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Massive bleeding

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https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#1
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28530488/the-effect-of-angiojet-rheolytic-thrombectomy-in-the-endovascular-treatment-of-lower-extremity-deep-venous-thrombosis
#2
Mert Dumantepe, Ibrahim Uyar
Objective To evaluate the clinical safety and effectiveness of percutaneous rheolytic thrombectomy in patients with acute lower extremity deep venous thrombosis. Method Sixty-eight consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. A percutaneous rheolytic thrombectomy device (Angiojet ® Rheolytic thrombectomy catheter, Boston Scientific, Marlborough, MA, USA) was used in all patients in an angiography suite through ipsilateral popliteal vein access...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28525329/thromboelastographic-profile-of-goat-blood-after-the-experimental-injury-of-the-femoral-artery-and-use-of-quikclot-gauze-and-celox-gauze-dressings
#3
P Sobiech, Z Adamiak, P Holak, P Jastrzębski, J Rogowski, M Brzeziński, K Bury, M Jałyński, W Baumgartner
The aim of this study was to evaluate the suitability of thromboelastometry for the analysis of blood test results in goats after the use of hemostatic dressings to control massive bleeding. The study was carried out on 12 goats, 6 animals in each of two subgroups. In all experimental animals incision of the femoral artery was performed, and bleeding was controlled with QuikClot gauze in the first group and Celox gauze in the second group. Dressings were applied for 60 minutes. Blood samples for thromboelastometry were collected from the jugular vein before the incision and 60 min after the application of a dressing...
March 28, 2017: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/28523318/hemobilia-through-aneurysm-of-the-right-hepatic-artery-22-months-after-laparoscopic-cholecystectomy-case-presentation
#4
Octavian Marius CreŢu, Radu Gheorghe Dan, Iulian Alexandru Ciprian Blidişel, LaurenŢiu Vasile Sima, Mihnea Munteanu, Ion Păun
Hemobilia is a rare cause of upper digestive bleeding, and it should be suspected when there are traumas of the liver area or surgical or exploratory interventions of the liver-bile-pancreas area in the patient's history. Iatrogenic bleeding occurs, most often, after transcutaneous bile punctures, laparoscopic cholecystectomies, cateterisms of the biliary ways. After such interventions, hemobilia may appear earlier, but also up to a few months later. We present a case of massive hemobilia occurring 22 months after a laparoscopic cholecystectomy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523092/management-of-a-life-threatening-bleeding-following-extraction-of-deciduous-second-molar-related-to-a-capillary-haemangioma
#5
REVIEW
Amr Amin Ghanem, Yasser Nabil El Hadidi
Various forms of vascular lesion affect the head and neck region. The head and neck vascular lesions are classified into neoplasms and malformations. Neoplasm presents either as hemangioma or lymphangioma; neoplasm usually presents in young age compared with vascular malformation. A 9-year-old female patient presented to the outpatient clinic referred from the department of pedodontics after extraction of a right mandibular second deciduous molar. Extraction was done by dental GP in outpatient clinic. Massive bleeding followed the extraction...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#6
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28507835/endoscopic-view-of-gastroduodenal-artery-coils-at-the-base-of-duodenal-ulcer-in-case-of-recurrent-massive-upper-gastrointestinal-bleed
#7
Rawaa Ebrahem, Salam Kadhem, John W Frey, William Salyers
Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28507028/rig-i-like-receptor-triggering-by-dengue-virus-drives-dendritic-cell-immune-activation-and-th1-differentiation
#8
Joris K Sprokholt, Tanja M Kaptein, John L van Hamme, Ronald J Overmars, Sonja I Gringhuis, Teunis B H Geijtenbeek
Dengue virus (DENV) causes 400 million infections annually and is one of several viruses that can cause viral hemorrhagic fever, which is characterized by uncontrolled immune activation resulting in high fever and internal bleeding. Although the underlying mechanisms are unknown, massive cytokine secretion is thought to be involved. Dendritic cells (DCs) are the main target cells of DENV, and we investigated their role in DENV-induced cytokine production and adaptive immune responses. DENV infection induced DC maturation and secretion of IL-1β, IL-6, and TNF...
May 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28503249/hierarchical-models-for-multiple-rare-outcomes-using-massive-observational-healthcare-databases
#9
Trevor R Shaddox, Patrick B Ryan, Martijn J Schuemie, David Madigan, Marc A Suchard
Clinical trials often lack power to identify rare adverse drug events (ADEs) and therefore cannot address the threat rare ADEs pose, motivating the need for new ADE detection techniques. Emerging national patient claims and electronic health record databases have inspired post-approval early detection methods like the Bayesian self-controlled case series (BSCCS) regression model. Existing BSCCS models do not account for multiple outcomes, where pathology may be shared across different ADEs. We integrate a pathology hierarchy into the BSCCS model by developing a novel informative hierarchical prior linking outcome-specific effects...
August 2016: Statistical Analysis and Data Mining
https://www.readbyqxmd.com/read/28503128/a-confounding-case-of-inherited-factor-v-deficiency-complicated-by-inhibitors-at-first-presentation
#10
Hema Subramanian, Rakhee Kar, Deepak Charles, Hitha Babu, Pagadalu Ambika, Tarun Kumar Dutta
INTRODUCTION: Inherited factor V deficiency / Owren's disease has varied clinical manifestations ranging from asymptomatic laboratory abnormalities to massive hemorrhage. The acquired form due to inhibitors following antibiotic therapy, infection, or surgery is less common, and spontaneous development of inhibitors is not known. CASE REPORT: An 18-year-old boy presented with bleeding axillary and groin ulcers. At the age of 15, due to recurrent epistaxis and gum bleed, he was diagnosed with acquired factor V deficiency with positive inhibitor screen and treated with fresh frozen plasma (FFP) transfusion and temporary azathioprine...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28501664/systemic-thrombolytic-therapy-and-catheter-directed-fragmentation-with-local-thrombolytic-therapy-in-patients-with-pulmonary-embolism
#11
Julia Klevanets, Vladimir Starodubtsev, Pavel Ignatenko, Olga Voroshilina, Pavel Ruzankin, Andrey Karpenko
The objective was to compare immediate and long-term results of systemic thrombolytic therapy (STT) and catheter-directed fragmentation (CDF) with local thrombolytic therapy (LTT) in patients with massive pulmonary embolism (PE). METHODS: 209 patients with massive PE (the high risk of early death) were included in our study. From 2008 till 2010 in the first group (n=102) STT was performed. From 2011 till 2013 in the second group (n=107) CDF with LTT was carried out. Echocardiography and pulmonary arteriography were performed in all patients on admission to hospital and in 5 days after treatment...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28497841/effect-of-fluid-resuscitation-with-balanced-solutions-on-platelets-in-vitro-simulation-of-20-volume-substitution
#12
Łukasz J Krzych, Piotr F Czempik
BACKGROUND: Fluid resuscitation in massive bleeding may cause coagulation disorders by dilution of platelets and clotting factors or by the definite influence on theirfunction. The aim of this study was to investigate the effects of balanced crystalloid and colloid solutions on platelets (PLT) in vitro using complex assessment of coagulation. METHODS: The study group was comprised of 32 American Society of Anesthesiologists physical status class I male volunteers, aged 21-35 (29 ± 4) years, weighting 59-103 (81...
May 12, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28493300/timing-of-surgery-for-placenta-previa-with-suspected-abnormally-invasive-placentation-a-test-of-team-competency
#13
Shigeki Matsubara, Hironori Takahashi, Daisuke Matsubara, Akihide Ohkuchi
For patients with placenta previa (PP) with a suspected abnormally invasive placenta (AIP), "the higher the 'concern' for preterm delivery and severity of AIP, the earlier the surgery date" may be better. Perlman et al. (1) showed that "scheduled surgery" at ≥36 weeks was possible for many patients. The incidence of massive bleeding did not differ among 34, 35 vs. ≥36 weeks. They concluded "patients with 'no concern' for percreta/increta or no prior cesarean section (and no preterm-delivery risk) may be candidates for later delivery"...
May 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28492158/metachronous-metastatic-renal-cell-carcinoma-to-the-jejunum-presenting-with-massive-lower-gastrointestinal-bleeding
#14
Reem Al- Salamah, Hamad Hadi Al- Qahtani, Jaber Ali Alfaifi, Saleh Al- Harbi
Metastatic renal cell carcinoma (MRCC) is a rare cause of massive lower gastrointestinal bleeding (LGIB). We report a 51-year man who underwent left nephrectomy for renal cell carcinoma (RCC) 6 years ago. presenting with massive LGIB. Preoperative abdominal computed tomography (CT) revealed small bowel mass. Exploration of the abdomen revealed jejunal mass. Resection of the mass along with the jejunal segment with end-to-end anastomosis was performed. Histopathology of the jejunal mass confirmed MRCC. MRCC should be expected as a source of massive LGIB in a patient with history of RCC...
April 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28486321/evaluation-tool-for-assessing-a-newly-implemented-massive-transfusion-protocol
#15
Shannon Broxton, Regina Medeiros, Autumn Schumacher
Exsanguination requires massive blood product replacement and termination of the bleeding source to prevent hemorrhagic shock and death. Massive transfusion protocols (MTPs) are algorithms that allow the health care team to quickly stabilize the bleeding patient and guide blood product administration. However, no national MTP guidelines or a standardized evaluation tool exist for collecting and reporting MTP-related data. The purpose of this article is to describe an original MTP evaluation tool, how it was used, barriers encountered, and a framework for reporting the MTP evaluation data...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#16
Ncedile Mankahla, David LeFeuvre, Allan Taylor
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28480107/clinical-features-microsurgical-treatment-and-outcome-of-vestibular-schwannoma-with-brainstem-compression
#17
Ali Harati, Kai-Michael Scheufler, Rolf Schultheiss, Albaraa Tonkal, Kamran Harati, Paul Oni, Thomas Deitmer
BACKGROUND: Presenting symptoms, treatment considerations, and outcome are strongly related to the extension of vestibular schwannomas (VS). The aim of the current retrospective study was to analyze the clinical features, microsurgical treatment, and outcome of VS with brainstem compression. METHODS: Forty-nine patients presented with VS (Hannover grading scale T4a or T4b) in our department. A subgroup analysis was performed among patients without (T4a) and with (T4b) compression and dislocation of the fourth ventricle...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28479812/unilateral-vision-loss-without-ophthalmoplegia-as-a-rare-complication-of-spinal-surgery
#18
Elif Akpınar, Mehmet Sabri Gürbüz, Gülfidan Bitirgen, Mehmet Özerk Okutan
Postoperative visual loss is an extremely rare complication of nonocular surgery. The most common causes are ischemic optic neuropathy, central retinal artery occlusion, and cerebral ischemia. Acute visual loss after spinal surgery is even rarer. The most important risk factors are long-lasting operations, massive bleedings, fluid overload, hypotension, hypothermia, coagulation disorders, direct trauma, embolism, long-term external ocular pressure, and anemia. Here, we present a case of a 54-year-old male who developed acute visual loss in his left eye after a lumbar instrumentation surgery and was diagnosed with retinal artery occlusion...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28477034/pulsating-tonsil-due-to-medial-displacement-of-the-internal-carotid-artery
#19
Albaraa Y Alsini, Alsheikhi Ibrahim
BACKGROUND The internal carotid artery (ICA) is about 2.5 cm away from the tonsils. It has no branches in the cervical portion. ICA anomalies of the neck zone may result in a massive arterial bleeding during pharynx and neck surgery. Due to these anomalies, the surgeon must be aware of this risk during tonsillectomy, adenoidectomy, and pharyngeal operations.  CASE REPORT A 23-year-old woman who was discovered to have an acute S curling-type anomaly of the ICA in contact with the lateral border of the right tonsil during a work-up for a tonsillectomy...
May 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28474658/spontaneous-massive-hemopneumothorax-double-trouble-with-a-twist
#20
Milta Kuriakose, Arjun Khanna, Deepak Talwar
Spontaneous hemopneumothorax (SHP) is observed in 3%-7% cases of spontaneous pneumothorax where the tear of an adhesion can lead to bleeding with associated hemothorax. This condition has been reported in patients with hemophilia, sarcoidosis, congenital cystic adenomatoid malformation, systemic lupus erythematosus, etc., Here, we describe an unusual case of acute massive SHP in a 62-year-old male who underwent a percutaneous transluminal coronary angioplasty (PTCA) and presented with worsening dyspnea over the next 3 days...
May 2017: Lung India: Official Organ of Indian Chest Society
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