BACKGROUND: To evaluate the accuracy of a portable hemoglobin photometer, the HemoCue, during surgery, hemoglobin concentrations (Hb) of HemoCue were compared with those of the SYSMEX XE-2100, in the situation of bleeding. METHODS: Hemoglobin concentrations were measured with HemoCue and by the SYSMEX XE-2100 at the same time, on 100 blood samples obtained from patients who were bleeding more than 500 ml, during surgery. The limits of agreement between the two methods were calculated from the results according to the method of Bland & Altman. The results of HemoCue were adjusted by adding the mean bias, defining the corrected values, and reevaluated the agreement with the results of the SYSMEX XE-2100. RESULTS: The differences in results between the two methods were 1.12 +/- 0.37 g/dl. The limits of agreement were 0.38-1.86 g/dl, which means disagreement between the two methods. However, the corrected values represented agreement with the values of the SYSMEX XE-2100. The limits of agreement were -0.74-0.74 g/dl. CONCLUSIONS: The corrected Hb values of HemoCue were comparable to the values of SYSMEX XE-2100. It is useful to evaluate the hemoglobin concentration using HemoCue intraoperatively.
Anemia ; Bias (Epidemiology) ; Hemoglobins ; Hemorrhage ; Humans

According to literature data, there are no distinct guidelines regarding the proper diagnostic and therapeutic management of traumatic carotid artery dissection (TCAD). Although most of cases evaluated in research studies refer to spontaneous carotid artery dissection, traumatic cases demand special considerations as far as diagnosis and treatment are concerned. Although both types of dissection share some common characteristics, a patient with TCAD usually presents with several concomitant injuries as well as a higher bleeding risk, thus complicating decision making in such patients. Therefore, aim of this review is to present available data regarding epidemiology, clinical presentation, diagnostics and treatment strategy in cases with TCAD in order to produce useful conclusions for everyday clinical practice.
Carotid Arteries* ; Decision Making ; Diagnosis ; Epidemiology ; Hemorrhage ; Humans ; Wounds, Nonpenetrating

Relevant research in recent years has demonstrated that the atrial fibrillation occurrence rate is significantly higher in patients with cirrhosis. The most common indication for long-term anticoagulant therapy is chronic atrial fibrillation. The use of anticoagulant therapy greatly reduces the incidence rate of ischemic stroke. Patients with cirrhosis combined with atrial fibrillation have an elevated risk of bleeding and embolism during anticoagulant therapy due to cirrhotic coagulopathy. At the same time, the liver of such patients will go through varying levels of metabolism and elimination while consuming currently approved anticoagulant drugs, thereby increasing the complexity of anticoagulant therapy. This article summarizes the clinical studies on the risks and benefits of anticoagulant therapy in order to provide a reference for patients with cirrhosis combined with atrial fibrillation.
Humans ; Atrial Fibrillation/epidemiology* ; Stroke/epidemiology* ; Anticoagulants/therapeutic use* ; Hemorrhage ; Liver Cirrhosis/drug therapy* ; Risk Factors

Aged, 80 and over ; Axilla ; Breast Neoplasms ; epidemiology ; surgery ; Comorbidity ; Diabetes Mellitus ; epidemiology ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; Length of Stay ; Lymph Node Excision ; Mastectomy ; Myocardial Infarction ; epidemiology ; Myocardial Ischemia ; epidemiology ; Operative Time ; Postoperative Complications ; epidemiology ; Postoperative Hemorrhage ; epidemiology ; Seroma ; epidemiology ; Singapore ; epidemiology ; Surgical Wound Dehiscence ; epidemiology ; Surgical Wound Infection ; epidemiology ; Venous Thrombosis ; epidemiology

OBJECTIVE: Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes. METHODS: There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done. RESULTS: Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes (15.3%) in 59 patients. These 59 patients were included in the study. First hemorrhagic cases (H) were 19 (32%), and the first infarction cases (I) were 40 (68%). Subsequent strokes after first stroke were as follows : H-->H 14 (23.7%)cases, H-->I 5 (8.5%), I-->H 8 (13.6%), I-->I 32 (54.2%). A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack (H-->H attack) increase 3.2 times than ischemic type and in ischemic stroke (I-->I attack) 3.6 times increased incidence of second ischemic attack. CONCLUSION: The recurrence rate of stroke was 12.4% (59 of 475 patients). If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke increase over 3 times. In H-->H group, the time interval between first and second stroke was shorter and the age of onset was earlier than in I-->I group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.
Age of Onset ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction ; Cohort Studies ; Epidemiology* ; Hemorrhage ; Humans ; Incidence ; Infarction ; Recurrence ; Retrospective Studies ; Stroke*

PURPOSE: Post-polypectomy bleeding is the most common colonoscopic polypectomy complication. However, the risk of post-polypectomy bleeding in liver cirrhosis is unknown. We aimed to evaluate the risk of post-polypectomy bleeding in patients with liver cirrhosis. MATERIALS AND METHODS: We included 89 patients with liver cirrhosis who received colonoscopic polypectomy between January 2006 and October 2012. Three hundred forty-eight subjects without liver disease who underwent colonoscopic polypectomy comprised the control group. Risks of post-polypectomy bleeding were analyzed according to patient- and polyp-related factors. RESULTS: Among 89 patients, 75 (84.3%) were Child-Pugh class A, 10 (11.2%) were class B, and 4 (4.5%) were class C. Incidence of immediate post-polypectomy bleeding was significantly increased in cirrhosis with Child-Pugh class B or C compared to liver cirrhosis with Child-Pugh class A or control group [hazard ratio (HR) 3.5; p<0.001]. Polyp size (HR 3.6; p=0.032) and pedunculated polyps (HR 2.4; p=0.022) were also significant risk factors for immediate post-polypectomy bleeding in multivariate analysis. CONCLUSION: Cirrhotic patients with Child-Pugh class B or C have a high risk of immediate post-polypectomy bleeding. Thus, endoscopists should be cautious about performing colonoscopic polypectomy in patients with Child-Pugh class B or C.
Aged ; Colonoscopy/*adverse effects ; Female ; Gastrointestinal Hemorrhage/*epidemiology ; Humans ; Incidence ; Liver Cirrhosis/complications/*surgery ; Male ; Middle Aged ; Postoperative Hemorrhage/*epidemiology ; Retrospective Studies ; Risk Factors ; Time Factors

Birth Weight ; Cerebral Hemorrhage ; epidemiology ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature, Diseases ; epidemiology ; Male ; Risk Factors

OBJECTIVETo explore the association between chorioamnionitis and brain injury in preterm infants.

METHODSA total of 88 preterm infants (28-34 weeks), who were born between June 2008 and June 2011, were divided into a case group (n=41) and a control group (n=47) according to whether or not they had chorioamnionitis. All the infants were examined by brain ultrasonography periodically after birth and underwent brain diffusion weighted imaging (DWI) between 3 and 7 days after birth. The two groups were compared in terms of the incidence of periventricular leukomalacia (PVL) and periventricular and intraventricular hemorrhage (PVH-IVH) by brain magnetic resonance imaging (MRI) at the corrected gestational age of 40 weeks.

RESULTSThere was statistical significance in the incidence of PVL between the case and the control groups (32% vs 6%; P<0.05), but no significant difference in the incidence of PVH-IVH between the two groups (27% vs 23%; P>0.05).

CONCLUSIONSChorioamnionitis is associated with brain injury in preterm infants, increasing the incidence of PVL but having little influence over the incidence of PVH-IVH.

Cerebral Hemorrhage ; epidemiology ; Chorioamnionitis ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; epidemiology ; Male ; Pregnancy

Objective: To explore the association between self-reported gingival bleeding and prevalent hypertension among adults in Zhejiang with a cross-sectional study. Methods: After excluding participants with self-reported, physician-diagnosed heart diseases, stroke, diabetes, cancer, and those who never or rarely brush their teeth at baseline study, 48 625 participants aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang, Zhejiang were included for the final analysis. Three multivariable logistic regression models were used to estimate the odds ratios (ORs) for the associations of self-reported gingival bleeding with prevalent hypertension. Results: The mean age of women was (51.2±9.2) years, and 42.9% of participants had prevalent hypertension. The percentage of self-reported frequent gingival bleeding was 6.56% (95%CI: 6.38%-6.75%), significantly higher among women (8.08%, 95%CI: 7.82%-8.35%) than among men (4.36%, 95%CI: 4.12%-4.60%) (P<0.001). After adjusting for socio-demographic factors, behavioral lifestyle, sleep duration, BMI, waist circumference, snoring, in comparison with men whose gingivae never or rarely bleed while brushing teeth, the odds ratio (95%CI) of hypertension for those with occasional, and frequent gingival bleeding were 1.04 (0.96-1.12) and 1.18 (1.02-1.37), respectively (trend P =0.038). The corresponding figures for women were 0.96 (0.91-1.02) and 0.95 (0.86-1.05), respectively (trend P=0.344). Conclusion: Frequent gingival bleeding was positively associated with prevalent hypertension among men.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Gingival Hemorrhage ; Humans ; Hypertension/epidemiology* ; Male ; Middle Aged ; Risk Factors ; Self Report

Six hundred eighty seven cases of cerebrovascular disease, confirmed by C-T scan, were evaluated at Hanyang University Hospital from January 1985, to December 1988, and the following results were obtained. 1) The incidence of cerebral infarction was markedly increased in the last 5 years. 2) Cerebral hemorrhage showed a peak age of incidence in the fifties, cerebral infarction in the sixties. 3) Among the preceding diseases at the onset of cerebrovascular disease, hypertension was the most common. 4) Total lipid, Total-cholesterol/HDL-cholesterol ratio were significantly higher in cerebral infarction than in cerebral hemorrhage. 5) Triglyceride concentration and total cholesterol concentration were also higher in cerebral infarction than those of cerebral hemorrhage, but statistically not significant. 6) In cerebral infarction HDL-cholesterol concentration was significantly lower than that of cerebral hemorrhage. (p less than 0.01.) 7) In cerebral infarction, hematocrit and hemoglobin concentration were significantly higher, respectively, than those of cerebral hemorrhage.
Adult ; Age Factors ; Aged ; Cerebral Hemorrhage/*epidemiology/mortality ; Cerebral Infarction/*epidemiology/mortality ; Female ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; Risk Factors ; Sex Factors