successful-balloon-assisted-hepatic-tract-embolization-using-the-pull-through-technique-to-remove-a-malpositioned-chest-tube-penetrating-the-liver-and-into-the-right-ventricle
#18
Kunio Hamanaka, Yuusuke Hirokawa, Tsuyoshi Itoh, Michio Yamasaki, Kazuki Hayashi, Satoru Sawai, Kei Nishiyama
Intra-abdominal injury is an uncommon complication of chest tube insertion. A 66-year-old man had empyema and underwent chest tube insertion for drainage. Massive hemorrhage occurred; the postprocedural radiograph showed the malpositioned chest tube in the mediastinum. Computed tomography scan showed that the tube's tip penetrated through the liver capsule and passed through the hepatic vein to the right ventricle. Hepatic tract embolization with coiling was performed during chest tube removal under a controlled condition with the hepatic tract occluded by a balloon catheter...
May 1, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29716840/terrorist-attack-in-nice-the-experience-of-general-surgeons
#19
D Massalou, C Ichai, D Mariage, P Baqué
INTRODUCTION: After the attacks in Paris, France was again struck by terrorism in the city of Nice during the night of July 14, 2016. At 22:33 in the evening, a 19-ton truck drove into the crowd of holiday celebrators. The attack resulted in 458 wounded and 86 deaths. The purpose of this study was to describe the management of patients with abdominal trauma admitted alive in our institution, in the context of a massive influx of victims. MATERIAL AND METHODS: We performed a retrospective analysis of the management of adults with abdominal trauma arising from the terrorist attack in Nice...
April 28, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29709368/empiric-transfusion-strategies-during-life-threatening-hemorrhage
#20
Geoffrey R Nunns, Ernest E Moore, Gregory R Stettler, Hunter B Moore, Arsen Ghasabyan, Mitchell Cohen, Benjamin R Huebner, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Resuscitation guided by thrombelastography improves survival after injury. If bleeding is rapid, however, or if no thrombelastography data are available, the optimal strategy remains controversial. Our current practice gives fresh frozen plasma and red blood cells (1:2) empirically in patients with life-threatening hemorrhage, with subsequent administration based on rapid thrombelastography. We identified patients at risk of massive transfusion at 1 hour, examined their initial rapid thrombelastography, and used this value to provide empiric recommendations about transfusions...
April 27, 2018: Surgery
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