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epistaxis managment

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https://www.readbyqxmd.com/read/29784243/management-of-severe-and-or-refractory-epistaxis
#1
Patricia García-Cabo, Laura Fernández-Vañes, Daniel Pedregal, Marta Menéndez Del Castro, Eduardo Murias, Pedro Vega, José Luis Llorente, Juan Pablo Rodrigo, Fernando López
OBJECTIVE: The objective was to determine the results of the treatment of severe and/or refractory epistaxis requiring hospital admission. In addition, the results of arterial ligation versus embolization were compared. MATERIAL AND METHOD: Sixty-three patients with severe and/or refractory epistaxis requiring hospital admission between August 2014 and December 2016 were included prospectively. RESULTS: Eleven patients (17%) underwent embolization, 5 (8%) endoscopy ligation and the remaining 47 (75%) underwent conservative treatment with tamponade...
May 18, 2018: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/29774760/safety-of-nonsteroidal-anti-inflammatory-drugs-in-copperhead-snakebite-patients
#2
Hoang X Pham, Michael E Mullins
INTRODUCTION: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not...
May 18, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29765824/changing-trends-in-the-management-of-esthesioneuroblastoma-irish-and-international-perspectives
#3
Robbie S R Woods, Thavakumar Subramaniam, Mary Leader, Rory McConn-Walsh, James Paul O'Neill, Peter D Lacy
Objectives  Evaluation of the changing trends in esthesioneuroblastoma in an Irish context and review of management options nationally to clarify the best current therapeutic approach by comparing with international research on this uncommon malignancy. Design  Retrospective review. Setting  Tertiary referral center. Participants  All patients presenting with esthesioneuroblastoma in Beaumont hospital or on the National Cancer Registry of Ireland between 1994 and 2013. Main Outcome Measures  Recurrence-free and overall survival...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29739664/epidemiology-of-epistaxis-in-the-emergency-department-of-a-southern-european-tertiary-care-hospital
#4
Luis Roque Reis, Filipe Correia, Luis Castelhano, Pedro Escada
OBJECTIVE: Epistaxis is the most common rhinological emergency seen in the emergency department. The purpose of this study was to evaluate epidemiological data of epistaxis in a southern European tertiary care hospital. METHODS: A retrospective study was conducted during the period between January 2009 and December 2015. We analyzed the distribution by cross-referencing the demographic variables, destination after medical discharge, inpatient characteristics (major comorbid diseases, medication, bleeding localization and treatment) and health-care costs with the disease...
May 5, 2018: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/29735286/epistaxis-complicating-treatment-by-anti-vitamin-k-and-new-oral-anticoagulants
#5
V L'Huillier, C Badet, L Tavernier
OBJECTIVES: To assess any differences in severity and management of epistaxis when complicating treatment by anti-vitamin K (AVK) or by new oral anticoagulants (NOAC). MATERIALS AND METHOD: All patients admitted to the ENT department of a University Hospital Center for epistaxis under oral anticoagulation therapy between January 2010 and June 2015 were included in a retrospective study. Severity was assessed in terms of management and of hemoglobin level at admission...
May 4, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29691639/a-blind-area-of-origins-of-epistaxis-technical-or-cognitive
#6
Wei Wei, Yuting Lai, Chaoping Zang, Jiqin Luo, Bijun Zhu, Quan Liu, Ying Liu
PURPOSE: To investigate common origins and features of anterior epistaxis. METHODS: Patients (168) with anterior nose bleed were studied from May to October 2013. Endoscopic examination with angled endoscope and then subsequent management (radiofrequency, selective packing,) was performed. RESULTS: Under thorough nasal endoscopy, anterior nasal bleeding origin was ranked in turn as follows: the anterior nasal septum (NS 83.3%), the small area of anterior lateral wall of nasal cavity corresponding to the nasal back (NB 7...
April 24, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29683824/a-randomized-trial-comparing-the-effect-of-fiberoptic-selection-and-guidance-versus-random-selection-blind-insertion-and-direct-laryngoscopy-on-the-incidence-and-severity-of-epistaxis-after-nasotracheal-intubation
#7
Jeffrey Leighton Tong, Avery Tung
BACKGROUND: Epistaxis, or nasal bleeding, is a common complication after nasotracheal intubation (NTI). Because such bleeding is likely related to trauma during intubation, use of fiberoptic visualization and guidance rather than direct laryngoscopy may affect the incidence and severity of epistaxis. We compared the incidence of epistaxis after NTI using a fiberoptic versus a direct laryngoscopy approach. METHODS: Seventy patients who were able to breathe easily through unobstructed nostrils and required NTI as part of their anesthetic management were recruited...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29676168/transnasal-endoscopic-sphenopalatine-artery-ligation-compared-with-embolization-for-intractable-epistaxis-a-long-term-analysis
#8
G de Bonnecaze, Y Gallois, F Bonneville, S Vergez, B Chaput, E Serrano
Background Transnasal endoscopic sphenopalatine artery ligation (TESPAL) and selective embolization both provide excellent treatment success rate in the management of intractable epistaxis. Few long-term studies comparing these approaches have been previously published. Recommendations often present these techniques as alternatives, but there is no clear consensus. Objective The purpose of this study was to evaluate and compare the clinical efficacy of sphenopalatine artery ligation versus embolization to control intractable epistaxis...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29602670/topical-tranexamic-acid-for-the-treatment-of-acute-epistaxis-in-the-emergency-department
#9
Asha R Birmingham, Nathan D Mah, Ran Ran, Matthew Hansen
OBJECTIVE: To evaluate the effectiveness and potential benefits of topical tranexamic acid (TXA) in the management of acute epistaxis. METHODS: Retrospective review was performed among all patients presenting to the institution's emergency department (ED) with epistaxis between September 2014 and August 2016. Patients achieving hemostasis with standard of care agents, such as oxymetazoline, lidocaine, or epinephrine were excluded. The primary outcome was the ED length of stay (LOS)...
March 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29600317/septal-branches-of-the-anterior-ethmoidal-artery-anatomical-considerations-and-clinical-implications-in-the-management-of-refractory-epistaxis
#10
Mario Turri-Zanoni, Alberto Daniele Arosio, Aldo Cassol Stamm, Paolo Battaglia, Giovanni Salzano, Antonio Romano, Paolo Castelnuovo, Frank Rikki Canevari
PURPOSE: Epistaxis is a commonly presenting complaint. In severe cases, nosebleeds may occur despite antero-posterior nasal packing and often in the absence of identifiable sources of bleeding. In such cases, epistaxis may occur from septal branches of the anterior ethmoidal artery (sbAEA). The purposes of this study are to highlight the clinical role of the sbAEA in different fields of endoscopic endonasal surgery and to evaluate the efficacy and safety of their selective endoscopic endonasal ligation in the management of refractory epistaxis...
March 29, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29592986/pleomorphic-adenoma-of-nasal-septum-a-rare-case
#11
Shama Shetty, Dipak Ranjan Nayak, Padmapriya Jaiprakash
The most common benign tumour of the major salivary glands is the pleomorphic adenoma. They are seen rarely in the minor salivary glands, usually in hard palate, soft palate and nasopharynx. Pleomorphic adenomas in nasal cavity are unusual and may be misdiagnosed because they have predominant myoepithelial cellularity and fewer myxoid stromata compared with those elsewhere. We present a case of 38-year-old male with a 2-year history of left nasal obstruction and epistaxis since 6 months. Diagnostic nasal endoscopic examination showed a soft lobulated mass in left nasal cavity attached to anterior part of the septum...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29554974/renal-dialysis-and-long-term-treatment-of-a-dog-with-kidney-disease-associated-with-canine-leishmaniosis
#12
Gad Baneth, Gilad Segev, Michal Mazaki-Tovi, Hila Chen, Sharon Kuzi
BACKGROUND: Renal disease is considered the main cause of natural mortality in dogs with canine leishmaniosis. The pathological mechanisms associated with kidney injury in canine leishmaniosis include immune complex glomerulonephritis, tubulointerstitial nephritis and occasionally renal amyloidosis. Proteinuria is a frequent finding in canine leishmaniosis and its quantification by the urine protein-creatinine ratio (UPC) is an important parameter in the staging of canine lesihmaniosis as presented by the LeishVet group...
March 20, 2018: Parasites & Vectors
https://www.readbyqxmd.com/read/29554892/immune-thrombocytopenic-purpura-presenting-in-a-patient-after-renal-transplant-for-diabetic-nephropathy
#13
Raja Muhammad Rashid, Zahid Nabi, Ahmad Zaki Ansari, Quratul-Ain Qaiser
BACKGROUND: Immune thrombocytopenic purpura (ITP) is primarily characterized by immune-mediated destruction of platelets in circulation. Major treatment options range from careful observation, steroids, immunosuppressive medications, immunoglobulins to splenectomy. Interestingly and rarely, ITP has also been reported after solid organ transplantation in patients receiving immunosuppressive medications. While the incidence of new onset ITP after solid organ transplant is comparatively well documented, new onset ITP after renal transplant has only been reported in two patients...
March 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29554412/incidence-of-epistaxis-after-endoscopic-pituitary-surgery-proposed-treatment-algorithm
#14
Lee A Zimmer, Norberto Andaluz
Endoscopic transsphenoidal surgery for pituitary tumors is an increasingly common practice. Little has been reported on the incidence and treatment of postoperative epistaxis in this population. The aim of this study was to analyze the incidence of postoperative epistaxis and formulate a treatment algorithm based on our experience. We performed a case series with chart review. A total of 434 consecutive patients who had endoscopic transsphenoidal pituitary surgery were identified between April 2006 and November 2013...
March 2018: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29481516/bidirectional-management-of-a-transnasal-intracranial-chopstick-transecting-optic-nerve
#15
Tsung-You Tsai, Li-Ang Lee, Wei-Chieh Chao, Yi-Chan Lee
Herein, the authors report a rare patient with a transnasal intracranial penetration injury caused by a chopstick that resulted in optic nerve transection as well as the removal of the chopstick using a bidirectional approach. A 25-year-old male presented to our emergency department with right blindness and bilateral epistaxis. Preoperative computed tomographic angiography demonstrated a transnasal stick-like foreign body causing a skull base fracture and suspected vascular injury. Due to the shape of the chopstick and the high risk of massive bleeding, an exclusively endoscopic or open craniotomy approach is not suitable for removal...
February 23, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#16
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29395350/intravenous-bevacizumab-for-refractory-hereditary-hemorrhagic-telangiectasia-related-epistaxis-and-gastrointestinal-bleeding
#17
Vivek N Iyer, Dinesh R Apala, Bibek S Pannu, Aditya Kotecha, Waleed Brinjikji, Michael D Leise, Patrick S Kamath, Sanjay Misra, Kebede H Begna, Rodrigo Cartin-Ceba, Hilary M DuBrock, Michael J Krowka, Erin K O'Brien, Rajiv K Pruthi, Darrell R Schroeder, Karen L Swanson
OBJECTIVE: To present a multiyear clinical experience with intravenous bevacizumab for the management of severe gastrointestinal bleeding and/or epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). PATIENTS AND METHODS: All patients treated with intravenous bevacizumab for severe hereditary hemorrhagic telangiectasia-related bleeding from June 1, 2013, through January 31, 2017, were included in this report. Severity of epistaxis (determined using the Epistaxis Severity Score questionnaire); hemoglobin, iron, and ferritin levels; and quality of life data were collected serially in all patients...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29362165/preoperative-detailed-coagulation-tests-are-required-in-patients-with-noonan-syndrome
#18
Anne Morice, Annie Harroche, Pascale Cairet, Roman H Khonsari
PURPOSE: Patients with Noonan syndrome often require surgery at young ages. They are at high risk of perioperative bleeding from coagulation defects that might not have been detected by routine screening. These risks are rarely described in the oral and maxillofacial surgery (OMS) literature. The aim of this study was to evaluate the perioperative bleeding risks associated with Noonan syndrome and to propose preoperative guidelines. MATERIALS AND METHODS: This report describes a retrospective case series of patients with Noonan syndrome who underwent OMS procedures during a continuous observational period (2013 through 2016) in the authors' center...
December 29, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29350840/a-phase-3-trial-of-mometasone-furoate-sinus-implants-for-chronic-sinusitis-with-recurrent-nasal-polyps
#19
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
April 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29345234/current-approaches-to-epistaxis-treatment-in-primary-and-secondary-care
#20
Rafael Beck, Martin Sorge, Antonius Schneider, Andreas Dietz
BACKGROUND: The lifetime prevalence of epistaxis is approximately 60%, and 6-10% of the affected persons need medical care. In rare cases, severe bleeding calls for the rapid initiation of effective treatment. METHODS: This review is based on pertinent articles that were retrieved by a selective search PubMed, and on the authors' clinical experience. RESULTS: There are no German guidelines for the management of epistaxis. The available evidence consists mainly of retro spective analyses and expert opinions...
January 8, 2018: Deutsches Ärzteblatt International
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