Pelvic Fractures With Associated Retroperitoneal Hematoma: Time Until Angioembolization and Results

ConclusionsThere was a short delay from admission to AE, even during off-hours, and a good correlation of CE on CT scan and angiography.ResumenIntroducciónEl tratamiento de las fracturas de pelvis con hematoma retroperitoneal (HRP) es controvertido. Especialmente la necesidad de angioembolización (AE) cuando no hay extravasación de contraste (EC) en la tomografía computarizada (TC) o angiografía. Otro aspecto relevante es el retraso hasta la misma.Nuestro objetivo ha sido determinar si existen diferencias en el tiempo hasta la AE entre los pacientes admitidos durante el horario laboral y los admitidos fuera del mismo y durante los fines de semana y festivos. Nuestra hipótesis era que la angiografía y AE serían más frecuentes en el horario laboral, y el tiempo hasta las mismas sería superior fuera del horario laboral habitual, con una mortalidad mayor en este grupo para una gravedad global similar. Un objetivo secundario ha sido valorar la correlación entre EC en la TC y la angiografía.MétodosAnálisis retrospectivo de 2 cohortes de pacientes con HRP por fractura de pelvis. Se estudia la realización de angiografía dividiendo a los pacientes según su hora de llegada a lo largo de un periodo de 24 años (grupo A: horario laboral, y grupo B: fuera del mismo). La indicación de angiografía y AE fue realizada por la guardia de cirugía gener...
Source: Cirugia Espanola - Category: Surgery Source Type: research

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Lower gastrointestinal bleeding (LGIB) is both common and morbid, with a mortality rate ranging from 1.5-4%. Use of computed tomography angiography (CTA) in localizing LGIB has replaced tagged red blood cell scans in many institutions but little data exists to guide the choice of first-line testing. Current guidelines suggest colonoscopy as standard of care based on limited supporting data. We aimed to compare the utility and yield of early CTA versus colonoscopy in lower gastrointestinal hemorrhage.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Tuesday abstract Source Type: research
Conclusions: In this pilot study, we have demonstrated the feasibility and potential utility of V/Q PET/CT for the management of patients with suspected acute PE. V/Q PET/CT may be of particular relevance in cases of equivocal findings or isolated subsegmental findings on CTPA, adding further discriminatory information to allow important decision-making regarding application or withholding of treatment courses of therapeutic anticoagulation, which may confer an increased risk of bleeding. Given the other advantages of V/Q PET/CT (reduced acquisition time, low radiation dose), and with increasing availability of 68Ga-genera...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Outcomes/Infectious Disease/Pulmonary II Source Type: research
Authors: Campbell BC Abstract In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dramatically reduced disability and revolutionised stroke management. Thrombolysis with alteplase is effective when administered to patients with potentially disabling stroke, who are not at high risk of bleeding, within 4.5 hours of the time the patient was last known to be well. Emerging evidence suggests that other thrombolytics such as tenecteplase may be even more effective. Treatment may be possible beyond 4.5 hours in patients selected using brain imagi...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
AbstractHeart failure is a clinical condition that is associated with significant morbidity and mortality. With the advent of left ventricular assist device (LVAD), an increasing number of patients have received an artificial heart both as a bridge-to-therapy and as a destination therapy. Clinical trials have shown clear survival benefits of LVAD implantation. However, the increased survival benefits and improved quality of life come at the expense of an increased complication rate. Common complications include perioperative bleeding, infection, device thrombosis, gastrointestinal bleeding, right heart failure, and aortic ...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
Hyperglycemia was proved to cause neuron death in both animal experiments and poor outcome of hemorrhage patients, but the predictive ability of admission blood glucose level for early hematoma growth in patients with intracranial hemorrhage (ICH) is still controversial. Spot sign is a well-established imaging predictor for early hematoma growth, implying active microvascular bleeding. Here, we aim to assess associations between admission serum glucose and early hematoma expansion in ICH patients, as well as spot sign. We retrospectively reviewed all the patients with ICH from January 2017 to March 2018 in West China Hosp...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Authors: Robustelli U, Andreano M, Candida M, Antropoli M, Ambrosino F, Esposito A Abstract The authors present a series of 15 patients with lower gastrointestinal bleeding. 11 (73%) out of 15 patients, were directly subjected to surgery, and 4 (37%) attempted to stop hemorrhage with angiography. In the group of patients undergoing surgery we had a mortality of 1 out of 12 (8%). In the group of patients undergoing embolization, two of four died with 50% of mortality. All patients undergoing surgery had received from a minimum of two to a maximum of four blood bags before surgery. 8 out of 12 patients (67%) received...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
HeartFlow said yesterday that it won reimbursement coverage from the Japanese Ministry of Health, Labor and Welfare for its HeartFlow FFRct fractional flow reserve analysis. The Redwood City, Calif.-based company said that it has already received approval from the Japanese Pharmaceuticals and Medical Devices Agency, and that reimbursement will go into effect beginning on December 1. “When a patient presents with symptoms suggesting CAD, we want to be able to quickly and effectively diagnose patients while reducing the need for unnecessary tests or invasive procedures. In clinical studies, we were able to see fir...
Source: Mass Device - Category: Medical Devices Authors: Tags: Business/Financial News Cardiovascular Featured Imaging Software / IT HeartFlow Source Type: news
J Neurol Surg B DOI: 10.1055/s-0038-1669974The case described in this video involved a 38-year-old man, who presented with a 4-week history of worsening acute-onset headache, nausea, double vision, and vertigo. On examination, he had impaired tandem gait and diplopia on right horizontal gaze. A computed tomography (CT) scan revealed a hyperdense lesion of the right cerebellopontine angle. Magnetic resonance imaging (MRI) revealed a nonenhancing middle cerebellar peduncle lesion that was isointense on T2-weighed imaging and hypointense on FLAIR imaging (Fig. 1A–B). The differential diagnoses for this lesion included c...
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Skull Base: Operative Videos Source Type: research
DISCUSSION: To the best of our knowledge, this study is the first to correlate the levels of endogenous NPY in supratentorial CSF with cognitive outcome in good-grade sSAH patients. Excessive NPY release into CSF may have a short-term influence on the pathogenesis of neuropsychological deficits. The impact of cerebrovascular manipulation on NPY release has to be further elucidated. ABBREVIATIONS: ANOVA: analysis of variance; aSAH: aneurysmal subarachnoid haemorrhage; AUC: area under the curve; CBF: cerebral blood flow; CSF: cerebrospinal fluid; CT (scan): computed tomography (scan); CV: cerebral vasospasm; DIND: delaye...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
We present the case of 54-year-old man admitted in the Department of Ear, Nose and Throat (ENT), Emergency University Hospital of Bucharest, Romania, with a nasopharynx tumor certificated by computed tomography (CT) scan with significant bleeding to a previous incisional biopsy temptation rising angiofibroma suspicion. We performed the radical surgical excision of mass by transoral approach. Postoperative bleeding imposed angiography with right internal maxillary artery embolization. Histopathological evaluation showed the diagnosis of lymphangioma. After three years, the patient is without recurrence. PMID: 30173266 [PubMed - in process]
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
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