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https://www.readbyqxmd.com/read/29321947/portal-vein-thrombosis-due-to-an-increase-in-dose-of-testosterone-in-a-young-man-with-klinefelter-syndrome
#1
Waseem Amjad, Salma Khatoon, Twara Tarasaria, Gulru Sharifova
Klinefelter syndrome (KS) is associated with increased incidence of thrombotic events. Hypofibrinolysis is associated with increased risk of thromboembolism. Although testosterone replacement therapy (TRT) inhibits the hypofibrinolysis, it can still cause thrombosis paradoxically due to increased dose and duration of use. Herein, we present a case of a young male diagnosed with KS who was taking testosterone. The dose was increased to boost the energy levels, and the patient presented with abdominal pain. Computed tomography (CT) of the abdomen showed extensive portal vein thrombosis...
November 6, 2017: Curēus
https://www.readbyqxmd.com/read/29319779/recovery-of-renal-function-after-bilateral-renal-vein-thrombo-sis-episode-as-complication-of-membranous-glomerulopa-thy-case-report
#2
Ana Larissa Pedrosa Ximenes, Elizabeth De Francesco Daher, Pedro Duarte Barreto Castillo, Francisco Eduardo Siqueira da Rocha, Camila Freire Salem de Miranda, Flavio Bezerra de Araujo
Renal vein thrombosis (RVT) is a complication often associated with nephrotic syndrome. It occurs due to a state of hypercoagulability common in the diseases that attend to this syndromic diagnosis. It should be suspected whenever there is nephrotic syndrome associated with sudden flank pain, hematuria and worsening of proteinuria. Bilateral RVT also presents with frequently oliguric renal dysfunction. This case reports a 33-year-old patient hospitalized for a nephrotic syndrome, with etiologic investigation suggestive of primary membranous glomerulopathy, which evolved with bilateral RVT associated with deterioration of renal function and need for renal replacement therapy...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#3
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302462/valve-sparing-aortic-root-replacement-midterm-outcomes-and-quality-of-life
#4
Abdel-Kémal Bori Bata, Nicolas D'Ostrevy, Bruno Pereira, Etienne Geoffroy, Nicolas Dauphin, Vedat Eljezi, Kasra Azarnoush, Lucie Ulman, Lionel Camilleri
Background: This study evaluated the midterm outcomes, the valve related events and quality of life of patients treated by valve-sparing aortic root replacement (VSRR). Methods: From January 2003 to December 2014, 88 consecutive patients diagnosed with an aortic root aneurysm or ascending aortic aneurysms underwent VSRR surgery. The mean age was 55±14 (range 19-77) years. A total of 84% of the patients were male; 89% were in New York Heart Association functional class I or II, 55% had aortic regurgitation (AR) grade III or IV...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#5
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29284171/post-tavi-follow-up-with-mdct-of-the-valve-prosthesis-technical-application-regular-findings-and-typical-local-post-interventional-complications
#6
Martin Soschynski, Fabio Capilli, Philipp Ruile, Franz-Josef Neumann, Mathias Langer, Tobias Krauss
BACKGROUND:  Transcatheter aortic valve implantation (TAVI) has evolved into an alternative procedure to surgical valve replacement for high-risk patients with aortic valve stenosis. Despite technical innovations, there is still a risk of complications during and after the intervention. After a TAVI procedure, ECG-gated multidetector computed tomography (MDCT) plays an important role in the early diagnosis of local complications. In this article, we explain for the first time how the technical acquisition of MDCT in the region of the aortic root is performed as post-interventional control of the TAVI prosthesis...
December 28, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29283053/structural-and-design-evolution-of-bio-resorbable-scaffolds-the-journey-so-far
#7
Sundeep Mishra
BACKGROUND: Coronary stenting has now become a gold standard to prevent or counteract narrowing and blocking of vessels due to disease or injury. While the use of stents has been successful, they are not without drawbacks and concerns. Restenosis and stent thrombosis after an interventional procedure are the dreaded side effects resulting from the body's natural response to a foreign object in the vasculature. New developments in drug-eluting stents, such as biodegradable materials could mitigate some of the problems like stent thrombosis at least late stent thrombosis...
December 27, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29281606/expanding-indications-for-tavr-the-preferred-procedure-in-intermediate-risk-patients
#8
REVIEW
David L Brown
Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29281095/proximal-and-distal-occlusion-of-complex-cerebral-aneurysms-implications-of-flow-modeling-by-fluid-structure-interaction-analysis
#9
Jasper H G Helthuis, Sindhoor Bhat, Tristan P C van Doormaal, Ramarathnam Krishna Kumar, Albert van der Zwan
BACKGROUND: In complex cerebral aneurysms, adequate treatment by complete occlusion is not always possible. Partial occlusion by either proximal or distal occlusion is an alternative. However, the hemodynamic consequences of these partial occlusion options are often not easily predictable. OBJECTIVE: To assess the feasibility of fluid-structure interaction (FSI) analysis to investigate the hemodynamic changes after partial occlusion in cerebral aneurysms. METHODS: Two patients were analyzed...
December 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29276174/routine-use-of-anticoagulation-after-transcatheter-aortic-valve-replacement-initial-safety-outcomes-from-a-single-center-experience
#10
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Demetris Yannopoulos, Santiago Garcia
BACKGROUND: Subclinical leaflet thrombosis (SCLT) can be seen in up to 12% of patients after transcatheter aortic valve replacement (TAVR). Anticoagulation appears to prevent and reverse SCLT but concerns exist about bleeding risk. METHODS: Our program adopted a strategy of routine anticoagulation after TAVR, starting warfarin on post-procedure day 0 and continuing for 3months in 10/2015. We report the initial safety and efficacy outcomes of this approach. Bleeding events were assessed using Valve Academic Research Consortium (VARC) and Bleeding Academic Research Consortium (BARC) definitions...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29273289/inpatient-consults-and-complications-during-primary-total-joint-arthroplasty-in-a-bundled-care-model
#11
Billy T Baumgartner, Vasili Karas, Beau J Kildow, Daniel J Cunningham, Mitchell R Klement, Cindy L Green, David E Attarian, Thorsten M Seyler
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) are implementing changes in hospital reimbursement models for total joint arthroplasty (TJA), moving to value-based bundled payments from the fee-for-service model. The purpose of this study is to identify consults and complications during the perioperative period that increase financial burden. METHODS: We combined CMS payment data for inpatient, professional, and postoperative with retrospective review of patients undergoing primary TJA and developed profiles of patients included in the Comprehensive Care for Joint Replacement bundle undergoing TJA...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29251812/the-physical-spacing-between-the-von-willebrand-factor-d-d3-and-a1-domains-regulates-platelet-adhesion-in-vitro-and-in-vivo
#12
Changjie Zhang, Anju Kelkar, Mehrab Nasirikenari, Joseph T Y Lau, Michele Sveinsson, Umesh C Sharma, Saraswati Pokharel, Sriram Neelamegham
BACKGROUND: Previous ex vivo studies using truncated VWF (Von Willebrand Factor) suggest that domain-level molecular architecture may control platelet-GpIbα binding function. OBJECTIVE: We determined if this is the case with multimeric VWF in vivo. METHODS: Full-length human VWF ('hV') was modified with a 22-amino acid mucinous stretch at either the N-terminus of VWF-A1 to create 'hNV' or C-terminus to yield 'hCV'. This extends the physical distance between VWF-A1 and the adjacent domains by ~6nm...
December 18, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29235436/bioprosthetic-aortic-valve-leaflet-thrombosis-detected-by-multidetector-computed-tomography-is-associated-with-adverse-cerebrovascular-events-a-meta-analysis-of-observational-studies
#13
Hashrul N Rashid, Robert P Gooley, Nitesh Nerlekar, Abdul R Ihdayhid, Liam M McCormick, Arthur Nasis, James D Cameron, Adam J Brown
AIMS: Leaflet thrombosis (LT) has become increasingly recognised following transcatheter and surgical aortic ABV replacement and can be reliably identified by MDCT. However, it is ongoing debate whether MDCT-defined LT is associated with adverse cerebrovascular outcomes. We performed a systematic review and meta-analysis to assess the incidence and clinical outcomes associated with multidetector computed tomography (MDCT)-defined leaflet thrombosis following aortic bioprosthetic valve (ABV) replacement...
December 12, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29233189/head-to-head-comparison-of-prasugrel-versus-ticagrelor-in-patients-with-acute-coronary-syndrome-a-systematic-review-and-meta-analysis-of-randomized-trials
#14
Pravesh Kumar Bundhun, Jia-Xin Shi, Feng Huang
BACKGROUND: Prasugrel and Ticagrelor are emerging antiplatelet drugs that might have the potential to replace currently used antiplatelet agents. Previous analyses comparing prasugrel with ticagrelor mainly focused on an indirect comparison whereas direct comparison was reported only in a few recently published trials. We aimed to systematically carry out a head to head comparison of the adverse clinical outcomes which were associated with prasugrel versus ticagrelor in patients with acute coronary syndrome (ACS)...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29217087/evolution-of-simplified-frozen-elephant-trunk-repair-for-acute-debakey-type-i-dissection-midterm-outcomes
#15
Eric E Roselli, Jay J Idrees, Faisal G Bakaeen, Michael Z Tong, Edward G Soltesz, Stephanie Mick, Douglas R Johnston, Mathew J Eagleton, Venu Menon, Lars G Svensson
BACKGROUND: A modified technique for frozen elephant trunk (FET) repair of acute DeBakey type I dissection has evolved. Procedural modifications are described and midterm outcomes evaluated. METHODS: From 2009 to 2016, 72 patients with DeBakey type I dissection underwent emergency simplified FET. Mean age was 59 ± 15 years. Presentation included malperfusion (n = 22, 31%), rupture (n = 12, 16%), and aortic insufficiency (n = 42, 58%). Concomitant procedures included valve replacement (n = 9), root replacement (n = 11; valve sparing n = 6), cusp repair (n = 11), and valve resuspension (n = 21)...
December 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29216720/testosterone-replacement-therapy-trt-and-its-effect-on-bone-marrow-how-serious-is-it-and-is-there-a-true-polyglobulia
#16
M Levcikova, J Breza, J Luha, J Dubravicky, E Kovacova, J Fillo
INTRODUCTION: TRT in men with testosterone deficiency syndrome (TDS) had multiple positive effects and restore a quality of life of affected men. Polyglobulia is the most common dose-limiting adverse effect of TRT, but the mechanisms of TRT-mediated erythropoesis remain unclear. In this study, we evaluated long term haematological side effects of TRT: polyglobulia, elevated hemoglobin (Hb) and haematocrit (Ht). METHODS: In a cross-sectional descriptive study, the authors treated 69 men with TDS and the average age 59 years and the follow-up period 81...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29216531/living-donor-liver-transplantation-for-adult-budd-chiari-syndrome-resection-without-replacement-of-retrohepatic-ivc-a-case-report
#17
Tarek Abdelazeem Sabra, Hideaki Okajima, Tetsuya Tajima, Ken Fukumitsu, Koichiro Hata, Kentaro Yasuchika, Toshihiko Masui, Kojiro Taura, Toshimi Kaido, Shinji Uemoto
INTRODUCTION: Suprahepatic caval resection and replacement of inferior vena cava (IVC) is standard procedure in deceased donor liver transplantation for patients with Budd-Chiari syndrome (BCS). However, replacement of IVC in living donor liver transplantation (LDLT) is difficult. We report a case of BCS successfully treated by LDLT without replacement of IVC. PRESENTATION OF CASE: A 52-years-old female with a primary BCS due to IVC thrombosis. A vena cava (VC) stent placed after angioplasty without improvement of the hepatic, portal venous flow and liver functions, Transjugular intrahepatic portosystemic shunt was considered and the patient had a rapid deterioration and increased ascites...
December 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29211941/impact-of-aberrant-left-hepatic-artery-ligation-on-the-outcome-of-liver-transplantation
#18
Roberto Montalti, Andrea Benedetti Cacciaguerra, Daniele Nicolini, Emad Alì Ahmed, Martina Coletta, Lesley De Pietri, Andrea Risaliti, Roberto Ivan Troisi, Federico Mocchegiani, Marco Vivarelli
BACKGROUND: The preservation of a graft's aberrant left hepatic artery (LHA) during liver transplantation (LT) ensures optimal vascularization of the left liver but can also be considered a risk factor for hepatic artery thrombosis. In contrast, ligation of an aberrant LHA may lead to hepatic ischaemia with the potential risk of graft dysfunction and biliary complications. The aim of this study was to prospectively analyse the impact on the surgical strategy for LT of 5 tests performed to establish whether an aberrant LHA was an accessory or a replaced artery, thus leading to the design of a decisional algorithm...
December 6, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29206177/new-therapeutic-agent-against-arterial-thrombosis-an-iridium-iii-derived-organometallic-compound
#19
Chih-Wei Hsia, Marappan Velusamy, Jeng-Ting Tsao, Chih-Hsuan Hsia, Duen-Suey Chou, Thanasekaran Jayakumar, Lin-Wen Lee, Jiun-Yi Li, Joen-Rong Sheu
Platelet activation plays a major role in cardio and cerebrovascular diseases, and cancer progression. Disruption of platelet activation represents an attractive therapeutic target for reducing the bidirectional cross talk between platelets and tumor cells. Platinum (Pt) compounds have been used for treating cancer. Hence, replacing Pt with iridium (Ir) is considered a potential alternative. We recently developed an Ir(III)-derived complex, [Ir(Cp*)1-(2-pyridyl)-3-(2-hydroxyphenyl)imidazo[1,5-a]pyridine Cl]BF₄ (Ir-11), which exhibited strong antiplatelet activity; hence, we assessed the therapeutic potential of Ir-11 against arterial thrombosis...
December 5, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29198572/acute-myocardial-infarction-as-the-initial-manifestation-of-delayed-bioprosthesis-thrombosis-after-transcatheter-aortic-valve-replacement
#20
Yi-Jian Li, Yan-Biao Liao, Xin Wei, Yuan Feng, Mao Chen
Bioprosthesis thrombosis after transcatheter aortic valve replacement (TAVR) raised concerns about further clinical events. We report the case of a patient who suffered acute myocardial infarction (AMI) after TAVR for 3 years. Thrombosis was confirmed in the right coronary sinus of Valsalva by transthoracic echocardiography. Coronary angiography demonstrated the ostium of the right coronary artery was occluded. As an attempt to perform percutaneous coronary intervention (PCI) was unsuccessful, long-term therapeutic anticoagulation with warfarin was undertaken...
November 14, 2017: Heart, Lung & Circulation
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