Twelve autologous blood transfusions in eight cats with haemoperitoneum

2018 ◽  
Vol 21 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Laura P Cole ◽  
Karen Humm
Keyword(s):  
Medical Records ◽  
Autologous Blood ◽  
Disease Process ◽  
Underlying Disease ◽  
Effective Technique ◽  
Median Percentage ◽  
Postoperative Haemorrhage ◽  
Allogenic Blood ◽  
Time Period ◽  
Median Volume

Objectives The objectives of this study were to describe the clinical use and outcome of autologous transfusions in cats with intracavitary haemorrhage. Methods A retrospective descriptive study was performed. Computerised medical records of a single referral centre were searched for cats receiving an autotransfusion. Medical records were evaluated for underlying disease process, autotransfusion technique, autotransfusion volume, time period over which the autotransfusion was given, packed cell volume (PCV) pre- and post-autotransfusion, percentage rise in PCV, use of other blood products and any complications of the procedure. Survival to discharge and survival at 2 months was documented. Results Between July 2012 and March 2018 a total of 12 autotransfusions were performed in eight cats. All patients were diagnosed with haemoperitoneum. Four of the eight cats were diagnosed with abdominal neoplasia, three had postoperative haemorrhage and one had a traumatic haemoperitoneum. Three cats received more than one autotransfusion. Blood was collected using a 23 G butterfly catheter and 20 ml syringe in 7/12 collections, a 23 G needle and 20 ml syringe in 2/12 collections and directly into syringes from the open abdomen at the time of surgery in 3/12 collections. A median volume of 50 ml (range 25–80 ml) was collected and administered, meaning a median volume of 16.5 ml/kg (range 9–26 ml/kg) was administered. The autologous transfusions were given over a median of 3 h (0.25–6 h). Five cats were given another blood product alongside the autotransfusion. Median percentage PCV increase was 5% (range 1–7%). Anticoagulant was used in 5/12 autotransfusions. No clinically relevant adverse effects were reported. Six of the eight cats survived to discharge. Two month survival was 60% (3/5). Conclusions and relevance Autologous transfusion appears to be a safe and effective technique for stabilising cats with haemoperitoneum. This technique allows rapid and cheap provision of blood and avoids the need for an allogenic blood donor.

scholarly journals Efficacy and Economics of Postoperative Blood Salvage in Patients Undergoing Elective Total Hip Replacement

2007 ◽  
Vol 89 (8) ◽  
pp. 777-784 ◽  
Author(s):  
Saqeb B Mirza ◽  
Jon Campion ◽  
John H Dixon ◽  
Sukhmeet S Panesar
Keyword(s):  
Total Hip Replacement ◽  
Medical Records ◽  
Hip Replacement ◽  
Autologous Blood ◽  
Allogenic Blood Transfusion ◽  
Blood Transfusions ◽  
Allogenic Blood ◽  
Blood Salvage ◽  
Total Hip ◽  
Postoperative Drainage

INTRODUCTION Patients undergoing total hip replacement (THR) regularly receive allogenic blood transfusions. The infusion of allogenic blood exposes the recipient to significant risks including the transmission of infection, anaphylactic and haemolytic reactions. The purpose of this study was to determine the effect of introducing a system to retransfuse salvaged drainage blood in patients undergoing primary THR. PATIENTS AND METHODS We reviewed records of 109 consecutive patients who underwent THR following the introduction of the ABTrans™ autologous retransfusion system at our institution in January 2000. For comparison, we reviewed the medical records of 109 patients who underwent the same procedure immediately before the introduction of the retransfusion system. RESULTS Overall, 9% of patients treated with blood salvage and 30% treated without blood salvage required allogenic blood transfusions. Patients treated with the salvage system had significantly smaller haemoglobin drops in the peri-operative period (difference 0.56 g/dl; P = 0.001). The overall cost of using the retransfusion system was similar to that of routine vacuum drainage when the savings of reduced allogenic blood transfusion were taken into account. CONCLUSIONS The retransfusion of postoperative drainage blood is a simple, effective and safe way of providing autologous blood for patients undergoing primary THR.

Mechanical ventilation increases microvascular permeability in oleic acid-injured lungs

1990 ◽  
Vol 69 (6) ◽  
pp. 2057-2061 ◽  
Author(s):  
L. A. Hernandez ◽  
P. J. Coker ◽  
S. May ◽  
A. L. Thompson ◽  
J. C. Parker
Keyword(s):  
Mechanical Ventilation ◽  
Oleic Acid ◽  
Autologous Blood ◽  
Ventilatory Support ◽  
Disease Process ◽  
Peak Inspiratory Pressure ◽  
Underlying Disease ◽  
Young Rabbit ◽  
Treatment Groups ◽  
Pulmonary Arterial

The pulmonary pathology for which a patient receives ventilatory support may increase the risk of developing barotrauma, because an underlying disease process may weaken the vasculature and render the lung more susceptible to damage by mechanical ventilation. We determined the response of isolated young rabbit lungs to mechanical ventilation after oleic acid (OA) injury. New Zealand White rabbits (0.7-1.3 kg) were anesthetized with pentobarbital sodium (30 mg/kg), tracheotomized, and exsanguinated. The heart and lungs were isolated and perfused with autologous blood at a constant flow. The capillary filtration coefficient (Kf,c, in ml.min-1.cmH2O-1.100 g wet wt-1) and pulmonary arterial (Ppa) and venous pressures were determined before and 30 and 60 min after oleic acid administration (OA group; 0.2 ml into the venous reservoir), ventilation alone (Vent group; peak inspiratory pressure = 25 cmH2O), or oleic acid combined with ventilation (OA + Vent group). Ppa transiently increased by 4.21 +/- 0.822 cmH2O after OA administration but then returned to approximately control values. Baseline Kf,c values for OA (0.288 +/- 0.042), Vent (0.296 +/- 0.035), or OA + Vent (0.276 +/- 0.028) groups were not significantly different from each other. Kf,c after either OA administration (0.45 +/- 0.066) or Vent (0.35 +/- 0.75) were not significantly different from each other or from baseline measurements. In the group ventilated after OA administration (OA + Vent), Kf,c (0.883 +/- 0.148) increased significantly from baseline (P less than 0.001) and was significantly different from all other treatment groups. We conclude that the combination of minimal OA injury and ventilation was more deleterious to the lung than either one alone.

Drug-Induced Movement Disorders

2015 ◽  
Vol 25 (2) ◽  
pp. 70-77
Author(s):  
Amy Lustig ◽  
Cesar Ruiz
Keyword(s):  
Movement Disorders ◽  
Medical Management ◽  
Disease Process ◽  
Underlying Disease ◽  
Extrapyramidal Symptoms ◽  
Drug Induced ◽  
General Overview ◽  
Management Approaches ◽  
Broad Understanding ◽  
Underlying Disease Process

The purpose of this article is to present a general overview of the features of drug-induced movement disorders (DIMDs) comprised by Parkinsonism and extrapyramidal symptoms. Speech-language pathologists (SLPs) who work with patients presenting with these issues must have a broad understanding of the underlying disease process. This article will provide a brief introduction to the neuropathophysiology of DIMDs, a discussion of the associated symptomatology, the pharmacology implicated in causing DIMDs, and the medical management approaches currently in use.

scholarly journals Longitudinal rates of hospital adverse events that contributed to death in Norway and Sweden from 2013 to 2018

2021 ◽  
pp. 251604352110261
Author(s):  
Ellen Tveter Deilkås ◽  
Marion Haugen ◽  
Madeleine Borgstedt Risberg ◽  
Hanne Narbuvold ◽  
Øystein Flesland ◽  
...  
Keyword(s):  
Adverse Events ◽  
Acute Care ◽  
Medical Records ◽  
Hospital Care ◽  
Hospital Admissions ◽  
Demographic Characteristics ◽  
Mutual Learning ◽  
Time Period ◽  
Relevant Context ◽  
Linear Trends

Objectives In this paper, we explore and compare types and longitudinal trends of hospital adverse events in Norway and Sweden in the years 2013–2018 with special reference to AEs that contributed to death. Design Acute care hospitals in both countries performed medical record reviews on randomly selected medical records from all eligible admissions. Analysis: Comparison between Norway and Sweden of linear trends from 2013–2018, and percentage rates of admissions with at least one AE according to types and severities. Setting Norway and Sweden have similar socio-economic and demographic characteristics, which constitutes a relevant context for cooperation, comparison and mutual learning. This setting has promoted the use of GTT to monitor national rates of AEs in hospital care in the two countries. Participants 53 367 medical records in Norway and 88 637 medical records in Sweden were reviewed. Results 13.2% of hospital admissions in Norway and 13.1% in Sweden were associated with an AE of all severities (E-I). 0.23% of hospital admissions in Norway and 0.26% in Sweden were associated with an AE that contributed to death (I). The differences between the two countries were not statistically significant. Conclusions There were no significant differences in overall rates (E-I) of AEs in Norway and Sweden, nor in rates of AEs that contributed to death (I). There was no significant change in AEs or fatal AEs in either country over the six-year time period.

Measuring Disease Modification in Alzheimer's Disease

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S1) ◽  
pp. 11-14
Author(s):  
Jeffrey L. Cummings
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Immunoglobulin A ◽  
Disease Process ◽  
Underlying Disease ◽  
Therapeutic Interventions ◽  
Disease Modification ◽  
Amyloid Disease ◽  
Therapeutic Modalities ◽  
Disease Modifying

AbstractWe appear to be on the brink of a new epoch of treatment for Alzheimer's disease. Compelling evidence suggests that Aβ42 secretion is the triggering event in the pathogenesis of Alzheimer's disease, and that tau aggregation may be an important secondary event linked to neurodegeneration. Prophylactic administration of anti-amyloid agents designed to prevent Aβ accumulation in persons with subclinical disease is likely to be more effective than therapeutic interventions in established Alzheimer's disease. Drug development programs in Alzheimer's disease focus primarily on agents with anti-amyloid disease-modifying properties, and many different pharmacologic approaches to reducing amyloid pathology and tauopathy are being studied. Classes of therapeutic modalities currently in advanced-stage clinical trial testing include forms of immunotherapy (active β -amyloid immunoconjugate and human intravenous immunoglobulin), a γ-secretase inhibitor, the selective Aβ42-lowering agent R-flurbiprofen, and the anti-aggregation agent tramiprosate. Non-traditional dementia therapies such as the HMG-CoA reductase inhibitors (statins), valproate, and lithium are now being assessed for clinical benefit as anti-amyloid disease-modifying treatments. Positive findings of efficacy and safety from clinical studies are necessary but not sufficient to demonstrate that a drug has disease-modifying properties. Definitive proof of disease-modification requires evidence from validated animal models of Alzheimer's disease; rigorously controlled clinical trials showing a significantly improved, stabilized, or slowed rate of decline in cognitive and global function compared to placebo; and prospectively obtained evidence from surrogate biomarkers that the treatment resulted in measurable biological changes associated with the underlying disease process.

scholarly journals Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

2017 ◽  
Vol 45 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Fernanda Payan Schober ◽  
Meghan A. Jobson ◽  
Caroline J. Poulton ◽  
Harsharan K. Singh ◽  
Volker Nickeleit ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Disease Process ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Underlying Disease ◽  
Fibrillary Glomerulonephritis ◽  
Black Patients ◽  
End Stage ◽  
20 Nm ◽  
The University

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

Human Immunodeficiency Virus-Associated Thrombocytopenia

DICP ◽  
1989 ◽  
Vol 23 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Dennis M. Hoffman ◽  
Rocco F. Caruso ◽  
Timothy Mirando
Keyword(s):  
Human Immunodeficiency Virus ◽  
Immune Globulin ◽  
Disease Process ◽  
Underlying Disease ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
A New Technique ◽  
Immunodeficiency Syndrome

Thrombocytopenia has emerged as a major hematological manifestation associated with AIDS (acquired immunodeficiency syndrome) and human immunodeficiency virus (HIV)-positive patients. A study of homosexual patients with thrombocytopenia indicates 93 percent had serological evidence of HIV exposure whereas only 33 percent of homosexuals without thrombocytopenia exhibited this finding. Thrombocytopenia in patients with hemophilia has been identified as an increased risk factor for AIDS development and has been observed in about one-third of children with AIDS. The management of thrombocytopenia in HIV-infected patients poses a therapeutic dilemma for clinicians since many of the traditional modalities for treating immune thrombocytopenia may adversely affect the underlying disease process or further compromise the immune system. Splenectomy, corticosteroids, danazol, intravenous immune globulin, vincristine, and RHo(D) immune globulin have all been used with variable results. A new technique that physically removes antibodies and immune complexes associated with thrombocytopenia is under investigation. Due to either toxicity or the high incidence of transient response, asymptomatic patients may not be candidates for treatment.

Pharmacologic and Technological Innovations in Pain Medicine

2016 ◽  
Author(s):  
Anita Gupta ◽  
Hawa Abubakar
Keyword(s):  
Pain Management ◽  
Disease Process ◽  
Multimodal Analgesia ◽  
Underlying Disease ◽  
Antiinflammatory Drug ◽  
Treatment Modalities ◽  
Technological Innovations ◽  
Duration Of Action ◽  
Key Words Pain ◽  
Opioid Receptor Antagonists

The experience of pain is subjective, and treatment modalities should aim at providing the greatest amount of pain relief while minimizing adverse effects. Pharmacologic and technological innovations are making this possible. By taking advantage of new manufacturing processes, the pharmaceutical industry is retooling old and effective drugs. SoluMatrix diclofenac uses nanotechnology to address the need for an effective nonsteroidal antiinflammatory drug at the lowest possible dose to minimize risks associated with cardiac, renal, and gastrointestinal side effects. Intravenous acetaminophen provides an additional alternative in multimodal analgesia in instances when the oral or rectal route of delivery is not desirable. Liposomal bupivacaine uses liposomal encapsulated, resulting in a local anesthetic with a prolonged duration of action that can be used effectively in the management of postoperative pain. With the recognition that opioid therapy still remains a mainstay in pain management, advances in science have allowed for the development of peripherally acting mu opioid receptor antagonists such as naloxegol, which minimize the bothersome side effect of opioid-induced constipation. In terms of interventional pain management, advances in radiofrequency ablation (RFA) technology have resulted in cooled RFA, which allows for the creation of larger spherical lesions, thereby alleviating pain by interfering with neurotransmission. Advances in stem cell research have led to the application of multipotent cells with the aim of treating the underlying disease process and thereby eliminating pain. Finally, pharmacogenetics testing and smart drugs provide an avenue via which issues surrounding how medication is consumed, determination of effectiveness, and ensuring compliance and adherence can be optimized. Key words: Pain, Pharmacology, Medications, Technology, Innovation, Smart Pills, Personalized Medicine, Biotechnology, Device, Surgery, Multimodal

Delayed Puberty

2020 ◽  
Author(s):  
Amanda French
Keyword(s):  
Pubertal Timing ◽  
Hormone Replacement ◽  
Hypogonadotropic Hypogonadism ◽  
Disease Process ◽  
Optimal Growth ◽  
Underlying Disease ◽  
Delayed Puberty ◽  
Hypergonadotropic Hypogonadism ◽  
Pubertal Delay ◽  
Constitutional Delay

Although common, delayed puberty can be distressing to patients and families.   Careful assessment is necessary to ensure appropriate physical and social development in patients that require intervention to reach pubertal milestones and achieve optimal growth.  Most pubertal delay is from lack of activation of the hypothalamic-pituitary-gonadal axis which then results in a functional or physiologic GnRH deficiency.  The delay may be temporary or permanent.  Constitutional delay (CDGP), also referred to as self-limited delayed puberty (DP), describes children on the extreme end of normal pubertal timing and is the most common cause of delayed puberty, representing about one third of cases.  Hypergonadotropic hypogonadism (primary hypogonadism) results from a failure of the gonad itself, and hypogonadotropic hypogonadism (secondary hypogonadism) results from a failure of the hypothalamic-pituitary axis, which is usually caused by another process, often systemic.  Diagnosis is based on history and examination.  Treatment is based on the underlying cause of pubertal delay and may include hormone replacement.  Involving a pediatric endocrinologist should be considered.  Appropriate counseling and ongoing support are important for all patients and families, regardless of underlying disease process.   This review contains 4 figures, 4 tables, and 32 references. Keywords: puberty, delayed puberty, hypogonadism, hypogonadotropic hypogonadism, hypergonadotropic hypogonadism, menarche, thelarche, constitutional delay and growth in puberty, Turner syndrome

Surgical Management of Benign and Malignant Colorectal Disease in the Immunocompromised Patient

2017 ◽  
Author(s):  
Cindy Kin ◽  
Amy Lightner ◽  
Mark Welton
Keyword(s):  
Preoperative Evaluation ◽  
Disease Process ◽  
Underlying Disease ◽  
Colorectal Disease ◽  
Immunosuppressed Patient ◽  
Neutropenic Enterocolitis ◽  
Anal Squamous Cell Carcinoma ◽  
Benign Colorectal Disease ◽  
Immunosuppressed Patients ◽  
Inflammatory Bowel

Patients who are immunosuppressed either due to an underlying disease process or medications to treat a disease require important perioperative considerations. Preoperative evaluation mandates a higher index of suspicion for pathology given that peritoneal and systemic markers of illness may be masked. Intraoperatively, consideration should be given for diversion more frequently than in a nonimmunosuppressed patient. Postoperatively, patients should be managed in a multidisciplinary fashion. This review largely focuses on the immunosuppressive mediations used for the treatment of inflammatory bowel disease, benign colorectal disease in an immunosuppressed patient, and colorectal malignancies in immunosuppressed patients to highlight important considerations for this patient population. This review contains 4 figures, 5 tables, and 78 references. Key words: anal squamous cell carcinoma, appendicitis versus typhlitis, biologic therapy, corticosteroids, human papillomavirus, immunosuppression, neutropenic enterocolitis 

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