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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering and reinfusing blood lost during operation has been used on 51 patients (major trauma, 20; ectopic pregnancy, 2; portacaval shunt, 9; peripheral vascular surgery, 20). From 700 to 20,000 cc's of blood were reinfused. Platelets, hematocrit, fibrinogen, free plasma hemoglobin, bilirubin, and creatinine showed no significant changes as compared to preoperative values in 39 survivors. There were 12 deaths. Eight died postoperatively as a result of their injuries, 3 of uncontrollable bleeding and one of renal failure. This study shows that autotransfusion, when used with proper operating technique, is a most satisfactory technique for restoring blood volume in severe trauma cases and elective vascular operations. This method provides a rapid, simple way of reinfusing fresh blood, free of hepatitis contamination with minimal derangement in cellular and plasma coagulation parameters.
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PMID:Autologous blood in the treatment of intraoperative hemorrhage. 84 30

The technique of intraoperative autotransfusion (AT) is being used to date only in a few individual clinics. Since there is a clinically safe and economical AT-apparatus available the routine application of this rational blood replacement method is easy to perform. The authors have used this technique altogether in 111 patients, applying the Bentley-ATS-machine in the last 69 cases. In a previous series of 42 cases AT was used for ruptured ectopic pregnancy, in the series of 69 surgical cases for hemothorax or intraabdominal hemorrhages of mainly traumatic origin. The most frequent indications for AT in emergency surgical operations were ruptures of spleen and liver, and in elective surgery for portocaval shunt. Altogether 247 litres of blood have been retransfused with an AT-volume per patient ranging from 0,5 to 15 litres. For anticoagulation generally ACD was used, only in vascular surgery was heparin preferred. Methodical complications have not been seen. Technique, indications, consequences and possible complications of AT are described. The main advantages of autologous intraoperative transfusion are the immediate availability of blood, the absence of the risk of hepatitis and of incompatibility reactions, reduction of pressure on the blood banks and lower transfusion costs. The authors therefore believe that the possibility of intraoperative AT should exist at every surgical and gynecological clinic.
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PMID:[Intraoperative autotransfusion in gynecology and surgery (author's transl)]. 94 5

Between January 1st and May 31 1989, there were 31 cases of perihepatic adhesions (Fitz-Hugh-Curtis syndrome) about 90 ectopic pregnancies (rate: 34 p. cent). The Chlamydia's serology is positive at 1/64 level in 97 p. cent of cases and at 1/256 level in 72 p. cent. Only three cases are not allied with pelvic disease. Peri-splenitis accompanies severe hepatitis (3 cases) and no perinephritis was observed in this study. The authors emphasize the wish to explore perihepatic space in all pelvic surgery. In the department of Gynecology and Obstetrics at the University Hospital of Libreville, increased the rate of ectopic pregnancy (1 for 44 deliveries), this coincides with the increased prevalence to Chlamydia trachomatis infection (81 p. cent ectopic pregnancies and 63 p. cent deliveries). This situation creates a new and greater problem of health in sub-Saharan Africa.
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PMID:[The sequela of peri-hepatitis due to Chlamydia trachomatis (Fitz-Hugh-Curtis syndrome) seen during an ectopic pregnancy]. 238 7

Microval, a low dose progestin oral contraceptive (OC) containing .03 mg levonorgestrel, provides contraception through 3 mechanisms: rendering the cervical mucus impermeable to sperm, slowing the descent of the egg through the fallopian tube, and causing endometrial atrophy unfavorable to nidation. The Pearl index is about 1%. Formal contraindications to Microval include suspicion of pregnancy, recent history of hepatitis or hepatic insufficiency, and breast or uterine cancer, while relative contraindications include ovarian dystrophy, mastopathy, and history of extrauterine pregnancy, jaundice, or pruritus of pregnancy. As with any other OC, a complete physical examination should be done before prescription to rule out contraindications, and follow-up examinations should be given twice yearly. Irregular cycles, spotting, amenorrhea, edema, and breast discomfort are not unusual at the beginning of treatment. Rifampicine, barbiturates, phenylbutazone, and the hydantoin group of drugs render Microval ineffective. The pill should be taken every day without exception at the same hour, and it is advisable to use another method of contraception during the 1st month of Microval use. A single pill taken 12 hours late can bring a risk of pregnancy. Low dose progestins are of interest for patients with contraindications to synthetic estrogens who desire an OC, but they can induce a relative hyperestrogenism with ovarian dystrophy and other symptoms, and they can cause menstrual irregularity.
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PMID:[Microval]. 392 36

General anesthesia offers greater comfort for both the abortion patient and the operator. The combination of diazepam and ketamine which is rapidly reversible and offers a moderately deep anesthesia was used in 127 voluntary abortions and 3 therapeutic abortions. Patients ranged in age from 14-40 years and averaged 26, with 58% under 26. Patient weights ranged from 40-82 kg and averaged 56 kg. 43% were primaparas and average parity was 2.5. The average duration of the prenancy was 8.1 weeks. 10 patients were obese, 1 was asthmatic, 1 was a controlled hypertensive, 3 had cardiopathies, and 4 each had hepatitis and meningitis. 1 had treated epilepsy and 2 had serious depressive syndromes. 3 women had previously had voluntary abortions, 9 had had miscarriages, and 1 had had an extrauterine pregnancy. 17% had no fear or anxiety before the procedure, 56% had moderate levels, 28% had significant levels, and 19% had very high levels. 94% of the procedures were done by aspiration and in most cases a preliminary insertion of laminaria was done. The average duration of the procedure was 5 minutes, with extremes of 2 and 25 minutes. Patients were premedicated 1 hour before the procedure with intramuscular injections of 10 mg diazepam and 1/4 mg of atropine. For the induction, a butterfly needle with an antireturn system was used to inject 10 mg of diazepam and 1/4 mg of atropine diluted in 20 ml of distilled water. The patient was placed in the gynecological position and, if necessary, 5 mg of diazepam were added. Between .5-1 mg/kg of ketamine were injected in 10-15 seconds. The same dose was reinjected if the anesthesia was insufficient or the procedure was prolonged. A mixture of 40% oxygen and 60% nitrous oxide was administered if necessary. Patients remained in bed for 6 hours after awakening. 85% of patients received total doses of ketamine of .70mg/kg or less. Average duration of anesthesia was 9.2 minutes, with durations of less than 15 minutes in 94% of cases. On awakening 5% of patients had nausea and vomiting. 16% had minor psychic disturbances or disorientation, 8% had moderate problems with vocalization, and 2% had hallucinatory delirium with agitation. Overall, 20% of patients experienced headaches, 11% nausea, and 9% dizziness. It was concluded that the combination of diazepam .2 mg/kg and ketamine .5-.7 mg/kg provides well tolerated light anesthesia utilizable for outpatient abortions.
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PMID:[Diazepam and ketamine for voluntary interruptions of pregnancy]. 692 72

Obstetricians and Gynecologists care for many patients with conditions potentially requiring blood transfusions. Cesarean section and hysterectomy are the two surgeries performed most frequently and both have the potential for blood loss requiring transfusion. Other examples include postpartum hemorrhage, placenta previa, and ruptured ectopic pregnancy. Obstetricians and gynecologists need to become knowledgeable about the ever-changing aspects of blood transfusion and apply it in their clinical practice. This review intends to update obstetricians and gynecologists and other health care professionals about the basic as well as the latest technologies of blood transfusion. The different types of blood components are discussed including their preparation, indications, risks, and benefits. The complications of blood transfusion and their management are reviewed, including infections, noninfectious, and immunological etiologies. HIV and hepatitis are explored, these being the most serious infectious risks of transfusion. Autologous blood transfusion, an underutilized option, is examined. Hemodilution and intraoperative blood salvage, other techniques for using the patient's own blood, are discussed. Finally, synthetic agents such as erythropoietin, granulocyte colony-stimulating factors, factors, desmopressin acetate, gonadotropin-releasing hormone agonists, and new products are introduced as potential replacements to blood transfusion in the future.
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PMID:Transfusion medicine in obstetrics and gynecology. 765 95

Drug combination is extensive in the clinical real world,which is an important part and the inherent requirements of the post-marketing evaluation of traditional Chinese medicine (TCM). The key issues and technology include multi-domain and multi-disciplinary such as the rationality, efficacy and safety evaluation of combination drug starting from clinical real world, study on component in vivo and mechanism of combination drug, the risk/benefit assessment and cost-benefit evaluation of combination drug and so on. The topic has been studied as clinical demonstration on combination therapy of variety of diseases such as coronary heart disease, stroke, insomnia, depression, hepatitis, herpes zoster, psoriasis and ectopic pregnancy. Meanwhile, multi-disciplinary dynamic innovation alliance of clinical drug combination has been presented, which can promote the academic development and improving service ability and level of TCM.
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PMID:[Exploration and demonstration study on drug combination from clinical real world]. 2553 71