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https://www.readbyqxmd.com/read/28102879/the-conservative-and-pharmacological-management-of-chronic-subdural-haematoma
#1
Jehuda Soleman, Fabio Noccera, Luigi Mariani
Chronic subdural haematoma (cSDH), one of the most common neurosurgical entities, occurs typically in elderly patients. The incidence is expected to double by the year 2030, owing to the continuous aging of the population. Surgery is usually the treatment of choice, but conservative treatment may be a good alternative in some situations. We provide a systematic review of studies analysing the conservative treatment options and the natural history of cSDH. Of 231 articles screened, 35 were included in this systematic review...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28102773/the-optimal-duration-of-anticoagulant-therapy-after-unprovoked-venous-thromboembolism-still-a-challenging-issue
#2
Giovanna Elmi, Giuseppe Di Pasquale, Raffaele Pesavento
As about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102615/comparative-effectiveness-of-venous-thromboembolism-prophylaxis-options-for-the-patient-undergoing-total-hip-and-knee-replacement-a-network-meta-analysis
#3
A Kapoor, A Ellis, N Shaffer, J Gurwitz, A Chandramohan, J Saulino, A Ishak, T Okubanjo, F Michota, E Hylek, T A Trikalinos
: Essentials Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options. We provide profiles of venous thromboembolism and hemorrhage risk for 12 options. Direct oral Xa inhibitors had a favorable profile compared with low-molecular-weight heparin. Other options did not have favorable profiles compared with low-molecular-weight heparin. SUMMARY: Background There are numerous trials and several meta-analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR)...
November 7, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28101117/maternal-mortality-ratio-and-causes-of-death-in-iri-between-2009-and-2012
#4
Marzieh Vahiddastjerdy, Nasrin Changizi, Abas Habibollahi, Leila Janani, Zahra Farahani, Farah Babaee
Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran. Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9) during pregnancy, labor, and 42 days after parturition...
September 2016: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/28100960/a-survey-of-thrombosis-experts-evaluating-practices-and-opinions-regarding-venous-thromboprophylaxis-in-patients-post-major-abdominal-surgery
#5
Bader Al Rawahi, Grégoire Le Gal, Rebecca Auer, Marc Carrier
BACKGROUND: Patients undergoing major abdominal surgery are at high risk for developing venous thromboembolism in the post-operative period. Current evidence-based guidelines recommend routine pharmacological venous thromboembolism prophylaxis in patient at moderate to high risk post major abdominal surgery. However, the type of agent, dose and duration of thromboprophylaxis remain unclear. We sought to survey current clinical practice and assess for potential clinical equipoise regarding pharmacological thromboprophylaxis post major abdominal surgery...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#6
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28100430/three-decades-later-the-fate-of-the-population-of-patients-who-underwent-the-atriopulmonary-fontan-procedure
#7
Chin Leng Poh, Diana Zannino, Robert G Weintraub, David S Winlaw, Leeanne E Grigg, Rachael Cordina, Tim Hornung, Andrew Bullock, Robert N Justo, Thomas L Gentles, Charlotte Verrall, Karin du Plessis, David S Celermajer, Yves d'Udekem
OBJECTIVE: To review our experience of patients with an atrio-pulmonary Fontan circulation to determine their long-term outcomes. METHODS AND RESULTS: A retrospective analysis of long-term follow-up data using the Australia and New Zealand Fontan Registry was performed. There were 215 patients surviving hospital discharge after an atrio-pulmonary Fontan completion. A total of 163 patients were alive at latest follow-up, with 52 deaths. Twelve patients had required heart transplantation and 95 had Fontan failure (death, transplantation, Fontan takedown, Fontan conversion, severe systemic ventricular dysfunction or NYHA≥3)...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28100360/-end-tidal-pco-2-for-evaluation-of-severity-of-disease-in-idiopathic-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#8
X Shi, G L Yang, Y Chen, J Guo, W L Yang, P Yuan, S G Gong, R Jiang, Q H Zhao, L Wang, J He, T X Chen, J M Liu
Objective: To explore the difference in end tidal PCO(2) (P(ET)CO(2)) between idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and to analyze the correlation between P(ET)CO(2) and the indexes of disease severity in IPAH and CTEPH patients. Methods: Data were retrieved from 68 IPAH patients and 52 CTEPH patients who all had received right-heart catheterization, pulmonary function test and cardiopulmonary exercise testing at Shanghai Pulmonary Hospital from October 2011 to October 2014...
January 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#9
Arun Sharma, Sharmila Duraisamy, Priya Jagia, Gurpreet S Gulati
Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099311/aspirin-the-unsung-champion-of-deep-venous-thrombosis-chemoprophylaxis-a-historical-perspective-commentary-on-an-article-by-javad-parvizi-md-frcs-et-al-low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following
#10
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#11
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28098122/a-case-of-abdominal-aortic-thrombosis-associated-with-the-nephrotic-syndrome
#12
Jannet Labidi, Yosra Selmi, Yosra Ben Ariba, Zied Elloumi, Saleh Othmani
Thromboembolic disease is an important and frequent complication in patients with the nephrotic syndrome (NS), and the consequences are often severe. Usually, the venous system is affected. Arterial thrombosis has rarely been reported and occurs mainly in children. We report the case of a 27-year-old man with a history of NS due to focal and segmental glomerulosclerosis resistant to steroids and cyclosporine, admitted for bilateral pain in the calves. Aortogram revealed a suspended thrombus in the abdominal aorta just below the origin of the renal arteries with embolism into the left tibioperoneal trunk and the right anterior tibial artery...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097811/fc-silent-anti-cd154-domain-antibody-effectively-prevents-non-human-primate-renal-allograft-rejection
#13
Steven C Kim, Walter Wakwe, Laura B Higginbotham, David V Mathews, Cynthia P Breeden, Allison C Stephenson, Joe Jenkins, Elizabeth Strobert, Karen Price, Laura Price, Robert Kuhn, Haiqing Wang, Aaron Yamniuk, Suzanne Suchard, Alton B Farris, Thomas C Pearson, Christian P Larsen, Mandy L Ford, Anish Suri, Steven Nadler, Andrew B Adams
The advent of costimulation blockade provides the prospect for targeted therapy with improved graft survival in transplant patients. Perhaps the most effective costimulation blockade in experimental models is the use of reagents to block the CD40/CD154 pathway. Unfortunately, successful clinical translation of anti-CD154 therapy has not been achieved. In an attempt to develop an agent that is as effective as previous CD154 blocking antibodies but lacks the risk of thromboembolism, we evaluated the efficacy and safety of a novel anti-human CD154 domain antibody (dAb, BMS-986004)...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28097761/shortened-hospital-length-of-stay-and-lower-costs-associated-with-rivaroxaban-in-patients-with-pulmonary-embolism-managed-as-observation-status
#14
Erin R Weeda, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Philip S Wells, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
BACKGROUND: Unlike rivaroxaban, treatment of patients with pulmonary embolism (PE) with warfarin requires parenteral bridging and coagulation monitoring that may prolong length-of-stay (LOS) and increase hospital costs. AIMS: The aim of this study was to compare LOS, hospital costs and readmissions in PE patients managed through observation stays treated with rivaroxaban or parenterally bridged warfarin. METHODS: Premier Hospital claims data from November 2012 to March 2015 were used to identify patients with a primary diagnosis code for PE managed through an observation stay and with ≥1 claim for a PE-related diagnostic test on day 0-2...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28097621/practice-patterns-of-venous-thromboembolism-prophylaxis-in-underweight-critically-ill-patients-with-neurologic-injury
#15
Kevin Betthauser, Hannah Pope, Mollie Gowan, Theresa Human
PURPOSE: Venous thromboembolism (VTE) prophylaxis in underweight patients with neurologic injury remains unaddressed by guidelines and primary literature. This study aimed to describe VTE prophylaxis strategies employed in this population and compare the impact of underweight and non-obese patients on thrombotic and bleeding events. METHODS: A retrospective review of adults admitted with a diagnosis of neurologic injury to a neurology/neurosurgery intensive care unit (ICU) over 6 years...
January 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28097445/pregnancy-outcomes-in-hiv-positive-women-a-retrospective-cohort-study
#16
Kholoud Arab, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim A Abenhaim
PURPOSE: In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. METHODS: A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV...
January 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#17
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096100/efficacy-and-safety-of-apixaban-compared-with-warfarin-in-patients-with-atrial-fibrillation-and-peripheral-artery-disease-insights-from-the-aristotle-trial
#18
Peter T Hu, Renato D Lopes, Susanna R Stevens, Lars Wallentin, Laine Thomas, John H Alexander, Michael Hanna, Basil S Lewis, Freek W A Verheugt, Christopher B Granger, W Schuyler Jones
BACKGROUND: We studied (1) the rates of stroke or systemic embolism and bleeding in patients with atrial fibrillation and peripheral artery disease (PAD) and (2) the efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation with and without PAD. METHODS AND RESULTS: The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial randomized 18 201 patients with atrial fibrillation to apixaban or warfarin for stroke/systemic embolism prevention; 884 (4...
January 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28095921/papillary-fibroelastoma-of-the-aortic-valve-presenting-with-chronic-angina-and-acute-stroke-a-case-report
#19
Fan Zhang, Ziqiang Zhu, Gautham K Upadhya, Jiankun Tong, Vlad Gotlieb, Abdullah Khan, Rakesh P Gupta
BACKGROUND: Papillary fibroelastomas are rare, benign cardiac tumors that are often found on cardiac valvular surfaces. Most are incidental discoveries during surgery or autopsy. The clinical presentation of fibroelastoma varies widely, ranging from clinically asymptomatic to severe thromboembolic events. CASE PRESENTATION: We report a case of 65-year-old white man diagnosed with scattered, bilateral acute cerebral hemisphere infarcts with a history of chronic angina...
January 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28095380/polycythemia-vera-management-and-challenges-in-the-community-health-setting
#20
Aaron T Gerds, Kim-Hien Dao
Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms...
January 18, 2017: Oncology
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