Aortic balloon occlusion in distal zone 3 reduces blood loss from obstetric hemorrhage in placenta accreta spectrum.

Background: Peripartum hemorrhage is a significant cause of maternal death. We developed a standardized, multidisciplinary cesarean hysterectomy protocol for placenta accreta spectrum (PAS) using prophylactic resuscitative endovascular balloon occlusion of the aorta (REBOA). We initially placed the balloon in proximal zone 3, below the renal arteries.

A comparison of two open surgical cricothyroidotomy techniques by military medics using a cadaver model.

Study Objective: The CricKey is a novel surgical cricothyroidotomy device combining the functions of a tracheal hook, stylet, dilator, and bougie incorporated with a Melker airway cannula. This study compares surgical cricothyroidotomy with standard open surgical versus CricKey technique.

Methods: This was a prospective crossover study using human cadaveric models.

An analysis of battlefield cricothyrotomy in Iraq and Afghanistan.

Objective: Historical review of modern military conflicts suggests that airway compromise accounts for 1?2% of total combat fatalities. This study examines the specific intervention of pre-hospital cricothyrotomy (PC) in the military setting using the largest studies of civilian medics performing PC as historical controls. The goal of this paper is to help define optimal airway management strategies, tools and techniques for use in the military pre-hospital setting.

Advanced airway management in combat casualties by medics at the point of injury: a sub-group analysis of the reach study.

Unlabelled: background: Optimal airway management protocols for the prehospital battlefield setting have not been defined. Airway management strategies in this environment must take into account the injury patterns, the environment and training requirements of military prehospital providers.

Methods: This is a post-hoc, sub-group analysis of the Registry of Emergency Airways Arriving at Combat Hospitals or REACH database.

Adjuvant enoxaparin therapy may decrease the incidence of postoperative thrombotic events though does not increase the incidence of postoperative intracranial hemorrhage in patients with meningiomas.

Patients with brain tumors including intracranial meningiomas are at increased risk for developing deep vein thrombosis (DVTs) and suffering thromboembolic events (VTEs). Many surgeons are concerned that early use of low dose enoxaparin may increase the risk of intracranial hemorrhage which outweighs the benefit of DVT/VTE reduction. We aimed to address concerns around the use of enoxaparin after meningioma resection in the development of postoperative intracranial hemorrhages and DVT/VTEs.

Gastric versus duodenal feeding in patients with neurological disease: a pilot study.

Both gastric and duodenal feeding tubes are used to provide enteral nutrition. Most studies comparing the two methods have focused primarily on rates of complications, rather than on nutritional outcomes, and show no difference in complications between the two methods. It is not clear which feeding route provides the best nutritional outcomes.

[Peculiarities and complexities of questioning the patient in myocardial infarct].

The author depicted several cases of myocardial infarction which onset or preinfarction angina symptoms were taken by the patients for a catarrhal disease. The signs enabling the doctor to exclude the "catarrhal" origin of patient's feelings were indicated. The author suggested that the term of "catarrhal" variant of myocardial infarction onset" should be used as a pattern of its atypical onset.

[Various methodological aspects of patient interviewing].

The paper recommends a number of rules useful in interviewing patients, draws attention to some typical mistakes made by physicians gaining clinical information from their patients. It is thought advisable to provide medical students with advanced guidelines how to manage a valid and informative interview of patients.

Use of etomidate, temporary arterial occlusion, and intraoperative angiography in surgical treatment of large and giant cerebral aneurysms.

The operative management of large and giant aneurysms is complicated by their typically atheromatous and thick walls, frequent intramural thrombosis with calcification, and broad-based necks that often incorporate perforating and other vital vessels. Not infrequently, it is necessary to at least focally arrest the intracranial circulation and open or excise these aneurysms to facilitate vascular reconstruction. This maneuver, in patients whose disease processes have destroyed autoregulatory function or who have inadequate sources of anatomical collateral supply, may cause the threshold for permanent ischemic injury to be exceeded.

[Dynamics of myocardial contraction in patients with auricular fibrillation after restoration of sinus rhythm by means of electric countershock].

The dynamics of left ventricular contraction was studied in 107 patients with cardiac fibrillation 1 and 6-8 days after restoration of sinus rhythm by electroimpulsive therapy. It has been found that contraction of the left ventricle improves markedly 24 hours after the sinus rhythm is restored and practically does not change by the 6th -8th day after that. On the grounds of such dynamics of left ventricular contraction it is concluded that it is quite sufficient to observe complete bedrest after successful defibrillation for 24 hours, since the risk of normalization embolisms and pulmonary edema sharply diminishes beginning 24 hours after the sinus rhythm has been restored.