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JOURNAL ARTICLE
Shengliang Zhou, Lan Li, Shuai Li, Haibo Si, Limin Wu, Bin Shen
OBJECTIVE: Sarcopenia, as an emerging public health concern, has been associated with postoperative adverse outcomes in various surgical procedures. However, the evidence regarding the impacts of sarcopenia on total knee arthroplasty (TKA) remained limited. This study aimed to assess the impacts of sarcopenia on primary TKA based on the enhanced recovery after surgery (ERAS) protocol. METHODS: This retrospective study included 291 patients who received unilateral TKA from October 2017 to May 2018 in our institution...
March 31, 2024: Orthopaedic Surgery
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JOURNAL ARTICLE
Luciana Correa Oliveira, Juan Carlos Montano-Pedroso, Fernanda Vieira Perini, Roseny Dos Reis Rodrigues, Enis Donizetti, Silvia Renata Cornélio Parolin Rizzo, Guilherme Rabello, Dante Mario Langhi Junior
The management of major bleeding is a critical aspect of modern healthcare and it is imperative to emphasize the importance of applying Patient Blood Management (PBM) principles. Although transfusion support remains a vital component of bleeding control, treating severe bleeding goes beyond simply replacing lost blood. A more comprehensive, multidisciplinary approach is essential to optimize patient outcomes and minimize the risks associated with excessive transfusions.
March 13, 2024: Hematology, Transfusion and Cell Therapy
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JOURNAL ARTICLE
Lin Ding, Yi Duan, Lan Yao, Zhifeng Gao
INTRODUCTION: Liver disease causes 2 million deaths annually, accounting for 4% of all deaths worldwide. Liver surgery is one of the effective therapeutic options. Bleeding is a major complication during liver surgery. Perioperative bleeding and allogeneic blood transfusion may deteriorate the prognosis. Terlipressin (TP), a synthetic analogue of the antidiuretic hormone, may reduceblood loss during abdominal surgery. Several clinical centres have attempted to use TP during liver surgery, but the evidence for its effectiveness in reducing blood loss and the need for allogeneic blood transfusion, as well as its safety during the perioperative period, remains unclear...
March 29, 2024: BMJ Open
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JOURNAL ARTICLE
Steven G Schauer, Brit J Long, Michael D April, Daniel Resnick-Ault, Jessica Mendez, Allyson A Arana, Jill J Bastman, William T Davis, Joseph K Maddry, Adit A Ginde, Vikhyat S Bebarta
INTRODUCTION: Video laryngoscope (VL) technology improves first-pass success. The novel i-view VL device is inexpensive and disposable. We sought to determine the first-pass intubation success with the i-view VL device versus the standard reusable VL systems in routine use at each site. METHODS: We performed a prospective, pragmatic study at two major emergency departments (EDs) when VL was used. We rotated i-view versus reusable VL as the preferred device of the month based on an a priori schedule...
March 28, 2024: Transfusion
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JOURNAL ARTICLE
Valentina Da Prat, Lucia Aretano, Marco Moschini, Arianna Bettiga, Silvia Crotti, Francesca De Simeis, Emanuele Cereda, Amanda Casirati, Andrea Pontara, Federica Invernizzi, Catherine Klersy, Giulia Gambini, Valeria Musella, Carlo Marchetti, Alberto Briganti, Paolo Cotogni, Richard Naspro, Francesco Montorsi, Riccardo Caccialanza
Radical cystectomy (RC) with pelvic lymph node dissection is the standard treatment for patients with limited-stage muscle-invasive bladder cancer. RC is associated with a complication rate of approximately 50-88%. Immunonutrition (IMN) refers to the administration of substrates, such as omega-3 fatty acids, arginine, glutamine, and nucleotides, that modulate the immune response. IMN has been associated with improved outcomes following surgery for esophagogastric, colorectal and pancreatic cancer. In this paper, we describe a study protocol for a multicentre, randomised, open-label clinical trial to evaluate the effect of IMN in patients undergoing RC for bladder cancer...
March 20, 2024: Healthcare (Basel, Switzerland)
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JOURNAL ARTICLE
Eun Ju Kim, Hyunju Kim, Younchan Park
BACKGROUND: Over the past 4 years, aesthetic surgery, notably liposuction, has substantially increased. Tumescent liposuction, a popular technique, has two variants-true tumescent liposuction (TTL) and semi-tumescent liposuction. While TTL reduces risks, it has limitations. There is no literature reported on semi-tumescent liposuction under deep sedation using the propofol-ketamine protocol, which is proposed as a potentially safe alternative. METHODS: The retrospective analysis covered 8 years and included 3094 patients performed for tumescent liposuction under deep sedation, utilizing the propofol-ketamine protocol...
March 27, 2024: Aesthetic Plastic Surgery
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JOURNAL ARTICLE
Anne M Beukers, Carolien S E Bulte, Ruben J Bosch, Susanne Eberl, Charissa E van den Brom, Stephan A Loer, Alexander B A Vonk
BACKGROUND: Acute microcirculatory perfusion disturbances and organ edema are important factors leading to organ dysfunction during cardiac surgery with cardiopulmonary bypass (CPB). Priming of the CPB system with crystalloid or colloid fluids, which inevitably leads to hemodilution, could contribute to this effect. However, there is yet no optimal evidence-based strategy for this type of priming. Hence, we will investigate different priming strategies to reduce hemodilution and preserve microcirculatory perfusion...
March 26, 2024: Trials
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Chun Tian, Aihua Wang, He Huang, Youwan Chen
BACKGROUND: Animal experiments have confirmed that remote ischemic preconditioning (RIPC) can reduce hepatic ischemia-reperfusion injuries (HIRIs), significantly improving early tissue perfusion and oxygenation of the residual liver after resections, accelerating surgical prognoses, and improving survival rates. However, there is still controversy over the role of RIPC in relieving HIRI in clinical studies, which warrants clarification. This study aimed to evaluate the beneficial effects and applicability of RIPC in hepatectomy and to provide evidence-based information for clinical decision-making...
March 26, 2024: BMC Anesthesiology
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JOURNAL ARTICLE
Jonathan P Meizoso, Bryan A Cotton, Ryan A Lawless, Lisa M Kodadek, Jennifer M Lynde, Nicole Russell, John Gaspich, Adrian Maung, Christofer Anderson, John M Reynolds, Krista L Haines, George Kasotakis, Jennifer J Freeman
INTRODUCTION: Whole blood resuscitation has reemerged as a resuscitation strategy for injured patients. However, the effect of whole blood-based resuscitation on outcomes has not been established. The primary objective of this guideline was to develop evidence-based recommendations on whether whole blood should be considered in civilian trauma patients receiving blood transfusions. METHODS: An EAST working group performed a systematic review and meta-analysis utilizing the GRADE methodology...
March 27, 2024: Journal of Trauma and Acute Care Surgery
#30
REVIEW
W M Simmonds, Y Awuku, C Barrett, M Brand, K Davidson, D Epstein, E Fredericks, S Gabriel, S Grobler, C Gounden, L Katsidzira, V J Louw, V Naidoo, C Noel, E Ogutu, N Ramonate, N Seabi, M Setshedi, J Van Zyl, G Watermeyer, C Kassianides
BACKGROUND: Over 30% of the world's population is anaemic, with a significant proportion of these being iron deficient. As iron deficiency (ID) anaemia in men and post-menopausal women is mostly caused by gastrointestinal blood loss or malabsorption, the initial evaluation of a patient with ID anaemia involves referral to a gastroenterologist. The current drive towards patient blood management in sub-Saharan Africa (SSA)prescribes that we regulate not only the use of blood transfusion but also the management of patients in whom the cause of iron loss or inadequate iron absorption is sought...
February 2, 2024: South African Medical Journal
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JOURNAL ARTICLE
Flavia Leite, Bruno Deltreggia Benites, Roberto Luiz da Silva, Selma Soriano, Susankerle de Oliveira Costa Alves, Silvia Renata Cornélio Parolin Rizzo, Guilherme Rabello, Dante Mario Langhi Junior
Managing coagulation disorders and potential bleeding risks, especially in the context of anticoagulant medications, is of immense value both clinically and prior to surgery. Coagulation disorders can lead to bleeding complications, affecting patient safety and surgical outcomes. The use of Patient Blood Management protocols offers a comprehensive, evidence-based approach that effectively addresses these challenges. The problem is to find a delicate balance between preventing thromboembolic events (blood clots) and reducing the risk of bleeding...
March 13, 2024: Hematology, Transfusion and Cell Therapy
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JOURNAL ARTICLE
Lauren Cravassac, Rayan Hamadmad, Simon Crequit, Redel Diane, Yakhou Leila, Verton Caroline, Bassam Haddad, Edouard Lecarpentier
INTRODUCTION: red blood cell (RBC) transfusions are of utmost importance in the management of severe post-partum haemorrhage. Although the recommendations for blood transfusion protocols are regularly issued, there are significant differences in management depending on the context and the medical teams involved. OBJECTIVE: to determine during the first 24 hours, the clinical and biological factors associated with the decision for RBC transfusion during severe PPH (≥1000 mL) for vaginal and caesarean deliveries...
March 21, 2024: Journal of Gynecology Obstetrics and Human Reproduction
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JOURNAL ARTICLE
Steven C Mehl, Adam M Vogel, Amy E Glasgow, Suzanne Moody, Meera Kotagal, Regan F Williams, Mark L Kayton, Emily C Alberto, Randall S Burd, Thomas J Schroeppel, Joanne E Baerg, Amanda Munoz, William B Rothstein, Laura A Boomer, Eric M Campion, Caitlin Robinson, Rachel M Nygaard, Chad J Richardson, Denise I Garcia, Christian J Streck, Michaela Gaffley, John K Petty, Cynthia Greenwell, Samir Pandya, Alicia M Waters, Robert T Russell, Brian K Yorkgitis, Jennifer Mull, Jeffrey Pence, Matthew T Santore, Taleen A MacArthur, Denise B Klinkner, Shawn D Safford, Tanya Trevilian, Megan Cunningham, Christa Black, Jessica Rea, Ryan G Spurrier, Aaron R Jensen, Bethany J Farr, David P Mooney, Bavana Ketha, Melvin S Dassinger, Anna Goldenberg-Sandau, Janika San Roman, Todd M Jenkins, Richard A Falcone, Stephanie F Polites
BACKGROUND: The benefit of targeting high ratio fresh frozen plasma (FFP):red blood cell (RBC) transfusion in pediatric trauma resuscitation is unclear as existing studies are limited to patients who retrospectively met criteria for massive transfusion. The purpose of this study is to evaluate the use of high ratio FFP:RBC transfusion and the association with outcomes in children presenting in shock. METHODS: A post-hoc analysis of a 24-institution prospective observational study (4/2018-9/2019) of injured children <18 years with elevated age-adjusted shock index was performed...
March 18, 2024: Journal of Trauma and Acute Care Surgery
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JOURNAL ARTICLE
Vivek Bagaria, Lahari Badragiri, C S Hiremath
INTRODUCTION: Cardiac surgery is fraught with increased consumption of blood and blood products. Various strategies for blood conservation have been described. Our aim was to study the impact of a structured blood conservation protocol (BCP) on the utilization of blood and patient outcome. METHODS: Retrospective analysis of prospectively collected data comparing adult patients undergoing open heart surgery with BCP with those undergoing surgery without BCP. The primary objective was to compare the amount of blood utilized and the hematocrit at discharge...
March 16, 2024: Perfusion
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JOURNAL ARTICLE
Li Huang, Jun Zou, Yuxin Zhang, Jiaowei Gu, Jianlong Wu, Che Zhang
INTRODUCTION: Alport syndrome (AS) is one of the most common fatal hereditary renal diseases in human, with a high risk of progressing to end-stage renal disease without effective treatments. Mesenchymal stem cells (MSCs) have recently emerged as a promising therapeutic strategy for chronic kidney disease. However, the safety and therapeutic potential of MSC transfusion for patients with AS are still need to be confirmed. Therefore, we have designed a clinical trial to evaluate the hypothesis that intravenous infusion of human umbilical cord-derived MSC (hUC-MSC) is safe, feasible, and well-tolerated in children with AS...
March 15, 2024: BMJ Open
#36
JOURNAL ARTICLE
Zhang Peng, Lu Ya, Zhang Yichi, Lin Dong, Zhang Dechun
BACKGROUND: Locally advanced colon cancer is considered a relative contraindication for minimally invasive proctectomy (MIP), and minimally invasive versus conventional open proctectomy (COP) for locally advanced colon cancer has not been studied. METHODS: We have searched the Embase, Cochrane Library, PubMed, Medline, and Web of Science for articles on minimally invasive (robotic and laparoscopic) and COP. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs)...
March 15, 2024: Medicine (Baltimore)
#37
JOURNAL ARTICLE
Charissa L de Herdt, Sverre A I Loggers, Daphne van de Embden, Taco Bijlsma, Pieter Joosse, Kees-Jan Ponsen
INTRODUCTION: Low-energy fragility fractures of the pelvis (FFP) are an underestimated entity, yet increasing in incidence. The bleeding risk for pelvic fractures in high-energy trauma is well known, resulting in adequate treatment guidelines and clear protocols. This is not the case for FFPs but this risk is presumably low. This study aims to investigate the clinically relevant bleeding risk, in patients older than 50 years with a fragility fracture of the pelvis admitted to the emergency department (ED)...
March 13, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
#38
JOURNAL ARTICLE
Faisal A Alghamdi, Fawaz Al-Kasim, Forat Alshhada, Eatedal Ghareeb, Fauzia R Azmet, Adel Almudaibigh, Lobna Baitalmal, Bedah Alnawfal, Rehab Alluqmani
Sickle cell anemia (SCA) is a globally prevalent inherited condition, with acute chest syndrome (ACS) being one of its most severe complications. ACS frequently leads to hospitalization, requires intensive care unit (ICU) admission, and can even result in death. This study aimed to discern the early indicators of impending ACS in children with SCA who were initially hospitalized due to painful vaso-occlusive crises (VOC). This was a retrospective, case‒control investigation of 120 patients aged 1-14 years seen at the King Saud Medical City in Riyadh, Saudi Arabia from January 2021 to December 2022...
March 12, 2024: Scientific Reports
#39
Anusha Rayamajhi, Manisha Shrestha, Priyanka K C, Robin Maskey
INTRODUCTION AND IMPORTANCE: Hereditary spherocytosis (HS), a rare familial extravascular haemolytic disorder, typically follows an autosomal dominant inheritance pattern with variable expressivity. Despite its classical presentation of anaemia, jaundice, and splenomegaly, HS is infrequently reported among individuals of Asian descent, contributing to its under diagnosis or delayed diagnosis. The primary objective of this case report is to underscore the pivotal role of the osmotic fragility test in diagnosing HS, emphasizing the importance of accurate and timely identification for effective clinical management and improved patient outcomes...
March 2024: Annals of Medicine and Surgery
#40
REVIEW
Muhammed A Shafique, Syeda Q Abbas, Ume Habiba, Aira Mughal, Tagwa Kalool Fadlalla Ahmad, Anfal Munir Chaudhary
BACKGROUND: Blood transfusion intervention has been proven to be a crucial therapeutic aid for preterm infants with serious morbidities such as sepsis, intraventricular hemorrhage, and cardiopulmonary insufficiencies. However, blood transfusion practices have also been shown to cause significant adverse outcomes, which may negate the therapeutic effect of the intervention. To address the varying policies regarding the administration of blood products, healthcare professionals have adopted a consensus-based approach...
March 2024: Annals of Medicine and Surgery
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