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https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#1
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
#2
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
#3
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...
November 29, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#4
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27882555/a-randomized-controlled-pilot-study-of-vo2-max-testing-a-potential-model-for-measuring-relative-in-vivo-efficacy-of-different-red-blood-cell-products
#5
Elliott Bennett-Guerrero, Evelyn L Lockhart, Nicholas Bandarenko, Mary L Campbell, Michael J Natoli, Veronika K Jamnik, Timothy R Carter, Richard E Moon
BACKGROUND: Randomized trials, for example, RECESS, comparing "young" (median, 7-day) versus "middle-aged" (median, 28-day) red blood cells (RBCs), showed no difference in outcome. These data are important; however, they do not inform us about the safety and effectiveness of the oldest RBCs, which some patients receive. It may not be feasible to conduct a clinical trial randomizing patients to receive the oldest blood. Therefore, we propose strenuous exercise (VO2 max testing) as a model to study the relative efficacy to increase oxygen delivery to tissue of different RBC products, for example, extremes of storage duration...
November 23, 2016: Transfusion
https://www.readbyqxmd.com/read/27878115/supradiaphragmatic-inferior-vena-caval-thrombectomy-without-cardiopulmonary-bypass-a-case-series-at-a-single-center
#6
Mohammad Soleimani, Reza Mohammadi, Navid Masoumi, Mohammad Reza Safarinejad
INTRODUCTION: Inferior vena cava tumor thrombectomy in renal cell carcinoma patients is a challenging procedure, frequently requiring the vascular bypass technique for high-level thrombi with additional complications. Adopting a technique such as intrapericardial control in selected cases will circumvent these problems. Here, we present the results of our intrapericardial control technique during supradiaphragmatic inferior vena caval tumor thrombectomy. CASE PRESENTATION: The records of six patients with supradiaphragmatic tumor thrombi, who underwent radical nephrectomy and thrombectomy at our center with intrapericardial control between the years 2008 and 2015, were retrospectively reviewed...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27873326/complications-of-turbinate-reduction-surgery-in-combination-with-tonsillectomy-in-pediatric-patients
#7
Sonia N Yuen, Peggy P Leung, Jamie Funamura, Kosuke Kawai, David W Roberson, Eelam A Adil
OBJECTIVES/HYPOTHESIS: To examine whether the addition of turbinoplasty to tonsillectomy and adenoidectomy (T&A) increases the risk of postoperative complications. STUDY DESIGN: Retrospective cohort study of children (18 years old and younger) who underwent tonsillectomy and/or turbinoplasty between July 1, 2013 and June 30, 2015 using the 2016 Pediatric Health Information System administrative database METHODS: Patients were divided into three groups: 1) T&A and turbinoplasty, 2) T&A alone, and 3) turbinoplasty alone...
November 22, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27872768/hip-replacement-surgery-in-14-year-old-girl-with-factor-v-deficiency-haemostatic-treatment-and-thromboprophylaxis
#8
María Eva Mingot-Castellano, Josefina Pérez-Núñez, Lourdes Baeza-Montañez
Factor V (FV) is a pivotal coagulation factor present in plasma and platelets. It plays an essential role in secondary haemostasis acting as a cofactor in the prothrombinase complex, catalysing the conversion of prothrombin to thrombin. There is little evidence on the management of mayor orthopaedic surgery in paediatric or adolescents subjects with this coagulopathy and almost no information about thromboprophylaxis in these situations. We report a case of a hip replacement in a 14-year-old girl with moderate FV deficiency (0...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27872733/hyperhemolytic-syndrome-complicating-a-delayed-hemolytic-transfusion-reaction-due-to-anti-p1-alloimmunization-in-a-pregnant-woman-with-hbo-arab-%C3%AE-thalassemia
#9
Zoe Bezirgiannidou, Anna Christoforidou, Eftychia Kontekaki, Athanasios G Anastasiadis, Spyros I Papamichos, Helen Menexidou, Dimitrios Margaritis, Georges Martinis, Elpis Mantadakis
BACKGROUND: Hyperhemolytic Syndrome or Hyperhemolytic Transfusion Reaction (HHTR), a life-threatening subset of Delayed Hemolytic Transfusion Reaction (DHTR) is characterized by destruction of both transfused and autologous erythrocytes evidenced by a fall in post transfusion hemoglobin below the pre-transfusion level. CASE REPORT: We describe a case of DHTR due to anti-P1 alloimmunization manifesting with hyperhemolysis in a 30-year-old Greek Pomak woman with thalassemia intermedia (HbO-Arab/β-thalassemia), during the11(th) week of her first gestation...
2016: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27850802/1165-massive-transfusion-protocol-in-a-community-nontrauma-setting-is-blood-product-wastage-avoidable
#10
Noubar Kevorkian, Sharon Weintraub, Nancy Bienkowski, Peg Basch, Stacy Pagliaruli, Susan Parker, Jacobs Barry, Rekha Singh
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843180/point-of-care-hemoglobin-testing-in-plateletpheresis-donors-noninvasive-versus-invasive-methods
#11
R S Mallhi, Amit Pawar, Neerja Kushwaha, Sudeep Kumar, Ujjwal Dimri
BACKGROUND: Predonation hemoglobin (Hb) for plateletpheresis donors is estimated by presently available invasive methods. Venous samples of only those donors whose Hb is more than 12.5 g/dl are screened for complete blood count and transfusion transmissible infections. There is a pressing need to substitute this invasive Hb test with noninvasive one to reduce donor discomfort and avoid further pricking the donor. We therefore went ahead with the aim of comparing a noninvasive Hb estimation method NBM 200 with the invasive method - Hemocue, taking SYSMEX KX-21 as a gold standard...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27830459/comparison-of-radial-brachial-and-femoral-accesses-using-hemostatic-devices-for-percutaneous-coronary-intervention
#12
Masaya Otsuka, Nobuo Shiode, Yasuhisa Nakao, Yuki Ikegami, Yusuke Kobayashi, Arinori Takeuchi, Ayako Harima, Tadanao Higaki, Kuniomi Oi, Kazuoki Dai, Tomoharu Kawase, Yasuharu Nakama, Kazuyoshi Suenari, Kenji Nishioka, Koyu Sakai, Yuji Shimatani, Yoshiko Masaoka, Ichiro Inoue
Some studies have suggested that radial access (RA) for percutaneous coronary intervention (PCI) reduces vascular complications and bleeding compared to femoral access (FA). The purpose of this study was to investigate the routine use of hemostatic devices and bleeding complications among RA, brachial access (BA), and FA. Between January 2015 and December 2015, 298 patients treated for PCI with RA were compared with 158 patients using BA and 206 patients using FA. The radial sheath was routinely removed with ADAPTY, the brachial sheath with BLEED SAFE, and the femoral sheath with Perclose ProGlide...
November 9, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27819205/iron-deficiency-anemia-in-the-emergency-department-over-utilization-of-red-blood-cell-transfusion-and-infrequent-use-of-iron-supplementation
#13
Jordan Spradbrow, Yulia Lin, Dominick Shelton, Jeannie Callum
OBJECTIVES: Three are no clinical practice guidelines that specifically address the management of patients with iron deficiency anemia (IDA) in the emergency department (ED). The goal of this study was to describe the characteristics of IDA patients who present to the ED, documentation of IDA by emergency physicians, utilization of iron supplementation, and the appropriateness of red blood cell (RBC) transfusions ordered in the ED. METHODS: A retrospective medical chart review was performed of IDA patients who visited the ED of a large tertiary center over a three-month period...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27812254/evaluation-of-magnetized-erythrocyte-group-antigens-to-detect-abo-antibodies
#14
O Nathalang, K Intharanut, P Sriwanitchrak, M Setthakarn, S Duan, H Wang, S Ding, Y Li
Screening for IgM titers of anti-A and anti-B is recommended when providing ABO incompatible platelet transfusion. The life-time of reagent cells depends upon the preservative diluents. We aimed to evaluate the IgM titers of anti-A and anti-B testing with magnetized-erythrocyte group antigens (MEGA) and fresh RBCs and study the relationship of ABO antibody titers between both techniques. Altogether, 100 serum samples from group O donors at the National Blood Centre, Thai Red Cross Society, Bangkok, Thailand were included...
December 2016: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/27804245/conservative-treatment-of-massive-hemothorax-in-a-girl-with-neuroblastoma
#15
Naohiro Shiokawa, Yasuhiro Okamoto, Yuichi Kodama, Takuro Nishikawa, Takayuki Tanabe, Motoi Mukai, Takako Yoshioka, Yoshifumi Kawano
We report the case of a 1-year-old girl with stage 4 neuroblastoma who developed massive hemothorax due to tumor invasion before treatment. She presented with tachypnea, worsening anemia, and oxygen desaturation. Hemothorax was diagnosed based on chest radiography, ultrasonography, and diagnostic thoracic puncture results. High neuron-specific enolase, vanillylmandelic acid, and homovanillic acid as well as computed tomography strongly supported a diagnosis of neuroblastoma. Chemotherapy along with intermittent puncture drainage, oxygen, and blood transfusion reduced the accumulated blood, and hemothorax disappeared within 1 week...
October 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27799172/fibrinogen-supplementation-ex-vivo-increasesclot-firmness-comparable-to-platelet-transfusion-in-thrombocytopenia
#16
B Schenk, A K Lindner, B Treichl, M Bachler, M Hermann, O H Larsen, C Fenger-Eriksen, D Wally, H Tauber, C Velik-Salchner, D Fries
BACKGROUND: Fibrinogen concentrate can improve clot firmness and offers a better safety profile than platelet concentrates. Reduction or avoidance of blood transfusions represents a strategy to reduce associated risks. We investigated whether supplementation of fibrinogen concentrate ex vivo can compensate for clot strength as compared with platelet transfusion in vivo METHODS: One hundred patients in need of platelet transfusion (PT) were enrolled. Blood samples were collected immediately before PT and at 1 h and 24 h after PT...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27795535/transfusion-medicine-in-practice
#17
Shigeyoshi Makino
The safety and stability of the supply of blood products must be ensured for appropriate blood transfusion therapy. Various security measures need to be taken and a balanced blood donation system should be maintained by the Japanese Red Cross Society. Based on such a system, each institute needs to establish a proper management protocol and to assure adequate use of blood products, as well as creating measures to deal with adverse events associated with blood transfusion. The system for preventing transfusion errors is particularly essential...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27747723/postoperative-bleeding-after-administration-of-a-single-dose-of-rivaroxaban-to-a-patient-receiving-antiretroviral-therapy
#18
Carmela E Corallo, Louise Grannell, Huyen Tran
A 62-year-old man was admitted to hospital for elective revision of a left total hip arthroplasty. His history was significant for human immunodeficiency virus (HIV) infection for which he was taking the following antiretroviral agents (ARVs): etravirine, ritonavir, darunavir, raltegravir and tenofovir/emtricitabine. Rivaroxaban 10 mg daily was commenced on the second postoperative day for venous thromboembolism (VTE) prophylaxis. Approximately 24 h later, the patient developed hypotension and anaemia, accompanied by thigh swelling due to bleeding at the surgical site...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27745618/hemophilia-what-the-oral-and-maxillofacial-surgeon-needs-to-know
#19
Julie Ann Smith
Hemophilia will be encountered in the oral and maxillofacial surgeon's office. A thorough understanding of hemophilia is necessary to safely care for these patients. One must understand the severity of the patient's hemophilia as well as whether or not inhibitors are present. The patient's surgical management will be influenced by these two factors. In addition to the possible need to transfuse factors or desmopressin, special care must be taken perioperatively to avoid bleeding complications. This article reviews the overall management of hemophilia A and B as well as the specific perioperative management of these patients...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27741940/observational-studies-should-we-simply-ignore-them-in-assessing-transfusion-outcomes
#20
Kevin Trentino, Shannon Farmer, Irwin Gross, Aryeh Shander, James Isbister
BACKGROUND: As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elements of study design. A long-standing debate regarding findings of randomized controlled trials compared with those of observational studies, their strengths and limitations and questions regarding causal inference, has recently come into focus in relation to research assessing patient outcomes in transfusion medicine...
October 14, 2016: BMC Anesthesiology
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