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https://www.readbyqxmd.com/read/28207362/the-precautionary-principle-and-the-tolerability-of-blood-transfusion-risks
#1
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/28203132/modified-devine-exclusion-for-unresectable-distal-gastric-cancer-in-symptomatic-patients
#2
María Carmen Fernández-Moreno, Roberto Martí-Obiol, Fernando López, Joaquín Ortega
BACKGROUND: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. METHODS: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28202065/alternative-transmission-routes-in-the-malaria-elimination-era-an-overview-of-transfusion-transmitted-malaria-in-the-americas
#3
Regina M Alho, Kim Vinícius Amaral Machado, Fernando F A Val, Nelson A Fraiji, Marcia A A Alexandre, Gisely C Melo, Judith Recht, André M Siqueira, Wuelton M Monteiro, Marcus V G Lacerda
BACKGROUND: Transfusion-transmitted (TT) malaria is an alternative infection route that has gained little attention from authorities, despite representing a life-threatening condition. There has been no systematic review of this health problem in American countries. The aim of this study was to describe the clinical and epidemiological characteristics of TT malaria in the Americas and identify factors associated with lethality based on the studies published in the literature. METHODS: Potentially relevant papers in all languages were retrieved from MEDLINE and LILACS...
February 15, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28191515/medicolegal-implications-of-radial-and-femoral-access-for-coronary-angiography-and-intervention-in-2016-focus-on-retroperitoneal-hemorrhage
#4
Konstantinos V Voudris, Mladen I Vidovich
BACKGROUND AND OBJECTIVES: Retroperitoneal hemorrhage is a rare but serious complication of transfemoral approach (TFA) and TFA percutaneous coronary intervention (PCI). Radial approach for coronary angiography and intervention (transradial approach, TRA) is associated with lower access site complications and reduced blood transfusion rates. Retroperitoneal bleeding has not been described with TRA. This study sought to evaluate the relationship between femoral access for coronary angiography (TFA) and PCI-induced retroperitoneal hemorrhage and the resulting medical litigation in the United States...
April 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28188760/long-term-clinical-efficacy-and-safety-profile-of-transurethral-resection-of-prostate-vs-plasmakinetic-resection-of-the-prostate-for-benign-prostatic-hyperplasia
#5
Zhe Liu, Yuan Wei Li, Wan Rui Wu, Qiang Lu
OBJECTIVE: To investigate differences on clinical efficacy, complications and safety profile between transurethral resection of prostate (TURP) and bipolar plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH). METHODS: 690 patients of BPH were recruited from May 2008 to May 2011 and divided into TURP group and PKRP group, IPSS, QoL, PVR, Qmax, complications, IIEF-5 and retrograde ejaculation were used for evaluation of clinical effective, safety and sexual function between two groups...
February 8, 2017: Urology
https://www.readbyqxmd.com/read/28164668/development-of-a-multiplex-pcr-for-human-neutrophil-antigens-1-3-4-and-5-genotyping-among-thai-blood-donors
#6
Oytip Nathalang, Kamphon Intharanut, Kanokpol Siriphanthong, Wiradee Sasikarn, Siriporn Nathalang
BACKGROUND: Different polymerase chain reaction (PCR) techniques for human neutrophil antigens (HNA) genotyping have been implemented to diagnose the clinical conditions of patients with alloimmune neutropenia, febrile non-hemolytic transfusion reactions, and transfusion-related acute lung injury and to provide effective HNAmatched granulocyte transfusions. The present study aimed to develop an in-house multiplex-PCR for HNA-1, -3, -4, and -5 genotyping in the Thai population. METHODS: Altogether, 500 DNA samples obtained from unrelated, healthy Thai blood donors at the National Blood Centre, Thai Red Cross Society, Bangkok, Thailand were included...
November 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28162984/eltrombopag-versus-placebo-for-low-risk-myelodysplastic-syndromes-with-thrombocytopenia-eqol-mds-phase-1-results-of-a-single-blind-randomised-controlled-phase-2-superiority-trial
#7
Esther N Oliva, Caterina Alati, Valeria Santini, Antonella Poloni, Alfredo Molteni, Pasquale Niscola, Flavia Salvi, Grazia Sanpaolo, Enrico Balleari, Ulrich Germing, Pierre Fenaux, Aspasia Stamatoullas, Giuseppe A Palumbo, Prassede Salutari, Stefana Impera, Paolo Avanzini, Agostino Cortelezzi, Anna Marina Liberati, Paola Carluccio, Francesco Buccisano, Maria Teresa Voso, Stefano Mancini, Austin Kulasekararaj, Fortunato Morabito, Monica Bocchia, Patrizia Cufari, Maria Antonietta Aloe Spiriti, Irene Santacaterina, Maria Grazia D'Errigo, Irene Bova, Gina Zini, Roberto Latagliata
BACKGROUND: In myelodysplastic syndromes, thrombocytopenia is associated with mortality, but treatments in this setting are scarce. We tested whether eltrombopag, a thrombopoietin receptor agonist, might be effective in improving thrombocytopenia in lower-risk myelodysplastic syndromes and severe thrombocytopenia. METHODS: EQoL-MDS was a single-blind, randomised, controlled, phase 2 superiority trial of adult patients with low-risk or International Prognostic Scoring System intermediate-1-risk myelodysplastic syndromes and severe thrombocytopenia...
February 2, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28154997/risk-associated-with-perioperative-red-blood-cell-transfusion-in-cranial-surgery
#8
Jonathan A Cohen, Nima Alan, Andreea Seicean, Robert J Weil
We assessed the impact of intra- and postoperative RBC transfusion on postoperative morbidity and mortality in cranial surgery. A total of 8924 adult patients who underwent cranial surgery were identified in the 2006-2011 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing a biopsy, radiosurgery, or outpatient surgery were excluded. Propensity scores were calculated according to demographic variables, comorbidities, and preoperative laboratory values...
February 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28152572/safety-and-efficacy-of-transhepatic-and-transsplenic-access-for-endovascular-management-of-portal-vein-complications-after-liver-transplantation-1
#9
Joon-Young Ohm, Gi-Young Ko, Kyu-Bo Sung, Dong-Il Gwon, Heung-Gyu Koh
OBJECTIVE: To evaluate and compare the safety and efficacy of endovascular management of the portal vein (PV) via percutaneous transsplenic access versus percutaneous transhepatic access in liver transplant recipients. METHODS: Eighteen patients who underwent endovascular management of PV via percutaneous transhepatic (n = 8) and transsplenic (n = 10) access were enrolled. Transsplenic access was chosen if the spleen was located in a normal position, the splenic vein was preserved, and the target lesion did not involve confluence of the superior mesenteric and splenic veins...
February 2, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28141942/reverse-breech-extraction-versus-the-standard-approach-of-pushing-the-impacted-fetal-head-up-through-the-vagina-in-caesarean-section-for-obstructed-labour-a-randomised-controlled-trial
#10
Ahmed Mohamed Nooh, Hussein Mohammed Abdeldayem, Othman Ben-Affan
The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28138249/propylthiouracil-induced-liver-failure-and-artificial-liver-support-systems-a-case-report-and-review-of-the-literature
#11
Dong-Bo Wu, En-Qiang Chen, Lang Bai, Hong Tang
BACKGROUND: Antithyroid drugs carry a potential risk of hepatotoxicity. Propylthiouracil (PTU) is commonly prescribed for patients with hyperthyroidism. PTU, however, can induce liver injury, ranging from mild asymptomatic elevation of aminotransferases to acute liver failure (ALF). CASE PRESENTATION: This case reports on a 16-year-old Chinese girl with hyperthyroidism, who was admitted to our hospital for jaundice, nausea, and fatigue associated with severe hyperbilirubinemia and coagulopathy...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28121489/registry-based-prospective-active-surveillance-of-medical-device-safety
#12
COMPARATIVE STUDY
Frederic S Resnic, Arjun Majithia, Danica Marinac-Dabic, Susan Robbins, Henry Ssemaganda, Kathleen Hewitt, Angelo Ponirakis, Nilsa Loyo-Berrios, Issam Moussa, Joseph Drozda, Sharon-Lise Normand, Michael E Matheny
Background The process of assuring the safety of medical devices is constrained by reliance on voluntary reporting of adverse events. We evaluated a strategy of prospective, active surveillance of a national clinical registry to monitor the safety of an implantable vascular-closure device that had a suspected association with increased adverse events after percutaneous coronary intervention (PCI). Methods We used an integrated clinical-data surveillance system to conduct a prospective, propensity-matched analysis of the safety of the Mynx vascular-closure device, as compared with alternative approved vascular-closure devices, with data from the CathPCI Registry of the National Cardiovascular Data Registry...
9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28120426/characterization-of-buffy-coat-derived-granulocytes-for-clinical-use-a-comparison-with-granulocyte-colony-stimulating-factor-dexamethasone-pretreated-donor-derived-products
#13
A van de Geer, R P Gazendam, A T J Tool, J L van Hamme, D de Korte, T K van den Berg, S S Zeerleder, T W Kuijpers
BACKGROUND AND OBJECTIVES: Buffy coat-derived granulocytes have been described as an alternative to the apheresis product from donors pretreated with dexamethasone and granulocyte colony-stimulating factor (G-CSF). The latter is - dependent on the local and national settings - obtained following a demanding and time-consuming procedure, which is undesirable in critically ill septic patients. In contrast, buffy coat-derived products have a large volume and are often heavily contaminated with red cells and platelets...
January 25, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28118622/targeting-hypoxia-inducible-factors-for-the-treatment-of-anemia-in-chronic-kidney-disease-patients
#14
Francesco Locatelli, Steven Fishbane, Geoffrey A Block, Iain C Macdougall
BACKGROUND: Anemia, a common complication of chronic kidney disease (CKD), has previously been attributed primarily to decreased production of erythropoietin. More recently, it has become apparent that the etiology of anemia involves several other factors, most notably dysfunctional iron metabolism, mediated via increased hepcidin activity and reduced clearance. Current management of anemia in patients with advanced CKD is based on erythropoiesis-stimulating agents and iron supplementation, along with red blood cell transfusions when necessary; however, safety considerations associated with these therapies highlight the need to pursue alternative treatment options targeting other mechanisms such as hypoxia-inducible factors (HIFs) that act as central regulators of erythropoiesis by coordinating a series of graded hypoxic responses...
January 25, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28116749/alternatives-in-blood-operations-when-choosing-non-dehp-bags
#15
P F van der Meer, D V Devine
The use of di-ethylhexyl-phthalate (DEHP) in blood bags is under discussion due to toxicity concerns and possible restrictions. A questionnaire among 15 blood centres in nine countries showed that none so far have fully switched to non-DEHP blood bags. If centres had to change, sites with a 42-day outdate would choose for a shorter outdating period, while others would allow a higher haemolysis rate (but within current specifications). To improve red cell quality, about half of the centres are willing to move to an alternative red cell storage solution, while the other half would not change for various reasons...
January 24, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28110840/use-of-fresh-frozen-plasma-from-the-2012-french-guidelines-to-recent-advances
#16
REVIEW
Samy Figueiredo, Dan Benhamou
Fresh frozen plasma (FFP) is widely used by anesthetists and/or intensivists managing bleeding patients. In this context, two clinical situations with different benefit/risk ratio for FFP transfusion should be distinguished: moderate or controlled hemorrhage on one side, and massive hemorrhage on the other. In the former situation, administration of FFP is most often ineffective, associated with potential side effects (pulmonary complications, product shortage) and should therefore be restricted. In case of massive hemorrhage, transfusion of FFP, red blood cells and platelets using a ratio close to 1:1:1 is recommended based on a large number of studies...
December 30, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28108236/comparison-between-piezosurgery-and-conventional-osteotomy-in%C3%A2-cranioplasty-with-fronto-orbital-advancement
#17
Markus Martini, Andreas Röhrig, Rudolf Hermann Reich, Martina Messing-Jünger
BACKGROUND: Cranioplasty of patients with craniosynostosis requires rapid, precise and gentle osteotomy of the skull to avoid complications and benefit the healing process. The aim of this prospective clinical study was to compare two different methods of osteotomy. Piezosurgery and conventional osteotomy were compared using an oscillating saw and high speed drill while performing cranioplasties with fronto-orbital advancement. METHODS: Thirty-four children who required cranioplasty with fronto-orbital advancement were recruited consecutively...
December 21, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28107815/upfront-haploidentical-transplant-for-acquired-severe-aplastic-anemia-registry-based-comparison-with-matched-related-transplant
#18
Lan-Ping Xu, Song Jin, Shun-Qing Wang, Ling-Hui Xia, Hai Bai, Su-Jun Gao, Qi-Fa Liu, Jian-Min Wang, Xin Wang, Ming Jiang, Xi Zhang, De-Pei Wu, Xiao-Jun Huang
BACKGROUND: Haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) is an alternative treatment method for severe aplastic anemia (SAA) patients lacking suitable identical donors and those who are refractory to immunosuppressive therapy (IST). The current study evaluated the feasibility of upfront haploidentical HSCT in SAA patients. METHODS: We conducted a multicenter study based on a registry database. One hundred fifty-eight SAA patients who underwent upfront transplantation between June 2012 and September 2015 were enrolled...
January 21, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28106401/transmembrane-difference-in-colloid-osmotic-pressure-affects-the-lipid-membrane-fluidity-of-liposomes-encapsulating-a-concentrated-protein-solution
#19
Tomoko Kure, Hiromi Sakai
A hemoglobin vesicle (Hb-V) is an artificial oxygen carrier encapsulating a highly concentrated hemoglobin solution (40 g/dL) in a liposome. The in vivo safety and efficacy of Hb-V suspension as a transfusion alternative and structural stability during storage have been studied extensively. Because the intraliposomal Hb aqueous solution can possess colloid osmotic pressure (COP, 200-300 Torr) that is much higher than that of blood plasma (20-25 Torr), a question arises as to whether the lipid membrane senses the transmembrane difference in COP...
January 31, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28099120/the-clinical-significance-of-platelet-microparticle-associated-micrornas
#20
Patrick Provost
Circulating blood platelets play a central role in the maintenance of hemostasis. They adhere to subendothelial extracellular matrix proteins that become exposed upon vessel wall damage, which is followed by platelet activation, further platelet recruitment, platelet aggregation and formation of an occlusive, or non-occlusive, platelet thrombus. Platelets host a surprisingly diverse transcriptome, which is comprised of ~9500 messenger RNAs (mRNAs) and different classes of non-coding RNAs, including microRNAs, as well as a significant repertoire of proteins that contribute to their primary (adhesion, aggregation, granule secretion) and alternative (RNA transfer, mRNA translation, immune regulation) functions...
January 18, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
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