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https://www.readbyqxmd.com/read/28515859/conservative-management-of-aortic-root-rupture-complicated-with-cardiac-tamponade-following-transcatheter-aortic-valve-implantation
#1
Luca Vannini, Rut Andrea, Manel Sabaté
Aortic root rupture and cardiac tamponade during transcatheter aortic valve implantation is a frightening complication with high mortality rate. A conservative management of this complication could represent an initial strategy, especially in high-risk patients, to avoid emergent cardiac surgery. This conservative management includes: Immediate detection of pericardial effusion by echocardiography, a fast instauration of pericardial drainage, auto-transfusion and anticoagulation reversal. We describe two cases of patients who suffered this complication and were treated successfully with this initial approach...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28509435/inpatient-iron-deficiency-detection-and-management-how-do-general-physicians-and-gastroenterologists-perform-in-a-tertiary-care-hospital
#2
Muhammad Waqas Fazal, Jane Andrews, Josephine Thomas, Eliana Saffouri
BACKGROUND: Iron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long term morbidity, and allows for prompt iron repletion avoiding ID anaemia (IDA) and need for blood transfusion. AIM: We aimed to evaluate the management of ID in two internal medicine units [General Medical (GM) & Gastroenterology (GE)] in a large metropolitan hospital and compare it to international guidelines.(3,4) METHOD: All consecutive inpatient admissions under GM & GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#3
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28496021/feasibility-and-safety-of-transulnar-catheterization-in-ipsilateral-radial-artery-occlusion
#4
Shu-Kai Hsueh, Cheng-I Cheng, Hsiu-Yu Fang, Mostafa Mohammad Omran, Wen-Hao Liu, Wen-Jung Chung, Chien-Jen Chen, Cheng-Hsu Yang, Chih-Yuan Fang, Chiung-Jen Wu
To investigate the postprocedural cardiovascular events and vascular outcomes, including hand ischemia and neurological compromise, after transulnar (TU) catheterization in ipsilateral radial artery occlusion.Previous randomized trials have shown that the transulnar (TU) approach for coronary angiogram and intervention has safety and outcomes similar to those of the transradial (TR) approach. However, the safety of the TU procedure when ipsilateral radial artery occlusion occurs is unknown.We retrospectively reviewed 87 TU cases with ipsilateral radial artery occlusion confirmed by a forearm angiogram...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28492124/predicting-postoperative-haemoglobin-changes-after-burn-surgery
#5
Petrus Slabber, Zane Farina, Nikki Allorto, Reitze Nils Rodseth
BACKGROUND: Burn surgery is associated with significant blood loss and fluid shifts that cause rapid haemoglobin (Hb) changes during and after surgery. Understanding the relationship between intraoperative and postoperative (day 1) Hb changes may assist in avoiding postoperative anaemia and unnecessary peri-operative blood transfusion. OBJECTIVE: To describe the Hb changes into the first day after burn surgery and to identify factors predictive of Hb changes that would guide blood transfusion decisions...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28477360/impact-of-transplant-accessibility-for-sensitized-patients-by-avoiding-unacceptable-antigens
#6
Arnaud Del Bello, Nicolas Congy-Jolivet, Benoit Audry, Corinne Antoine, Laure Esposito, Anne-Laure Hebral, Nassim Kamar
Recent data have confirmed the negative impact of preformed donor-specific antibodies after liver transplantation. In order to reduce the risk of developing lesions associated with acute and chronic antibody-mediated rejection in liver-transplant recipients, we evaluated the consequences in terms of transplant accessibility, associated with avoiding preformed DSAs according to several MFI-titer thresholds that have been previously reported to be relevant in liver transplantation. Among the 484 included LT candidates, 99 (20...
May 6, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28461823/neonatal-indirect-hyperbilirubinemia-and-glucose-6-phosphate-dehydrogenase-deficiency
#7
Hasan M Isa, Masooma S Mohamed, Afaf M Mohamed, Adel Abdulla, Fuad Abdulla
PURPOSE: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. METHODS: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed...
April 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28451416/laparoscopic-local-extraperitoneal-para-aortic-lymphadenectomy-description-of-a-novel-technique
#8
Xuyin Zhang, Jingxin Ding, Keqin Hua
The aim of the present study was to introduce and describe a novel technique, which has been termed 'laparoscopic local extraperitoneal para-aortic lymphadenectomy', and to evaluate its feasibility and safety. In this retrospective case study, a series of 21 patients were selected who underwent laparoscopic local extraperitoneal para-aortic lymphadenectomy for gynecological malignancies between March and August 2014 at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. All the surgical procedures were performed by the same operational team...
March 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28439902/concentrated-lyophilized-plasma-used-for-reconstitution-of-whole-blood-leads-to-higher-coagulation-factor-activity-but-unchanged-thrombin-potential-compared-with-fresh-frozen-plasma
#9
Giacomo E Iapichino, Martin Ponschab, Janne Cadamuro, Susanne Süssner, Christian Gabriel, Benjamin Dieplinger, Margot Egger, Christoph J Schlimp, Soheyl Bahrami, Herbert Schöchl
BACKGROUND: During massive hemorrhage, it is recommended to transfuse red blood cells, platelet concentrate, and fresh-frozen plasma in a ratio close to 1:1:1. To avoid the thawing process of fresh frozen plasma, lyophilized plasma (LP) is increasingly used. Evidence is limited on the activity of coagulation factors in reconstituted blood using LP and concentrated LP versions. STUDY DESIGN AND METHODS: Whole blood from ten healthy volunteers was separated into red blood cell, fresh frozen plasma, and platelet concentrate units...
April 25, 2017: Transfusion
https://www.readbyqxmd.com/read/28436074/an-evaluation-of-the-mixed-pediatric-unit-for-blood-loss-replacement-in-pediatric-craniofacial-surgery
#10
Stefan Mogensen, Norbert Lubenow, Pelle Nilsson, Henrik Engquist, Folke Knutsson, Per Enblad, Daniel Nowinski, Peter Frykholm
BACKGROUND: Surgical correction for craniosynostosis is often associated with significant perioperative hemorrhage. We implemented a transfusion strategy with a strict protocol including transfusion triggers, frequent assessment of coagulation tests, and the use of a novel transfusion unit, the mixed pediatric unit. AIM: The aim of the study was to evaluate if the applied transfusion strategy could reduce total blood loss and number of blood donors. METHODS: Children <1 year old admitted for craniosynostosis surgery were included for the study...
April 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28416828/-application-of-bilateral-direct-anterior-approach-total-hip-arthroplasty-a-report-of-22-cases
#11
J Tang, M Lv, Y X Zhou, J Zhang
OBJECTIVE: To analyze the operation technique and the methods to avoid early complications on the learning curve for bilateral direct anterior approach (DAA) total hip arthroplasty (THA). METHODS: We retrospectively studied a series of continued cases with bilateral avascular necrosis of the femoral head (AVN) or degenerative dysplastic hip and rheumatoid arthritis that were treated by DAA THA in Beijing Jishuitan Hospital. A total of 22 patients with 44 hips were analyzed from June 2014 to August 2016 in this study...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28410631/comparison-of-three-caval-reconstruction-techniques-in-orthotopic-liver-transplantation-a-retrospective-review
#12
Tiffany Chan, Kristin DeGirolamo, Stephanie Chartier-Plante, Andrzej K Buczkowski
BACKGROUND: Classic caval reconstruction during liver transplantation involves complete cross-clamping and resection of the recipient inferior vena cava (IVC) followed by donor IVC interposition. Other techniques preserve the IVC, with piggyback (PB) to the hepatic veins or side-to-side (SS) caval anastomosis. Avoidance of cross-clamping may be beneficial for minimizing hemodynamic instability and transfusion requirements. METHODS: Retrospective review of a provincial transplant database (2007-2011)...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28410562/superior-vena-cava-reconstruction-under-the-left-internal-jugular-vein-to-left-femoral-vein-bypass-support
#13
Jun Ba, Runsheng Peng, Hui Shi, Chunsheng Wang
The complete surgical resection of malignant thymoma is recommended. We present a rare case of tumor resection and superior vena cava (SVC) reconstruction under veno-venous bypass support from the left internal jugular vein to the left femoral vein. The full amount of systemic heparinization (3 mg/kg) was avoided. The surgical pathology revealed thymic squamous cell carcinoma. No complications such as fatal extensive bleeding, coagulopathy, thromboembolism or transfusion reaction were found postoperatively...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28409618/zika-virus-common-questions-and-answers
#14
Irogue I Igbinosa, Ingrid B Rabe, Titilope Oduyebo, Sonja A Rasmussen
Since local mosquito-borne transmission of Zika virus was first reported in Brazil in early 2015, the virus has spread rapidly, with active transmission reported in at least 61 countries and territories worldwide, including the United States. Zika virus infection during pregnancy is a cause of microcephaly and other severe brain anomalies. The virus is transmitted primarily through the bite of an infected Aedes mosquito, but other routes of transmission include sexual, mother-to-fetus during pregnancy, mother-to-infant at delivery, laboratory exposure, and, possibly, transfusion of blood products...
April 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28409600/postpartum-hemorrhage-prevention-and-treatment
#15
Ann Evensen, Janice M Anderson, Patricia Fontaine
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration...
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28409222/incidental-splenic-nodules-found-on-mr-imaging-done-for-assessment-of-iron-overload-in-children
#16
Rayan A Ahyad, Christopher Z Lam, Omid Shearkhani, Oscar M Navarro
BACKGROUND: MR imaging is used to assess iron overload in patients with hemoglobinopathies and in those who have undergone multiple blood transfusions. Sometimes splenic nodules are found incidentally on these examinations and this may cause diagnostic uncertainty. OBJECTIVE: To determine the prevalence, imaging characteristics and evolution of splenic nodules found on MR imaging for iron overload evaluation. MATERIALS AND METHODS: Retrospective review of all MR imaging examinations performed for iron overload assessment from 2005 to 2015 in a tertiary pediatric hospital...
April 13, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28408234/the-acute-hemolytic-anemias-the-importance-of-emergency-diagnosis-and-management
#17
Jennifer J Robertson, Elizabeth Brem, Alex Koyfman
BACKGROUND: Hemolytic anemias are defined by the premature destruction of red blood cells. These anemias have many causes that are mostly due to chronic diseases, but, occasionally, cases of acute life-threatening hemolysis can occur. OBJECTIVE: The objectives of this article were to review the pathophysiology of hemolytic anemias, to discuss the general emergency department (ED) evaluation, and to discuss the assessment and treatment of important and "cannot miss" hemolytic diseases...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28392212/n-acetylcysteine-improves-the-quality-of-red-blood-cells-stored-for-transfusion
#18
Florencia Amen, Andrea Machin, Cristina Touriño, Ismael Rodríguez, Ana Denicola, Leonor Thomson
Storage inflicts a series of changes on red blood cells (RBC) that compromise the cell survival and functionality; largely these alterations (storage lesions) are due to oxidative modifications. The possibility of improving the quality of packed RBC stored for transfusion including N-acetylcysteine (NAC) in the preservation solution was explored. Relatively high concentrations of NAC (20-25 mM) were necessary to prevent the progressive leakage of hemoglobin, while lower concentrations (≥2.5 mM) were enough to prevent the loss of reduced glutathione during the first 21 days of storage...
May 1, 2017: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#19
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28369916/feeling-the-burn-the-significant-burden-of-febrile-nonhemolytic-transfusion-reactions
#20
Robert Cohen, Alioska Escorcia, Farzana Tasmin, Ana Lima, Yulia Lin, Lani Lieberman, Jacob Pendergrast, Jeannie Callum, Christine Cserti-Gazdewich
BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) are characterized by a post-transfusion temperature rise (of ≥ 1°C, to ≥ 38°C) or chills/rigors unrelated to the underlying condition. FNHTRs are provoked by inflammatory cytokines in the product or by host antileukocyte antibodies against residual donor leukocytes. FNHTRs are among the most commonly reported transfusion disturbances and are generally deemed nonserious events. However, their impact on patients and hospitals may be underestimated...
March 28, 2017: Transfusion
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