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https://www.readbyqxmd.com/read/28682477/preclinical-safety-and-efficacy-of-andexanet-alfa-in-animal-models
#1
G Lu, S J Hollenbach, D C Baker, S Tan, A Hutchaleelaha, J T Curnutte, P B Conley
BACKGROUND: Andexanet is a recombinant modified form of factor Xa (FXa), designed to bind to and reverse the anticoagulant activity of FXa inhibitors. OBJECTIVES: To evaluate the ability of andexanet to reverse the anticoagulant activity of rivaroxaban, and assess its pharmacokinetics (PK) and toxicity in animal models. METHODS: The effects of andexanet on blood loss, anti-FXa activity, rivaroxaban unbound plasma concentrations, and other coagulation parameters were assessed in a rabbit liver laceration 'treatment' model...
July 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28644516/hemostatic-efficiency-of-modern-topical-sealants-comparative-evaluation-after-liver-resection-and-splenic-laceration-in-a-swine-model
#2
Hamidreza Fonouni, Arash Kashfi, Ali Majlesara, Oliver Stahlheber, Lukas Konstantinidis, Negin Gharabaghi, Thomas W Kraus, Arianeb Mehrabi, Hani Oweira
Parenchymal transection during hepatobiliary surgery can disrupt small vasculature or bile ducts, which could be managed difficultly. Sealants are helpful tools to achieve better hemostasis. The aim of this study is to analyze the hemostatic efficiency of four modern sealants in a porcine model. In this study, 40 landrace pigs were assigned equally to the control (without sealant) and four sealant groups. Standardized liver resection and splenic lesions were performed and left without using sealant (control) or treated with one of the following sealants: TachoSil(®) , Tissucol Duo(®) , Coseal(®) , and FloSeal(®) ...
June 23, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#3
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28597665/-injuries-associated-with-cardiopulmonary-resuscitation-in-non-survivors-after-out-of-hospital-cardiac-arrest-autopsy-study
#4
Lucia Ihnát Rudinská, Petr Hejna, Margita Smatanová, Peter Ihnát, Igor Dvořáček
The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 - 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/28570538/uncontrolled-hemorrhagic-shock-modeled-via-liver-laceration-in-mice-with-real-time-hemodynamic-monitoring
#5
Mitchell Dyer, Shannon Haldeman, Andres Gutierrez, Lauryn Kohut, Anirban Sen Gupta, Matthew D Neal
Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via a liver laceration that results in consistent blood loss, hemodynamic alterations, and survival. Mice undergo a standardized resection of the left-middle lobe of the liver. They are allowed to bleed without mechanical intervention. Hemostatic agents can be administered as pre-treatment or rescue therapy depending on the interest of the investigator. During the time of hemorrhage, real-time hemodynamic monitoring via a left femoral arterial line is performed...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28538647/bilateral-pulmonary-emboli-and-extensive-inferior-vena-cava-thrombosis-in-the-setting-of-large-subcapsularhematoma-and-liver-laceration-after-blunt-trauma
#6
Alejandro Betancourt-Ramirez, Soraya SMolero, Patrizio Petrone, Corrado P Marini, Heidi L Frankel
No abstract text is available yet for this article.
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28532047/porous-chitosan-microspheres-for-application-as-quick-in-vitro-and-in-vivo-hemostat
#7
Jixiang Li, Xiaowei Wu, Yanqing Wu, Zonghao Tang, Xun Sun, Meng Pan, Yufeng Chen, Juanjuan Li, Rongdong Xiao, Zhengchao Wang, Haiqing Liu
Controlling massive hemorrhage is of great importance to lower transfusional medical cost, and to reduce death and mobility rate in battlefield and civilian accidents. We reported the fabrication of porous chitosan microspheres (CSMS) with tunable surface pore size by microemulsion combined with thermally induced phase separation technique, and its application as a quick hemostat. Their hemostatic property was characterized by blood clotting kinetics, adherence interaction between red blood cells/platelets and CSMS, in vitro and in vivo hemostasis by rat tail amputation and liver laceration models, and histological analysis...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28515753/traumatic-pneumatocele-in-an-11-year-old-boy-report-of-a-rare-case-and-review-of-the-literature
#8
Ewa Matuszczak, Marzanna Oksiuta, Adam Hermanowicz, Wojciech Dębek
The authors present a case of a pneumatocele associated with blunt trauma in a child. An 11-year-old boy was admitted to the emergency department after he was knocked over and his chest was trapped under a soccer goal. Chest computed tomography (CT) revealed several cavities in the lobes of both lungs. The CT of the abdomen revealed traumatic laceration of the liver. The patient was treated conservatively. His condition was stable and subsequently improved. He was discharged 19 days later. After nine months, a chest radiograph showed complete resolution of the pneumatocele, and abdominal ultrasound demonstrated complete resolution of the liver hematoma...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28489685/solid-organ-laceration-in-an-adolescent-soccer-player-a-case-report
#9
Michael Visenio, Keely Buesing, Kody Moffatt
Pediatric solid organ lacerations are a relatively uncommon but potentially dangerous injury that must be addressed urgently once recognized. Seen most often during recreational or team sports, they usually occur after a blunt deceleration mechanism to the abdomen or flank. Depending on the severity of injury, solid organ laceration may not be immediately apparent clinically. This emphasizes the importance of sideline witnessing and evaluation, acting quickly once symptoms develop, and placing importance on safe sporting technique...
May 9, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28466615/angiographic-embolization-in-pediatric-abdominal-trauma
#10
Yechiel Sweed, Jonathan Singer-Jordan, Sorin Papura, Norman Loberant, Alon Yulevich
BACKGROUND: Trauma is the leading cause of childhood morbidity and mortality. Abdominal bleeding is one of the common causes of mortality due to trauma. Angiography and embolization are well recognized as the primary treatments in certain cases of acute traumatic hemorrhage in adults; however, evidence is lacking in the pediatric population. OBJECTIVES: To assess the safety and efficacy of transcatheter arterial embolization (TAE) for blunt and penetrating abdominal and pelvic trauma in the pediatric age group...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28262236/disseminated-intravascular-coagulation-in-pregnancy-clinical-phenotypes-and-diagnostic-scores
#11
Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28261700/fibrin-glue-infiltrating-hemostasis-for-intractable-bleeding-from-the-liver-or-spleen-during-liver-transplantation
#12
Shin Hwang, Dong-Hwan Jung, Gi-Won Song, Tae-Yong Ha, Eun-Kyeong Jwa, Sung-Gyu Lee
Portal hypertension induces congestion of the liver and spleen, thus any capsular or parenchymal injury to these organs can produce intractable bleeding which generally is not easily controlled. To cope with intractable bleeding such as being encountered during liver transplantation, we developed an infiltrating hemostasis technique as a conceptual shift from conventional application methods, in which fibrin glue is locally injected into the bleeding area on the liver or spleen. This technique, which uses a fibrin glue kit (2 ml kit; Greenplast, Green Cross, Seoul, Korea), consists of inserting the needle 0...
November 2016: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28248762/splenic-rupture-and-liver-laceration-in-an-adolescent-with-autism-spectrum-disorder
#13
Desiree Noel Wagner Neville, Jennifer R Marin
We report a case of a 16-year-old adolescent boy with autism who presented to the pediatric emergency department after falling from a standing position, with a relatively benign examination, who was found to have significant hemoperitoneum on the focused assessment with sonography in trauma examination.
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28245861/liver-radiofrequency-ablation-as-emergency-treatment-for-a-ruptured-hepatocellular-carcinoma-a-case-report
#14
Alessandra Bertacco, Francesco D'Amico, Maurizio Romano, Michele Finotti, Alessandro Vitale, Umberto Cillo
BACKGROUND: Hemoperitoneum is a possible complication of hepatocellular carcinoma that may require emergency surgery as an alternative to radiological locoregional therapies. CASE PRESENTATION: We present a case report of a 78-year-old white man with alcoholic-related cirrhosis and a multifocal hepatocellular carcinoma. An abdominal computed tomography scan showed multiple and bilateral foci of bleeding from broken liver cancer. He was urgently transferred from our radiology unit to our operating room for massive hemoperitoneum...
March 1, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28092783/pulmonary-emboli-cardiac-arrest-with-cpr-complication-liver-laceration-and-massive-abdominal-bleed-a-case-report
#15
John Lundqvist, Jan G Jakobsson
INTRODUCTION: Massive pulmonary emboli may cause right ventricular failure and backward stasis with parenchymal organ swelling thus increasing the risk for laceration, e.g. if CPR is needed. PRESENTATION OF CASE: A 28-year-old Colombian female with no medical history but taking contraceptive pills and having had a recent longer flight was admitted to Danderyds hospital Emergency Department because of respiratory failure. She developed cardiac arrest in the emergence department following the emergent diagnosis of pulmonary emboli...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28000769/characterization-of-blunt-chest-trauma-in-a-long-term-porcine-model-of-severe-multiple-trauma
#16
K Horst, T P Simon, R Pfeifer, M Teuben, K Almahmoud, Q Zhi, S Aguiar Santos, C Castelar Wembers, S Leonhardt, N Heussen, P Störmann, B Auner, B Relja, I Marzi, A T Haug, M van Griensven, M Kalbitz, M Huber-Lang, R Tolba, L K Reiss, S Uhlig, G Marx, H C Pape, F Hildebrand
Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock)...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#17
Raúl J Gazmuri, Kasen Whitehouse, Karla Whittinghill, Alvin Baetiong, Kruti Shah, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32-40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27896328/liver-laceration-related-to-cardiopulmonary-resuscitation
#18
Halil Beydilli, Yasemin Balci, Melike Erbas, Ethem Acar, Sahin Isik, Bulent Savran
Cardiopulmonary resuscitation (CPR) is recognized as a medical procedure performed to maintain vital functions of a person whose cardiac and respiratory functions have stopped. Chest compression is the most essential component of CPR and it is performed on the lower half of the sternum. During CPR, many complications may occur because of chest compressions, especially chest injuries including sternum and rib fractures. Rarely tracheal injury, rupture of the stomach, or liver or spleen injury may also occur as complications...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27854071/staged-laparotomies-based-on-the-damage-control-principle-to-treat-hemodynamically-unstable-grade-iv-blunt-hepatic-injury-in-an-eight-year-old-girl
#19
Takashi Kobayashi, Masayuki Kubota, Yuhki Arai, Toshiyuki Ohyama, Naoki Yokota, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Kazuyasu Takizawa, Jun Sakata, Masayuki Nagahashi, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Severe blunt hepatic injury is a major cause of morbidity and mortality in pediatric patients. Damage control (DC) surgery has been reported to be useful in severely compromised children with hepatic injury. We applied such a technique in the treatment of a case of hemodynamically unstable grade IV blunt hepatic injury in an eight-year-old girl. This case is the first to use multimodal approaches including perihepatic packing, temporary closure of the abdominal wall with a plastic sheet, transarterial embolization (TAE), and planned delayed anatomical hepatic resection in a child...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27807573/portal-hypertension-and-ascites-due-to-an-arterioportal-fistula-sequela-of-a-remote-traumatic-liver-laceration
#20
Benjamin M Hulkower, Sabah Butty, Marwan Ghabril
Arterioportal fistulas (APFs) are a group of vascular disorders, in which systemic arteries communicate with the portal circulation, presenting as a congenital syndrome or more commonly acquired from iatrogenic instrumentation or abdominal trauma. We report the case of a 58-year-old man who developed ascites without underlying risk factors for portal hypertension, which was attributed to an APF found on imaging, manifesting 43 years after sustaining a liver laceration. After angiographic embolization of the APF, the patient's ascites resolved completely...
August 2016: ACG Case Reports Journal
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