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https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#1
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520652/a-systematic-review-and-meta-analysis-of-laparoscopic-and-open-distal-pancreatectomy-of-nonductal-adenocarcinomatous-pancreatic-tumor-ndacpt-in-the-pancreatic-body-and-tail
#2
Xiaojiang Yi, Sile Chen, Wei Wang, Liaonan Zou, Dechang Diao, Yansheng Zheng, Yaobin He, Hongming Li, Lijie Luo, Wenjun Xiong, Jin Wan
BACKGROUND: Currently, laparoscopic distal pancreatectomy is regarded as a safe and effective surgical approach for lesions in the body and tail of the pancreas. This review examined the evidence from published data of comparative studies of laparoscopic versus open distal pancreatectomy of nonductal adenocarcinomatous pancreatic tumor in pancreatic body and tail. METHODS: A systematic review of the studies comparing laparoscopic and open distal pancreatectomy was conducted...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#3
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28498299/machine-learning-for-predicting-outcomes-in-trauma
#4
Nehemiah T Liu, Jose Salinas
To date, there are no reviews on machine learning (ML) for predicting outcomes in trauma. Consequently, it remains unclear as to how ML-based prediction models compare in the triage and assessment of trauma patients. The objective of this review was to survey and identify studies involving ML for predicting outcomes in trauma, with the hypothesis that models predicting similar outcomes may share common features but the performance of ML in these studies will differ greatly. MEDLINE and other databases were searched for studies involving trauma and ML...
May 11, 2017: Shock
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#5
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28488974/blood-donor-deferral-policies-across-europe-and-characteristics-of-men-who-have-sex-with-men-screened-for-human-immunodeficiency-virus-in-blood-establishments-data-from-the-european-men-who-have-sex-with-men-internet-survey-emis
#6
Susanne B Schink, Ruth Offergeld, Axel J Schmidt, Ulrich Marcus
BACKGROUND: The predominant mode of transmission of human immunodeficiency virus (HIV) in Europe is male-to-male transmission. Men who have sex with men (MSM) are deferred from donating blood in many countries, but nevertheless do donate blood. Based on data from 34 countries, we estimated the proportion of MSM screened for HIV in the context of a blood donation and identified individual factors associated with this HIV screening in order to propose possible public health interventions...
March 23, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28488958/strategies-to-identify-candidates-for-d-variant-genotyping
#7
Xunda Luo, Margaret A Keller, Ian James, Michelle Grant, Shiguang Liu, Kellie Simmons Massey, Andrew Czulewicz, Sandra Nance, Yanhua Li
BACKGROUND: RhD variants have altered D epitopes and/or decreased antigen copies per red cell. Individuals carrying these variants may test antigen negative, weakly positive, or positive by serology, and may or may not be at risk of alloimmunisation after exposure. There have been recommendations to perform RHD genotyping of patients, pregnant women and females of childbearing potential with serological weak D phenotype, to guide prophylactic use of Rh immune globulin (RhIG), and better conserve D-negative blood products...
April 5, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28484665/retrospective-review-of-pediatric-blunt-renal-trauma-a-single-institution-s-five-year-experience
#8
Carly R Richards, Margaret E Clark, Ronald S Sutherland, Russell K Woo
Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i...
May 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28481839/high-ratio-plasma-resuscitation-does-not-improve-survival-in-pediatric-trauma-patients
#9
Jeremy W Cannon, Michael A Johnson, Robert C Caskey, Matthew A Borgman, Lucas P Neff
BACKGROUND: Damage control resuscitation (DCR) including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric trauma patients (<18 years)...
May 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28476526/restrictive-transfusion-in-radical-cystectomy-is-safe
#10
Sumeet Syan-Bhanvadia, Siri Drangsholt, Swar Shah, Jie Cai, Gus Miranda, Hooman Djaladat, Siamak Daneshmand
INTRODUCTION AND OBJECTIVE: Perioperative blood transfusion (PBT) is commonplace in radical cystectomy (RC) and has been linked to poorer oncologic outcomes. Limiting PBT in this largely elderly and comorbid population has not been studied. Herein, we first investigate the safety of a restrictive transfusion protocol (RTP) in patients undergoing RC for urothelial carcinoma and then compare oncologic outcomes between patients who did and did not receive PBT. METHODS: Outcomes for 173 consecutive patients meeting inclusion criteria undergoing RC for urothelial carcinoma from April 2010 to June 2014 by a single surgeon employing RTP were analyzed from an institutional review board-approved, prospectively collected database...
May 2, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28474978/angiographic-analysis-of-vascular-integrity-after-percutaneous-closure-using-prostar-xl-device-during-transcatheter-aortic-valve-implantation
#11
Fabien Lareyre, Juliette Raffort, Carine Dommerc, Mohamed Benhammamia, François Bourlon, Yacoub Habib, Claude Mialhe
INTRODUCTION: Percutaneous closure devices are commonly used to achieve hemostasis during endovascular procedures including transcatheter aortic valve implantation (TAVI). The aim of our study was to investigate the quality of the percutaneous femoral arterial closure by Prostar XL device using a systematic peroperative angiographic control at the end of TAVI procedure. MATERIALS AND METHODS: Two hundred seventeen consecutive patients (mean age: 84 [6.5]; 112 women and 105 men) undergoing TAVI with percutaneous transfemoral access were prospectively registered in our center...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28472239/association-between-ibuprofen-use-and-severity-of-surgically-managed-posttonsillectomy-hemorrhage
#12
Pamela A Mudd, Princy Thottathil, Terri Giordano, Ralph F Wetmore, Lisa Elden, Abbas F Jawad, Luis Ahumada, Jorge A Gálvez
Importance: Ibuprofen used in postoperative management of pain after tonsillectomy has not been shown to increase the overall risk for posttonsillectomy hemorrhage (PTH). The severity of bleeding is difficult to quantify but may be a more important outcome to measure. Objective: To evaluate the association between ibuprofen use and severity of PTH using transfusion events as a marker of severity. Design, Setting, and Participants: This retrospective cohort study identified 8868 patients who underwent tonsillectomy from January 20, 2011, through June 30, 2014, at the tertiary academic Children's Hospital of Philadelphia...
May 4, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#13
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463896/a-meta-analysis-of-the-impact-of-aspirin-clopidogrel-and-dual-antiplatelet-therapy-on-bleeding-complications-in-noncardiac-surgery
#14
Jesse A Columbo, Andrew J Lambour, Rebecca A Sundling, Nirali B Chauhan, Sarah Y Bessen, David L Linshaw, Ravinder Kang, Natalie B V Riblet, Philip P Goodney, David H Stone
OBJECTIVE: The aim of this study was to determine the bleeding risks associated with single (aspirin) and dual (aspirin + clopidogrel) antiplatelet therapy (DAPT) versus placebo or no treatment in adults undergoing noncardiac surgery. SUMMARY OF BACKGROUND DATA: The impact of antiplatelet therapy on bleeding during noncardiac surgery remains controversial. A meta-analysis was performed to examine the risk associated with single and DAPT. METHODS: A systematic review of antiplatelet therapy, noncardiac surgery, and perioperative bleeding was performed...
May 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28461767/can-mhealth-improve-access-to-safe-blood-for-transfusion-during-obstetric-emergency
#15
Aminur Rahman, Sadika Akhter, Monjura Khatun Nisha, Syed Shariful Islam, Fatema Ashraf, Monjur Rahman, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Iqbal Anwar
PURPOSE: Of the 99% maternal deaths that take place in developing countries, one-fourth is due to postpartum hemorrhage (PPH). PPH accounts for one-third of all blood transfusions in Bangladesh where the transfusion process is lengthy as most facilities do not have in-house blood bank facilities. In this context, the location where blood is obtained and the processes of obtaining blood products are not standardized, leading to preventable delays in collecting blood, when it is needed...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28458753/fibrinogen-degradation-product-levels-on-arrival-for-trauma-patients-requiring-a-transfusion-even-without-head-injury
#16
Youichi Yanagawa, Kouhei Ishikawa, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Kazuhiko Omori, Hiromichi Ohsaka
BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product (FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical significance of the FDP level. METHODS: From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28458065/outcomes-of-lumbopelvic-fixation-in-the-treatment-of-complex-sacral-fractures-using-minimally-invasive-surgical-techniques
#17
Ehsan Jazini, Tristan Weir, Emeka Nwodim, Oliver Tannous, Comron Saifi, Nicholas Caffes, Timothy Costales, Eugene Koh, Kelley Banagan, Daniel Gelb, Steven C Ludwig
BACKGROUND CONTEXT: Complex sacral fractures with vertical and anterior pelvic ring instability treated with traditional fixation methods are associated with high rates of failure and poor clinical outcomes. Supplemental lumbopelvic fixation (LPF) has been applied for additional stability to help with fracture union. PURPOSE: To determine whether minimally invasive LPF provides reliable fracture stability and acceptable complication rates in cases of complex sacral fractures...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#18
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28457412/factors-related-to-hepatocellular-carcinoma-recurrence-after-liver-transplantation-a-brazilian-multicenter-study
#19
M Bina Possatto, E C de Ataíde, C A Fazzio Escanhoela, T Sevá-Pereira, R de Cassia Martins Alves da Silva, H Felicio, L R de Navarro Amado, R Ferreira da Silva, A Soares Lima, I F S F Boin
BACKGROUND: Liver transplantation (LT) is a curative treatment option for hepatocellular carcinoma (HCC); recurrent HCC after liver transplantation (HCC-R) is diagnosed in 9%-16%. The objective of this study was to evaluate which factors are associated with R-HCC after liver transplantation. METHODS: This retrospective real-life study analyzed 278 LTs from 3 reference centers (2,093 LTs) in Brazil from 1988 to 2015. HCC-R with histologic confirmation was seen in 40 patients (14...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28452795/association-between-allogeneic-blood-transfusion-and-postoperative-infection-in-major-spine-surgery
#20
Christian Fisahn, Shiveindra Jeyamohan, Daniel C Norvell, Richard S Tubbs, Marc Moisi, Jens R Chapman, Jeni Page, Rod J Oskouian
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study is to compare the incidence of infection in patients who do and do not receive blood transfusions in major deformity surgery (>8 levels). SUMMARY OF BACKGROUND DATA: Postoperative infections increase morbidity and mortality rates in spine surgery and generate additional costs for the health care system. It has been proposed that blood transfusions increase the risk of wound infection, urinary tract infection, pneumonia, and sepsis...
April 27, 2017: Clinical Spine Surgery
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