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https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#1
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28815410/efficacy-and-safety-of-a-4-factor-prothrombin-complex-concentrate-for-rapid-vitamin-k-antagonist-reversal-in-japanese-patients-presenting-with-major-bleeding-or-requiring-urgent-surgical-or-invasive-procedures-a-prospective-open-label-single-arm-phase-3b-study
#2
Shigeki Kushimoto, Toshio Fukuoka, Akio Kimura, Kazunori Toyoda, Andres Brainsky, Amy Harman, Thomas Chung, Masahiro Yasaka
Rapid vitamin K antagonist (VKA) reversal is required in patients experiencing major bleeding or requiring urgent surgery. Four-factor prothrombin complex concentrate (4F-PCC; Beriplex(®)/Kcentra(®)) was shown in two large randomized controlled, international phase 3b trials to be an effective alternative to plasma for urgent VKA reversal. In the present prospective, open-label, single-arm phase 3b trial, we evaluate the efficacy and safety of 4F-PCC in Japanese patients. Eleven patients [international normalized ratio (INR) ≥2] requiring rapid VKA reversal owing to major bleeding (n = 6) or before urgent surgical/invasive procedures (n = 5) were administered 4F-PCC dosed based on INR and weight...
August 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28805775/-the-features-of-diagnosis-and-treatment-of-traumatic-and-non-traumatic-pulmonary-bleeding
#3
Sh N Danielyan, M M Abakumov, E A Tarabrin, L S Kokov, A M Gasanov, A P Wilk, A A Saprin
AIM: To analyze an efficacy of differentiated approach for pulmonary bleeding of different etiology and severity. MATERIAL AND METHODS: The study included 134 cases of pulmonary bleeding for the period 2006-2015 including 53 patients with traumatic and 81 with non-traumatic etiology. Men/women ratio was 2.7:1, mean age was 43 years. Comparative retrospective analysis of X-ray and CT data in diagnosis of bleeding source was performed. Bronchoscopy was used to confirm these data...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28805608/the-utility-and-effectiveness-of-an-internal-iliac-artery-balloon-occlusion-catheter-in-surgery-for-large-cervical-uterine-fibroids
#4
Hiroshi Kaneda, Yasuhisa Terao, Yuko Matsuda, Kazunari Fujino, Takafumi Ujihira, Soshi Kusunoki, Miki Kimura, Akihiko Shiraishi, Ryohei Kuwatsuru, Satoru Takeda
OBJECTIVE: Surgery for uterine cervical fibroids is difficult because of restricted surgical access and risks such as intraoperative bleeding or injury to other organs. The internal iliac artery balloon occlusion catheter (IIABOC) provides effective hemostasis for placenta previa and atonic hemorrhage, and is increasingly used in surgery for uterine fibroids for controlling intraoperative hemorrhage. We investigated the efficacy and safety of the IIABOC for controlling intraoperative bleeding in total abdominal hysterectomies (TAH) and abdominal myomectomies (AM) for large cervical fibroids...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28804853/thromboelastography-teg
#5
Maha Othman, Harmanpreet Kaur
Thromboelastography (TEG) has been used for decades to guide transfusion therapy during cardiac and hepatic surgeries. Renewed interest and improved technology have led to wider applications of TEG in other areas of hemostasis. To correctly interpret the data generated and to validate outcomes, it is important to improve the understanding of the differences in the currently available assay procedures, the issues related to sample activation, and the importance of the use of appropriate controls. Current TEG assays use a variety of samples and can vary slightly in the procedures...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#6
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28776354/multidisciplinary-approach-to-refractory-upper-gastrointestinal-bleeding-case-series-of-angiographic-embolization
#7
Ko Eun Lee, Ki Nam Shim, Chung Hyun Tae, Min Sun Ryu, Sun Young Choi, Chang Mo Moon, Seong Eun Kim, Hey Kyung Jung, Sung Ae Jung
Although medical and endoscopic hemostasis is now considered as the first-line therapy for nonvariceal upper gastrointestinal (UGI) bleeding, refractory bleeding still occurs in 5%-10% of the patients. In these patients, transcatheter arterial embolization (TAE) or surgery is required, but research on embolization for unmanageable UGI bleeding in Korea is scanty. We reviewed the medical records of 518 patients who underwent endoscopic hemostasis during 4 years. Among these subjects, 8 patients who required embolization due to failure of endoscopic hemostasis were enrolled...
September 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28760134/life-threatening-bleeding-from-gastric-dieulafoy-s-lesion-in-a-pregnant-woman-with-hellp-syndrome-a-case-report-and-literature-review
#8
Chen Si, Zhu Xiuli, Xie Li, Jia Yong, Zhou Ying, Zhang Kaiguang
BACKGROUND: Dieulafoy's lesion (DL) is one of the rare causes of upper gastrointestional bleeding. This disease is characterized by small sub-mucosal arteriole that eroded the stomach mucosa and cause severe upper GI bleeding without obvious ulceration. The most common location is fundus area of stomach and usually affects patients over 50 years of age with multiple comorbidities. CASE PRESENTATION: We report a case of life-threatening bleeding from DL during late pregnancy 31 weeks...
July 31, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28757691/cut-and-place-technique-of-pterygium-excision-with-autograft-without-using-sutures-or-glue-our-experience
#9
Jagdish Bhatia, Mathew Varghese, Bindu Narayanadas, Arti Bhatia
BACKGROUND: Conjunctival sutures used in pterygium surgery are not only time-consuming process but also may lead to local complications such as discomfort, scarring, granuloma, or infection. Plasma-derived products such as fibrin glue may produce possible hypersensitivity reactions whereas the risk of viral transmission remains theoretically possible. We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin glue or sutures...
May 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28755919/use-of-laser-in-avm-surgery
#10
Cenzato Marco, Dones Flavia, Marcati Eleonora, Debernardi Alberto, Scerrati Alba, Piparo Maurizio
BACKGROUND: AVM surgery is particularly demanding as for the bleeding control of small deep white matter vessels during and after the removal of the nidus, this representing probably one of the most critical moments of AVMs surgery. OBJECTIVE: of the present manuscript is to describe a useful technique based on the use of tweezers to temporarily stop the blood flow followed by coagulation with thulium laser. METHODS: Twenty patients with unruptured cerebral AVMs underwent surgical treatment...
July 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28755096/analysis-of-the-hemostatic-potential-of-modern-topical-sealants-on-arterial-and-venous-anastomoses-an-experimental-porcine-study
#11
Hamidreza Fonouni, Arash Kashfi, Ali Majlesara, Oliver Stahlheber, Lukas Konstantinidis, Thomas W Kraus, Arianeb Mehrabi, Hani Oweira
One of the widely accepted adjunctive agents in the variety of surgical modalities are sealants. Our study aim was to compare four commonly used modern sealants in a standardized experimental setting to assess their feasibility, and hemostatic efficacy in vascular anastomosis. Forty landrace pigs (weight: 24.7 ± 3.8 kg) were randomized into the control (n = 8) and four sealant groups; TachoSil® (n = 8), Tissucol Duo® (n = 8), Coseal® (n = 8), and FloSeal® (n = 8). After doing a portal vein end-to-end anastomosis as well as stitches of aortic incision, the sealants were applied on anastomotic site...
September 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28753222/acute-hemorrhagic-rectal-ulcer-ahru-syndrome-comparison-with-non-ahru-lower-gastrointestinal-bleeding
#12
Joo Hyuk Jung, Jong Wook Kim, Hyun Woo Lee, Min Yong Park, Woo Hyun Paik, Won Ki Bae, Nam-Hoon Kim, Kyung-Ah Kim, June Sung Lee
AIM: Acute hemorrhagic rectal ulcer (AHRU) syndrome can cause massive, life-threatening rectal bleeding. Sigmoidoscopic hemostasis with enema can often be performed to effectively control rectal bleeding. METHODS: The medical records of AHRU patients were retrospectively reviewed. The baseline clinical characteristics were compared with those of non-AHRU lower gastrointestinal bleeding patients to identify predictive factors for AHRU. RESULTS: Among the 118 patients who underwent emergent endoscopy due to acute massive hematochezia from 2013 to 2015, 25 (21...
July 28, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28712898/iatrogenic-vertebral-artery-injury-during-anterior-cervical-spine-surgery-a-systematic-review
#13
REVIEW
Qing Guan, Long Chen, Ye Long, Zhou Xiang
BACKGROUND: Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. METHOD: The causes, presentation, diagnosis, management, prognosis, and prevention of VAI were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from 1980 to 2017 were retrieved. Data on diagnosis, surgical procedures and approach, site and cause of VAI, management, outcomes, and VA status were extracted...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28705341/-is-ultrasound-guidance-contributive-to-vascular-access-in-endovascular-therapy
#14
B Dakhil, F Couineau, J Hernigou, J Bardet, E Tella, P Bagan
OBJECTIVES: The aim of this study was to evaluate the contribution of ultrasound guidance (UG) to vascular puncture in endovascular therapy. Ultrasound guidance was evaluated by comparison with the rates of failures and complications of the traditional techniques of percutaneous vascular access. MATERIALS AND METHODS: We reviewed all the consecutive percutaneous revascularizations (percutaneous transluminal angioplasty and/or stenting, treatment of aneurysms and vascular traumatisms) since the standardization of the systems of closing (extra- and endovascular)...
July 2017: J Med Vasc
https://www.readbyqxmd.com/read/28699088/sepsis-prediction-in-critically-ill-patients-by-platelet-activation-markers-on-icu-admission-a-prospective-pilot-study
#15
Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot, Cécile Oury
BACKGROUND: Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical illness remains unknown. The aim of this work was to identify platelet markers that could predict sepsis occurrence in critically ill injured patients. METHODS: This single-center, prospective, observational, 7-month study was based on a cohort of 99 non-infected adult patients admitted to ICUs for elective cardiac surgery, trauma, acute brain injury, and post-operative prolonged ventilation and followed up during ICU stay...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28698745/new-surgical-technologies-could-facilitate-surgical-hemostasis-in-hemophilic-patients
#16
Milcho J Panovski, Igor V Fildishevski, Ljubomir Lj Ognjenovic, Violeta I Dejanova-Ilijevska
BACKGROUND: It's assumed that surgery in haemophilia can be accomplished these days safely. AIM: The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs. METHODS: Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28696876/experience-using-kaolin-impregnated-sponge-to-minimize-perioperative-bleeding-in-norwood-operation
#17
Takeshi Shinkawa, Jessica Holloway, Xinyu Tang, Jeffrey M Gossett, Michiaki Imamura
PURPOSE: A kaolin-impregnated hemostatic sponge (QuikClot) is reported to reduce intraoperative blood loss in trauma and noncardiac surgery. The purpose of this study was to assess if this sponge was effective for hemostasis during Norwood operation. DESCRIPTION: We conducted a retrospective review of patients undergoing Norwood operation in infancy between 2011 and 2016 at our institution. EVALUATION: Of 31 identified Norwood operations, a kaolin-impregnated sponge was used intraoperatively in 15 (48%) patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#18
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28677091/does-topical-hemostatic-agent-floseal-%C3%A2-have-a-long-term-adverse-effect-on-erectile-function-recovery-after-nerve-sparing-robot-assisted-radical-prostatectomy
#19
Eugenio Martorana, Bernardo Rocco, Shaniko Kaleci, Giacomo Maria Pirola, Luigi Bevilacqua, Luca Reggiani Bonetti, Stefano Puliatti, Salvatore Micali, Giampaolo Bianchi
OBJECTIVES: To investigate the long-term effects of Floseal(®) on erectile function recovery (EFR) after nerve-sparing robot-assisted radical prostatectomy (RALP). METHODS: We prospectively collected results of the self-administered International Index Erectile Function Questionnaire 1-5 and 15 (IIEF 1-5 and 15) of 532 consecutive patients who underwent RALP for prostate cancer in our institution between October 2007 and December 2015. Patients were divided into two groups according to Floseal(®) application after prostatectomy...
July 4, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28672139/management-of-surgical-third-lower-molar-extraction-and-postoperative-progress-in-patients-with-factor-vii-deficiency-a-clinical-protocol-and-focus-on-this-rare-pathologic-entity
#20
Pier Carmine Passarelli, Guido Pasquantonio, Antonio D'Addona
PURPOSE: The purpose of the present study was to analyze the management of surgical third molar extraction and postoperative progress in patients with a diagnosis of factor VII deficiency. Close collaboration between the oral-maxillofacial surgeon and hematologist will allow the team to categorize the risk and operate safely, thereby minimizing the incidence and severity of intraoperative and postoperative complications. MATERIALS AND METHODS: The present retrospective study included 7 patients with factor VII deficiency who had undergone third lower molar surgery...
June 14, 2017: Journal of Oral and Maxillofacial Surgery
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