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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...
January 1, 2017: Vascular
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...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
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
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...
January 31, 2017: Burns: Journal of the International Society for Burn Injuries
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
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
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
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
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
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
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
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
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
Andrew O Maree, Ronan J Margey, Faith Selzer, Amrit Bajrangee, Hani Jneid, Oscar C Marroquin, Suresh R Mulukutla, Warren K Laskey, Alice K Jacobs
AIMS: To establish the relationship between renal insufficiency, bleeding and prescription of cardiovascular medication. METHODS AND RESULTS: This was a prospective, multi-center, cohort study of consecutive patients undergoing PCI during three NHLBI Dynamic Registry recruitment waves. Major and minor bleeding, access site bleeding and rates of prescription of cardiovascular medication at discharge were determined based on estimated glomerular filtration rate (eGFR)...
July 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Isabel Baldizon, Andres Espinoza, Thomas Kuntze, Evaldas Girdauskas
Some patients who underwent previous mitral valve surgery experience bioprosthetic valve degeneration or recurrent mitral valve regurgitation, and the transcatheter valve-in-valve or valve-in-ring procedure is a promising therapeutic option. Early thrombotic complications have been recently reported in 0.6-0.8% of TAVI prostheses implanted in aortic position. To the best of our knowledge, this article reports on the first case of thrombotic transcatheter mitral valve dysfunction which occurred on oral anticoagulation with Coumadin in combination with antiplatelet therapy...
April 2016: Interactive Cardiovascular and Thoracic Surgery
Vidal Essebag, Atul Verma, Jeff S Healey, Andrew D Krahn, Eli Kalfon, Benoit Coutu, Felix Ayala-Paredes, Anthony S Tang, John Sapp, Marcio Sturmer, Arieh Keren, George A Wells, David H Birnie
BACKGROUND: The BRUISE CONTROL trial (Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial) demonstrated that a strategy of continued warfarin during cardiac implantable electronic device surgery was safe and reduced the incidence of clinically significant pocket hematoma (CSH). CSH was defined as a post-procedure hematoma requiring further surgery and/or resulting in prolongation of hospitalization of at least 24 h, and/or requiring interruption of anticoagulation...
March 22, 2016: Journal of the American College of Cardiology
Paul E Marik, Rodrigo Cavallazzi
BACKGROUND: Patients who have had an unprovoked deep venous thrombosis (DVT) or pulmonary embolus (PE) are at a high risk for recurrent venous thromboembolism (VTE). Extended "life-long" anticoagulation has been recommended in these patients. However, the risk benefit ratio of this approach is controversial and the role of the direct oral anticoagulants (DOACs) and aspirin is unclear. Furthermore, in some patients with a "weak provoking factor" there is clinical equipoise regarding continuation or cessation of anticoagulant therapy after treatment of the acute VTE event...
2015: PloS One
Murat Sunbul, Mustafa Oguz, Zekeriya Dogan, Halil Atas, Mehmet Bozbay, Altug Cincin, Mehmet Agirbasli
Heart failure (HF) is the leading cause of in-hospital morbidity and mortality in the elderly population. Coexistence of HF and atrial fibrillation (AF) increases the risk of thromboembolic events. Oral anticoagulant therapy reduces the risk of thromboembolic events in patients with AF. Novel oral anticoagulants (NOACs) have been introduced as an alternative drug for prevention from thromboembolic events in patients with nonvalvular AF. The primary aim of this study is to investigate the clinical effects of warfarin, dabigatran, and rivaroxaban in patients with nonvalvular AF...
November 12, 2015: Clinical and Applied Thrombosis/hemostasis
Neel Choksi, B Joseph Elmunzer, Ryan W Stidham, Dmitry Shuster, Cyrus Piraka
BACKGROUND: Endoscopic removal of duodenal and colorectal adenomas is currently considered to be the standard of care for prevention of adenocarcinoma. The use of cautery carries a risk of delayed bleeding, post-polypectomy syndrome, and perforation. We examined the safety and feasibility of removing colonic and duodenal polyps ≥ 1 cm using a piecemeal cold snare polypectomy technique. PATIENTS: The study included 15 patients with duodenal polyps ≥ 1 cm and 15 patients with colonic polyps ≥ 1 cm...
October 2015: Endoscopy International Open
Celenne Morfin Zepeda, Kristen H Coffey
PATIENT: 66-year-old ethnic Egyptian man. CHIEF COMPLAINT: Hematuria. HISTORY OF PRESENT ILLNESS: The patient had a history of multiple episodes of gross hematuria for the past 5 years. Because the hematuria usually resolved on its own, he did not seek medical attention during that time. Bladder cancer was suspected. PAST MEDICAL HISTORY: The patient had a history of coronary artery disease, hypertension, nephrolithiasis, congestive heart failure, lifelong smoking, and ischemic cardiomyopathy...
2015: Laboratory Medicine
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