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Fast is fine, but accuracy is everything: making intraoperative transfusion decisions using point-of-care testing.
Br J Anaesth
February 2025
Transfusion Research Unit, Department of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Clayton, VIC, Australia.
Accurate and timely diagnostic information is a vital adjunct to clinical assessment to inform therapeutic decision-making, including decisions to transfuse, or not transfuse, blood components. A prospective cohort study of diagnostic point-of-care (POC) haemoglobin measurements on arterial or central venous samples from adults undergoing major noncardiac surgery compared three widely used devices, HemoCue®, i-STAT™, and the Rad-67™ pulse CO-Oxymeter® finger sensor device, against standard laboratory haemoglobin measurements, but importantly not against a blood gas analyser. The study focused on haemoglobin results below 100 g L to establish the utility of these devices to guide red cell transfusion decisions.
View Article and Find Full Text PDFIndividualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial.
Int J Surg
January 2025
Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Background: Acute kidney injury (AKI) is a common postoperative complication, and hypotension may contribute. We therefore tested the primary hypothesis that individualized intraoperative blood pressure regulation reduces postoperative AKI in older surgical patients.
Methods: We enrolled patients ≥60 years old scheduled for elective major abdominal surgery with invasive arterial pressure monitoring.
Intramural pregnancy after intrauterine insemination in a nulligravid patient without previous uterine trauma, complicated by idiopathic thrombocytopenic purpura: A case report.
Case Rep Womens Health
March 2025
Sakai City Medical Center, 1-1-1, Ebaraji-cho, Nishi-ku, Sakai, Osaka 593-8304, Japan.
Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage.
View Article and Find Full Text PDFOsteochondral Fractures in Adolescents With First-time Patellar Dislocation: Three-dimensional Characterization and Association With Radiographic Features.
Am J Sports Med
January 2025
Washington University in St Louis, Saint Louis, Missouri, USA.
Background: Consequences of osteochondral fractures associated with patellar dislocation can be severe for younger patients. Precise 3-dimensional characterization of fracture location, size, frequency, and radiographic associations remain undefined in this population.
Purpose: (1) To define the topographic characteristics of osteochondral fractures in pediatric and adolescent patients with first-time patellar dislocations and (2) to determine the relationship between these characteristics and radiographic and patient factors.
Femtosecond Laser-Assisted Pterygium Surgery Using a Customized Algorithm for Trapezoidal Conjunctival Grafts.
Cornea
January 2025
Tissue Engineering & Cell Therapy Group, Singapore Eye Research Institute, Singapore.
Purpose: Conjunctival autografts (CAGs) are the gold standard treatment after pterygium resection, but it is challenging to achieve consistently thin Tenon-free CAGs with manual dissection. We herein report the reproducibility and clinical outcomes of a novel algorithm to produce customizable trapezoidal CAGs using femtosecond laser (femtosecond lasers)-assisted pterygium surgery.
Methods: We first tested this algorithm in 4 pig eyes to show reproducibility.
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