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https://www.readbyqxmd.com/read/28100266/arranging-blood-for-elective-thyroid-surgeries-dilemma-continues-in-the-developing-world
#1
Salman Faridi, Aman Ahmad, Mirza Arshad Beg, Faisal Siddiqui, Muhammad Muzzammil Edhi, Mehmood Khan
BACKGROUND: Cross matched blood is frequently ordered based on a subjective anticipation of blood loss for a procedure. Excessive blood arrangement and wastage overburdens the blood bank in terms of work load and storage of blood, increases cost of medical care and results in injudicious use of a limited resource. The aim of this short report is to assess the current practice for arranging cross matched blood in elective thyroid surgeries by comparing cross match to blood transfused ratio...
January 18, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28097913/cost-consequence-analysis-of-different-active-flowable-hemostatic-matrices-in-cardiac-surgical-procedures
#2
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of FLOSEAL® Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions and shorter length of surgery than use of SURGIFLO(®) Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28078984/rasburicase-induced-methemoglobinemia-in-a-patient-with-glucose-6-phosphate-dehydrogenase-deficiency
#3
Maliha Khan, Shilpa Paul, Saad Farooq, Thein Hlaing Oo, Priya Ramshesh, Nitin Jain
BACKGROUND: Rasburicase is commonly used in patients with hematologic malignancies for tumor lysis syndrome prophylaxis and management. Methemoglobinemia is a serious rare adverse effect of rasburicase, more common in patients with G6PD deficiency. Prompt diagnosis and appropriate management of this condition can make the difference between successful recovery and significant morbidity. Here we discuss the link of rasburicase with methemoglobinemia and the pathophysiology behind increased incidence of this side effect in G6PD deficient patients...
January 11, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28070235/bevacizumab-and-gastrointestinal-bleeding-in-hereditary-hemorrhagic-telangiectasia
#4
George Ou, Cherry Galorport, Robert Enns
We report a case of severe, refractory gastrointestinal (GI) bleeding in a patient with hereditary hemorrhagic telangiectasia (HHT) whose massive transfusion dependence was lifted shortly after treatment with bevacizumab, an anti-vascular endothelial growth factor. The patient's bleeding had been refractory to repeated endoscopic interventions, tranexamic acid, and tamoxifen. However, following treatment with bevacizumab at 5 mg/kg every other week, nearly 300 units of packed red blood cell transfusions were avoided in one year's time...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#5
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060132/variation-in-transfusion-requirements-among-children-with-thalassemia-on-regular-transfusion-programs-which-formula-closely-predicts-the-actual-requirements
#6
Nikki Cornell, Michael Eisenhut, Stalin Ramprakash
BACKGROUND: Various different formulae are used to calculate blood transfusion volumes in thalassemia. Using the right formula will avoid iron overload and complications of undertransfusion. OBSERVATIONS: Five years of transfusion data in 11 children with thalassemia showed that no single formula-calculated transfusion volumes accurately. The formula used in the United Kingdom with a hematocrit of the transfused blood of 0.6: (0.4×body weight×desired raise in hemoglobin [g/L]) yielded a volume closest to empirically determined requirements on average...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28039503/does-postoperative-erythropoietin-reduce-transfusions-and-hemodynamic-instability-following-liposuction-either-alone-or-associated-with-abdominoplasty-or-mammaplasty-a-comparative-prospective-study-of-50-consecutive-patients
#7
Rodrigo G Rosique, Marina J F Rosique, Mariana Quintino Rabelo
INTRODUCTION: Erythropoietin (EPO) is a hematopoietic growth factor and an alternative to avoid blood transfusion in high-blood-loss surgeries. We evaluate EPO efficacy to reduce clinically relevant anemia and dehydration in patients undergoing liposuction. METHODS: We prospectively evaluated 50 consecutive patients subjected to liposuction greater than 2.5 L and alternately assigned into two comparable groups (25 patients each), except for the postoperative administration of erythropoietin (4000 UI per day subcutaneously) during five consecutive days...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28026072/activation-of-klf1-enhances-the-differentiation-and-maturation-of-red-blood-cells-from-human-pluripotent-stem-cells
#8
Cheng-Tao Yang, Rui Ma, Richard A Axton, Melany Jackson, A Helen Taylor, Antonella Fidanza, Lamin Marenah, Jan Frayne, Joanne C Mountford, Lesley M Forrester
Blood transfusion is widely used in the clinic but the source of red blood cells (RBCs) is dependent on donors, procedures are susceptible to transfusion-transmitted infections and complications can arise from immunological incompatibility. Clinically-compatible and scalable protocols that allow the production of RBCs from human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) have been described but progress to translation has been hampered by poor maturation and fragility of the resultant cells...
December 27, 2016: Stem Cells
https://www.readbyqxmd.com/read/28005739/minimally-invasive-strip-craniectomy-simplifies-anesthesia-practice-in-patients-with-isolated-sagittal-synostosis
#9
Daan P F van Nunen, Bart M Stubenitsky, Peter A Woerdeman, Kuo Sen Han, Corstiaan C Breugem, Aebele B Mink van der Molen, Jurgen C de Graaff
BACKGROUND: Traditional open corrective surgery for isolated sagittal synostosis entails significant blood loss, transfusion rates, morbidity, and a lengthy hospitalization. Minimally invasive strip craniectomy (MISC) was introduced to avoid the disadvantages of open techniques. OBJECTIVES: The aim of the study was, first, to compare the anesthesia practice in MISC and open extended strip craniectomy (OESC), and, second, to evaluate the incidence of perioperative complications in both surgical procedures...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005161/-epidural-anesthesia-for-fetoscopy-retrospective-analysis-of-a%C3%A2-one-year-cohort
#10
N Kiefer, S F Suter, C Berg, U Gembruch, S U Weber
BACKGROUND: The introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus' intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother's abdominal wall...
December 22, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27991657/molecular-typing-for-blood-group-antigens-within-40%C3%A2-min-by-direct-polymerase-chain-reaction-from-plasma-or-serum
#11
Franz F Wagner, Willy A Flegel, Rita Bittner, Andrea Döscher
Determining blood group antigens by serological methods may be unreliable in certain situations, such as in patients after chronic or massive transfusion. Red cell genotyping offers a complementary approach, but current methods may take much longer than conventional serological typing, limiting their utility in urgent situations. To narrow this gap, we devised a rapid method using direct polymerase chain reaction (PCR) amplification while avoiding the DNA extraction step. DNA was amplified by PCR directly from plasma or serum of blood donors followed by a melting curve analysis in a capillary rapid-cycle PCR assay...
December 19, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27989426/surgical-management-of-complicated-necrotizing-pneumonia-in-children
#12
Jin-Yao Lai, Wendy Yang, Yung-Ching Ming
BACKGROUND: There are no well-established indications for the surgical management of acute necrotizing pneumonitis in children. This study presents our experience regarding this challenging topic. METHODS: Between 2002 and 2009, 56 necrotizing pneumonitis patients with empyema were treated surgically. The outcomes were analyzed retrospectively. Computed tomography findings of massive lung necrosis or large cavities involving more than 50% of the involved lobe were deemed to be complicated necrotizing pneumonitis...
October 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/27979572/a-fourteen-year-experience-with-vascular-anomalies-encountered-during-transaxillary-rib-resection-for-thoracic-outlet-syndrome
#13
Jeniann A Yi, Robert J Johnston, Mark R Nehler, Douglas R Gibula, Kristen Alix, Natalia O Glebova, Charles O Brantigan
OBJECTIVES: Transaxillary approach to first rib resection and scalenectomy (TAFRRS) is a well-established technique for treatment of thoracic outlet syndrome (TOS). Although anatomic features encountered during TAFRRS are in general constant, vascular anomalies may be encountered but have not been described to date. Herein we describe vascular abnormalities encountered during TAFRRS. METHODS: We performed a retrospective review of a prospective practice database of 224 operations for TOS performed in 172 patients from 3/2000 to 3/2014...
December 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27951566/new-strategies-for-anaemia-management-in-chronic-kidney-disease
#14
Francesco Locatelli, Lucia Del Vecchio
Erythropoiesis-stimulating agents (ESAs) and iron therapy are the standard of care for normocytic normochromic anaemia, which is a frequent comorbidity of patients with chronic kidney disease. In a large percentage of patients, ESAs and iron increase haemoglobin levels, thus reducing the risk of blood transfusions and improving patient quality of life. However, randomised trials have raised some concerns about higher haemoglobin targets and/or high ESA dose use. These concerns include higher cardiovascular and thrombosis risk, cancer progression, and increased mortality...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#15
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942394/current-outcomes-of-off-pump-versus-on-pump-coronary-artery-bypass-grafting-evidence-from-randomized-controlled-trials
#16
REVIEW
Daniel Fudulu, Umberto Benedetto, Gustavo Guida Pecchinenda, Pierpaolo Chivasso, Vito Domenico Bruno, Filippo Rapetto, Alan Bryan, Gianni Davide Angelini
Coronary artery bypass grafting remains the standard treatment for patients with extensive coronary artery disease. Coronary surgery without use of cardiopulmonary bypass avoids the deleterious systemic inflammatory effects of the extracorporeal circuit. However there is an ongoing debate surrounding the clinical outcomes after on-pump versus off-pump coronary artery bypass (ONCAB versus OPCAB) surgery. The current review is based on evidence from randomized controlled trials (RCTs) and meta-analyses of randomized studies...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27925685/in-vitro-characterization-of-synthoplate-%C3%A2-synthetic-platelet-technology-and-its-in-vivo-evaluation-in-severely-thrombocytopenic-mice
#17
Meenal Shukla, Ujjal D S Sekhon, Venkaiah Betapudi, Wei Li, DaShawn A Hickman, Christa L Pawlowski, Mitchell R Dyer, Matthew D Neal, Keith R McCrae, Anirban Sen Gupta
BACKGROUND: Platelet transfusion applications face severe challenges due to the limited availability and portability, high risk of contamination and short shelf-life of platelets. Therefore there is significant interest in synthetic platelet substitutes that can render hemostasis while avoiding these issues. Platelets promote hemostasis by injury site-selective adhesion and aggregation, and propagation of coagulation reactions on their membrane. Based on these mechanisms, we have developed a synthetic platelet technology (SynthoPlate(™) ) that integrates platelet-mimetic site-selective 'adhesion' and 'aggregation' functionalities via heteromultivalent surface-decoration of lipid vesicles with Von Willebrand Factor-binding, collagen-binding and active platelet integrin GPIIb-IIIa-binding peptides...
December 7, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#18
Samual Francis, Ned Williams, Christopher J Anker, Akram Shaaban, Robin Kim, Dennis Shrieve, Jonathan Tward
The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah's Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27908184/irradiation-with-x-rays-of-the-energy-18-mv-induces-radioactivity-in-transfusion-blood-proposal-of-a-safe-method-using-6-mv
#19
Katharina Frentzel, Harun Badakhshi
PURPOSE: To prevent a fatal transfusion-associated graft-versus-host disease, it is recommended to irradiate transfusion blood and blood components with ionizing radiation. Using x-rays from a linear accelerator of the radiotherapy department is an accepted alternative to gamma irradiation devices of the blood bank and to the orthovoltage units that are replacing the gamma irradiators today. However, the use of high energy x-rays may carry a potential risk of induced radioactivity. The objective of this study was to investigate the effect of two different energy levels, 6 and 18 MV, which are executed in routine clinical settings...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27902502/zika-virus-and-patient-blood-management
#20
Lawrence T Goodnough, Marisa B Marques
Sporadic Zika virus infections had only occurred in Africa and Asia until an outbreak in Micronesia (Oceania) in 2007. In 2013 to 2014, several outer Pacific Islands reported local outbreaks. Soon thereafter, the virus was likely introduced in Brazil from competing athletes from French Polynesia and other countries that participated in a competition there. Transmission is thought to have occurred through mosquito bites and spread to the immunologically naive population. Being also a flavivirus, the Zika virus is transmitted by the Aedes mosquito that is endemic in South and Central America that is also the vector of West Nile virus, dengue, and chikungunya...
January 2017: Anesthesia and Analgesia
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