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https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#1
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
March 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28333828/prehospital-blood-transfusion-programs-capabilities-and-lessons-learned
#2
Martin D Zielinski, James R Stubbs, Kathleen S Berns, Elon Glassberg, Alan D Murdock, Eilat Shinar, Geir Arne Sunde, Steve Williams, Mark H Yazer, Scott Zietlow, Donald H Jenkins
The Trauma and Hemostasis Oxygenation Research (THOR) network has met in Bergen, Norway every summer over the past six years in an effort to have experts in transfusion, blood banking, military medicine, and trauma surgery exchange ideas, share their experiences, and set an agenda to move the science of remote damage control resuscitation forward. In this manuscript, we supply the lessons shared from the authors/speakers to the reader. These lessons include the experiences of the Norwegian Military with freeze dried plasma and whole blood resuscitation, lessons from extreme remote damage control resuscitation situations on oceanic cruises, and remote blood product resuscitation techniques at Mayo Clinic and the University of Pittsburgh...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#3
Hanna Kaisa Tolska, Annika Takala, Karin Blomgren, Katri Hamunen, Vesa Kontinen
BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28327067/common-carotid-artery-ligation-to-minimize-blood-loss-during-oral-and-maxillofacial-surgery
#4
Alice E Goodman, Andrew R Goodman
Oral and maxillofacial surgery in veterinary medicine carries the risk of severe hemorrhage due to the great vascular supply of the head. Temporary hemostasis can be achieved with the application of pressure or hemostatic agents, but more definitive treatment may be needed to ensure bleeding will not resume once the patient is awake and normotensive. (1 , 2) Actively bleeding vessels encountered during maxillofacial surgery may be inaccessible, and vessels may recoil into bone, sometimes preventing definitive ligation...
September 2016: Journal of Veterinary Dentistry
https://www.readbyqxmd.com/read/28326680/the-effect-of-desmopressin-on-the-amount-of-bleeding-and-transfusion-requirements-in-patients-undergoing-heart-transplant-surgery
#5
Alireza Jahangirifard, Mohammad Reza Razavi, Zargham Hosein Ahmadi, Mohammad Forozeshfard
One of the most common risks after a heart transplant is bleeding. In this study, the effect of desmopressin administration on the amount of bleeding and transfusion requirements following heart transplant surgery was investigated. In a double-blind clinical trial, 48 patients who were candidates for heart transplant surgery were randomly assigned to two groups. In the intervention group, patients received desmopressin 0.3 μg/kg, 30 min. before surgery. Patients in the control group received normal saline at the same amount and time...
March 22, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28326242/nasal-lobular-capillary-hemangioma-as-a-complication-after-an-endoscopic-transsphenoidal-gonadotrophin-producing-pituitary-adenoma-resection
#6
Dalila Forte, Amets Sagarribay Irañeta, Anabela Nabais, António Figueiredo, Manuela Mafra, Victor Gonçalves
Background Lobular capillary hemangioma is a rare benign tumor, most frequently located in the head or neck region, the nasal cavity being uncommonly affected. Its etiopathogenesis is not fully established, although traumatic and hormonal factors have been implied. Case Description A 50-year-old female patient underwent an uneventful endoscopic transsphenoidal removal of a pituitary cystic macroadenoma at our institution. Nasal packing was used in postoperative hemostasis. Histopathology was compatible with a gonadotrophin-producing adenoma...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28319440/markers-of-blood-coagulation-and-fibrinolysis-in-patients-with-early-and-delayed-microsurgical-reconstructions-in-the-lower-extremities
#7
Oliver Kloeters, Dalibor Vasilic, Pieter Hupkens, Dietmar Ulrich
BACKGROUND: In this study, markers of coagulation and fibrinolysis were assessed during early and delayed microsurgical reconstruction in patients with traumatic defects of their lower legs to analyse whether an imbalance of the hemostasis after trauma might predispose the development of vascular complications. METHODS: The prospective study included 70 patients. In 35 patients, surgery was performed within 72 hours after injury. In 35 other patients, delayed free flap transfer was performed between 14-21 days after trauma...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28314905/comparison-of-two-and-three-dimensional-display-for-performance-of-laparoscopic-total-gastrectomy-for-gastric-cancer
#8
Shingo Kanaji, Satoshi Suzuki, Hitoshi Harada, Masayasu Nishi, Masashi Yamamoto, Takeru Matsuda, Taro Oshikiri, Tetsu Nakamura, Yasuhiro Fujino, Masahiro Tominaga, Yoshihiro Kakeji
PURPOSE: Introduction of three-dimensional (3D) display might remove technical obstacles of laparoscopic surgery and improve laparoscopic skills. We analyzed the effect of 3D technology on operative performance during laparoscopic total gastrectomy (LTG) for gastric cancer and assessed its advantages over two-dimensional (2D) laparoscopy. METHODS: This study included 30 consecutive surgeries of LTG with esophagojejunostomy by the overlap method performed (3D group, n = 15, 2D group, n = 15)...
March 17, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28296728/a-meta-analysis-comparing-the-outcomes-of-ligasure-small-jaw-versus-clamp-and-tie-technique-or-harmonic-focus-scalpel-in-thyroidectomy
#9
COMPARATIVE STUDY
Lei Zhang, Namei Li, Xuemei Yang, Jie Chen
BACKGROUND: LigaSure (LS) Small Jaw is a surgical hemostasis equipment that is newly introduced in thyroid surgery. The objective of this study is to assess the short-term efficacy and safety outcomes of LS Small Jaw compared with clamp-and-tie technique or Harmonic Focus Scalpel in thyroidectomy. METHODS: A literature search was performed in the PubMed and Embase databases (until June 12, 2016) that reported the comparisons between LS Small Jaw and other techniques in thyroidectomy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28296287/bio-inspired-nanomedicine-strategies-for-artificial-blood-components
#10
REVIEW
Anirban Sen Gupta
Blood is a fluid connective tissue where living cells are suspended in noncellular liquid matrix. The cellular components of blood render gas exchange (RBCs), immune surveillance (WBCs) and hemostatic responses (platelets), and the noncellular components (salts, proteins, etc.) provide nutrition to various tissues in the body. Dysfunction and deficiencies in these blood components can lead to significant tissue morbidity and mortality. Consequently, transfusion of whole blood or its components is a clinical mainstay in the management of trauma, surgery, myelosuppression, and congenital blood disorders...
March 15, 2017: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/28292635/value-of-round-ligament-artery-embolization-in-the-management-of-postpartum-hemorrhage
#11
Grégoire Leleup, Audrey Fohlen, Anthony Dohan, Lara Bryan-Rest, Vincent Le Pennec, Olivier Limot, Olivier Le Dref, Philippe Soyer, Jean-Pierre Pelage
PURPOSE: To evaluate the feasibility and efficacy of embolization of the round ligament arteries in the management of postpartum hemorrhage. MATERIALS AND METHODS: Eleven women (mean age, 31 y) underwent round ligament artery because of persistent or recurrent hemorrhage after initial uterine or internal iliac artery embolization. RESULTS: A total of 16 round ligament arteries were embolized. The round ligament artery arose from the inferior epigastric artery in 11 cases (69%) and directly from the external iliac artery in 5 (31%)...
March 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#12
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28287015/cost-consequence-analysis-of-two-different-active-flowable-hemostatic-matrices-in-spine-surgery-patients
#13
D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#14
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28284576/hemostasis-in-endoscopic-endonasal-skull-base-surgery-using-the-aquamantys-bipolar-sealer-technical-note
#15
Richard Bram, Susan Fiore, Daryl McHugh, Ghassan J Samara, Raphael P Davis
BACKGROUND: A major challenge during endoscopic transsphenoidal surgery is adequate intraoperative hemostasis. The Aquamantys® is a relatively new bipolar sealing device which uses radiofrequency energy and saline. This promotes hemostasis while decreasing charring and thermal spread. In this paper, we describe our experience with the Aquamantys® Mini EVS 3.4 Epidural Vein Sealer Bipolar Electrocautery System (Medtronic Advanced Energy, Portsmouth, NH, USA) during endoscopic surgery for tumors of the skull base with particular attention to ergonomic benefits and technical nuances...
March 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28284452/advances-in-absorbable-biomaterials-and-nasal-packing
#16
REVIEW
Conner J Massey, Ameet Singh
Nasal biomaterials have been developed to improve postoperative outcomes after functional endoscopic sinus surgery (FESS). These products have been designed to overcome certain common complications in FESS, and to maximize patient comfort. This article evaluates the performance of nonabsorbable and absorbable packing with respect to these outcomes. The collected trials suggest superior performance of bioabsorbable packs compared with absorbable packs with respect to patient comfort. For hemostasis and wound healing, variation in performance metrics makes interstudy comparison difficult...
March 9, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28283245/effect-of-tranexamic-acid-on-intraoperative-blood-loss-and-transfusion-requirements-in-patients-undergoing-excision-of-intracranial-meningioma
#17
Bhavna Hooda, Rajendra Singh Chouhan, Girija Prasad Rath, Parmod Kumar Bithal, Ashish Suri, Ritesh Lamsal
Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery...
March 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28283215/the-use-of-bovine-serum-albumin-glutaraldehyde-tissue-adhesive-bioglue-%C3%A2-for-tumor-bed-closure-following-open-partial-nephrectomy
#18
Z Bahouth, S Halachmi, S Shprits, Y Burbara, O Avitan, I Masarwa, B Moskovitz, O Nativ
OBJECTIVES: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure in open nephron-sparing surgery (NSS). MATERIALS AND METHODS: The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in-situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue(®) sealant for tumor bed filling, without suturing the edges...
March 7, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28280667/intradermal-infiltration-of-local-anesthetic-rapid-and-bloodless-deepithelialization-of-the-breast-pedicle
#19
Katelyn G Bennett, Robert H Gilman
Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28276202/safety-osseointegration-and-bone-ingrowth-analysis-of-pmma-based-porous-cement-on-animal-metaphyseal-bone-defect-model
#20
Bruno Cimatti, Mariana Avelino Dos Santos, Maria Sol Brassesco, Laura Tiemi Okano, Wendell Monteiro Barboza, Marcello Henrique Nogueira-Barbosa, Edgard Eduard Engel
Bone defects created after curettage of benign bone tumors are customarily filled with solid poly(methyl methacrylate) (PMMA) or other bone substitutes. In this study, we depicted a porous PMMA-based cement (produced by mixing sodium bicarbonate and citric acid) and evaluated the prospect of its clinic application. Cement samples were characterized by high-performance liquid chromatography (HPLC) coupled to mass spectrometry and its cytotoxicity evaluated in fibroblast cultures. Implantation in rabbits allowed the histologic analysis of bone, kidneys, and liver for toxicity and coagulation tests, and MRI images for hemostasis evaluation...
March 9, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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