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Automatic Detection of Internal Bleeding in Air Ambulances |

A new system being tested on medical helicopters in the Boston area has been shown to help detect serious cases of internal hemorrhaging that would otherwi  
medgadget.com
almost 5 years ago
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Endoscopic injection of cyanoacrylate glue versus other endoscopic procedures for acute bleeding gastric varices in people with portal hypertension | Cochrane

Acute bleeding from ruptured gastric varices (enlarged veins), the most severe consequence of portal hypertension (that is increased pressure in the veins leading to the liver), is associated with high death rates. The most promising treatment for this condition is considered to be endoscopic sclerotherapy (passing a flexible tube with a camera at the end down the oesophagus (swallowing tube) allowing direct visualisation and treatment of bleeding varices) with N-butyl-2-cyanoacrylate (cyanoacrylate), which is a glue that causes blood clots to form and stops the bleeding. However, incidence of re-bleeding and complications have opened a debate on when this glue should be used compared with other endoscopic procedures.  
cochrane.org
almost 5 years ago
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Recognition of Common Childhood Malignancies - American Family Physician

Although cancer has an annual incidence of only about 150 new cases per 1 million U.S. children, it is the second leading cause of childhood deaths. Early detection and prompt therapy have the potential to reduce mortality. Leukemias, lymphomas and central nervous system tumors account for more than one half of new cancer cases in children. Early in the disease, leukemia may cause nonspecific symptoms similar to those of a viral infection. Leukemia should be suspected if persistent vague symptoms are accompanied by evidence of abnormal bleeding, bone pain, lymphadenopathy or hepatosplenomegaly. The presenting symptoms of a brain tumor may include elevated intracranial pressure, nerve abnormalities and seizures. A spinal tumor often presents with signs and symptoms of spinal cord compression. In children, lymphoma may present as one or more painless masses, often in the neck, accompanied by signs and symptoms resulting from local compression, as well as signs and symptoms of systemic disturbances, such as fever and weight loss. A neuroblastoma may arise from sympathetic nervous tissue anywhere in the body, but this tumor most often develops in the abdomen. The presentation depends on the local effects of the solid tumor and any metastases. An abdominal mass in a child may also be due to Wilms' tumor. This neoplasm may present with renal signs and symptoms, such as hypertension, hematuria and abdominal pain. A tumor of the musculoskeletal system is often first detected when trauma appears to cause pain and dysfunction out of proportion to the injury. Primary care physicians should be alert for possible presenting signs and symptoms of childhood malignancy, particularly in patients with Down syndrome or other congenital and familial conditions associated with an increased risk of cancer.  
aafp.org
over 4 years ago
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150

ENT Basics: Epistaxis

www.facebook.com/Shortsharpscratch to see the whole series! We hope you enjoy our humorous guide to understanding and managing Epistaxis! The video covers th...  
youtube.com
over 4 years ago
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90

Bedside Obstetrics & Gynecology

The second edition of Bedside Obstetrics & Gynecology brings postgraduate trainees fully up to date with the most recent advances in the field. The first section covers obstetrics, discussing normal and abnormal presentations (such as normal labour versus breech presentation), complications in pregnancy (including early pregnancy bleeding and ante- and postpartum haemorrhage), and medical disorders related to pregnancy (such as preeclampsia and gestational diabetes). Section two covers numerous gynaecological abnormalities. This new edition has been fully revised but continues to emphasise the importance of history taking and clinical examination. New chapters have been added to cover topics such as preterm pregnancy, post-dated pregnancy and intrauterine death, bleeding due to miscarriage, menopause and contraception. Nearly 1100 images, illustrations and tables enhance learning, and each chapter includes questions and answers related to case studies. Key points Fully revised, new edition providing recent advances in obstetrics and gynaecology Many new chapters added Includes 1100 images, illustrations and tables Previous edition published in 2010  
books.google.co.uk
over 4 years ago
Static.www.bmj
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Optimal duration of dual antiplatelet therapy after drug eluting stent remains unclear

Longer duration of dual antiplatelet therapy after implantation of a drug eluting stent is associated with fewer myocardial infarctions but more major bleeding than a shorter duration, a systematic review has found.  
feeds.bmj.com
over 4 years ago
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New oral anticoagulants: dosing and monitoring

The two reports on the risk of gastrointestinal bleeding with new oral anticoagulants come as no surprise given the dosing regimens that have been adopted.1 2  
feeds.bmj.com
over 4 years ago
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CODE BROWN: COMBATIVE AND BLEEDING

I’ve had combative patients in my ER lots of times. Combative enough to warrant sedation or anaesthesia. And bleeding patients. Serious bleeding. Lots of times. But not the extremes of both at the same time.  
scancrit.com
over 4 years ago
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Podcast Time! Upper Gastrointestinal Bleeds

PEM Currents, the Pediatric Emergency Medicine podcast returns today with an episode focusing on upper GI bleeds. Serious UGI bleeds – you know, the ones with shock, massive transfusions and more – are fortunately rare in the Pediatric Emergency Department. However, there is a growing population of patients with chronic diseases that can lead to portal hypertension, varies and other causes of bleeding from the upper GI tract.  
pemcincinnati.com
over 4 years ago
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Critical Care

Whether hydroxyethyl starch (HES) is safe for perioperative use is not known. Evaluating HES in cardiac surgery, Jacob and colleagues suggested conclusion was of a more favorable safety profile for HES 130/0.4 [1]. The authors, however, wrongly stated that they followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines because the meta-analysis lacked a table of included study characteristics, an assessment of bias, identification of any pre-specified subgroup analyses, and tests of interaction to compare different HES solutions. In many included studies, the control group received HES, patients with heavy bleeding were excluded post hoc, and anti-fibrinolytic drugs were used to minimize bleeding. For instance, in two included trials the group assigned to gelatin actually received significantly more postoperative HES 130/0.4 than the group allocated to HES 130/0.4 [2,3]. In an included trial of HES 130/0.4, the results from one of the four study centers were excluded post hoc without explanation [4]. Other sources of bias were aggregation of intra- with postoperative blood loss and preferential use of calculated rather than measured blood loss. Furthermore, no tests of interaction were presented even to address the question of whether HES 130/0.4 differs from other HES solutions in its effect on bleeding risk after cardiac surgery.  
ccforum.com
over 4 years ago
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Antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease | Cochrane

Review question We reviewed antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.  
cochrane.org
over 4 years ago
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Snake antivenoms for treating people who have been bitten by a snake, and have developed abnormal blood clotting | Cochrane

Many snake venoms cause coagulopathy in humans. Coagulopathy is a condition in which the person’s blood is unable to clot because the venom causes decreased levels of clotting factors. Coagulopathy increases the risk of bleeding. Antivenom is a treatment used to neutralise venom in people who have been bitten by a snake. There is some evidence from observational studies in humans which suggest that snake antivenom is helpful to people who have been bitten by a snake. However, the use of antivenom has some risks, and can cause allergic reactions.  
cochrane.org
over 4 years ago
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Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases | Cochrane

Review question We reviewed vitamin K for upper gastrointestinal bleeding in people with acute liver disease (that is, loss of normal liver functions which occurs in days or weeks; most often, people do not have a pre-existing liver disease) or chronic liver disease (that is, progressive destruction of normal liver functions, usually associated with fibrotic regeneration of the liver tissue).  
cochrane.org
over 4 years ago
28977
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PMC3263934

Objective: Antepartum haemorrhage (APH) defined as bleeding from the genital tract in the second half of pregnancy, remains a major cause of perinatal mortality and maternal morbidity in the developed world.  
ncbi.nlm.nih.gov
over 4 years ago
Www.bmj
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Endometriosis is linked to greater risk of complications in pregnancy and birth, study finds

Women with endometriosis have a higher risk of miscarriage and ectopic pregnancy, a large cohort study in Scotland has found. Women with the condition who maintain a pregnancy for more than 24 weeks face further risks, including a higher risk of placenta praevia, bleeding before and after birth, and caesarean section.  
feeds.bmj.com
over 4 years ago
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Emergency Medicine Literature of Note: Where’s the Beef With TXA?

Despite the study many major concerns arused about CRASH 2. I am aware at least of 3 major of them1. Fewer than 2% of the patients in CRASH-2 were treated in countries that routinely provide rapid access to blood products, damage-control surgery and angiography, and advanced critical care.2. Unanswered question about safety of TxA when combined with other treatments targeting bleeding and coagulopathies.3. Unanswered question wich patients should receive TXAIn my opinion new and more accurate studies are needed build more solid evidences  
emlitofnote.com
over 4 years ago
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Tranexamic acid for preventing bleeding after delivery | Cochrane

Postpartum haemorrhage is a common and an occasionally life-threatening complication of labour. The majority of women receive drugs that directly stimulate the uterus (prophylactic uterotonics) during childbirth to prevent haemorrhages resulting from failure of the uterine muscle to contract normally (uterine atony).  
cochrane.org
over 4 years ago
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CT angiography for lower GI bleed: the University of Pennsylvania Experience

Introduction 0 A post two months ago explored the use of CT angiography instead of tagged RBC scans for the evaluation of lower GI bleeding (here).  The al  
pulmcrit.org
over 4 years ago
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Prevention of blood clots in patients undergoing cardiac or thoracic surgery | Cochrane

Patients undergoing surgery have an increased probability of developing blood clots in their veins (venous thromboembolism). These clots may be in the deep veins (deep vein thrombosis) or travel to the lungs (pulmonary embolism). As in other types of surgery, effective prevention of blood clots (thromboprophylaxis) after cardiac or thoracic surgery may reduce the risk of postoperative vein clots. These potential benefits, however, have to be balanced against the associated risks of bleeding. This systematic review looked at the effectiveness and safety of anticoagulants (medicines that reduce the ability of the blood to clot), mechanical interventions (such as pneumatic pumps on the legs to promote blood flow), and caval filters (a type of vascular filter, implanted into the main abdominal vein to prevent movement of clots from the legs to the lungs) in patients undergoing cardiac or thoracic surgery.  
cochrane.org
over 4 years ago
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Effect of administration of antihelminthic for soil-transmitted helminths during pregnancy | Cochrane

Intestinal worms (helminths) contribute to iron-deficiency anaemia as they feed on blood and cause further bleeding by releasing anticoagulant compounds. They also affect the supply of nutrients and cause anorexia, vomiting and diarrhoea. Pregnancy complicated by maternal hookworm infection poses a serious threat to the health of mothers and their babies, especially in developing countries. Women who are anaemic during pregnancy are more likely to have ill health, give birth prematurely, and have low birthweight babies with low iron reserves. Antihelminthic drugs are highly effective and have minimal side-effects but information on their use during pregnancy is limited. The major concern is that the drugs may cause malformation of the fetus (teratogenic effects). We examined the research published up to 31 January 2015 on the impact of giving a single antihelminthic treatment in the second trimester of pregnancy on maternal anaemia and pregnancy outcomes.  
cochrane.org
over 4 years ago