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https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#1
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28605745/current-standard-and-future-perspectives-in-non-surgical-therapy-for-hepatocellular-carcinoma
#2
Tobias Eggert, Tim F Greten
BACKGROUND: Hepatocellular carcinoma (HCC) is an aggressive liver tumor with a poor 5-year survival rate. Many HCCs are not amenable to surgical resection, because of tumor size, location, or because of the patient's poor liver function, a common obstacle to HCC therapy, because HCCs almost always develop in chronically inflamed livers. SUMMARY: In recent years, many efforts have been made to improve patient survival by conducting clinical trials investigating local and systemic treatment options for patients with unresectable tumors...
June 13, 2017: Digestion
https://www.readbyqxmd.com/read/28480062/locoregional-and-systemic-therapy-for-hepatocellular-carcinoma
#3
REVIEW
Olumide B Gbolahan, Michael A Schacht, Eric W Beckley, Thomas P LaRoche, Bert H O'Neil, Maximilian Pyko
The management of hepatocellular carcinoma (HCC) remains challenging due to late presentation and the presence of accompanying liver dysfunction. As such, most patients are not eligible for curative resection and liver transplant. Management in this scenario depends on a number of factors including hepatic function, tumor burden, patency of hepatic vasculature and patients' functional status. Based on these, patients can be offered catheter based intra-arterial therapy for intermediate stage disease and in more advanced disease, sorafenib...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28470653/scoring-systems-for-postthrombotic-syndrome
#4
Hilde Skuterud Wik, Waleed Ghanima, Per Morten Sandset, Susan R Kahn
Postthrombotic syndrome (PTS) is the most common long-term complication after deep vein thrombosis (DVT) and is associated with reduced quality of life. There is no single objective test to diagnose the presence of PTS and it is usually diagnosed on the basis of typical symptoms and signs in a limb previously affected by DVT. Scoring systems for PTS are primarily developed as research tools, but could possibly also be useful in the clinical setting. A main advantage of a good scoring system is standardization of the diagnostic process...
July 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28445455/structural-insight-into-allosteric-modulation-of-protease-activated-receptor-2
#5
Robert K Y Cheng, Cédric Fiez-Vandal, Oliver Schlenker, Karl Edman, Birte Aggeler, Dean G Brown, Giles A Brown, Robert M Cooke, Christoph E Dumelin, Andrew S Doré, Stefan Geschwindner, Christoph Grebner, Nils-Olov Hermansson, Ali Jazayeri, Patrik Johansson, Louis Leong, Rudi Prihandoko, Mathieu Rappas, Holly Soutter, Arjan Snijder, Linda Sundström, Benjamin Tehan, Peter Thornton, Dawn Troast, Giselle Wiggin, Andrei Zhukov, Fiona H Marshall, Niek Dekker
Protease-activated receptors (PARs) are a family of G-protein-coupled receptors (GPCRs) that are irreversibly activated by proteolytic cleavage of the N terminus, which unmasks a tethered peptide ligand that binds and activates the transmembrane receptor domain, eliciting a cellular cascade in response to inflammatory signals and other stimuli. PARs are implicated in a wide range of diseases, such as cancer and inflammation. PARs have been the subject of major pharmaceutical research efforts but the discovery of small-molecule antagonists that effectively bind them has proved challenging...
May 4, 2017: Nature
https://www.readbyqxmd.com/read/28402686/the-creation-and-implementation-of-an-outpatient-pulmonary-embolism-treatment-protocol
#6
Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Blair Alden Parry, Erin Deadmon, Charlotte Kreger, Nicholas Giordano
The ability to rapidly and accurately risk-stratify patients with venous thromboembolism (VTE), and the availability of direct acting oral anticoagulants have reduced the need for intravenous anticoagulation for patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). Emergency physicians are generally reluctant to discharge patients with VTE without defined and reliable follow up in place, and VTE patients treated with anticoagulants can be at risk for complications related to recurrent VTE and bleeding...
April 21, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28395882/should-studies-on-glanzmann-thrombasthenia-not-be-telling-us-more-about-cardiovascular-disease-and-other-major-illnesses
#7
REVIEW
Alan T Nurden
Glanzmann thrombasthenia (GT) is a rare inherited bleeding disorder caused by loss of αIIbβ3 integrin function in platelets. Most genetic variants of β3 also affect the widely expressed αvβ3 integrin. With brief mention of mouse models, I now look at the consequences of disease-causing ITGA2B and ITGB3 mutations on the non-hemostatic functions of platelets and other cells. Reports of arterial thrombosis in GT patients are rare, but other aspects of cardiovascular disease do occur including deep vein thrombosis and congenital heart defects...
April 4, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28363516/vascular-disease-in-cocaine-addiction
#8
REVIEW
Keren Bachi, Venkatesh Mani, Devi Jeyachandran, Zahi A Fayad, Rita Z Goldstein, Nelly Alia-Klein
Cocaine, a powerful vasoconstrictor, induces immune responses including cytokine elevations. Chronic cocaine use is associated with functional brain impairments potentially mediated by vascular pathology. Although the Crack-Cocaine epidemic has declined, its vascular consequences are increasingly becoming evident among individuals with cocaine use disorder of that period, now aging. Paradoxically, during the period when prevention efforts could make a difference, this population receives psychosocial treatment at best...
March 14, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28343935/blood-derived-products-in-pediatrics-new-laboratory-tools-for-optimizing-potency-assignment-and-reducing-side-effects
#9
REVIEW
Jean Amiral, Jerard Seghatchian
Neonates and children can develop rare bleeding disorders due to congenital/acquired coagulation Factor deficiencies, or allo-immune/autoimmune complications, or can undergo surgeries at high haemorrhagic risk. They then need specialized transfusion of blood components/products, or purified blood extracted products or recombinant proteins. Blood-derived therapies conventionally used for management of affected infants with genetic/acquired deficiencies, bleeding problems (coagulation Factor reduced or missing) or thrombotic disorders (reduced or missing anticoagulant proteins) pose some additional risks...
April 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28332376/pathological-significance-of-tissue-trapped-in-retrieved-optease-vena-cava-filter-at-18th-day-after-installation-in-patient-with-deep-vein-thrombosis
#10
Sang Min Park, Jung Woo Son, Kyung Soon Hong, Kyung Chan Choi
The retrievable type of inferior vena cava filter has been widely used to prevent pulmonary thromboembolism in patients with deep vein thrombosis and contraindication of anticoagulation. Physicians make considerable efforts to remove the filter according to the manufacturer and US Food and Drug Administration safety advisory recommendation. However, forced filter retrieval might cause vascular injury within 3 weeks. Herein, we report pathologic and angiographic findings to suggest filter associated vascular injury during forced retrieval just within recommended period in a patient with deep vein thrombosis...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28290470/descriptive-study-of-earthquake-related-spinal-cord-injury-in-nepal
#11
C C Groves, M K Poudel, M Baniya, C Rana, D R House
STUDY DESIGN: Descriptive study. OBJECTIVES: To describe the epidemiological features of spinal cord injury (SCI) following the 2015 earthquakes in Nepal. SETTING: Spinal Injury Rehabilitation Centre, Kavre, Nepal. METHODS: Data were collected from the medical records of all earthquake-related patients seen from 25 April 2015 through to 16 June 2016. Data collected included patient demographics, mechanism of injury, initial medical treatment, neurological assessment, complications, neurological/functional outcomes and length of stay...
March 14, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28259267/timing-of-complications-occurring-within-30-days-after-adult-spinal-deformity-surgery
#12
Rafael De la Garza Ramos, C Rory Goodwin, Peter G Passias, Brian J Neuman, Khaled M Kebaish, Virginie Lafage, Frank Schwab, Daniel M Sciubba
STUDY DESIGN: Cross-sectional study of a national surgical database. OBJECTIVE: To investigate the timing of complications after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: There is limited data on the range of days when complications after ASD surgery occur. METHODS: The American College of Surgeons National Surgical Quality Improvement database was reviewed for the years 2007-2013. Inclusion criteria were adult patients (over 21 years of age) who underwent spinal fusion for ASD...
March 2017: Spine Deformity
https://www.readbyqxmd.com/read/28203499/sandwich-fascial-anterolateral-thigh-flap-in-head-and-neck-reconstruction-evolution-or-revolution
#13
Mario Cherubino, Jens Berli, Mario Turri-Zanoni, Paolo Battaglia, Francesca Maggiulli, Martina Corno, Federico Tamborini, Edoardo Montrasio, Paolo Castelnuovo, Luigi Valdatta
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28161096/relationship-between-yellow-plaque-grade-and-tissue-protrusion-after-stent-implantation-a-coronary-angioscopy-study
#14
Toru Miyoshi, Hideo Kawakami, Fumiyasu Seike, Akira Oshita, Hiroshi Matsuoka
BACKGROUND: Tissue protrusion detected with optical coherence tomography after percutaneous coronary intervention using stents is one of the risk factors for early stent thrombosis. However, tissue protrusion features have not been described. The aim of this study was to compare tissue morphology at stented sites with or without tissue protrusion by using coronary angioscopy. METHODS: Using optical coherence tomography and coronary angioscopy, we assessed 42 patients [31 men, 11 women; age, 70...
February 1, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28057809/factors-associated-with-long-term-mortality-after-fontan-procedures-a-systematic-review
#15
REVIEW
Tarek Alsaied, Jouke P Bokma, Mark E Engel, Joey M Kuijpers, Samuel P Hanke, Liesl Zuhlke, Bin Zhang, Gruschen R Veldtman
BACKGROUND: Despite an ageing Fontan population, data on late outcomes are still scarce. Reported outcome measures and determinants vary greatly between studies making comprehensive appraisal of mortality hazard challenging. METHODS: We conducted a systematic review to evaluate causes and factors associated with late mortality in patients with Fontan circulation. Late mortality was defined as mortality beyond the first postoperative year. Studies were included if they had ≥90 patients or ≥20 late mortalities and/or transplants...
January 15, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#16
Daniel D Bohl, Nathaniel T Ondeck, Bryce A Basques, Brett R Levine, Jonathan N Grauer
BACKGROUND: Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur. QUESTIONS/PURPOSES: (1) On which postoperative day do certain adverse events occur? (2) What adverse events occur earlier after TKA than after THA? (3) For each adverse event, what proportion occurred after hospital discharge? METHODS: We screened the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to identify all patients undergoing primary THA and primary TKA between 2005 and 2013, resulting in a study population of 124,657 patients evaluated as part of this retrospective database analysis...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28053157/blockade-of-protease-activated-receptor-4-par4-provides-robust-antithrombotic-activity-with-low-bleeding
#17
Pancras C Wong, Dietmar Seiffert, J Eileen Bird, Carol A Watson, Jeffrey S Bostwick, Mary Giancarli, Nick Allegretto, Ji Hua, David Harden, Jocelyne Guay, Mario Callejo, Michael M Miller, R Michael Lawrence, Jacques Banville, Julia Guy, Brad D Maxwell, E Scott Priestley, Anne Marinier, Ruth R Wexler, Michel Bouvier, David A Gordon, William A Schumacher, Jing Yang
Antiplatelet agents are proven efficacious treatments for cardiovascular and cerebrovascular diseases. However, the existing drugs are compromised by unwanted and sometimes life-threatening bleeding that limits drug usage or dosage. There is a substantial unmet medical need for an antiplatelet drug with strong efficacy and low bleeding risk. Thrombin is a potent platelet agonist that directly induces platelet activation via the G protein (heterotrimeric guanine nucleotide-binding protein)-coupled protease-activated receptors PAR1 and PAR4...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28051291/biobanking-in-carotid-artery-disease-translation-to-clinical-practice
#18
REVIEW
Ian D van Koeverden, Joyce E Vrijenhoek, Gert J de Borst, Hester M den Ruijter, Gerard Pasterkamp
Biobanking of atherosclerotic tissue samples has contributed to our understanding of vascular occlusive disease. The careful examination of atherosclerotic plaques derived during vascular surgery or autopsies helped shape our minds in understanding the underlying substrate of arterial thrombosis. This review will outline concepts of progression of atherosclerotic disease that have been based on descriptions of human plaque pathology. In addition, we will discuss the current shift in clinical presentation and underlying pathology of acute cerebral and coronary events that asks for a careful consideration of the currently widely applied description of the "vulnerable plaque"...
April 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#19
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27998897/antithrombotic-stewardship-a-multidisciplinary-team-approach-towards-improving-antithrombotic-therapy-outcomes-during-and-after-hospitalisation-a-study-protocol
#20
Albert R Dreijer, Marieke J H A Kruip, Jeroen Diepstraten, Suzanne Polinder, Rolf Brouwer, Frank W G Leebeek, Arnold G Vulto, Patricia M L A van den Bemt
INTRODUCTION: Antithrombotic therapy carries high risks for patient safety. Antithrombotics belong to the top 5 medications involved in potentially preventable hospital admissions related to medication. To provide a standard for antithrombotic therapy and stress the importance of providing optimal care to patients on antithrombotic therapy, the Landelijke Standaard Ketenzorg Antistolling (LSKA; Dutch guideline on integrated antithrombotic care) was drafted. However, the mere publication of this guideline does not guarantee its implementation...
December 20, 2016: BMJ Open
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