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Splenic Injury

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141. Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study. Full Text available with Trip Pro

to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters.First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative (...) rate of embolization was 87.5%. The two-week survival rate in all animal models of splenic injury was 100%.Our findings in the current study demonstrate that the mobile minimally invasive interventional shelter can be adapted to the field perfectly and complete emergency surgical intervention for splenic injury efficiently and safely. Therefore, on-spot emergency interventional TAE for vascular injury of solid organs (e.g. spleen) in mobile minimally invasive interventional shelter is available

2014 Scandinavian journal of trauma, resuscitation and emergency medicine

142. Preserved function after angioembolisation of splenic injury in children and adolescents: a case control study. (Abstract)

sized and well perfused spleens in the SAE patients when compared to their controls.This case control study indicates preserved splenic function after SAE for splenic injury in children. Mandatory immunization to prevent severe infections does not seem warranted.Copyright © 2012 Elsevier Ltd. All rights reserved. (...) Preserved function after angioembolisation of splenic injury in children and adolescents: a case control study. Non-operative management for blunt splenic injuries was introduced to reduce the risk of overwhelming post splenectomy infection in children. To increase splenic preservation rates, splenic artery embolization (SAE) was added to our institutional treatment protocol in 2002. In the presence of clinical signs of ongoing bleeding, SAE was considered also in children. To our knowledge

2014 Injury

143. Reliability of injury grading systems for patients with blunt splenic trauma. (Abstract)

Reliability of injury grading systems for patients with blunt splenic trauma. The most widely used grading system for blunt splenic injury is the American Association for the Surgery of Trauma (AAST) organ injury scale. In 2007 a new grading system was developed. This 'Baltimore CT grading system' is superior to the AAST classification system in predicting the need for angiography and embolization or surgery. The objective of this study was to assess inter- and intraobserver reliability between (...) radiologists in classifying splenic injury according to both grading systems.CT scans of 83 patients with blunt splenic injury admitted between 1998 and 2008 to an academic Level 1 trauma centre were retrospectively reviewed. Inter and intrarater reliability were expressed in Cohen's or weighted Kappa values.Overall weighted interobserver Kappa coefficients for the AAST and 'Baltimore CT grading system' were respectively substantial (kappa=0.80) and almost perfect (kappa=0.85). Average weighted

2014 Injury

144. Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre. (Abstract)

Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre. Timely intervention in patients with splenic injury is essential, since delay to treatment is associated with an increased risk of mortality. Transcatheter Arterial Embolisation (TAE) is increasingly used as an adjunct to non-operative management. The aim of this study was to report time intervals between admission to the trauma room and start of intervention (TAE or splenic surgery) in patients with splenic (...) injury.Consecutive patients with splenic injury aged ≥ 16 years admitted between January 2006 and January 2012 were included. Data were reported according to haemodynamic status (stable versus unstable). In haemodynamically (HD) unstable patients, transfusion requirement, intervention-related complications and the need for a re-intervention were compared between the TAE and splenic surgery group.The cohort consisted of 96 adults of whom 16 were HD unstable on admission. In HD stable patients, median time

2014 Injury

145. Population-based analysis of blunt splenic injury management in children: operative rate is an informative quality of care indicator. (Abstract)

-level observed to expected (O/E) ratios for rate of operative management.We identified 3122 children with BSI. The majority (74%) were isolated splenic injuries and the grade of splenic injury was specified in 45% of cases (n=1391, 38% grade I or II; 62% grade III, IV, or V). The overall operative rate was 11% (n=315), of which 9% were total splenectomy and 2% were spleen-preserving operations. After adjusting for age, gender, mechanism of injury, splenic injury grade, ISS, and centre volume (...) Population-based analysis of blunt splenic injury management in children: operative rate is an informative quality of care indicator. In hemodynamically normal children with blunt splenic injury (BSI), the standard of care is non-operative management. Several studies have reported that non-paediatric and non-trauma centres have higher operative rates in children with BSI compared to paediatric hospitals and trauma centres. We investigate the feasibility of using operative rate for BSI

2014 Injury

146. Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database. (Abstract)

Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database. Association between rib fractures and incidence of abdominal solid organs injury is well described. However, the correlation between the number of fractured ribs and severity of splenic injury is not clear. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of splenic injury (...) in blunt trauma patients.A retrospective cohort study involving blunt trauma patients with concomitant splenic injuries and rib fractures, between the years 1998 and 2012, registered in the Israeli National Trauma Registry.Of 321,618 patients with blunt mechanism of trauma, 57,130 had torso injuries, and of these 14,651 patients sustained rib fractures, and 3691 patients suffered from splenic injury. Concomitant splenic injury occurred in 1326 of the patients with rib fractures (9.1%), as compared

2014 Injury

147. Ultrasonography of the healing process during a 3-month follow-up after a splenic injury Full Text available with Trip Pro

Ultrasonography of the healing process during a 3-month follow-up after a splenic injury We present a 14-year-old boy with a grade III splenic injury due to a bicycle accident, who was treated conservatively. The boy's medical history included splenomegaly due to thalassemia. The splenic lesion was initially investigated with computed tomography (CT) and then, was followed by ultrasonography for 3 months. CT revealed a large intraparenchymal hematoma which appeared hyperechoic

2014 Ultrasonography

148. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients

Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02232191 Recruitment Status : Recruiting First Posted : September 5

2014 Clinical Trials

149. Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? (Abstract)

Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in patients undergoing colectomy procedures are reliably coded (...) 114 patients (1%) who had a concurrent splenic procedure code recorded in either ACS NSQIP or Medicare inpatient claims. There were 7 patients who had a splenic injury diagnosis code recorded in either data source. Agreement of splenic procedure codes between the data sources was substantial (κ statistic 0.72; 95% CI, 0.64-0.79). Medicare inpatient claims identified 81% of the splenic procedure codes recorded in ACS NSQIP, and 99% of the patients without a splenic procedure code.It is feasible

2014 Journal of the American College of Surgeons

150. Role of spleen-derived monocytes/macrophages in acute ischemic brain injury. Full Text available with Trip Pro

Role of spleen-derived monocytes/macrophages in acute ischemic brain injury. Monocytes/macrophages (MMs), mononuclear phagocytes, have been implicated in stroke-induced inflammation and injury. However, the presence of pro-inflammatory Ly-6C(high) and antiinflammatory Ly-6C(low) monocyte subsets raises uncertainty regarding their role in stroke pathologic assessment. With recent identification of the spleen as an immediate reservoir of MMs, this current study addresses whether the spleen (...) -derived MMs are required for stroke pathologic assessment. We observed that the spleen was contracted in poststroke animals and the contraction was accompanied by decreased number of Ly-6C(high) and Ly-6C(low) subsets in the spleen. The deployment of these subsets from the spleen temporally coincided with respective increases in the ischemic brain. Compared to mice with the spleen, mice receiving a splenectomy just before the stroke displayed less accumulation of Ly-6C(high) and Ly-6C(low) MMs

2014 Journal of Cerebral Blood Flow and Metabolism

151. Reducing scheduled phlebotomy in stable pediatric patients with blunt liver or spleen injury. (Abstract)

Reducing scheduled phlebotomy in stable pediatric patients with blunt liver or spleen injury. Although consensus-based guidelines exist for managing pediatric liver/spleen injuries, optimal phlebotomy frequency is unknown. We hypothesize surgeons order more phlebotomy than necessary and propose a pathway with one blood draw, early ambulation and discharge, fewer ICU admissions, and physiology-driven interventions.Records of 120 children with solid organ injury from two hospital registries (2008 (...) -2012) were analyzed. We compared resource utilization between our current management and management if the proposed pathway were in place. Paired t-test was used for statistical analysis.Sixty-one patients were included (35 spleen, 22 liver, 4 combined). Average age was 11.6 (±4.2) years, injury severity score 9 (±5), and median injury grade 3. 51% of children were admitted to the ICU. Average phlebotomy per patient was 5 (±2) and length-of-stay 4.3 (±1.5) days. Three patients became unstable

2014 Journal of Pediatric Surgery

152. National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol. (Abstract)

National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol. Recent reports suggest that an abbreviated bed rest protocol (ABRP) may safely reduce length of stay (LOS) and resource utilization in pediatric blunt spleen and liver injury (BSLI) patients. This study evaluates national temporal trends in BLSI management and estimates national reduction in LOS using an ABRP.Pediatric patients (<18 years old) sustaining BLSI were (...) identified in the Kids' Inpatient Database from 2000 to 2009. Yearly rates of injury and operative intervention were examined and stratified by type of injury. APSA guidelines and the reported ABRP were applied based on abbreviated injury score (AIS) and compared with actual LOS.22,153 patients were identified. Over the study period, operative rates for spleen and liver injuries and overall mortality significantly declined: LOS=3.1 days (±1.6) and 2.7 days (±1.9) for spleen and liver, respectively

2014 Journal of Pediatric Surgery

153. Latest Study on the Relationship between Pathological Process of Inflammatory Injury and the Syndrome of Spleen Deficiency and Fluid Retention in Alzheimer's Disease. Full Text available with Trip Pro

Latest Study on the Relationship between Pathological Process of Inflammatory Injury and the Syndrome of Spleen Deficiency and Fluid Retention in Alzheimer's Disease. Inflammation exists throughout the incidence and progression of Alzheimer's disease (AD). Traditional Chinese medicine (TCM) differentiates the pathogenesis of AD as kidney essence deficiency and qi and blood deficiency as well as blood stasis in syndromes, whose action mechanisms are all associated with the intervention in its (...) inflammatory process. Our preliminary studies both in clinic and in vitro have demonstrated that the syndrome of spleen deficiency and fluid retention has also been an important pathogenesis for the incidence and development of AD. Hence, the paper aims to further illustrate the correlation between inflammatory process in AD and the syndrome of spleen deficiency and fluid retention, laying solid foundation for the application of invigorating the spleen and eliminating the dampness in clinic, and enriching

2014 Evidence-based Complementary and Alternative Medicine (eCAM)

154. Splenosis: The Autotransplantation of Splenic Tissue Following Injury to the Spleen : Report of Two Cases and Review of the Literature Full Text available with Trip Pro

Splenosis: The Autotransplantation of Splenic Tissue Following Injury to the Spleen : Report of Two Cases and Review of the Literature 13627998 2000 07 01 2018 12 01 0003-4932 149 3 1959 Mar Annals of surgery Ann. Surg. Splenosis: the autotransplantation of splenic tissue following injury to the spleen; report of two cases and review of the literature. 402-14 COTLAR A M AM CERISE E J EJ eng Journal Article United States Ann Surg 0372354 0003-4932 OM Humans Spleen Splenosis Transplantation (...) , Autologous 5936:1778:504 SPLEEN 1959 3 1 1959 3 1 0 1 1959 3 1 0 0 ppublish 13627998 PMC1451006 Br Med J. 1956 Jun 2;1(4978):1271-2 13316128 Am J Anat. 1950 Nov;87(3):459-503 14789742 Ann Surg. 1954 Jul;140(1):107-12 13159150 J Am Med Assoc. 1953 Jul 25;152(13):1227-8 13061249 Am J Pathol. 1945 Jan;21(1):81-5 19970805 Ann Surg. 1953 Apr;137(4):551-7 13031495 Can Med Assoc J. 1947 Apr;56(4):374-7 20286939 Am J Pathol. 1936 Sep;12(5):665-676.3 19970293 Mem Acad Chir (Paris). 1954 Jun 2-9;80(19-20):520-2

1959 Annals of Surgery

155. Randomised controlled trial: Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Full Text available with Trip Pro

Randomised controlled trial: Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity | BMJ Evidence-Based Medicine We use cookies to improve our service (...) name or password? You are here Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Article Text Therapeutics Randomised controlled trial Hydroxycarbamide for very young children with sickle cell anaemia: no effect on the primary outcomes of spleen or kidney function, but evidence for decreased pain and dactylitis, with minimal toxicity Deepa Manwani

2012 Evidence-Based Medicine

156. Is CT thorax necessary to exclude significant injury in paediatric patients with blunt chest trauma?

pneumothorax, 1 splenic laceration and 1 liver laceration found 2 pts had change in management in that moved to ITU but no pts had surgical intervention. Small study at single centre. Comment(s) It is clear that CT scans are more sensitive than plain CXRs for the detection of thoracic injuries; a more difficult question is whether this additional information is clinically important. The risks of missing a significant injury have to be balanced against the risks of the diagnostic procedure. CT scans involve (...) Is CT thorax necessary to exclude significant injury in paediatric patients with blunt chest trauma? BestBets: Is CT thorax necessary to exclude significant injury in paediatric patients with blunt chest trauma? Is CT thorax necessary to exclude significant injury in paediatric patients with blunt chest trauma? Report By: Craig Ferguson - Consultant in Emergency Medicine Search checked by Katharine de la Morandiere - Consultant in Emergency Medicine Institution: Central Manchester Foundation

2015 BestBETS

157. Excessive Selenium Supplementation Induced Oxidative Stress and Endoplasmic Reticulum Stress in Chicken Spleen. (Abstract)

Excessive Selenium Supplementation Induced Oxidative Stress and Endoplasmic Reticulum Stress in Chicken Spleen. Excessive selenium (Se) intake is harmful for animals and humans. The aim of the present study was to examine the effect of long-term excessive Se supplementation on oxidative stress and endoplasmic reticulum (ER) stress-related injuries in chicken spleen. A total of 180 1-day-old chickens were randomly divided into four groups with different Se dietary contents (0.2 mg/kg Se, 5 mg/kg (...) Se, 10 mg/kg Se, or 15 mg/kg Se) for 45 days. Then, the levels of antioxidative enzymes, GPx, SOD, and MDA as well as the expression levels of GRP78, ARF6, caspase 3, caspase 12, and Bcl 2 in the spleen were determined at days 15, 30, and 45, respectively. The results showed that excessive Se treatment decreased the activities of GPx and SOD (P < 0.05) but increased the levels of MDA (P < 0.05) in a dose- and time-dependent manner. In addition, the ER stress genes GRP78 and ATF6 were highly

2017 Biological trace element research Controlled trial quality: uncertain

158. Splenic Artery Pseudoaneurysm. (Abstract)

Splenic Artery Pseudoaneurysm. Splenic artery pseudoaneurysm is an extremely rare entity, although it is the most frequent location of visceral pseudoaneurysms. Trauma or previous pancreatitis (where the proteolytic pancreatic enzymes lead to the formation of pseudoaneurysm, as a result of enzymatic injury to the splenic artery wall) (Amico and Alves in Pancreatology 14: 144-145, 2014) is the most frequent causes. A high degree of suspicion is required for the accurate diagnosis. The authors (...) present a case of splenic artery pseudoaneurysm in a middle-aged man who came to the emergency department with several days of abdominal pain.

2017 Journal of Gastrointestinal Surgery

159. Strategy of laparoscopic surgery for colon cancer of the splenic flexure: a novel approach. Full Text available with Trip Pro

Strategy of laparoscopic surgery for colon cancer of the splenic flexure: a novel approach. The splenic flexure (SF) anatomy is complex due to multiple vessels, surrounding organs, layers, and irregular adhesions [1-3].Our laparoscopic approach involves a lateral-to-medial approach to the left-sided transverse mesocolon (TM), a medial-to-lateral approach to the left mesocolon (LM), and take-down of the remnant SF. First, the omental bursa is opened and its posterior wall and the anterior layer (...) to the SF. The descending colon is mobilized from its lateral attachment. Finally, the SF is taken down from the spleen by separating remnant structures, including adhesions. Subsequently, functional end-to-end anastomosis was performed extracorporeally.During March 2012-December 2016, 39 patients with left-sided transverse or descending colon cancer underwent this treatment. The mean operative time, blood loss, number of harvested LNs, and hospital stay duration were 283 min, 45 ml, 15, and 9 days

2017 Surgical endoscopy

160. The incidence of delayed splenic bleeding in pediatric blunt trauma. (Abstract)

The incidence of delayed splenic bleeding in pediatric blunt trauma. One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI).A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤18years) BSI presenting to one of 10 pediatric trauma centers (...) . Patients were tracked at 14 and 60days. Descriptive statistics were used to summarize patient and injury characteristics.During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available

2017 Journal of Pediatric Surgery

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