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https://www.readbyqxmd.com/read/28314307/post-hepatectomy-refractory-ascites-in-cirrhotic-patients-with-hepatocellular-carcinoma-risk-factor-analysis-to-overcome-this-problematic-complication
#1
Shinji Itoh, Hideaki Uchiyama, Yasuharu Ikeda, Kazutoyo Morita, Noboru Harada, Keishi Sugimachi, Hirofumi Kawanaka, Daisuke Korenaga, Tomoharu Yoshizumi, Kenji Takenaka, Yoshihiko Maehara
BACKGROUND: Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28295397/red-blood-cell-transfusions-can-induce-proinflammatory-cytokines-in-preterm-infants
#2
Carlo Dani, Chiara Poggi, Elena Gozzini, Valentina Leonardi, Alice Sereni, Rosanna Abbate, Anna Maria Gori
BACKGROUND: The risk of developing red blood cell (RBC) transfusion-associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect. STUDY DESIGN AND METHODS: We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n = 20) admitted to a tertiary neonatal intensive care unit...
March 11, 2017: Transfusion
https://www.readbyqxmd.com/read/28293407/thrombocytopenia-in-patients-with-chronic-hepatitis-c-virus-infection
#3
REVIEW
Sumit Dahal, Smrity Upadhyay, Rashmi Banjade, Prajwal Dhakal, Nabin Khanal, Vijaya Raj Bhatt
Thrombocytopenia in patients with chronic hepatitis C virus (HCV) infection is a major problem. The pathophysiology is multifactorial, with auto-immunogenicity, direct bone marrow suppression, hypersplenism, decreased production of thrombopoietin and therapeutic adverse effect all contributing to thrombocytopenia in different measures. The greatest challenge in the care of chronic HCV patients with thrombocytopenia is the difficulty in initiating or maintaining IFN containing anti-viral therapy. Although at present, it is possible to avoid this challenge with the use of the sole Direct Antiviral Agents (DAAs) as the primary treatment modality, thrombocytopenia remains of particular interest, especially in cases of advanced liver disease...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28271523/safety-and-collection-efficiency-with-a-lower-transfusion-threshold-for-extracorporeal-photopheresis-in-adult-patients-with-graft-versus-host-disease
#4
C Liu, E Schindler, M LeRoy, K Martin-Bredahl, M Dino, K Shah, M Dynis, C S Eby, B J Grossman
BACKGROUND: Extracorporeal photopheresis (ECP) is an established treatment for graft-versus-host disease (GVHD). Various haematocrit thresholds have been used to trigger red blood cells transfusion prior to ECP. Moderate-to-severe GVHD is frequently complicated by anaemia; the safety and collection efficiency with a lower haematocrit for ECP is unknown. METHODS: We prospectively enrolled 26 consecutive adult GVHD patients with haematocrits between 25% and 28·9% who received ECP on the CELLEX system...
March 7, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28265590/laparoscopic-retroperitoneal-nephron-sparing-surgery-without-renal-artery-clamping-with-preoperative-selective-arterial-embolization-for-management-of-right-renal-angiomyolipoma-of-diameter-10-cm-a-case-report
#5
Tatsuhiko Hoshii, Shinichi Morita, Yohei Ikeda, Go Hasegawa, Tsutomu Nishiyama
A 38-year-old female without the tuberous sclerosis complex was diagnosed with right renal angiomyolipoma of 10 cm in diameter. She underwent laparoscopic retroperitoneal nephron-sparing surgery without renal artery clamping with preoperative selective arterial embolization to avoid a significant risk of hemorrhage and the damage of the renal function during nephron-sparing surgery. The tumor was resected completely. The time taken to complete the procedure was 4 hours 11 minutes and blood loss was 780 mL...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/28254677/robotic-radical-parametrectomy-with-upper-vaginectomy-and-pelvic-lymphadenectomy-in-patients-with-occult-cervical-carcinoma-after-extrafascial-hysterectomy
#6
Arthur-Quan Tran, Stephanie A Sullivan, Paola A Gehrig, John T Soper, John F Boggess, Kenneth H Kim
STUDY OBJECTIVE: To confirm the safety and feasibility outcomes of robotic radical parametrectomy and pelvic lymphadenectomy and compare the clinicopathologic features of women requiring adjuvant treatment to historical literature. DESIGN: Retrospective cohort study and review of literature (Canadian Task Force classification II-2). SETTING: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA PATIENTS: All patients who underwent robotic radical parametrectomy, upper vaginectomy (RRPV) and pelvic lymphadenectomy for occult cervical cancer discovered after an extrafascial hysterectomy at our institution from January 2007 to December 2015...
February 22, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28248852/serosurveillance-of-hepatitis-a-in-a-region-which-adopted-the-universal-mass-vaccination
#7
Maria Filomena Gallone, Francesco Desiante, Maria Serena Gallone, Giovanna Barbuti, Silvio Tafuri, Cinzia Germinario
Hepatitis A is a common infectious disease worldwide that was endemic in many regions of Southern Italy, such as Apulia region. After a large hepatitis A outbreak occurred between 1996 and 1997, in Apulia an active-free immunization program that was targeted to new-borns and adolescents was started. The aim of this study is to investigate the hepatitis A seroprevalence in the adult Apulian population 18 years after the immunization program introduction, in order to evaluate the risk of new epidemics onset.The study was carried out from May 2011 to June 2012 among blood donors from Department of Transfusion Medicine and Blood Bank of Policlinico General Hospital in Bari...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28241909/reducing-unnecessary-postoperative-complete-blood-count-testing-in-the-pediatric-intensive-care-unit
#8
Maya Dewan, Jorge Galvez, Tracey Polsky, Genna Kreher, Blair Kraus, Luis Ahumada, John Mccloskey, Heather Wolfe
CONTEXT: Complete blood count (CBC) testing commonly occurs to determine the need for blood transfusions after surgical procedures. Many clinicians believe postoperative CBCs are "routine." OBJECTIVE: To decrease unnecessary routine CBC testing in a low-risk cohort of postoperative patients in the pediatric intensive care unit (PICU) at The Children's Hospital of Philadelphia by 50% in 6 months. DESIGN: Quality-improvement study. Data from our institution regarding frequency of ordering laboratory studies and transfusion requirements were collected for prior quality-improvement work demonstrating the safety and feasibility of avoiding routine postoperative CBCs in this cohort...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28236299/development-of-the-platelet-efficacy-score-pescore-to-predict-the-efficacy-of-platelet-transfusion-in-oncohematologic-patients
#9
Anna Quaglietta, Maura Di Saverio, Giuseppe Lucisano, Patrizia Accorsi, Antonio Nicolucci
BACKGROUND: Despite the prophylactic use of platelet transfusion, hemorrhagic complications still represent an important cause of morbidity and mortality in patients with hematologic malignancies. Patient-related factors and characteristics of the transfused product can affect transfusion efficacy. STUDY DESIGN AND METHODS: The aim of this study was to develop and validate the Platelet Efficacy Score (PEscore), based on patient and product characteristics, to predict the likelihood of a satisfactory platelet transfusion (absolute increment ≥10...
February 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28222238/thrombolysis-with-intravenous-recombinant-tissue-plasminogen-activator-during-early-postpartum-period-a-review-of-the-literature
#10
Munetoshi Akazawa, Makoto Nishida
Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28221198/red-cell-transfusion-associated-hemolysis-in-cardiac-surgery-an-observational-cohort-study
#11
Keyvan Karkouti, Jeannie L Callum, Jason P Acker, Paul Yip, Vivek Rao
BACKGROUND: Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in susceptible patients, such as those undergoing cardiac surgery with cardiopulmonary bypass. To explore this hypothesis, we assessed the relationship of red cell transfusions with cell-free hemoglobin and transferrin saturation levels in a consecutive cohort of cardiac surgical patients...
February 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#12
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28207362/the-precautionary-principle-and-the-tolerability-of-blood-transfusion-risks
#13
Koen Kramer, Hans L Zaaijer, Marcel F Verweij
Tolerance for blood transfusion risks is very low, as evidenced by the implementation of expensive blood tests and the rejection of gay men as blood donors. Is this low risk tolerance supported by the precautionary principle, as defenders of such policies claim? We discuss three constraints on applying (any version of) the precautionary principle and show that respecting these implies tolerating certain risks. Consistency means that the precautionary principle cannot prescribe precautions that it must simultaneously forbid taking, considering the harms they might cause...
March 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28203425/false-positive-hepatitis-c-antibody-test-results-in-left-ventricular-assist-device-recipients-increased-risk-with-age-and-transfusions
#14
Grace Y Minamoto, Doreen Lee, Adriana Colovai, Dana Levy, Ljiljana Vasovic, Keith W Roach, Jonathan Shuter, Daniel Goldstein, David D'Alessandro, Ulrich P Jorde, Victoria A Muggia
Left ventricular assist devices (LVADs) have been successfully used in patients with heart failure. However, LVADs may trigger immune activation, leading to higher frequencies of autoantibodies. We describe the clinical, epidemiological, and laboratory characteristics of LVAD recipients with false positive hepatitis C (FPHC) serology among 39 consecutive adult LVAD recipients who bridged to heart transplantation from January 2007 to January 2013 at Montefiore Medical Center. FPHC patients were identified as those with post-LVAD positive hepatitis C ELISA antibody tests and negative confirmatory testing with hepatitis C RNA PCR and/or radioimmunoblot assay...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199077/skin-to-calyx-distance-is-not-a-predictive-factor-for-miniaturized-percutaneous-nephrolithotomy-outcomes
#15
Faruk Ozgor, Onur Kucuktopcu, Burak Ucpinar, Fatih Yanaral, Murat Binbay
OBJECTIVE: To evaluate the predictive value of the distance from skin to calyx (SCD) on the outcome and complication rates of patients undergoing mPNL. MATERIALS AND METHODS: Patient's charts, who had undergone mPNL between June 2012 and June 2015, were analyzed retrospectively. Patients who had a preoperative computerized tomography (CT) were enrolled into the study. Two separateurologists evaluated the CT scans and calculated the SCD defined as the distance between the skin and surface/lateral edge of the calyx, which was the preferred site of entry for percutaneous access...
February 15, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28197644/routine-application-of-bloodless-priming-in-neonatal-cardiopulmonary-bypass-a-3-year-experience
#16
Wolfgang Boettcher, Nicodème Sinzobahamvya, Oliver Miera, Matthias Redlin, Frank Dehmel, Mi-Young Cho, Peter Murin, Felix Berger, Joachim Photiadis
A restrictive transfusion strategy led us to routinely try to conduct donor-blood free open-heart surgery even in neonates. The cardio-pulmonary bypass (CPB) circuit was minimized by priming volumina at 73 ml for the smallest patients with body weight up to 2.5 kg and 85-95 ml for those with body weight of more than 2.5 kg, and by positioning the console as close as possible to operation table. Measures were applied to save blood during the procedure. Transfusion threshold of 8 g/dl hemoglobin was retained...
February 14, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28197273/clinical-and-surgical-strategies-for-avoiding-or-reducing-allogeneic-blood-transfusions
#17
Antonio Alceu Dos Santos, Jose Francisco Baumgratz, Jose Henrique Andrade Vila, Rodrigo Moreira Castro, Rodrigo Freire Bezerra
Blood transfusions have still been used as a standard therapy to treat severe anemia. Current evidences point to both excessive allogeneic blood consumption and decreased donations, which result in reduced stocks in blood banks. Several studies have increasingly suggested a more restrictive transfusion practice for blood products. Currently, a number of autologous blood conservation protocols in surgeries have been noted. We report a case of severe anemia with 2.9 g/dL hemoglobin, which was successfully handled without using the standard therapy to treat anemia with hemotransfusions...
April 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196636/impact-of-schistosomiasis-on-increase-incidence-of-occult-hepatitis-b-in-chronic-hepatitis-c-patients-in-egypt
#18
Hanan H Omar, Samaa A Taha, Wafaa H Hassan, Hamdy H Omar
Co-infection of schistosomiasis, HBV and HCV is common in countries where schistosomiasis is endemic. Occult hepatitis B occurs in patients at high risk for HBV infection (e.g., patients on hemodialysis, patients receiving blood transfusions). Schistosomal infection is a risk factor of HBV infection that can increase the incidence of occult hepatitis B. We aimed to determine the prevalence of occult hepatitis B in chronic hepatitis C patients with and without schistosomiasis and to assess the effect of schistosomal infection on the increased risk of exposure to HBV infection and to occult hepatitis B...
February 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28194065/adverse-events-during-apheresis-procedures-audit-at-a-tertiary-hospital
#19
Kanchan Dogra, Parag Fulzele, Diptiranjan Rout, Rahul Chaurasia, Poonam Coshic, Kabita Chatterjee
Apheretic platelets are better quality blood components which reduce donor exposure and chances of TTIs to transfusion recipients when compared to the whole blood derived components. Though safe, these apheretic donations are associated with donor adverse events. We evaluated the incidence of such adverse events associated with the modern apheresis procedures that would provide an insight as well as help formulating preventive steps to avoid frequent occurrences of such events. This prospective audit-based observational study was conducted over 1 year...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28191788/full-thickness-skin-mesh-graft-vaginoplasty-a-skin-sparing-technique
#20
Guilherme Lang Motta, Patric Machado Tavares, Gabriel Veber Moisés Silva, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
INTRODUCTION: The ideal vaginoplasty method should promote good cosmetic and functional results with low morbidity. We describe a new technique for congenital vaginal agenesis using a full-thickness perforated skin graft. MATERIALS AND METHODS: We report an 18 year old patient with vaginal agenesis (Morris syndrome) that undergone a modified version of McIndoe vaginoplasty. Patient is set in a low lithotomy position and lateral traction sutures are placed in labia and a 16Fr urethral catheter inserted...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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