What is your diagnosis?

No abstract available.http://avmajournals.avma.org/loi/javmamn201

Prospectus, November 16, 1977

PC PLACES 13 IN YEARBOOK; Finals just a month away; SWAMP meets; Bio talk Dec. 1st; Air Force rep here next week; MSOE rep here; Male health is next CHI topic; Parkland Events; Letters to the editors: Canteen flayed, Quatrain query, Cartoon condemned, ...and defended, Should students drive vehicles?; Carolers sought for kids\u27 party; Nutrition course starts in Jan.; \u27Anne Sexton\u27 tomorrow night; State museum features three new art exhibits; PC art gallery may be a permanent addition; Madwoman of Chaillot: as a parable of Europe, ...as an amusing play; WILL Women\u27s Week specials; Women\u27s Conference hears girls\u27 arguments; Watch repairing wide open field, says Parkland grad; Last winter killed much wildlife: Hunting may be thin this fall; Only 40 spending days \u27til Christmas; Personal Service Guide; Numbers A Woman May Need; Hygienists out on own?; Sorority rush; Moraine Valley takes Women\u27s State Tourney; Attics high on insulation list; Doc says \u27Mason\u27s got it all together\u27; ...Lex says \u27Mason/Loggins remnants of former selves; Final exam schedule; Suppose Custer hadn\u27t died at Little Big Horn; Classifieds; Area teams still vying for state championship; NBC presents new basketball format; Ivy League revisited: Two tie in Freddy Forecast; One more Freddy; Women\u27s basketball tryouts this week; It\u27s basketball time again: Cobras short but accurate this season, State community college teams look to good seasons, Parkland Basketball Roster, Opener tonight at Lincoln pits young Cobras vs. Lynx; IM basketballhttps://spark.parkland.edu/prospectus_1977/1004/thumbnail.jp

Fibrinogen in traumatic haemorrhage: A narrative review

Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.Griffith Health, School of Medical ScienceNo Full Tex

What is your diagnosis?

A 9-month-old Standardbred filly was admitted to the veterinary teaching hospital for evaluation of a rightsided facial swelling. Swelling over the right maxillary bone had been first noticed at 3 months of age. At that time, the site had been drained, and the swelling resolved. Four months later (2 months prior to hospital admission), the swelling developed again at the same location and gradually increased in size. Mild right-sided nasal and ocular discharge and intermittent respiratory noise were also observed.http://avmajournals.avma.org/loi/javmaai2017Companion Animal Clinical Studie

Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial

Abstract Background Haemorrhage is a leading cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage. Early fibrinogen replacement is recommended by several international trauma guidelines using either fibrinogen concentrate (FC) or cryoprecipitate (Cryo). There is limited evidence to support one product over the other with widespread geographic and institutional variation in practice. This pilot trial is the first randomised controlled trial comparing FC to Cryo in traumatic haemorrhage. Methods/design The Fibrinogen Early In Severe Trauma studY (FEISTY) is an exploratory, multicentre, randomised controlled trial comparing FC to Cryo for fibrinogen supplementation in traumatic haemorrhage. This trial will utilise thromboelastometry (ROTEM®) to guide and dose fibrinogen supplementation. The trial will recruit 100 trauma patients at four major trauma centres in Australia. Adult trauma patients with evidence of haemorrhage will be enrolled on arrival in the trauma unit and randomised to receiving fibrinogen supplementation with either FC or Cryo. The primary outcome is the differential time to fibrinogen supplementation. There are a number of predetermined secondary outcomes including: effects of the intervention on plasma fibrinogen levels, feasibility assessments and clinical outcomes including transfusion requirements and mortality. Discussion The optimal method for replacing fibrinogen in traumatic haemorrhage is fiercely debated. In this trial the feasibility and efficacy of fibrinogen supplementation using FC will be compared to Cryo. The results of this pilot study will facilitate the design of a larger trial with sufficient power to address patient-centred outcomes. Trial registration ClinicalTrials.gov, ID: NCT02745041 . Registered 4 May 2016

Fibrinogen early in severe trauma study (Feisty): Results from an Australian multicentre randomised controlled pilot trial

Background: Haemorrhage is a major cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage, and early replacement using fibrinogen concentrate (FC) or cryoprecipitate (Cryo) is recommended by several international trauma guidelines. Limited evidence supports one product over the other, with widespread geographic and institutional variation in practice. Two previous trials have investigated the feasibility of rapid FC administration in severely injured trauma patients, with conflicting results. Objective: To compare the time to fibrinogen replacement using FC or Cryo in severely injured trauma patients with major haemorrhage and hypofibrinogenaemia. Design, setting, patients and interventions: A multicentre controlled pilot trial in which adult trauma patients with haemorrhage were randomly assigned (1:1) to receive FC or Cryo for fibrinogen replacement, guided by FIBTEM A5 (functional fibrinogen assessment at 5 minutes after clot formation, using rotational thromboelastometry). Main outcome measures: The primary outcome was time to commencement of fibrinogen replacement. Secondary outcomes included effects of the intervention on plasma fibrinogen levels and clinical outcomes including transfusion requirements and mortality. Results: Of the 100 randomly assigned patients, 62 were hypofibrinogenaemic and received the intervention (n = 37) or Cryo (n = 25). Median (interquartile range [IQR]) time to delivery of FC was 29 min (23-40 min) compared with 60 min (4080 min) for Cryo (P = 0.0001). All 62 patients were hypofibrinogenaemic before receiving FC or Cryo (FC: median FIBTEM A5, 8 mm [ IQR, 7-9 mm]; Cryo: median FIBTEM A5, 9 mm [IQR, 5-10 mm]). In the FC arm patients received a median of 3 g FC (IQR, 2-4 g), and in the Cryo arm patients received a median of 8 units of Cryo (IQR, 8-14 units). Restoration of fibrinogen levels was achieved in both arms after the intervention. Blood product transfusion, fluid resuscitation and thromboembolic complications were similar in both arms. Overall mortality was 15.3%, with more deaths in the FC arm. Conclusion: Fibrinogen replacement in severely injured trauma patients with major haemorrhage and hypofibrinogenaemia was achieved substantially faster using FC compared with Cryo. Fibrinogen levels increased appropriately using either product. The optimal method for replacing fibrinogen in traumatic haemorrhage is controversial. Our results will inform the design of a larger trial powered to assess patient-centred outcomes

Additional file 1: of Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial

FEISTY SPIRIT Checklist (DOC 66 kb)