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https://www.readbyqxmd.com/read/27918852/anomaly-detection-outperforms-logistic-regression-in-predicting-outcomes-in-trauma-patients
#1
Zachary D W Dezman, Chen Gao, Shiming Yang, Peter Hu, Li Yao, Hsiao-Chi Li, Chein-I Chang, Colin Mackenzie
OBJECTIVE: Recent advancements in trauma resuscitation have shown a great benefit of early identification and control of hemorrhage, which is the most common cause of death in injured patients. We introduce a new analytical approach, anomaly detection (AD), as an alternative method to the traditional logistic regression (LR) method in predicting which injured patients receive transfusions, intensive care, and other interventions. METHODS: We abstracted routinely collected prehospital vital sign data from patient records (adult patients who survived more than 15 minutes after being directly admitted to a level 1 trauma center)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27914462/recombinant-mhc-tetramers-for-isolation-of-virus-specific-cd8-cells-from-healthy-donors-potential-approach-for-cell-therapy-of-posttransplant-cytomegalovirus-infection
#2
A S Vdovin, S Y Filkin, P R Yefimova, S A Sheetikov, N M Kapranov, Y O Davydova, E S Egorov, E G Khamaganova, M Y Drokov, L A Kuzmina, E N Parovichnikova, G A Efimov, V G Savchenko
Patients undergoing allogeneic hematopoietic stem cell transplantation have a high risk of cytomegalovirus reactivation, which in the absence of T-cell immunity can result in the development of an acute inflammatory reaction and damage of internal organs. Transfusion of the virus-specific donor T-lymphocytes represents an alternative to a highly toxic and often ineffective antiviral therapy. Potentially promising cell therapy approach comprises transfusion of cytotoxic T-lymphocytes, specific to the viral antigens, immediately after their isolation from the donor's blood circulation without any in vitro expansion...
November 2016: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#3
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
#4
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/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#5
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893353/low-dose-erythropoietin-treatment-is-not-associated-with-clinical-benefits-in-severely-anaemic-jehovah-s-witnesses-a-plea-for-a-change
#6
Andrei M Beliaev, Sara J Allen, Paget Milsom, Parma Nand, Warren M Smith, Colleen J Bergin
BACKGROUND: Jehovah's Witnesses who refuse blood transfusion have high mortality. Erythropoietin (EPO) has been used as an alternative to blood transfusion. The optimal dosing of EPO in anaemic Jehovah's Witnesses is unknown. The aim of our study was to evaluate the clinical benefits of treatment with a low dose (<600 IU/kg/week) of epoietin beta (EPO-β). MATERIALS AND METHODS: This was an observational study, retrospectively considering a 10-year period during which 3,529 adult Jehovah's Witnesses with a total of 10,786 hospital admissions were identified from databases of four major public hospitals in New Zealand...
November 15, 2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/27890745/mini-open-thoracolumbar-corpectomy-perioperative-outcomes-and-hospital-cost-analysis-compared-to-open-corpectomy
#7
Olawale A R Sulaiman, Juanita Garces, Mansour Mathkour, Tyler Scullen, R Benson Jones, Teresa Arrington, Cuong J Bui
BACKGROUND: Standard open surgical management of thoracolumbar infection, trauma and tumor is associated with significant morbidity. Mini-open and less morbid surgical techniques are being introduced. Our objective is to compare perioperative and immediate post-operative morbidity of open and mini-open thoracolumbar corpectomy techniques including direct hospital costs. METHODS: We retrospectively reviewed the medical records of all patients who underwent open or mini-open corpectomy along with their demographics (age, sex, body mass index (BMI), primary diagnosis), operative data (length of surgery, EBL, blood transfusion-BT), surgical level, pre- and post-operative neurologic status (using ASIA scale), immediate peri-operative complications (within 30 days post-op), overall length of stay (LOS-A), length of stay from surgery (LOS-S), and total direct hospital costs were tabulated and analyzed...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27885890/use-of-a-thrombopoietin-receptor-agonist-in-von-willebrand-disease-type-2b-p-v1316m-with-severe-thrombocytopenia-and-intracranial-hemorrhage
#8
O Espitia, C Ternisien, C Agard, P Boisseau, C V Denis, M Fouassier
We present here a 63-year old woman with a long history of immune thrombocytopenia. She was hospitalized for a traumatic intracranial hemorrhage with thrombocytopenia. Following inefficient treatment of four platelet transfusions, immunoglobulins, and corticosteroids, we initiated treatment with a thrombopoietin (TPO) receptor agonist (eltrombopag 25 mg/d) with a good efficacy. Her mother and sister also had chronic thrombocytopenia. Clinical history, hemostasis results, and gene analysis revealed von Willebrand disease (VWD) type 2B with the mutation (c...
November 25, 2016: Platelets
https://www.readbyqxmd.com/read/27884409/percutaneous-perventricular-device-closure-of-ventricular-septal-defect-from-incision-to-pinhole
#9
Changping Gan, Ling Peng, Zhonglei Liang, Haibo Song, Jiahuang Yang, Weiqiang Ruan, Shuhua Luo, Ke Lin
BACKGROUND: As an alternative to open surgical repair, perventricular device closure provides minimally invasive treatment for doubly committed subarterial ventricular septal defects. However, unlike percutaneous transcatheter access, mini-thoracotomy is still needed. This report describes the percutaneous perventricular device closure technique and its short-term results for this type of heart defect. METHODS: Sixteen patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous perventricular device closure...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27881020/cardiac-function-during-resuscitation-from-hemorrhagic-shock-with-polymerized-bovine-hemoglobin-based-oxygen-therapeutic
#10
Eilleen S Y Ao-Ieong, Alexander Williams, Vivek Jani, Pedro Cabrales
Hemorrhage impairs myocardial contractile function and decreases oxygen delivery. This study investigates how polymerized bovine hemoglobin (PolyHb) solutions affect cardiac function after resuscitation from hemorrhagic shock (HS). Hamsters were hemorrhaged and resuscitated with PolyHb at 8.5 g/dL and 11.5 g/dL. Left ventricle (LV) function was assessed during shock and resuscitation using a miniaturize conductance catheter. PolyHb resuscitation had no beneficial effects in cardiac function; it increased cardiac afterload and systemic vascular resistance (SVR) of 46 and 116% for 8...
November 24, 2016: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/27844235/robot-assisted-laparoscopic-colpectomy-in-female-to-male-transgender-patients-technique-and-outcomes-of-a-prospective-cohort-study
#11
Freek Groenman, Charlotte Nikkels, Judith Huirne, Mick van Trotsenburg, Hans Trum
BACKGROUND: Gender-affirming surgeries in female-to-male (FtM) transgender patients include mostly hysterectomy, bilateral salpingo-oophorectomy and mastectomy. Sometimes further surgery is performed, such as phalloplasty. Colpectomy may be performed to overcome gender dysphoria and disturbing vaginal discharge; furthermore, it may be important in reducing the risk of fistulas due to the phalloplasty procedure with urethral elongation. Colpectomy prior to the reconstruction of the neourethra seems to reduce fistula rates on the very first anastomosis...
November 14, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27830776/artificial-blood-for-dogs
#12
Kana Yamada, Kyoko Yokomaku, Moeka Kureishi, Motofusa Akiyama, Kiyohito Kihira, Teruyuki Komatsu
There is no blood bank for pet animals. Consequently, veterinarians themselves must obtain "blood" for transfusion therapy. Among the blood components, serum albumin and red blood cells (RBCs) are particularly important to save lives. This paper reports the synthesis, structure, and properties of artificial blood for the exclusive use of dogs. First, recombinant canine serum albumin (rCSA) was produced using genetic engineering with Pichia yeast. The proteins showed identical features to those of the native CSA derived from canine plasma...
November 10, 2016: Scientific Reports
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/27813144/arterio-venous-fistula-for-automated-red-blood-cells-exchange-in-patients-with-sickle-cell-disease-complications-and-outcomes
#14
Marianne Delville, Sandra Manceau, Nassim Ait Abdallah, Jan Stolba, Sameh Awad, Thibaud Damy, Barnabas Gellen, Laurent Sabbah, Karima Debbache, Vincent Audard, Jean-Louis Beaumont, Cécile Arnaud, Christelle Chantalat-Auger, Françoise Driss, François Lefrère, Marina Cavazzana, Franco Gilbert, Frederic Galacteros, Jean-Antoine Ribeil, Justine Gellen-Dautremer
Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French sickle cell disease reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected...
November 4, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27810433/a-cost-comparison-of-unicompartmental-and-total-knee-arthroplasty
#15
Sheila Shankar, Matthew W Tetreault, Briana J Jegier, Gunnar B Andersson, Craig J Della Valle
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty (TKA) in appropriately selected patients. There is a paucity of data comparing hospital resource utilization and costs for UKA versus TKA. METHODS: We retrospectively reviewed 128 patients who underwent UKA or TKA for osteoarthritis by a single surgeon in the 2011 Fiscal Year. Sixty-four patients in each group were matched based on sex, age, race, body mass index, Charlson Comorbidity Index, and insurance type...
December 2016: Knee
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/27798034/rationale-and-design-of-platelet-transfusions-in-haematopoietic-stem-cell-transplantation-the-path-pilot-study
#17
Jason Tay, David Allan, Sara Beattie, Christopher Bredeson, Dean Fergusson, Dawn Maze, Mitchell Sabloff, Kednapa Thavorn, Alan Tinmouth
INTRODUCTION: In patients with transient thrombocytopenia being treated with high-dose chemotherapy followed by stem cell rescue-haematopoietic stem cell transplantation (HSCT), prophylactic transfusions are standard therapy to prevent bleeding. However, a recent multicentre trial suggests that prophylactic platelet transfusions in HSCT may not be necessary. Additionally, the potential overuse of platelet products places a burden on a scarce healthcare resource. Moreover, the benefit of prophylactic platelet transfusions to prevent clinically relevant haemorrhage is debatable...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27797129/alternative-agents-to-prophylactic-platelet-transfusion-for-preventing-bleeding-in-people-with-thrombocytopenia-due-to-chronic-bone-marrow-failure-a-meta-analysis-and-systematic-review
#18
REVIEW
Michael Desborough, Andreas V Hadjinicolaou, Anna Chaimani, Marialena Trivella, Paresh Vyas, Carolyn Doree, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: People with thrombocytopenia due to bone marrow failure are vulnerable to bleeding. Platelet transfusions have limited efficacy in this setting and alternative agents that could replace, or reduce platelet transfusion, and are effective at reducing bleeding are needed. OBJECTIVES: To compare the relative efficacy of different interventions for patients with thrombocytopenia due to chronic bone marrow failure and to derive a hierarchy of potential alternative treatments to platelet transfusions...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27795455/blood-soy-milk-and-vitality-the-wartime-origins-of-blood-banking-in-china-1943-45
#19
Wayne Soon
This article examines the multiple meanings of blood transfusion and banking in modern China through the history of the first Chinese blood bank, established by the Overseas Chinese in 1943 to solicit blood for the war effort. Through investigating the attitudes of Chinese soldiers and civilians toward the blood bank, this article argues for the multiplicity of motivations underpinning society's attitudes toward blood banking and donation. Cultural notions of blood were an important but not the sole factor in their consideration...
2016: Bulletin of the History of Medicine
https://www.readbyqxmd.com/read/27794527/the-challenges-of-daratumumab-in-transfusion-medicine
#20
REVIEW
Michael F Dizon
The field of transfusion medicine has evolved rapidly in recent years, but the central principle of transfusion is still simple, namely, the antigen-antibody interaction. Daratumumab (DARA), a monoclonal antibody (MoAb), was developed to treat relapsed/refractory multiple myeloma (RRMM). DARA works by targeting the CD38 portion of malignant cells; however, this drug attaches to the red blood cell (RBC) reagents used in blood banks, further complicating the antibody identification work-up. The AABB (formerly known as the American Association of Blood Banks) has issued a memorandum on how blood banks can effectively address panreactivity caused by DARA...
October 28, 2016: Laboratory Medicine
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