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https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#1
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28740633/papillary-fibroelastoma-arising-from-the-coumadin-ridge
#2
Mahim Malik, Konstantin Shilo, Ahmet Kilic
Cardiac papillary fibroelastomas (CPF) are rare cardiac tumors, mostly found on the valvular surfaces in the heart. These tumors are frond like in nature and are benign, intracardiac masses, rarely causing any hemodynamic disturbances. However, excision of these masses is indicated due to their propensity to embolize. We present a case report of the tumor found on the coumadin ridge, causing transient ischemic attacks in a patient. We performed complete excision of the tumor via median sternotomy on cardiopulmonary bypass support with cardiac arrest...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28646078/stereospecific-metabolism-of-r-and-s-warfarin-by-human-hepatic-cytosolic-reductases
#3
Dustyn A Barnette, Bryce P Johnson, Dakota L Pouncey, Robert Nshimiyimana, Linda P Desrochers, Thomas E Goodwin, Grover P Miller
Coumadin (rac-warfarin) is the most commonly used anticoagulant in the world; however, its clinical use is often challenging because of its narrow therapeutic range and interindividual variations in response. A critical contributor to the uncertainty is variability in warfarin metabolism, which includes mostly oxidative but also reductive pathways. Reduction of each warfarin enantiomer yields two warfarin alcohol isomers, and the corresponding four alcohols retain varying levels of anticoagulant activity. Studies on the kinetics of warfarin reduction have often lacked resolution of parent-drug enantiomers and have suffered from coelution of pairs of alcohol metabolites; thus, those studies have not established the importance of individual stereospecific reductive pathways...
September 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28529095/understanding-operator-stent-choice-in-the-catheterization-laboratory-using-a-pre-procedure-survey-opportunities-for-quality-improvement
#4
Matthew J Chung, Jonathan D Hansen, Ryan D Schulteis, Joel C Boggan, W Schuyler Jones, Thomas J Povsic, Susan Roberts, Mitchell W Krucoff, Sunil V Rao
OBJECTIVES: We sought to characterize how the perceived risk of early dual antiplatelet therapy (DAPT) discontinuation is incorporated into operator decision-making regarding stent choice, using a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation. BACKGROUND: Understanding which factors influence operator decision-making regarding stent choice during percutaneous coronary intervention (PCI) could help identify areas for quality improvement...
May 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28495065/the-miniaturized-pediatric-continuous-flow-device-preclinical-assessment-in-the-chronic-sheep-model
#5
Iki Adachi, Sarah Burki, David Horne, Gil G Costas, Taylor Spangler, Robert Jarvik, John Teal, J Timothy Baldwin, Kurt Dasse, M Patricia Massicotte, Jeff Conger, William E Cohn, Charles D Fraser
BACKGROUND: The Infant Jarvik 2015 is an implantable axial-flow ventricular assist device (VAD) that has undergone the major evolutionary design modifications to improve hemocompatibility. This study was conducted in anticipation of data submission to the US Food and Drug Administration to obtain Investigational Device Exemption approval. METHODS: The VAD was implanted via a left thoracotomy in Barbado sheep (n = 10, 26 (19-34] kg). Anticoagulation was maintained with coumadin, with a target international normalized ratio of greater than the individual sheep's baseline values...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28486232/osthole-a-coumadin-analog-from-cnidium-monnieri-l-cusson-ameliorates-nucleus-pulposus-induced-radicular-inflammatory-pain-by-inhibiting-the-activation-of-extracellular-signal-regulated-kinase-in-rats
#6
Hai-Xuan Wu, Yi-Min Wang, Hui Xu, Ming Wei, Qiu-Lan He, Mei-Na Li, Lai-Bao Sun, Ming-Hui Cao
AIM: This study was aimed at assessing the role of extracellular signal regulated kinase (ERK) in mechanical allodynia resulting from lumbar disc herniation (LDH) and exploring the osthole's anti-nociceptive effect on ERK activation. METHODS: Radicular pain was generated by applying nucleus pulposus (NP) to the L5 dorsal root ganglion (DRG). Allodynia was measured using Von Frey filaments to calculate the mechanical pain threshold. Phosphorylated ERK and total ERK protein in the lumbar spinal dorsal horn was detected by using the Western blot technique...
2017: Pharmacology
https://www.readbyqxmd.com/read/28444177/single-centre-experience-with-transapical-transcatheter-mitral-valve-implantation
#7
Gry Dahle, Kjell-Arne Rein, Arnt E Fiane
OBJECTIVES: A transcatheter heart valve technique can be used in failed mitral valve repairs with annuloplasty rings, deterioriated bioprostheses and in mitral annular calcification, all serving as 'docking stations' for balloon-expandable valves. Specially designed transcatheter mitral valve platforms are used in ongoing studies for native mitral valve regurgitation. We present our single centre experience with transcatheter mitral valve implantation-transapical approach procedures in eleven patients...
August 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28409546/clinical-correlation-with-failure-of-endovenous-therapy-for-leg-swelling
#8
Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Yuriy Ostrozhynskyy, Enrico Ascher
Background The development and use of minimally invasive procedures provide improved options for the management of symptoms of chronic venous insufficiency. While many patients with iliac venous occlusive disease and superficial venous insufficiency improve with combined iliac venous stenting and correction of superficial venous reflux, some patients have symptoms which persist. The goal of this study was to identify clinical factors related to persistent symptoms in patients with leg swelling after treatment of both iliac vein stenting and thermal ablation...
June 2017: Vascular
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#9
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28249326/laboratory-assessment-of-direct-oral-anticoagulants
#10
REVIEW
Jonathan Douxfils, Robert C Gosselin
Oral vitamin K anticoagulation (warfarin, Coumadin, coumarin) has long been used for long-term treatment and prophylaxis in a variety of clinical settings. Given the unpredictable pharmacokinetic and food impact of warfarin, episodic monitoring is required. Since the early 2000s, direct oral anticoagulants (DOACs) entered into clinical trials as a potential alternative strategy to oral vitamin K antagonists for long-term anticoagulation. As these drugs have predictable pharmacokinetics and pharmacodynamics, there was no requirement for episodic or routine monitoring...
April 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28159151/the-use-of-intravenous-tpa-for-the-treatment-of-severe-frostbite
#11
Larry M Jones, Rebecca A Coffey, Mona P Natwa, J Kevin Bailey
OBJECTIVE: tPA and anticoagulation for treatment of severe frostbite have been reported suggesting differences in imaging techniques, route of tPA administration and management of patients after tPA infusion. This is a report of our results following a protocol of Tc-99m scanning, intravenous tPA administration, followed by either systemic anticoagulation or antiplatelet therapy. METHODS: Patients admitted to our burn center between February 13, 2015 and February 13, 2016 for frostbite who met inclusion criteria were treated with Tc-99m scan and intravenous tPA followed by systemic anticoagulation or antiplatelet therapy...
August 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28031668/bilateral-superficial-femoral-artery-thrombosis-in-a-15-year-old-caucasian-male-with-homozygous-prothrombin-g20210a-genotype-and-associated-antiphospholipid-syndrome
#12
Uzung Yoon, LaiLai Kwok, Ingo Flessenkaemper
Prothrombin mutation was usually associated with other well-established predisposing factors for venous thrombosis such as antiphospholipid antibodies. Recently, even isolated prothrombin gene mutation G20210A has been reported to present severe or unusual vein thrombosis. Less clear is the role of prothrombin mutation in the formation of arterial thrombosis. We present a case of a 15-year-old healthy White male with acute bilateral femoral artery thrombosis. The patient presented with increasing left leg pain for about 1 week...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27873765/extensive-biatrial-thrombus-straddling-the-patent-foramen-ovale-and-traversing-into-the-left-and-right-ventricle
#13
Adil Sattar, Theingi Tiffany Win, Alex Schevchuck, Abinash Achrekar
We report an extremely rare case of an extensive biatrial thrombus straddling a patent foramen ovale (PFO) extending into the bilateral ventricles in a patient presenting with an acute embolic stroke. Our patient further developed a massive saddle pulmonary embolus (PE) with haemodynamic instability during the course of his hospitalisation. The risks of pharmacological thrombolysis or surgical thrombectomy for PE in a haemodynamically unstable patient with recent embolic stroke posed a significant therapeutic dilemma...
November 21, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27640616/-direct-oral-anticoagulants-in-cardiology
#14
REVIEW
Róbert Gábor Kiss
Antithrombotic drug therapy is a main cornerstone - sometimes a fairly uneven cornerstone - of today's clinical practice. Patients treated with antithrombotic drugs appear sometimes unawaited at those of our colleagues, who are not necessarily experts of this narrow field. Furthermore, new and newer molecules of antiplatelet and anticoagulant medicines have come into practice, frequently in combination. This dramatic development has been important to patients; pharmacological - and recently nonpharmacological - antithrombotic treatment has paved the way to improve current modalities in cardiology...
September 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27566206/anti-tumor-effects-of-osthole-on-ovarian-cancer-cells-in-vitro
#15
Guoqiang Jiang, Jia Liu, Baoyin Ren, Yawei Tang, Lawrence Owusu, Man Li, Jing Zhang, Likun Liu, Weiling Li
ETHNOPHARMACOLOGICAL RELEVANCE: Cnidium monnieri (L.) Cusson is a commonly used traditional Chinese medicine to treat gynecological disease in some countries. Osthole, an active O-methylated coumadin isolated from Cnidium monnieri (L.) Cusson, has been shown to induce various beneficial biochemical effects such as anti-seizure and anti-inflammatory effects. However, the anti-tumor mechanism of osthole is not well known. AIM OF STUDY: Here, we show that osthole inhibited the proliferation and migration of two widely used ovarian cancer cell lines, A2780 and OV2008 cells, in a dose-dependent manner...
December 4, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27513388/emergency-department-visits-caused-by-adverse-drug-reactions-results-of-aturkish-university-hospital
#16
Mehmet Can Girgin, Sedat Yanturali, Mualla Aylin Arici, Neşe Çolak Oray, Özgür Doylan, Yücel Demiral, Yeşim Tunçok
BACKGROUND/AIM: We aimed to evaluate adverse drug reaction (ADR)-related emergency department (ED) visits in the ED of the Dokuz Eylül University Hospital prospectively. MATERIALS AND METHODS: Patients who were admitted to the ED during 1-week periods of four different seasons between July 2010 and April 2011 were enrolled. Demographics of patients, previous ADR history, clinical progress, and outcomes were recorded. Causality assessment was done according to World Health Organization Uppsala Monitoring Centre categories...
June 23, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27482386/deep-vein-thrombosis-an-unreported-first-manifestation-of-polyglandular-autoimmune-syndrome-type-iii
#17
M Horsey, P Hogan, T Oliver
UNLABELLED: A 71-year-old woman with severe right lower leg pain, edema and erythema was presented to the Emergency Department and was found to have an extensive deep vein thrombosis (DVT) confirmed by ultrasound. She underwent an extensive evaluation due to her prior history of malignancy and new hypercoagulable state, but no evidence of recurrent disease was detected. Further investigation revealed pernicious anemia (PA), confirmed by the presence of a macrocytic anemia (MCV=115.8fL/red cell, Hgb=9...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27477871/idarucizumab-clinical-role-of-a-novel-reversal-agent-for-dabigatran
#18
REVIEW
Mohamed Teleb, Kevin Salire, Miraie Wardi, Haider Alkhateeb, Sarmad Said, Debabrata Mukherjee
Atrial fibrillation (AF), a common cardiac arrhythmia associated with increased risk of heart failure, thromboembolic phenomena and death, is a leading cause of hospitalization of adults. A major complication of AF is an increased risk of ischemic stroke leading to long-term disability and in severe cases, death. Historically, Coumadin has been the drug of choice for chronic anticoagulation and stroke prevention in AF patients however, given the need for constant monitoring and multiple drug interactions, newer anticoagulants have been developed...
2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/27121899/an-expanded-pharmacogenomics-warfarin-dosing-table-with-utility-in-generalised-dosing-guidance
#19
Payman Shahabi, Laura B Scheinfeldt, Daniel E Lynch, Tara J Schmidlen, Sylvie Perreault, Margaret A Keller, Rachel Kasper, Lisa Wawak, Joseph P Jarvis, Norman P Gerry, Erynn S Gordon, Michael F Christman, Marie-Pierre Dubé, Neda Gharani
Pharmacogenomics (PGx) guided warfarin dosing, using a comprehensive dosing algorithm, is expected to improve dose optimisation and lower the risk of adverse drug reactions. As a complementary tool, a simple genotype-dosing table, such as in the US Food and Drug Administration (FDA) Coumadin drug label, may be utilised for general risk assessment of likely over- or under-anticoagulation on a standard dose of warfarin. This tool may be used as part of the clinical decision support for the interpretation of genetic data, serving as a first step in the anticoagulation therapy decision making process...
August 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27088222/role-of-heparin-during-endovascular-therapy-for-acute-ischemic-stroke
#20
Naureen Farook, Diogo Haussen, Samir Sur, Brian Snelling, Zachary Gersey, Dileep Yavagal, Eric Peterson
OBJECTIVES: Systemic heparinization has become the mainstay anticoagulant in neurointerventional procedures to prevent thromboembolic complications. Its benefit during endovascular therapy for acute stroke however has not been established. The purpose of this study is to retrospectively evaluate the impact of heparin during endovascular therapy for acute ischemic stroke (AIS). PATIENTS AND METHODS: We performed a retrospective review of our interventional stroke database from February 2009 to September 2012 for patients with anterior circulation AIS with ICA-T or MCA M1 occlusions...
June 2016: Clinical Neurology and Neurosurgery
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