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Massive Blood Loss

Patrick Mucka, Nicholas Levonyak, Elena Geretti, Bernadette M M Zwaans, Xiaoran Li, Irit Adini, Michael Klagsbrun, Rosalyn M Adam, Diane R Bielenberg
The vasculature influences the progression and resolution of tissue inflammation. Capillaries express vascular endothelial growth factor (VEGF) receptors, including neuropilins (NRPs), which regulate interstitial fluid flow. NRP2, a receptor of VEGFA and semaphorin (SEMA) 3F ligands, is expressed in the vascular and lymphatic endothelia. Previous studies have demonstrated that blocking VEGF receptor 2 attenuates VEGFA-induced vascular permeability. The inhibition of NRP2 was hypothesized to decrease vascular permeability as well...
October 12, 2016: American Journal of Pathology
Chang-Qing Zhao, Wei Ding, Kai Zhang, Jie Zhao
BACKGROUND: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy...
September 2016: Indian Journal of Orthopaedics
Chao-Wei Lee, Hsin-I Tsai, Chang-Mu Sung, Chun-Wei Chen, Shu-Wei Huang, Wen-Juei Jeng, Tsung-Han Wu, Kun-Ming Chan, Ming-Chin Yu, Wei-Chen Lee, Miin-Fu Chen
Despite advances in surgical technique and medical care, liver resection for hepatocellular carcinoma (HCC) remains a high-risk major operation. The present study evaluated the risk factors for early mortality after hepatectomy.We retrospectively reviewed records of patients undergoing liver resection for HCC between 1983 and 2015. A point score (Risk Assessment for early Mortality (RAM) score) for hepatectomy was developed based on multivariate analyses.Three hundred eighty-three patients (11.3%) expired within 6 months after the operation...
September 2016: Medicine (Baltimore)
Claire Dossier, Agnès Jamin, Georges Deschênes
Steroid sensitive nephrotic syndrome is marked by a massive proteinuria and loss of podocytes foot processes. The mechanism of the disease remains debated but recent publications suggest a primary role of EBV. EBV replication in the peripheral blood is found in 50% of patients during the first flare of the disease. The genetic locus of steroid sensitive nephrotic syndrome was also identified as influencing antibodies directed against EBNA1. EBV is able to establish, latent benign infection in memory B cells that display phenotypes similar to antigen-selected memory B cells...
September 28, 2016: Pediatric Research
C Caleb Butts, Kelly Bose, M Amin Frotan, Juvonda Hodge, Salil Gulati
INTRODUCTION: One of the primary intraoperative challenges during burn surgery is to adequately excise the burn while avoiding massive hemorrhage. This has become increasingly important, as we see more burn patients that are older and with more medical comorbidities. While adequate excision down to healthy tissues for deep burns is essential for skin graft to take, it also leads to active bleeding that can be a challenge to control. Good hemostasis is imperative as a hematoma is the most common cause of graft loss...
September 19, 2016: Burns: Journal of the International Society for Burn Injuries
Rakesh Hasabe, Kumud Gupta, Pallavi Rathode
INTRODUCTION: Conventionally postpartum hemorrhage (PPH) has been defined as blood loss of more than 500 ml following vaginal delivery and 1000 ml following a cesarean section [Pritchard et al. in Am J Obstet Gynecol 84(10):1271-1282, (1962)]. Another definition labels PPH as any blood loss which causes a 10 % drop in hematocrit [Combs et al. in Obstet Gynecol 77:69-76, (1991)] or which threatens the hemodynamic stability of the patient and necessitates blood transfusion [Prendiville et al...
October 2016: Journal of Obstetrics and Gynaecology of India
Akihiro Hasegawa, Takeshi Murakoshi, Yoshiro Otsuki, Yuichi Torii
Amniotic fluid embolism (AFE) is a rare complication of pregnancy and its mortality rate is high. There have been few reports of AFE with presence of severe coagulopathy and incoagulable bleeding, and absence of cardiopulmonary symptoms or limited cardiopulmonary symptoms, followed by massive blood loss during delivery. Such cases have been referred to as disseminated intravascular coagulopathy-type AFE, and the characteristics of this condition have been presented previously. Here we report three cases that fulfilled the diagnostic characteristics of disseminated intravascular coagulopathy-type AFE...
September 20, 2016: Journal of Obstetrics and Gynaecology Research
Julien Pottecher, François-Xavier Ageron, Clémence Fauché, Denis Chemla, Eric Noll, Jacques Duranteau, Laurent Chapiteau, Jean-François Payen, Pierre Bouzat
BACKGROUND: Early and accurate detection of severe hemorrhage is critical for a timely trigger of massive transfusion (MT). Hemodynamic indices combining heart rate (HR) and either systolic (shock index [SI]) or pulse pressure (PP) (PP/HR ratio) have been shown to track blood loss during hemorrhage. The present study assessed the accuracy of prehospital SI and PP/HR ratio to predict subsequent MT, using the gray-zone approach. METHODS: This was a retrospective analysis (January 1, 2009, to December 31, 2011) of a prospectively developed trauma registry (TRENAU), in which the triage scheme combines patient severity and hospital facilities...
October 2016: Journal of Trauma and Acute Care Surgery
Claudia Villanueva, Mathew Doyle, Jessica Berger, Gary Fermanis, Derek Glenn
Massive mediastinal tumours are rare in clinical practice and complete surgical resection may be associated with serious complications. Preoperative angiography and embolisation are valuable adjuncts in the management of giant tumours to decrease perioperative blood loss, provide a clear operative field and facilitate complete resection. We report the safe use of preoperative embolisation which facilitated excision via clamshell incision, of a highly vascular massive anterior mediastinal tumour with an unusual final diagnosis...
August 30, 2016: Heart, Lung & Circulation
Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Hirotada Suzuki, Yosuke Baba, Shigeki Matsubara
Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy). Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919). Of the 18, 14 (78%) had a prior cesarean section (CS) history and the other 4 (22%) were primiparous women...
2016: Obstetrics and Gynecology International
J Hu, X Tao, L Yin, Y Shi
OBJECTIVE: The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy. DESIGN: Retrospective review. SETTING: Peking University First Hospital. SAMPLE: Patients with cervical pregnancy diagnosed by trans-vaginal ultrasound at Peking University First Hospital between January 2003 and December 2014...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Xufeng Pan, Chang Gu, Rui Wang, Heng Zhao, Jianxin Shi, Haiquan Chen
BACKGROUND: The purpose of this study was to identify the technical aspects and short-term results of robotic sleeve resection for lung cancer patients. METHODS: Twenty-one consecutive cases of robotic sleeve resection from September 2014 to September 2015 were reviewed. RESULTS: There were 17 single sleeve resection (bronchial) and 4 double sleeve resection (bronchial and vascular) cases. Nineteen of 21 cases (90.5%) achieved R0 resection...
September 9, 2016: Annals of Thoracic Surgery
Dong Hwi Kim, Gwang Chul Lee, Sang Hong Lee, Chi-Hyoung Pak, Sang Ha Park, Sung Jung
PURPOSE: There are many methods to reduce massive bleeding during total knee arthroplasty (TKA). In our study, tranexamic acid and neutral drainage were used to decrease total blood loss. MATERIALS AND METHODS: The study was performed on 97 TKA patients from March 2012 to January 2013. In the study group, tranexamic acid was administered and neutral drainage was applied. The study group had group I (unilateral, n=29) and group III (bilateral, n=17). The control group had group II (unilateral, n=35) and group IV (bilateral, n=16)...
September 2016: Knee Surgery & related Research
Neha Diwanji, Andreas Bergmann
Apoptosis-induced proliferation (AiP) maintains tissue homeostasis following massive stress-induced cell death. During this phenomenon, dying cells induce proliferation of the surviving cells to compensate for the tissue loss, and thus restore organ size. Along with wound healing and tissue regeneration, AiP also contributes to tumor repopulation following radiation or chemotherapy. There are several models of AiP. Using an "undead" AiP model that causes hyperplastic overgrowth of Drosophila epithelial tissue, we recently demonstrated that extracellular reactive oxygen species (eROS) are produced by undead epithelial cells, and are necessary for inducing AiP and overgrowth...
August 15, 2016: Fly
M El-Sokkary, K Wahba, Y El-Shahawy
BACKGROUND: To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic B-Lynch suture. METHOD: This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at Ain Shams University Maternity Hospital between January 2013 and October 2015. Participants were randomly assigned following simple randomization procedures (computerized random numbers) and divided into two groups...
2016: BMC Pregnancy and Childbirth
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
Wei Xiao, Wenya Fu, Tianlong Wang, Lei Zhao
Hemispherectomy is an established surgical procedure to treat medically refractory epilepsy caused by diffuse hemispheric diseases. The most common complication of hemispherectomy is intraoperative bleeding. Perioperative allogeneic blood transfusion increases mortality and morbidity in pediatric patients. Etiologies of massive blood loss during hemispherectomy include intraoperative diffuse vascular damage, antileptic drugs induced coagulation dysfunction, hyperfibrinolysis and dilutional coagulopathy. Great efforts should be made to minimize the need of blood transfusion...
September 2016: Journal of Clinical Anesthesia
M G Chen, X H Ye, H Y Liang, Q Yang
OBJECTIVE: To investigate the incidence, etiology, clinico- pathological characteristics and prognosis in primary IgA nephropathy (IgAN) children with acute kidney injury (AKI). METHOD: Retrospective analysis of the clinical and pathological manifestations and follow-up results of 19 Chlidren, who were associated with AKI in 196 cases of children with IgA nephropathy treated in our department from January, 1996 to Jun, 2012 was performed. RESULT: (1) The 19 cases associated with AKI accounted for 9...
August 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Murad A Jabir, Hesham M Hamza, Hussein Fakhry, Gamal Amira, Etsuro Hatano, Shinji Uemoto
PURPOSE: In this study, we aim to report the efficacy of using the anterior approach (AA) versus the conventional approach (CA), in surgical resection for large hepatocellular carcinoma (HCC) (≥7 cm) of the right hepatic lobe in terms of surgical and long-term outcomes. MATERIALS AND METHODS: Between 2000 and 2006, 138 consecutive patients who underwent hepatic resection with curative intent for large right lobe HCC ≥7 cm were identified from a retrospective database...
August 10, 2016: Journal of Gastrointestinal Cancer
Goran Rakić, Danica Stanić, Anna Uram Benka, Marina Pandurov, Jovana M Simin, Biljana Drasković
INTRODUCTION: Children who are subjected to surgical treatment for scoliosis usually end up receiving a lot of blood transfusions since they tend to lose one or more blood volumes during the surgery. Tranexamic acid is an antifibrinolytic agent, increasingly used in children to reduce perioperative blood loss in various settings, including corrective surgery of scoliosis. CASE REPORT: A 12-year-old girl, weighing 44 kg, was admitted to our hospital for scoliosis correction...
March 2016: Medicinski Pregled
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