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post part haemorrhage

Teresa Lambe, Georgina Bowyer, Katie J Ewer
Sporadic outbreaks of Ebola virus infection have been documented since the mid-Seventies and viral exposure can lead to lethal haemorrhagic fever with case fatalities as high as 90%. There is now a comprehensive body of data from both ongoing and completed clinical trials assessing various vaccine strategies, which were rapidly advanced through clinical trials in response to the 2013-2016 Ebola virus disease (EVD) public health emergency. Careful consideration of immunogenicity post vaccination is essential but has been somewhat stifled because of the wide array of immunological assays and outputs that have been used in the numerous clinical trials...
May 26, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
J E Newman, M J Bown, R D Sayers, J P Thompson, T G Robinson, B Williams, R Panerai, P Lacy, A R Naylor
OBJECTIVE/BACKGROUND: Post-endarterectomy hypertension (PEH) is a well recognised, but poorly understood, phenomenon after carotid endarterectomy (CEA) that is associated with post-operative intracranial haemorrhage, hyperperfusion syndrome, and cardiac complications. The aim of the current study was to identify pre-operative clinical, imaging, and physiological parameters associated with PEH. METHODS: In total, 106 CEA patients undergoing CEA under general anaesthesia underwent pre-operative evaluation of 24 hour ambulatory arterial blood pressure (BP), baroreceptor sensitivity, cerebral autoregulation, and transcranial Doppler measurement of cerebral blood flow velocity (CBFv) and pulsatility index...
March 3, 2017: European Journal of Vascular and Endovascular Surgery
Gilles Kayem, Catherine Deneux-Tharaux
PURPOSE OF REVIEW: Examine the available results from population-based studies to test the hypothesis that differences between countries in medical practices for the management of labour, delivery and early bleeding may lead to a differential risk of post-partum haemorrhage (PPH)-related maternal morbidity and in the need for PPH-related invasive therapies. RECENT FINDINGS: International comparison of ratios of maternal mortality due to PPH shows significant differences between developed countries...
April 2017: Current Opinion in Obstetrics & Gynecology
John Eraifej, William Clark, Benjamin France, Sebastian Desando, David Moore
BACKGROUND: Stroke can lead to significant impairment of upper limb function which affects performance of activities of daily living (ADL). Functional electrical stimulation (FES) involves electrical stimulation of motor neurons such that muscle groups contract and create or augment a moment about a joint. Whilst lower limb FES was established in post-stroke rehabilitation, there is a lack of clarity on the effectiveness of upper limb FES. This systematic review aims to evaluate the effectiveness of post-stroke upper limb FES on ADL and motor outcomes...
February 28, 2017: Systematic Reviews
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
M W Strachan, M Dalvi, R Ainsworth, F W Gibb, H Horsfall, D Patel
Fine needle aspiration is routinely performed as part of the assessment of thyroid nodules. It is generally regarded as a very safe procedure, though rarely significant bleeding can occur in its aftermath. A 79-year-old female was referred for assessment of an incidental thyroid nodule which had been identified on computed tomography of the chest and extended into the retrosternal space. The patient was referred for fine needle aspiration under ultrasound guidance. Three passes were made with a 25 gauge needle into the nodule; a haemorrhagic aspirate was obtained and sent for cytological examination...
September 2016: Journal of the Royal College of Physicians of Edinburgh
Eva Wiberg-Itzel, Andrea B Pembe, Hans Järnbert-Pettersson, Margareta Norman, Anna-Carin Wihlbäck, Irene Hoesli, Monya Todesco Bernasconi, Elie Azria, Helena Åkerud, Elisabet Darj
BACKGROUND: One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). OBJECTIVES: To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries...
2016: PloS One
M Z Mahmoud, M Alkhorayef, A Sulieman
Objective: This study was designed with an aim to visualize the status of the posterior portion of the eye globe of adult Saudi cataract patients with brightness mode (B-mode) ultrasound, to find out any posterior segment lesions in such preoperative cases. Methods: A prospective study was performed between May 2014 and May 2015. A 375 pre-operative cataract (184, 49.1%) males and (191, 50.9%) females between the ages from 18 to 90 years; mean age of 54 ± 0.5 years were scanned at two Radiology Departments...
February 15, 2016: West Indian Medical Journal
Lesley J Scott
Tetravalent, live-attenuated, dengue vaccine (Dengvaxia(®); CYD-TDV) is the first vaccine approved for the prevention of dengue disease caused by dengue virus (DENV) serotypes 1-4 in individuals aged 9-45 or 9-60 years living in high dengue endemic areas. This narrative review discusses the immunogenicity, protective efficacy, reactogenicity and safety of CYD-TDV in the prevention of dengue disease. In Latin American and Asian phase 3 trials in children and adolescents (n > 30,000), the recommended three-dose CYD-TDV regimen was efficacious in preventing virologically-confirmed dengue (VCD) during the period from 28 days after the last dose (month 13) to month 25, meeting the primary endpoint criteria...
September 2016: Drugs
Kavita Yadav, Akanksha Singh, Ashok Kumar Jaryal, Poonam Coshic, Kabita Chatterjee, K K Deepak
Non-hypotensive hypovolemia, observed during mild haemorrhage or blood donation leads to reflex readjustment of the cardiac autonomic tone. In the present study, the cardiac autonomic tone was quantified using heart rate and blood pressure variability during and after non-hypotensive hypovolemia of blood donation. 86 voluntary healthy male blood donors were recruited for the study (age 35 ± 9 years; weight 78 ± 12 kg; height 174 ± 6 cms). Continuous lead II ECG and beat-to-beat blood pressure was recorded before, during and after blood donation followed by offline time and frequency domain analysis of HRV and BPV...
August 2, 2016: Journal of Clinical Monitoring and Computing
A S Ducloy-Bouthors, A Duhamel, E Kipnis, A Tournoys, A Prado-Dupont, A Elkalioubie, E Jeanpierre, G Debize, E Peynaud-Debayle, D DeProst, C Huissoud, A Rauch, S Susen
BACKGROUND: Beneficial effects of tranexamic acid (TA) have been established in surgery and trauma. In ongoing postpartum haemorrhage (PPH), a moderate reduction of blood loss was observed in a previously published randomized controlled trial. Analysis of haemostasis parameters obtained from samples collected as part of this study are presented. METHODS: Women with PPH >800 ml after vaginal delivery were assigned to receive either TA (4 g over 1 h, then 1 g per h over six h) (TA) or not (H)...
May 2016: British Journal of Anaesthesia
Angelika Mennecke, Stanislav Svergun, Bernhard Scholz, Kevin Royalty, Arnd Dörfler, Tobias Struffert
OBJECTIVES: Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. METHODS: Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients...
January 2017: European Radiology
Esther Cathyln Atukunda, Godfrey Rwambuka Mugyenyi, Celestino Obua, Elly Bronney Atuhumuza, Nicholas Musinguzi, Yarine Fajardo Tornes, Amon Ganaafa Agaba, Mark Jacob Siedner
BACKGROUND: Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH), which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL) versus changes in peri-partum hemoglobin to detect PPH...
2016: PloS One
Gary P Morris, Amanda L Wright, Richard P Tan, Amadeus Gladbach, Lars M Ittner, Bryce Vissel
The intraluminal filament model of middle cerebral artery occlusion (MCAO) in mice and rats has been plagued by inconsistency, owing in part to the multitude of variables requiring control. In this study we investigated the impact of several major variables on survival rate, lesion volume, neurological scores, cerebral blood flow (CBF) and body weight including filament width, time after reperfusion, occlusion time and the choice of surgical method. Using the Koizumi method, we found ischemic injury can be detected as early as 30 min after reperfusion, to a degree that is not statistically different from 24 h post-perfusion, using 2,3,5-Triphenyltetrazolium chloride (TTC) staining...
2016: PloS One
Raj N Kalaria, Rufus Akinyemi, Masafumi Ihara
The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes...
May 2016: Biochimica et Biophysica Acta
Felix Sayinzoga, Leon Bijlmakers, Jeroen van Dillen, Victor Mivumbi, Fidèle Ngabo, Koos van der Velden
OBJECTIVE: Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. DESIGN: Nationwide facility-based retrospective cohort study. SETTINGS: All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed...
January 22, 2016: BMJ Open
A Kovitvadhi, F Gai, S Dabbou, I Ferrocino, L Rotolo, M Falzone, C Vignolini, M S Gennero, S Bergagna, Daniela Dezzutto, R Barbero, P Nebbia, S Rosati, L Cocolin, I Zoccarato, L Gasco
Echinacea pallida (EPAL), a herbaceous flowering plant with immunomodulatory properties, has been chosen to determine the pre- and post-supplementary effects on the growth performances, bacterial community, blood parameters and immunity of growing rabbits. The same Grimaud does (14-week-old) from the studied in the first part of this study were randomly divided into two groups (n=50/group). The first group was fed a basal diet without supplementation (Control group, C) while the another group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E)...
July 2016: Animal: An International Journal of Animal Bioscience
R Gray, F Baldwin, S Bruemmer-Smith
UNLABELLED: A previously fit and well 57-year-old gentleman who had recently undergone a colonoscopy and biopsy of a polyp presented with a 4-day history of progressive breathlessness and abdominal discomfort. The day after admission, he became haemodynamically unstable, developed ischaemic legs and suffered a brief cardiac arrest. Blood tests demonstrated a coagulopathy and hypoglycaemia. Continued haemodynamic instability post-arrest and clinical findings of high right-sided heart pressures were investigated by bedside screening echocardiogram...
March 1, 2015: Echo Research and Practice
Abdullah Pandor, Daniel Pollard, Tim Chico, Robert Henderson, Matt Stevenson
As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures rivaroxaban (Xarelto, Bayer) to submit evidence of the clinical and cost effectiveness of rivaroxaban for the prevention of adverse outcomes in patients after the acute management of acute coronary syndrome (ACS). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
May 2016: PharmacoEconomics
Lisa S Manning, Thompson G Robinson
Although blood pressure (BP) levels may rise in the weeks preceding intracerebral haemorrhage (ICH), in contrast to findings in the ischaemic stroke population, the initial post-ICH BP is often much higher than the last pre-morbid level. Elevated BP is therefore common in acute ICH, often with markedly elevated levels, and is associated with poor outcomes, though the exact pathophysiological mechanisms remain unclear. The Antihypertensive Treatment of Acute Cerebral Haemorrhage (ATACH) trial and the INTEnsive blood pressure Reduction in Acute Cerebral haemorrhage Trial (INTERACT) demonstrated that early and intensive lowering of elevated BP in the acute ICH period is feasible and safe...
2015: Frontiers of Neurology and Neuroscience
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