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https://www.readbyqxmd.com/read/29773764/degloving-lower-leg-injury-the-importance-of-additional-treatment-negative-pressure-and-hyperbaric-oxygen-therapy
#1
Piotr Stabryła, Joanna Kulińska, Łukasz Warchoł, Anna Kasielska-Trojan, Wojciech Gaszyński, Bogusław Antoszewski
Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss. In this article, we present the management and therapeutic outcomes of a patient admitted due to the degloving injury of the lower extremity caused by workplace accident. We described the complexity of treatment including surgical intervention as well as additional treatment, which combined brought good esthetic outcome...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29765292/platelet-additive-solutions-a-review-of-the-latest-developments-and-their-clinical-implications
#2
REVIEW
Pieter F van der Meer, Dirk de Korte
Summary Platelet additive solutions (PASs) have undergone many reformulations in order to further improve platelet storage. Studies of platelets stored in PAS-F (containing acetate, magnesium and potassium as key constituents) showed that platelets may be stored for 13 days with recovery and survival outcomes that are equal or even superior to 7-day stored platelets in plasma. Clinically, patients transfused with platelets in PAS have fewer allergic reactions, while for febrile reactions data are conflicting...
April 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29764557/-development-and-application-of-disposable-constant-volume-and-negative-pressure-drainage-device
#3
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/29751968/maintaining-oncologic-integrity-with-minimally-invasive-resection-of-pediatric-embryonal-tumors
#4
Hannah M Phelps, Gregory D Ayers, Josephine M Ndolo, Hannah L Dietrich, Katherine D Watson, Melissa A Hilmes, Harold N Lovvorn
BACKGROUND: Embryonal tumors arise typically in infants and young children and are often massive at presentation. Operative resection is a cornerstone in the multimodal treatment of embryonal tumors but potentially disrupts therapeutic timelines. When used appropriately, minimally invasive surgery can minimize treatment delays. The oncologic integrity and safety attainable with minimally invasive resection of embryonal tumors, however, remains controversial. METHODS: Query of the Vanderbilt Cancer Registry identified all children treated for intracavitary, embryonal tumors during a 15-year period...
May 8, 2018: Surgery
https://www.readbyqxmd.com/read/29724316/-retrospective-analysis-of-16-cases-receiving-cardiopulmonary-resuscitation-in-the-operating-room-among-127-053-anesthetics-undergoing-non-cardiac-surgeries
#5
Ling Lan, Le Shen, Xiu Hua Zhang, Yu Guang Huang
Objective To identify the high-risk factors of cardiac arrest during non-cardiac surgery and to provide experience for the effective cardiopulmonary resuscitation (CPR). Method The baseline data,co-morbidities,causes of cardiac arrest,treatment responsees,and survivals of 16 patients undergoing CPR among 127 053 patients receiving non-cardiac surgeries in our center from January 2013 to December 2016 were retrospectively analyzed. Results The main causes of intraoperative CPR included the co-existing cardiovascular diseases,massive intraoperative blood loss/high-risk surgical procedures,and allergy-related factors...
April 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29701391/diagnostic-challenges-in-chronic-constrictive-pericarditis
#6
Ana Braga, Afonso Oliveira, Kevin Domingues, Maria João Andrade, Miguel Abecacis, José Pedro Neves
INTRODUCTION: Chronic constrictive pericarditis (CCP) is a disease that has multiple possible causes and is associated with variable clinical findings, depending on its severity. It develops insidiously, and in many cases, particularly in developed countries, no antecedent diagnosis can be found. These cases are termed idiopathic. Tuberculosis is the leading cause of constrictive pericarditis in developing nations but represents only a small minority in developed countries. METHODS: Here the authors describe two different case reports where tuberculosis was the probable cause of CCP...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29695575/laparoscopic-left-hepatectomy-for-ruptured-hepatocellular-carcinoma-controlled-after-transcatheter-arterial-embolization-case-report-and-review-of-the-literature
#7
Shohei Yoshiya, Kentaro Iwaki, Akihiro Sakai, Shunsuke Fujita, Takahide Kawasaki, Fumitaka Yoshizumi, Shoji Hiroshige, Masahiro Okamoto, Kengo Fukuzawa, Akira Motohiro, Yoshihiko Maehara
BACKGROUND: Although spontaneous tumour rupture is a life-threatening complication of hepatocellular carcinoma (HCC), staged hepatectomy for HCC controlled after transcatheter arterial embolization (TAE) could provide a better prognosis. Laparoscopic liver resection (LLR) has been accepted worldwide and has been expanded from minor resection to anatomical major resection. We herein report the first case of pure laparoscopic left hepatectomy for ruptured HCC controlled after TAE. CASE REPORT: A 66-year-old man was transferred to our Institute because of abdominal pain and decreased consciousness...
May 2018: In Vivo
https://www.readbyqxmd.com/read/29673673/the-application-of-uterine-wall-local-resection-and-reconstruction-to-preserve-the-uterus-for-the-management-of-morbidly-adherent-placenta-case-series
#8
Xianlan Zhao, Ya Tao, Yingying Du, Lei Zhao, Cai Liu, Yan Zhou, Peng Wei
OBJECTIVE: We aimed to evaluate our experience with the application of uterine wall local resection and reconstruction to preserve the uterus in patients with morbidly adherent placenta. MATERIALS AND METHODS: In a retrospective study, data from patients with morbidly adherent placenta who delivered by cesarean section between January 1, 2013 and May 31, 2016 were analyzed. Prophylactic abdominal aorta balloon occlusion and tourniquet were used to prevent massive hemorrhage in all 62 cases, followed by uterine wall local resection and reconstruction to preserve the uterus...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#9
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29644287/successful-use-of-intrapelvic-quikclot-in-life-threatening-blast-injury
#10
Naveen Virin Goddard, Demetrius Evriviades
Patients that suffer multiple traumatic injuries often present with uncontrollable haemorrhage and rapidly descend into a viscous death triad consisting of hypothermia, coagulopathy and acidosis. Initial surgical intervention does not aim to provide conclusive repair, but instead strives to stop blood loss while priority is given to correct the patient's metabolic state (Duchesne et al., 2010). However in some cases of massive polytrauma, gaining surgical control of bleeding can be incredibly difficult. As a result a number of topical haemostatic agents were developed for use in military and civilian settings...
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29628848/wilm-s-tumor-with-intracardiac-extension-causing-dynamic-tricuspid-valve-obstruction-an-anesthetic-challenge
#11
Kamal Kajal, Ganesh Kumar Munirathinam, Banashree Mandal, Komal Gandhi, Harkant Singh, Ravi Kanojia
Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29621917/the-inferior-vena-cava-diameter-is-a-useful-ultrasound-finding-for-predicting-postpartum-blood-loss
#12
Tomohiro Oba, Maya Koyano, Junichi Hasegawa, Hiroko Takita, Tatsuya Arakaki, Masamitsu Nakamura, Akihiko Sekizawa
PURPOSE: To assess whether the ultrasonographic measurement of the inferior vena cava (IVC) diameter in postpartum women is a useful parameter in evaluating the actual blood loss during delivery due to massive postpartum hemorrhage. MATERIALS AND METHODS: In postpartum women with blood loss ≥ 500 g, abdominal ultrasonography was performed 1 hour after delivery. The IVC diameter was measured during inspiration (IVCi) and expiration (IVCe). The maternal heart rate, blood pressure, and shock index (heart rate/systolic blood pressure) were also measured...
April 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29606951/successful-surgical-resection-following-bronchial-artery-embolization-in-a-case-of-lung-cancer-complicated-with-massive-hemoptysis
#13
Hironori Sadamatsu, Koichiro Takahashi, Hiroshi Inoue, Hitomi Umeguchi, Satoko Koga, Hideo Kuroki, Michiaki Akashi, Masato Kato, Naoko Sueoka-Aragane
Hemoptysis is sometimes observed in lung cancer patients and can be life-threatening. We present a case with severe hemoptysis that was resolved by bronchial artery embolization (BAE) followed by surgery. The presence of necrotic tissue in the majority of the resected tumor and only few cancer cells was presumed to be from loss of bronchial artery blood flow. Although BAE is not a standard therapy for lung cancer, it can be useful and may be considered by physicians as one of the treatment options prior to surgical resection in cases with hemoptysis...
January 2018: Case Reports in Oncology
https://www.readbyqxmd.com/read/29606404/the-utility-of-abnormal-initial-arterial-blood-gas-values-in-determining-clinical-futility-of-trauma-cases-with-severe-hemorrhage
#14
Andrew Katirai, Mark J Landau, Jack M Berger
BACKGROUND: Patients who experience trauma with severe hemorrhage requiring immediate surgery and massive blood transfusion often present with markedly abnormal laboratory values. These cases require valuable resources; however, little is known regarding prognostic factors that correlate with mortality. The purpose of this study was to determine whether abnormal initial arterial blood gas (ABG) pH, a marker for severe blood loss, could serve as a prognostic indicator for these patients...
March 23, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29589985/a-giant-dermoid-cyst-of-the-orbit
#15
Bipasha Mukherjee, Akruti Desai
To describe a unique case of a non-germinomatous germ cell tumor, a giant orbital dermoid, present in adulthood. A 31-year-old male presented in our clinic with gradual, painless, progressive proptosis in the left eye since 28 years associated with gradual loss of vision. The left eye showed gross proptosis. Ocular structures could not be made out. Computed tomography scan showed a well-circumscribed oval heterogeneous mixed solid and cystic lesion completely filling the left orbit with calcification. The differential diagnosis was that of either teratoma or optic nerve glioma...
March 28, 2018: Orbit
https://www.readbyqxmd.com/read/29583023/a-viable-caesarean-scar-pregnancy-in-a-woman-using-a-levonorgestrel-releasing-intrauterine-device-a-case-report
#16
Emilie Hitzerd, Hein Bogers, Noush A Kianmanesh Rad, Johannes J Duvekot
BACKGROUND: Although the levonorgestrel-releasing intrauterine device (LNG-IUD) is one of the most reliable methods of contraception, it is associated with an increased risk of ectopic pregnancy in case of unintended pregnancy. A rare form of ectopic pregnancy is the caesarean scar pregnancy (CSP), with a high risk of serious maternal morbidity, such as uterine rupture, massive haemorrhage and resulting infertility. This report describes the first case of a viable CSP at 13 weeks of gestation in association with the use of a LNG-IUD...
March 27, 2018: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/29577780/random-placenta-margin-incision-for-control-hemorrhage-during-cesarean-delivery-complicated-by-complete-placenta-previa-a-prospective-cohort-study
#17
Dazhi Fan, Shuzhen Wu, Shaoxin Ye, Wen Wang, Lijuan Wang, Yao Fu, Meng Zeng, Yan Liu, Xiaoling Guo, Zhengping Liu
INTRODUCTION: Complete placenta previa (CPP) is one of the most problematic types of abnormal placenta, which is further complicated by placenta accreta or percreta that can unexpectedly lead to catastrophic blood loss, infection, multiple complications, emergency hysterectomy, and even death. The present study aimed to assess the efficacy of random placenta margin incision in controlling intraoperative and total blood loss during cesarean section for CPP women. METHODS: A prospective cohort study, including a total of 100 consecutive pregnant women with CPP, was performed at a tertiary university-affiliated medical center between March 2016 and July 2017...
April 3, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29547925/the-platinum-5-min-in-tccc-analysis-of-junctional-and-extremity-hemorrhage-scenarios-with-a-mathematical-model
#18
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
https://www.readbyqxmd.com/read/29539587/patients-with-neutral-lipid-storage-disease-with-myopathy-nlsdm-in-southwestern-china
#19
Jiaze Tan, Haitao Yang, Jingchuan Fan, Yulan Fan, Fei Xiao
OBJECTIVES: Neutral lipid storage disease with myopathy (NLSDM) is a rare metabolic myopathy occurring owing to mutations in the patatin like phospholipase domain containing 2 (PNPLA2) gene. Till date, less than 50 patients with PNPLA2 mutations have been reported. In this study, we describe the clinical, pathological, and genetic findings, and muscle magnetic resonance imaging (MRI) changes in four Chinese patients with NLSDM. PATIENTS AND METHODS: Peripheral blood smears were stained using Wright's stain...
March 5, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29525980/preoperative-embolization-and-local-hemostatic-agents-in-palliative-decompression-surgery-for-spinal-metastases-of-renal-cell-carcinoma
#20
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
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