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https://www.readbyqxmd.com/read/29790125/management-of-major-bleeding-and-outcomes-in-patients-treated-with-direct-oral-anticoagulants-results-from-the-start-event-registry
#1
Sophie Testa, Walter Ageno, Emilia Antonucci, Rossella Morandini, Jan Beyer-Westendorf, Maurizio Paciaroni, Marc Righini, Piera Sivera, Peter Verhamme, Vittorio Pengo, Daniela Poli, Gualtiero Palareti
The management of major bleeding in patients treated with direct oral anticoagulants (DOACs) is still not well established. START-Events, a branch of the START registry (Survey on anTicoagulated pAtients RegisTer) (NCT02219984), aims to describe the actual management of bleeding or recurrent thrombotic events in routine clinical practice. We here present the results of the management of bleeding patients. The START-Event registry is a prospective, observational, multicenter, international study. Baseline characteristics (demographic, clinical, risk factors) of patients, laboratory data at admission and during follow-up, site of bleeding, therapeutic strategies, and outcomes at the time of hospital discharge and after 6 months were recorded on a web-based case report form...
May 22, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29789047/concerns-for-bleeding-in-the-elderly-with-the-use-of-direct-oral-anticoagulants
#2
Michelle Min, Stephanie Sibicky
Since Food and Drug Administration approval of dabigatran in 2010, direct oral anticoagulants (DOACs) have been alternatives to warfarin for patients who are at risk for cardioembolic complications of nonvalvular atrial fibrillation. Unfortunately, there are limited safety data available on the use of these newer agents in older adults, particularly risks of gastrointestinal, intracranial, and major bleeding (as defined by the International Society on Thrombosis and Haemostasis) in those 75 years of age and older...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29788836/intracranial-hemorrhage-in-adults-on-ecmo
#3
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788198/venous-thromboembolism-after-intraventricular-hemorrhage-results-from-the-clear-iii-trial
#4
(no author information available yet)
BACKGROUND: Venous thromboembolism (VTE) after intracerebral hemorrhage is well studied, but data on patients with spontaneous intraventricular hemorrhage (IVH) are limited. OBJECTIVE: To study the factors associated with VTE, association between VTE and clinical outcomes in IVH, and safety of VTE chemoprophylaxis in IVH treated with intraventricular catheters and thrombolysis. METHODS: Retrospective cohort study of patients enrolled in the CLEAR III trial, a multicenter, randomized trial comparing external ventricular drainage, with administration of intraventricular alteplase vs placebo, for obstructive IVH...
May 21, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#5
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29780232/cerebral-arteriovenous-malformations-in-the-era-of-embolization-for-angiographic-cure-a-single-center-experience-in-egypt
#6
Mohamed K Elewa
Background: Embolization for cerebral arteriovenous malformations (AVMs) has evolved in the last decade with evolution in both equipment and material. Embolization targets have expanded to include angiographic cure. Methods: To discuss the technical and management outcomes of our first cerebral AVM case series treated with embolization. The clinical, angiographic, treatment, and outcome variables of consecutive cerebral arteriovenous malformation cases, treated with curative embolization, between January 2011 and June 2017 in one regional center, were retrospectively analyzed...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#7
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#8
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29776576/safety-of-apixaban-in-combination-with-dronedarone-in-patients-with-atrial-fibrillation
#9
Leif Friberg
BACKGROUND: There have been concerns about bleeding risks for patients with atrial fibrillation treated with dronedarone in combination with new oral anticoagulants (NOACs). The aim of the study was to compare the bleeding risks with the apixaban + dronedarone and warfarin + dronedarone combinations. METHOD: Retrospective study of Swedish nationwide health registers. All patients with atrial fibrillation who used dronedarone in combination with apixaban or warfarin during 2013-2016 were identified...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29774193/predictable-values-of-decompressive-craniectomy-in-patients-with-acute-subdural-hematoma-comparison-between-decompressive-craniectomy-after-craniotomy-group-and-craniotomy-only-group
#10
Hyunjun Kim, Sang-Jun Suh, Ho-Jun Kang, Min-Seok Lee, Yoon-Soo Lee, Jeong-Ho Lee, Dong-Gee Kang
Objective: Patients with traumatic acute subdural hematoma (ASDH) often require surgical treatment. Among patients who primarily underwent craniotomy for the removal of hematoma, some consequently developed aggressive intracranial hypertension and brain edema, and required secondary decompressive craniectomy (DC). To avoid reoperation, we investigated factors which predict the requirement of DC by comparing groups of ASDH patients who did and did not require DC after craniotomy. Methods: The 129 patients with ASDH who underwent craniotomy from September 2007 to September 2017 were reviewed...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29772326/thrombolysis-in-acute-lower-limb-ischemia-review-of-the-current-literature
#11
REVIEW
Panagiotis G Theodoridis, Constantinos H Davos, Ilias Dodos, Nikolaos Iatrou, Anastasios Potouridis, Georgios M Pappas, Dimitrios Staramos, Paul Antoniadis, Vasilios Argitis, Konstantinos Dervisis
INTRODUCTION: Catheter directed thrombolysis (CDT) is a therapeutic option with acceptable results in patients with acute limb ischaemia (ALI) but with severe systemic or intracranial bleeding being the most significant clinical complication. The aim of the study is to collect and present direct results of CDT in patients treated for ALI. MATERIALS AND METHODS: Reports on CDT treatment in ALI until December 2016 searched in PubMed using the key words catheter direct thrombolysis, acute lower limb ischemia and any combination of these...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770250/the-usefulness-of-indocyanine-green-during-surgery-for-hypervascular-posterior-fossa-tumors
#12
Takahiro Shinya, Hideki Nagamine, Ken-Ichi Sugawara, Shogo Ishiuchi
Background: Cerebral hemangioblastomas are benign tumors with abundant blood flow that occur mainly in the posterior fossa. Tumor removal en bloc is important in surgical treatment because of the risk of bleeding; however, it is actually rather difficult in practice. Therefore, we propose a surgical strategy for visualizing hypervascular tumors of the posterior fossa utilizing indocyanine green (ICG). Case Description: Case 1 involved a 48-year-old male with a history of von Hippel-Lindau (VHL) disease...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29769590/low-factor-xiii-levels-after-intravenous-thrombolysis-predict-short-term-mortality-in-ischemic-stroke-patients
#13
Edina Gabriella Székely, Katalin Réka Czuriga-Kovács, Zsuzsanna Bereczky, Éva Katona, Zoltán András Mezei, Attila Nagy, Noémi Klára Tóth, Ervin Berényi, László Muszbek, László Csiba, Zsuzsa Bagoly
In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29766771/five-year-risk-of-stroke-after-tia-or-minor-ischemic-stroke
#14
Pierre Amarenco, Philippa C Lavallée, Linsay Monteiro Tavares, Julien Labreuche, Gregory W Albers, Halim Abboud, Sabrina Anticoli, Heinrich Audebert, Natan M Bornstein, Louis R Caplan, Manuel Correia, Geoffrey A Donnan, José M Ferro, Fernando Gongora-Rivera, Wolfgang Heide, Michael G Hennerici, Peter J Kelly, Michal Král, Hsiu-Fen Lin, Carlos Molina, Jong Moo Park, Francisco Purroy, Peter M Rothwell, Tomas Segura, David Školoudík, P Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Éric Vicaut, Yongjun Wang, Lawrence K S Wong
Background After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke and other vascular events is not well known. In this follow-up to a report on 1-year outcomes from a registry of TIA clinics in 21 countries that enrolled 4789 patients with a TIA or minor ischemic stroke from 2009 through 2011, we examined the 5-year risk of stroke and vascular events. Methods We evaluated patients who had had a TIA or minor stroke within 7 days before enrollment in the registry. Among 61 sites that participated in the 1-year outcome study, we selected 42 sites that had follow-up data on more than 50% of their enrolled patients at 5 years...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29760293/-safety-of-dual-antiplatelet-therapy-with-argatroban-in-patients-with-acute-ischemic-stroke
#15
Yoshinari Nagakane, Eijirou Tanaka, Shinji Ashida, Yuta Kojima, Shiori Ogura, Keiko Maezono, Yasumasa Yamamoto
To prevent early neurological worsening or recurrence in stroke patients with intracranial arterial stenosis or branch atheromatous disease, aggressive antithrombotic therapy, such as dual antiplatelet therapy (DAPT) with or without anticoagulant therapy, is warranted. Such an aggressive antithrombotic therapy, however, may increase the bleeding risk. We studied the risks of DAPT with the anticoagulant argatroban in patients with acute ischemic stroke or transient ischemic attack (TIA). Between October 2011 and September 2015, 341 patients with stroke or TIA, who received DAPT with argatroban within 48 hours after onset, were retrospectively studied...
May 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29759666/patients-with-atrial-fibrillation-who-are-not-on-anticoagulant-treatment-due-to-increased-bleeding-risk-are-common-and-have-a-high-risk-of-stroke
#16
Björn Redfors, William A Gray, Randall J Lee, Kenneth A Ellenbogen, Machaon Bonafede, Ori Ben-Yehuda
OBJECTIVES: This study sought to determine how many patients with atrial fibrillation (AF) are not treated with oral anticoagulants (OAC) due to a high risk of bleeding and to characterize their risk of ischemic stroke in a real-world setting. BACKGROUND: AF is associated with a 5-fold increased risk of ischemic stroke. OAC reduce the risk of stroke in patients with AF who do not have an increased bleeding risk, but no comparably effective treatment exists for patients with contraindications to OAC...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754808/long-term-event-reduction-after-left-atrial-appendage-closure-results-of-the-iberian-registry-ii
#17
José R López-Mínguez, Juan M Nogales-Asensio, Eduardo Infante De Oliveira, Vasco De Gama Ribeiro, Rafael Ruiz-Salmerón, Dabit Arzamendi-Aizpurua, Marco Costa, Hipólito Gutiérrez-García, José Antonio Fernández-Díaz, Victoria Martín-Yuste, Juan Carlos Rama-Merchán, Raúl Moreno-Gómez, Amparo Benedicto-Buendía, Andrés Íñiguez-Romo
INTRODUCTION AND OBJECTIVES: Many patients with nonvalvular atrial fibrillation are still left without protection due to a contraindication for anticoagulants. This study aimed to establish the occurrence of stroke and major bleeding events in patients with nonvalvular atrial fibrillation and left atrial appendage closure with long-term follow-up and to explore the factors associated with higher long-term mortality. METHODS: Analysis of a multicenter single cohort prospectively recruited from 2009 to 2015...
May 10, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29752323/effectiveness-and-safety-of-rivaroxaban-in-patients-with-cancer-associated-venous-thrombosis
#18
Christine G Kohn, Gary H Lyman, Jan Beyer-Westendorf, Alex C Spyropoulos, Thomas J Bunz, William L Baker, Daniel Eriksson, Anna-Katharina Meinecke, Craig I Coleman
Background: Although not designated as guideline-recommended first-line anticoagulation therapy, patients are receiving rivaroxaban for the treatment and secondary prevention of cancer-associated venous thrombosis (CAT). We sought to estimate the cumulative incidence of recurrent venous thromboembolism (VTE), major bleeding, and mortality/hospice care in patients with CAT treated with outpatient rivaroxaban in routine practice. Methods: Using US MarketScan claims data from January 2012 through June 2015, we identified adults with active cancer (using SEER program coding) who had ≥1 primary hospitalization or emergency department discharge diagnosis code for VTE (index event) and received rivaroxaban as their first outpatient anticoagulant within 30 days of the index VTE...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29748354/increasing-use-of-anticoagulants-in-germany-and-its-impact-on-hospitalization-for-intracranial-bleeding
#19
Jan-Erik Gülker, Knut Kröger, Bernd Kowall, Markus Dingelstadt, Andreas Stang
No abstract text is available yet for this article.
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29747650/hospital-financing-of-ischaemic-stroke-determinants-of-funding-and-usefulness-of-drg-subcategories-based-on-severity-of-illness
#20
Sarah Dewilde, Lieven Annemans, Hilde Pincé, Vincent Thijs
BACKGROUND: Several Western and Arab countries, as well as over 30 States in the US are using the "All-Patient Refined Diagnosis-Related Groups" (APR-DRGs) with four severity-of-illness (SOI) subcategories as a model for hospital funding. The aim of this study is to verify whether this is an adequate model for funding stroke hospital admissions, and to explore which risk factors and complications may influence the amount of funding. METHODS: A bottom-up analysis of 2496 ischaemic stroke admissions in Belgium compares detailed in-hospital resource use (including length of stay, imaging, lab tests, visits and drugs) per SOI category and calculates total hospitalisation costs...
May 11, 2018: BMC Health Services Research
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