Search

Abstract Background Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes. Methods Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher’s exact test, or Kruskal-Wallis test. Statistical significance was set at P 0.05). Conclusions Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars.

Background: Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes. Methods: Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher's exact test, or Kruskal-Wallis test. Statistical significance was set at P < 0.05. Results: A total of 183 teeth in 106 patients were included in the analysis. The follow-up period fell into a range of 1–3 years, with a mean of 1.6 years. The clinical and radiographic success rates were 96.7% and 92.9%, respectively. The earliest time to observe the radiographic failures was half a year after the treatment, and the latest time was two years after the treatment. Among all the teeth, 130 were recorded with hemostasis time before the application of iRoot BP Plus. Compared to teeth with a hemostasis time of 5 min or less, teeth with a hemostasis time exceeding 5 min showed no significant differences in clinical and radiographic success (P = 1.000 and 0.879). Additionally, neither arch nor teeth type showed a relationship with the pulpotomy success rate (P > 0.05). Conclusions: Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars. [ABSTRACT FROM AUTHOR]

This study aims to assess the differences in coagulation function, intraoperative bleeding and hemostasis time resulting from immediate versus delayed infusion of residual physical blood in patients undergoing cardiopulmonary bypass for aortic dissection. From January 2018 to January 2021, the data of 122 patients diagnosed with acute Stanford type A aortic dissection and treated at Taihe Hospital Affiliated Hospital of Hubei University of Medicine were retrieved and assessed. They were then divided into two groups according to different treatments: a research group and a control group. The research group received a delayed infusion of residual physical blood intraoperatively, while the control group underwent immediate infusion. Various indicators of coagulation, encompassing activated partial thromboplastin time, prothrombin time, thrombin time, and fibrinogen levels, along with hemoglobin levels, utilization of blood products such as red cell suspension, plasma, platelets, and cryoprecipitate, as well as the volume of bleeding, total fluid intake and output, and durations of hemostasis, surgery, and anesthesia, were compared between the two groups. After surgery, coagulation and hemoglobin levels, which were initially similar between the two groups, were found to be significantly improved, with the research group showing superior outcomes (p < 0.05). Additionally, patients in the research group required significantly fewer blood products, experienced reduced bleeding and total body fluid exchange and had markedly shorter durations of hemostasis, surgery and anesthesia compared to those in the control group (p < 0.05). Pre-infusion adjustment of coagulation function before residual whole blood infusion effectively improves coagulation, reduces bleeding and fluid imbalance, and shortens hemostasis time during aortic dissection surgery with cardiopulmonary bypass. This approach not only reduces transfusion-related risks and improves postoperative recovery but also plays a significant role in optimizing blood management. [ABSTRACT FROM AUTHOR]

Purpose: Uterine myomas are the most common gynecological disease. In these cases, a myomectomy is performed traditionally laparotomically. However, alternatives have been widely used, including laparoscopic, endoscopic, and robotic surgery. During these techniques, diffuse parenchymatous bleeding remains one of the main intraoperative and postoperative complications and sometimes requires unplanned hysterectomies. Recently, hemostatic agents and sealants have been used to prevent excessive blood loss during surgical repair. Methods: We propose a prospective case–control study on the use of a sealing hemostat patch (HEMOPATCH®) on uterine sutures in laparotomic myomectomy. In the period between July 2016 and April 2017, 46 patients with symptomatic uterine fibromatosis underwent surgery. They were divided into two groups of 23 patients, with different treatments in the hemostatic phase of oozing bleeding. HEMOPATCH® is applied in group A, and spray electrocoagulation is applied in group B. Results: In group A, we achieve faster hemostasis (p < 0.05), than in group B. We report a significantly lower C-reactive protein value on the second and third days after surgery for group A compared to group B. Conclusions: HEMOPATCH®, during laparotomic myomectomy, is a valid alternative solution for obtaining rapid hemostasis and consequently intraoperative and postoperative bleeding. Furthermore, we suggest that a lower inflammatory peritoneal state is probably correlated with the barrier effect of the patch on the suture. [ABSTRACT FROM AUTHOR]

BACKGROUND: Absorbable hemostatic materials are currently a hot field of hemostatic materials. The clinical demand for safe and effective absorbable hemostatic materials is increasing. Fish scale collagen is not only safe and effective, but also can turn fish scales into treasures and make full use of resources reasonably. OBJECTIVE: To verify the hemostatic efficacy, the degradation procedure in vivo, and explore the safety of fish scale collagen. METHODS: Fish scale collagen material was extracted by chemical decalcification combined with low temperature enzymatic method, and used in the following three tests. (1) The First Part: The bleeding test included the body-liver bleeding and surface-tail bleeding. Liver bleeding and tail hemorrhage model was prepared by physical damage to the liver and tail. Model animals were divided into experimental group (use of fish scale collagen), the control group (use of hemostatic sponge), and blank group (no processing). The amount of blood loss and hemostatic time were recorded. (2) Part II: In vivo degradation test of fish scale collagen: Animals with liver hemostasis were euthanized at 1, 3, 5, 10, 20, 30, 40, 50, and 60 days after being filled with fish scale collagen material. Animals in the control group were euthanized at 5 and 50 days after being filled with hemostatic sponge. Animals in the blank group were euthanized at 5 and 50 days after modeling. The adhesions in abdominal cavity were observed, and the degradation of material and the progress of liver regeneration were observed pathologically. (3) Part III: Biological evaluation, including hemolysis test, epidermal stimulation test, intradermal stimulation test, pyrogen test, and acute toxicity test. RESULTS AND CONCLUSION: (1) The collagen of filamentous fish scale was extracted successfully by chemical decalcification combined with low temperature enzymatic method; the yield was 66%-73%, and the pore size of collagen of fish scale was 0.80±0.23 mm. (2) Tail bleeding model was used to verify the hemostatic effect of body surface. Compared with the blank group, the hemostatic time of fish scale collagen was significantly shortened, and the amount of blood loss was significantly reduced compared with the control group (hemostatic sponge) and the blank group (P < 0.05). (3) At 5 days after implantation, the collagen of fish scale was closely attached to the damaged liver without intraperitoneal adhesion. At 20 days after implantation, the volume of collagen of fish scale was significantly reduced; 50 days after implantation, no material was observed by eyes. (4) Pathological examination showed that at 1-3 days after collagen implantation, it was in the stage of acute inflammatory reaction. Cells attached to the material merchant at 5 days. On day 10, vascular structure was formed at the junction of the material and liver. The sinusoid structure of liver was formed in materials at 20-40 days. At 50-60 days, similar hepatic lobule structures could be seen, indicating that the degradation of the material was completed and liver regeneration was basically completed. (5) The results of biological test showed that the hemolysis, epidermal irritation, intradermal irritation, heat source and acute toxicity of collagen of fish scale met the requirements of GB/T16886 Biological Evaluation of Medical Devices. (6) It is concluded that the fish scale collagen extracted by chemical decalcification combined with low temperature enzymatic method has a definite hemostatic effect on bleeding in vivo and on body surface. In vivo degradation time is about 50 days, can provide support for liver regeneration, and is conducive to liver repair. [ABSTRACT FROM AUTHOR]

Transradial access is recommended for coronary angiography and angioplasty, and is associated with fewer complications when compared to femoral access. Nevertheless, there is a risk of hematoma and radial artery occlusion (RAO), and substantial time may elapse until hemostasis is achieved. We aimed to evaluate if an oximetry-guided deflation technique compared to a traditional rapid deflation technique was associated with earlier removal of the transradial band (TR-band) and lower rates of RAO following radial coronary intervention. Between October 2018 and December 2021, we randomized 3600 patients to either traditional rapid deflation where 1/3 of volume in the TR-band was removed every 20 min and reinflated if bleeding, or oximetry-guided deflation aiming at patent hemostasis and full deflation of the TR-band after 60 min, with cross-over to traditional deflation if bleeding at the time of deflation. A TR-band was applied in 3540 patients, and data on time to removal was available in 3288 (93 %) of these. The time to full deflation of the TR-band was 92 versus 74 min, P < 0.01 and the time to removal of the TR-band was 112 versus 100 min, P < 0.01 in patients randomized to traditional rapid (n = 1767) versus oximetry-guided deflation (n = 1773). The rate of RAO or sub- occlusion evaluated by oximetry after TR-band removal was 1.2 % versus 1.8 %, P = 0.16. Traditional rapid deflation of the TR-band with the first deflation attempt after 20 min is associated with re-bleeding and prolonged time to removal of the TR-band, as compared to a strategy where the first deflation attempt is performed after 60 min. Oximetry-guided deflation, however, was not associated with lower rates of RAO or subocclusion. [Display omitted] • Numerous strategies are used to achieve hemostasis after radial access. • We compared traditional- to oximetry-guided deflation of the transradial band. • Oximetry-guided deflation was associated with earlier removal of the transradial band. • Oximetry-guided deflation was associated with earlier hemostasis. • No difference was found in occurrence of Radial Artery Occlusion. [ABSTRACT FROM AUTHOR]

Although the buttonhole cannulation method is now widely used as an alternative to the rope- ladder method in most countries, only the latter method is used in Korea. This study was performed to investigate clinical benefit of the buttonhole technique for arteriovenous fistula (AVF) cannulation in maintenance hemodialysis (HD) patients. Thirty-two patients receiving HD via mature AVF were included and AVF cannulation was performed by 20 experienced nurses. During the 8 weeks, AVFs were cannulated by the rope-ladder method with 1 5-gauge sharp needles. After creating of 2 pairs of tunnel tracks by sharp needles for 7 weeks, AVFs were cannulated by the buttonhole method using 1 5-gauge blunt needles during the 16 weeks. Vascular access blood flow rate (BFR), dialysis venous pressure (DVP), and dialysis adequacy (Kt/V) were measured within the first week of the two cannulation methods. Cannulation pain, hemostasis time, and nurse's stress were evaluated at the end of the two methods. There were no statistical differences in vascular access BFR (P = 0.139), DVP (P = 0.1 52), and dialysis adequacy (P = 0.343) between the two methods. However, the buttonhole method shortened hemostasis time (P = 0.001) and decreased cannulation pain (P = 0.001) as well as nurse's stress (P = 0.001) compared with the rope-ladder method. In conclusion, the buttonhole cannulation method improves hemostasis time, cannulation pain, and nurse's stress without a change in vascular access BFR and dialysis adequacy in HD patients. [ABSTRACT FROM AUTHOR]

Objectives: To compare incidence of forearm radial artery occlusion (RAO) and hemostasis characteristics between distal and conventional transradial approach (DRA and TRA, respectively)., Background: DRA has the potential advantage of reducing RAO. DRA effectively reduces time-to-hemostasis, however its role on preserving flow in the radial artery (PF) during hemostasis and consequent impact on RAO remains speculative., Methods: Eight hundred thirty-seven patients with TRA were previously enrolled in a prospective registry investigating the relationship of residual anticoagulation and RAO. Three hundred twenty-six additional patients with DRA were added to the cohort and matched to the original cohort by propensity score. The composite end-point of RAO at forearm and distal site of puncture (dRAO) was evaluated as secondary end-point., Results: RAO occurred in 4.8% (41 of 837) of patients undergoing TRA and in 0% (0 of 326) of those undergoing DRA (p < 0.0001). DRA was associated with higher percentage of PF (97.2% vs. 78.5% in TRA group, p < 0.0001) and reduced time-to-hemostasis (147 ± 99 min vs. 285 ± 138 min, p < 0.0001). After matching, hemostasis characteristics were still significant different (PF 95.7% vs. 90.1%, p = 0.023, and 190 ± 92 vs. 323 ± 162 min, p < 0.0001) with reduction in the incidence of RAO (0 of 213, 0% vs. 7 of 213, 3.3%, p = 0.0015). dRAO occurred in one case (0.3% and 0.5% after matching, p < 0.0001 and p = 0.032 compared to TRA)., Conclusions: DRA was associated with lower rates of RAO compared to TRA. This effect is potentially explained by reduced time-to-hemostasis and maintained flow at the wrist during hemostasis., (© 2021 Wiley Periodicals LLC.)

Thirteen patients with chronic autoimmune thrombocytopenia (AITP) were treated for 14 days with daily oral doses of 120 mg of the novel platelet-activating-factor (PAF) antagonist WEB 2086 BS. Clinical bleeding symptoms remained essentially unchanged in 9 patients and became more pronounced in the post-treatment period in 4 patients. In no case was an increase in platelet counts observed. While the PAF antagonist was well tolerated subjectively during treatment, most patients exhibited a prolongation of the sensitive 'hemostasis time' (a modified bleeding time test) after treatment, but the Duke bleeding time was not changed. We conclude that the PAF antagonist WEB 2086 BS is ineffective for treatment of chronic AITP and should be used with caution in thrombocytopenic patients. [ABSTRACT FROM AUTHOR]