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Transfusion avoidance

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https://www.readbyqxmd.com/read/28720606/re-using-blood-products-as-an-alternative-supplement-in-the-optimisation-of-clinical-grade-adipose-derived-mesenchymal-stem-cell-culture
#1
J Phetfong, T Tawonsawatruk, K Seenprachawong, A Srisarin, C Isarankura-Na-Ayudhya, A Supokawej
OBJECTIVES: Adipose-derived mesenchymal stem cells (ADMSCs) are a promising strategy for orthopaedic applications, particularly in bone repair. Ex vivo expansion of ADMSCs is required to obtain sufficient cell numbers. Xenogenic supplements should be avoided in order to minimise the risk of infections and immunological reactions. Human platelet lysate and human plasma may be an excellent material source for ADMSC expansion. In the present study, use of blood products after their recommended transfusion date to prepare human platelet lysate (HPL) and human plasma (Hplasma) was evaluated for in vitro culture expansion and osteogenesis of ADMSCs...
July 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28715719/isolated-caudate-lobectomy-left-sided-approach-case-reports
#2
Orlando Jorge M Torres, Rodrigo Rodrigues Vasques, Ozimo Pereira Gama-Filho, Miguel Eugenio L Castelo-Branco, Camila Cristina S Torres
INTRODUCTION: The caudate lobe is a distinct liver lobe and surgical resection requires expertise and precise anatomic knowledge. Left-sided approach was described for resection of small tumors originated in the Spiegel lobe but now the procedure has been performed even for tumors more than five centimeters. The aim of this study is to present three cases of tumor of caudate lobe underwent isolated lobectomy by left-sided approach. PRESENTATION OF CASE: Three patients with metastasis of colorectal cancer, carcinoma hepatocellular and metastasis of neuroendocrine tumor underwent resection...
July 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28713429/treatment-of-severe-refractory-hematuria-due-to-radiation-induced-hemorrhagic-cystitis-with-dexamethasone
#3
José Carlos Rodrigues Nascimento, Márcio Wilker Soares Campelo, Iuri Arruda Aragão, José Fernando Bastos de Moura, Lúcio Flávio Gonzaga Silva, Reinaldo Barreto Oriá
Treatment of pelvic neoplasms with radiotherapy may develop sequelae, especially RHC. An 85-year-old male patient was admitted to a hospital emergency with gross hematuria leading to urinary retention and was diagnosed with RHC. The urinary bladder was probed, unobstructed, and maintained in continuous three-way saline irrigation. During 45 days of hospitalization, the patient underwent two cystoscopic procedures for urinary bladder flocculation, whole blood transfusions, and one platelet apheresis. None of these interventions led to clinical resolution...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28713150/a-jehovah-s-witness-adolescent-in-the-labor-and-delivery-unit-should-patient-and-parental-refusals-of-blood-transfusions-for-adolescents-be-honored
#4
Johan Christiaan Bester, Martin Smith, Cynthia Griggins
A 15-year-old was admitted to the labor and delivery unit for induction of a 41-week-gestation pregnancy. Her parents, members of Jehovah's Witnesses, and the patient, who had been studying the religion but had not yet been baptized, were adamant that no blood transfusions would be accepted even if a life-threatening hemorrhage were to occur. In our analysis, we examine the underlying ethical conflict and issues raised by this case. We considered two important ethical questions in analyzing the dilemma: first, whether adolescents are capable of providing autonomous and authentic refusals for lifesaving interventions; and second, whether parents can refuse such interventions for their adolescent children based on their religious beliefs...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#5
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#6
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702844/influence-of-acetylsalicylic-acid-and-low-molecular-weight-heparins-on-the-formation-of-renal-hematoma-after-shock-wave-lithotripsy
#7
Christoph Schregel, Hubert John, Marco Randazzo, Isabelle Keller
PURPOSE: To investigate the risk of renal hematoma (RHT) after shock wave lithotripsy (SWL) among patients on acetylsalicylic acid (ASA) or low-molecular-weight heparin (LMWH). PATIENTS AND METHODS: Retrospective analysis of 434 patients treated with SWL for nephrolithiasis and ureterolithiasis of the proximal ureter. Primary endpoint was detection of RHT by ultrasound the day after SWL. Secondary outcome variables included transfusion of erythrocyte concentrate(s), interventions, hospital readmission or death due to RHT within 30 days of SWL...
July 12, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28692498/distraction-of-fronto-orbital-segment-as-a-nonvascularized-bone-graft-in-craniosynostotic-patients
#8
Gökhan Tunçbilek, Ersoy Konaş, Mert Çaliş, Galip Gencay, Burçak Bilginer
Fronto-orbital advancement using distraction techniques involves the dura left attached to the osteotomized bone segment to avoid dead space formation and dural injury, whereas it is impossible to reshape the supraorbital bar and the frontal bone complex, when necessary. Our approach combines advantageous parts of conventional and distraction osteogenesis techniques as remodel and distract the supraorbital bar and frontal bone complex as a free bone graft. Twenty-seven patients either being syndromic and nonsyndromic craniosynostosis, with at least 3 years of follow-up were reviewed in this study...
July 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28690038/-transfusion-in-elderly-take-account-frailty
#9
R Mahmoudi, J-L Novella, Y Jaïdi
The conjunction of the demographic aging and the increase in the frequency of anemia with the advancing age, mean that the number of globular concentrates delivered each year increases with a consequent heavy pressure on blood collection. The etiologies of anemia in the elderly are often multifactorial and their investigation is an indispensable step and prior to any treatment. Transfusion thresholds, particularly in the elderly, are gradually evolving and a so-called restrictive strategy is now favored. Immediate and delayed complications of transfusion are more frequent in the elderly due to vulnerability factors associated with frailty and the risk of multiple transfusions...
July 6, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28689785/effect-of-tranexamic-acid-administration-on-bleeding-in-primary-total-hip-arthroplasty
#10
A B Fernández-Cortiñas, J M Quintáns-Vázquez, F Gómez-Suárez, O Simón Murillo, B R Sánchez-López, J M Pena-Gracía
OBJECTIVE: To study the efficacy of tranexamic acid to decrease perioperative bleeding in patients who have undergone a total hip arthroplasty operation and to evaluate drug safety. MATERIAL AND METHODS: Observational, prospective, controlled and randomized study on the efficacy of tranexamic acid as a method to reduce bleeding in primary hip replacement surgery. We included 134 patients operated during 2014 in our centre, who were divided into 2 groups according to whether or not they had received tranexamic acid...
July 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28687347/hestat-study-protocol-for-a-phase-ii-iii-randomized-placebo-controlled-single-blind-study-to-evaluate-the-new-hemostatic-agent-tt-173-in-total-knee-arthroplasty
#11
Aránzazu Gonzalez-Osuna, Sebastián Videla, Esther Cánovas, Gerard Urrútia, Santiago Rojas, Ramón López, Jesús Murat, Xavier Aguilera
BACKGROUND: Total knee arthroplasty is associated with postsurgical bleeding that often requires blood transfusion. Several hemostatic treatments have been evaluated with different degree of success. TT-173 is a topical hemostatic agent consisting in yeast derived vesicles containing recombinant tissue factor (rhFT) that activates the extrinsic pathway of coagulation. This trial sought to evaluate the efficacy and safety of TT-173 in total knee arthroplasty. METHODS/DESIGN: This is a phase II/III, sequential, simple blind, randomized, multicenter, placebo controlled and parallel clinical trial that will recruit 189 evaluable patients...
July 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28684001/five-year-experience-with-arterial-switch-operation-in-the-first-hours-of-life
#12
Kyrylo Chasovskyi, Yaroslav Mykychak, Nadiia Rudenko, Hanna Vorobyova, Illya Yemets
We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683893/a-comprehensive-choosing-wisely-quality-improvement-initiative-reduces-unnecessary-transfusions-in-an-academic-department-of-surgery
#13
Caitlin W Hicks, Jing Liu, William W Yang, Sandra R DiBrito, Daniel J Johnson, Alexandra Brito, Robert S D Higgins, Steven M Frank, Elizabeth C Wick
BACKGROUND: We implemented a comprehensive Choosing Wisely initiative to reduce unnecessary transfusions in an Academic Department of Surgery. METHODS: We conducted a survey- and lecture-based educational intervention to increase awareness about published transfusion guidelines. Monthly transfusion reports were subsequently distributed to all faculty, fellows, residents, and mid-level practitioners. Blood utilization measures were compared pre- vs. post-intervention to assess effectiveness...
June 29, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28681676/an-update-on-the-risk-factors-for-and-management-of-obstetric-haemorrhage
#14
Mercede Sebghati, Edwin Chandraharan
Obstetric haemorrhage is associated with increased risk of serious maternal morbidity and mortality. Postpartum haemorrhage is the commonest form of obstetric haemorrhage, and worldwide, a woman dies due to massive postpartum haemorrhage approximately every 4 min. In addition, many experience serious morbidity such as multi-organ failure, complications of multiple blood transfusions, peripartum hysterectomy and unintended damage to pelvic organs, loss of fertility and psychological sequelae, including posttraumatic stress disorders...
July 1, 2017: Women's Health
https://www.readbyqxmd.com/read/28680213/gallbladder-visualization-on-tc-99m-labeled-red-cell-scintigraphy-a-rare-finding-with-an-emphasis-on-role-of-single-photon-emission-computed-tomography-computed-tomography
#15
Narvesh Kumar, Rani Kunti Randhir Singh, Deepanksha Dutta, Mudalsha Ravina, Subhash Chand Kheruka, Sanjay Gambhir
Tc-99m labeled red blood cell (RBC) scintigraphy is one of the most sensitive tests to diagnose occult gastrointestinal (GI) bleed. Visualization of gallbladder is a rare finding in this study. Most of the previously reported cases with similar false-positive finding were associated chronic renal failure, anemia, and received multiple blood transfusions. Thus, while interpreting GI bleed scan, a thorough clinical history is of utmost importance to avoid any false-positive findings. Here, we report a case of gallbladder visualization in (99m)Tc-RBC scintigraphy confirmed by single-photon emission computed tomography/computed tomography in a patient with chronic renal failure and anemia with failed renal transplant within 3 months...
July 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28671283/low-prevalence-of-hepatitis-c-virus-rna-in-blood-donors-with-anti-hepatitis-c-virus-reactivity-in-rwanda
#16
Theogene Twagirumugabe, Gatare Swaibu, Tomas Bergström, Timothy David Walker, Jean Bosco Gahutu, Heléne Norder
BACKGROUND: Hepatitis C virus (HCV) is the leading cause of severe liver disease worldwide and is highly endemic in Africa, where it often has nosocomial spread. Little is known on the HCV prevalence, risk for transfusion-transmitted HCV, and circulating genotypes in Rwanda. This study was performed to investigate the prevalence of anti-HCV among blood donors from all regions of the country and genetically characterize identified HCV strains. STUDY DESIGN AND METHODS: Data on anti-HCV reactivity for all 45,061 Rwandan blood donations during 2014 were compiled...
July 3, 2017: Transfusion
https://www.readbyqxmd.com/read/28669521/management-of-delayed-hemolytic-transfusion-reaction-in-sickle-cell-disease-prevention-diagnosis-treatment
#17
F Pirenne, P Bartolucci, A Habibi
Transfusion remains a key treatment of sickle cell disease complications. However, delayed hemolytic transfusion reaction, the most serious complication of transfusion, may be life-threatening if hyperhemolysis develops. This syndrome is generally underdiagnosed because its biological and clinical features resemble those of vaso-occlusive crisis, and red blood cell antibodies are frequently absent. Further transfusions may aggravate the symptoms, leading to severe multiple organ failure and death. It is therefore essential to prevent, diagnose and treat this syndrome efficiently...
June 29, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28657762/hematologic-complications-in-a-patient-with-glycine-soja-polyagglutination-following-fresh-frozen-plasma-transfusion
#18
Ryan P Jajosky, Lloyd O Cook, Elizabeth Manaloor, James F Shikle, Roni J Bollag
Polyagglutination is a rare and underdiagnosed condition, characterized by agglutination of red blood cells(RBCs) with almost all ABO-compatible adult sera. Polyagglutination can occur when a cryptantigen is exposed on RBCs via microbial enzyme activity. Becausenearly all adults naturally produce antibodies against cryptantigens, transfusion of plasma can cause unexpected hemolysis and hematologic complications, such as thrombocytopenia and disseminated intravascular coagulation, in patients whose cryptantigens are exposed...
June 2017: Immunohematology
https://www.readbyqxmd.com/read/28655949/peri-operative-blood-management
#19
REVIEW
Alex Eeles, Ravishankar Rao Baikady
Anaemia and allogeneic blood transfusions in surgical patients are associated with poor outcomes. Patient blood management (PBM) has been developed as an evidence-based clinical tool, by which clinicians can optimise anaemia, manage peri-operative bleeding, avoid unnecessary blood transfusion and improve patient outcome. This article aims to highlight the recent updates regarding evidence-based PBM in the perioperative period, following a thorough literature review involving original research articles, published guidelines and consensus documents discovered through an extensive PubMed and Medline search...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28655456/reflections-on-multiple-strategies-to-reduce-transfusion-in-cancer-patients-a-joint-narrative
#20
REVIEW
Hadi Goubran, Jerard Seghatchian, Oksana Prokopchuk-Gauk, Julia Radosevic, Waleed Sabry, Nayyer Iqbal, Thierry Burnouf
Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogeneic or even autologous source, is not without risk and the long-term effect of blood transfusion on cancer outcomes remains questionable. Recognition of anemia associated with nutritional deficiency should be promptly corrected while avoiding the use of erythropoiesis stimulating agents...
June 2017: Transfusion and Apheresis Science
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