scholarly journals Masivno krvavljenje i mehanizmi koagulopatije u traumi

2006 ◽  
Vol 53 (4) ◽  
pp. 89-92
Author(s):  
N. Popovic ◽  
Z. Blagojevic ◽  
V. Nikolic ◽  
Lj. Arsenijevic ◽  
A. Karamarkovic ◽  
...  
Keyword(s):  
Massive Bleeding ◽  
Vascular Integrity ◽  
Small Vessels ◽  
Civilian Trauma ◽  
Risk Of Mortality ◽  
Lethal Triad ◽  
Increased Risk ◽  
Threatening Condition ◽  
Life Threatening ◽  
Dilutional Coagulopathy

Trauma is disease of the young, mainly affecting people between 15-40 years of age. Uncontrolled massive bleeding is the leading cause of early in-hospital mortality, within 48h of admission, and the second leading cause of prehospital death in victims of both military and civilian trauma, accounting for 40-45% of the total fatalities. Coagulopathy develops early after injury and is present in 25- 36% of trauma victims upon admission to the emergency department. Coagulopathy correlates to the severity of trauma and is associated with an increased risk of mortality. The aim of this paper is to explain pathophysiology of developing coagulopathy in trauma. The coagulopathy in the trauma patient is complex and multifactorial. It includes: dilutional coagulopathy, hypothermia, acidosis, hyperfibrinolysis, anemia and consumption coagulopathy. When the patient develops the so called ?lethal triad? of hypothermia, acidosis and coagulopathy, surgical restoration of vascular integrity may be insufficient to achieve a definitive control of blood loss and non-mechanical bleeding from small vessels, usually terminated by spontaneous coagulation, becomes a life-threatening condition.

scholarly journals Aortic Dissection in a Pregnant Patient without Other Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Priya V. Patel ◽  
Raanan Alter ◽  
Recia Frenn ◽  
Thaddeus P. Waters
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Aortic Rupture ◽  
Treatment Options ◽  
Pregnant Patient ◽  
Physical Exam ◽  
Vascular Events ◽  
Increased Risk ◽  
Threatening Condition ◽  
Life Threatening

Background. An aortic dissection is a life-threatening condition in which the intima of the artery tears causing separation of the intima and media. Pregnancy places women at a significantly increased risk of common vascular events including venous thromboembolism, myocardial infarction, and stroke, while also increasing the risk of rarer vascular events such as aortic dissection and aortic rupture. Case. A 30-year-old previously healthy multiparous woman presenting at 36 weeks of pregnancy with a Type A aortic dissection. She underwent a combined emergent cesarean delivery followed by repair of her aortic root. Conclusions. Aortic dissection should be high on the differential for pregnant patients presenting with the characteristic complaints and physical exam findings given the high mortality rate associated with this vascular event. Teaching Points. (1) This report reviews the characteristic presentation, risk factors, and physical exam findings in a patient with an aortic dissection. (2) The report includes treatment options for pregnant patients based on the classification of the dissection.

Catastrophic antiphospholipid syndrome (Ronald Asherson syndrome) and obstetric pathology

2018 ◽  
Vol 46 (4) ◽  
pp. 387-400 ◽  
Author(s):  
Alexander D. Makatsariya ◽  
Jamilya Khizroeva ◽  
Viktoriya O. Bitsadze
Keyword(s):  
Mortality Rate ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Multiorgan Failure ◽  
Multiple Organ ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Small Vessels ◽  
Threatening Condition ◽  
Life Threatening ◽  
Large Vessels

Abstract Background: Catastrophic antiphospholipid syndrome (CAPS) is an uncommon, often fatal, variant of the antiphospholipid syndrome (APS) that results in a widespread coagulopathy and high titres of antiphospholipid antibodies (aPL) and affects predominantly small vessels supplying organs with the development of multiorgan failure. It remains unclear why some patients develop the typical clinical picture of APS (thrombosis of large vessels), whereas others show the development of progressive microthrombosis, which the authors called “thrombotic storm” and multiple organ failure, that is, CAPS. Materials and methods: Since 2001–2016, we discovered 17 patients with CAPS development. Conclusion: CAPS is life-threatening condition, but optimal treatment for CAPS is not developed yet and the mortality rate is as high as 30%–40%.

Chestnut-like macro-acanthosphere triggered hemostasis: a featured mechanism based on puncturing red blood cells

Nanoscale ◽  
2021 ◽  
Author(s):  
Yang Liu ◽  
kun yu ◽  
Songming Shang ◽  
Ruiqi Xie ◽  
Fei Lu ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Massive Bleeding ◽  
Acute Hemorrhage ◽  
Threatening Condition ◽  
Life Threatening

Acute hemorrhage that occurs after trauma is a life-threatening condition. Hence, to halt massive bleeding, there is a critical need to develop a suitable therapy. In this study, we developed...

scholarly journals Catastrophic Antiphospholipid Syndrome in Obstetric Practice

2012 ◽  
Vol 61 (3) ◽  
pp. 7-21 ◽  
Author(s):  
Alexander D Makatsariya ◽  
Viktoriya O Bitsadze ◽  
Dzhamilya Kh Khizroeva
Keyword(s):  
Antiphospholipid Syndrome ◽  
Molecular Mechanisms ◽  
Multiorgan Failure ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Small Vessels ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fatal Form ◽  
High Level

Catastrophic antiphospholipid syndrome (CAPS) is an uncommon, often fatal, form of the antiphospholipid syndrome that results in a widespread coagulopathy and affects predominantly small vessels supplying organs with the development of multiorgan failure against a background of high level of antiphospholipid antibodies. Thrombotic microvasculopathy is the basis of multiorgan failure and clinically manifests with CNS disturbances, adrenal failure, and the development of acute respiratory distress syndrome. CAPS is a life-threatening condition and requires urgent measures. Optimal treatment for CAPS is not developed yet. CAPS present a multidisciplinary problem. Authors demonstrate 17 cases of CAPS in patients which were managed from 2001 to 2012 years. Molecular mechanisms of pathogenesis and different obstetric and non-obstetric manifestations of CAPS are discussed in the article. There is the description of first case of management of pregnancy and labor of patient with CAPS in her history. The methods of CAPS prevention are described

scholarly journals Coronavirus Disease 2019 (Covid-19) Outbreak and Pituitary Apoplexy

2021 ◽  
Author(s):  
Rafael Martinez-Perez ◽  
Benjamin W Carroll ◽  
Daniel Duran ◽  
James S Neill ◽  
Gustavo D Luzardo ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Molecular Mechanisms ◽  
Pituitary Apoplexy ◽  
Care Center ◽  
Tertiary Care ◽  
Perioperative Period ◽  
Common Symptom ◽  
Increased Risk ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background. Pituitary apoplexy (PA) is a rare and potentially life-threatening condition characterized by pituitary hemorrhage, often in the setting of a preexisting pituitary adenoma. Risk factors and mechanisms associated to PA are poorly understood. Although involvement of the nervous system in SARS-CoV-2 infection causing intracranial hemorrhagic complications has been documented, the association between COVID-19 infection and PA has yet to be determined. Methods . From a prospectively collected database of patients with pituitary adenomas, we retrospectively reviewed the electronical medical records and scans of patients with pituitary apoplexy during the COVID-19 outbreak, since March 2020 to December 2020, that were treated at a tertiary care center. Results. Herein, we report three consecutive cases of patients with PA and concomitant COVID-19 infection. Most common symptom at presentation was headache and visual worsening. Included patients were successfully treated with surgical decompression and medical management of the hormonal deficits, experiencing moderate to significant improvement of their visual symptoms at last follow up. COVID-19 infection in the perioperative period was corroborated throughout polymerase chain reaction testing in all patients. Conclusions. COVID-19 positive patients may be at an increased risk of developing PA. Angiotensin-converting enzyme 2 receptors expressed in cerebrovascular endothelium may potentially play a role in the molecular mechanisms that induce changes of the vascular autoregulation and cerebral blood flow and predispose to pituitary hemorrhage in patients harboring a pituitary adenoma.

scholarly journals Application of APACHE II Score in assessing the severity and outcome in peritonitis due to hollow viscus perforation

2019 ◽  
Vol 6 (3) ◽  
pp. 940
Author(s):  
M. Venkat Reddy ◽  
T. Amarsimha Reddy ◽  
Satyadev . ◽  
B. RaghuRam Teja ◽  
P. ShanmugaRaju
Keyword(s):  
Apache Ii ◽  
Individual Risk ◽  
Apache Ii Score ◽  
Hollow Viscus ◽  
Prospective Survey ◽  
Generalized Peritonitis ◽  
Risk Of Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis from Gastrointestinal hollow viscus perforation is a potentially life threatening condition. The aim of the study was to assess the application of APACHE II score in assessing the severity and outcome in peritonitis due to hollow viscus perforation and to correlate morbidity and mortality patterns using the modified APACHE II Score and its significance on the outcome.Methods: A prospective survey of 50 patients with acute generalized peritonitis due to hollow viscus perforation was carried out in general surgical wards, CAIMS, Karimnagar. APACHE-II scores were assigned to all patients in order to calculate their individual risk of mortality before undergoing emergency surgery.Results: Total 50 patients were admitted during the study period. Age and sex distribution shows that perforation was common >60 years in our study. Higher modified APACHE II scores statistically influenced mortality in all the patients irrespective of aetiology with p<0.001 which is statistically significant.Conclusions: Modified APACHE II scoring predicts mortality which was significant irrespective of the aetiology.

Off-Label Use and Safety of Drug Use in Vascular Anomalies

Dermatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Niina Kleiber ◽  
Laurence Gariépy-Assal ◽  
Jérôme Coulombe ◽  
Simon Marcoux ◽  
Sandrine Essouri ◽  
...  
Keyword(s):  
Drug Use ◽  
Oral Solution ◽  
Vascular Anomalies ◽  
Significant Safety ◽  
Safety Issues ◽  
Off Label ◽  
Safety Concerns ◽  
Increased Risk ◽  
Threatening Condition ◽  
Life Threatening

<b><i>Background:</i></b> Off-label drug use is associated with an increased risk of adverse drug reactions. It is common in pediatrics and in rare diseases, which are two characteristics applying to vascular anomalies (VA). <b><i>Objectives:</i></b> The aim of this work was to quantify off-label drug use in VA and assess its safety. <b><i>Methods:</i></b> A review was conducted to extract a list of drugs used in VA management. A drug was considered to have significant safety concerns if a black box warning was present or if a serious adverse drug reaction (SADR) was reported in at least 1% of the patients (SADR is defined as a noxious and unintended response to a drug that occurs at any dose and results in hospitalization, prolongation of existing hospitalization, congenital malformation, persistent or significant disability or incapacity, life-threatening condition, or death). The labelling status and safety of each drug was assessed based on the product monograph, Micromedex, and the FDA data. <b><i>Results:</i></b> We found that 98.9% of the inventoried drugs were used off-label or unlicensed for VA management. Only the oral solution of propranolol hydrochloride (Hemangeol®) for the treatment of infantile hemangiomas is approved. Significant safety issues concerned 73% of the drugs and were more frequent among systemic than locally delivered drugs. <b><i>Conclusions:</i></b> Off-label drug use in VA is the rule and not the exception. Significant safety concerns are common. It is necessary to carefully weigh risk and benefits for every patient when using systemic and local treatments carrying safety concerns. Patients should be openly informed and involved in the decision-making process.

1507: Acute Urinary Retention is Associated with an Increased Risk of Mortality

2007 ◽  
Vol 177 (4S) ◽  
pp. 497-497
Author(s):  
James Armitage ◽  
Nokuthaba Sibanda ◽  
Paul Cathcart ◽  
Mark Emberton ◽  
Jan Van Der Meulen
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Risk Of Mortality ◽  
Increased Risk

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

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