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https://www.readbyqxmd.com/read/28809046/platelet-transfusion-to-reverse-antiplatelet-therapy-before-decompressive-surgery-in-patients-with-intracranial-haemorrhage
#1
M Baschin, S Selleng, J-P Zeden, A Westphal, T Kohlmann, H W Schroeder, A Greinacher, T Thiele
BACKGROUND: Platelet concentrates (PC) are transfused to improve primary haemostasis before urgent neurosurgery in patients with intracranial haemorrhage (ICH) receiving antiplatelet therapy (APT). It is unresolved, whether PCs increase the risk for major cardio- and cerebrovascular adverse events. We evaluated a standardized transfusion regimen to reverse APT in patients with ICH who required decompressive neurosurgery. METHODS: Analysed were consecutive patients between 2012 and 2014...
August 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28807385/external-validation-of-a-5-year-survival-prediction-model-after-elective-abdominal-aortic-aneurysm-repair
#2
Randall R DeMartino, Ying Huang, Jay Mandrekar, Philip P Goodney, Gustavo S Oderich, Manju Kalra, Thomas C Bower, Jack L Cronenwett, Peter Gloviczki
OBJECTIVE: The benefit of prophylactic repair of abdominal aortic aneurysms (AAAs) is based on the risk of rupture exceeding the risk of death from other comorbidities. The purpose of this study was to validate a 5-year survival prediction model for patients undergoing elective repair of asymptomatic AAA <6.5 cm to assist in optimal selection of patients. METHODS: All patients undergoing elective repair for asymptomatic AAA <6.5 cm (open or endovascular) from 2002 to 2011 were identified from a single institutional database (validation group)...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28806270/new-clinical-paradigms-for-treating-and-preventing-antiplatelet-gastrointestinal-bleeding
#3
Neena S Abraham
PURPOSE OF REVIEW: To quantify antiplatelet-related gastrointestinal bleeding (GIB), characterize patients at greatest risk and summarize risk-management strategies emphasizing evolving knowledge in acute management of antiplatelet-related bleeding. RECENT FINDINGS: New paradigms for acute management of antiplatelet-related GIB exist in the domains of resuscitation and the transfusion of blood products, strategic use of proton pump therapy and identification and eradication of Helicobacter pylori...
August 12, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28803655/usefulness-of-pa32540-in-protecting-the-gastric-layer-while-providing-secondary-prevention-for-coronary-artery-disease
#4
REVIEW
Deepthi Kagolanu, Najia Sayedy, Syed Haseeb, Shivani Shah, Paul Lam, Swapna Munnangi, Prakash Viswanathan, Kent Stephenson
Aspirin has been the mainstay for secondary prevention of coronary artery disease to decrease early recurrence and severity of recurrent cardiovascular events. However, an increase in gastrointestinal bleeding due to aspirin is preventing many patients from adhering to this daily regimen. PA32540, a combination pill with aspirin and omeprazole, is a newly emerging intervention that has the potential to reinforce patient compliance with the aspirin regimen due to fewer gastrointestinal adverse effects. This systematic review assessed three recent phase 3 clinical trials investigating the safety and efficacy of PA32540...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#5
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28801633/evaluation-of-novel-factor-xa-inhibitors-from-oxya-chinensis-sinuosa-with-anti-platelet-aggregation-activity
#6
Wonhwa Lee, HeeSeung Lee, Mi-Ae Kim, Joonhyeok Choi, Kyung-Min Kim, Jae Sam Hwang, MinKyun Na, Jong-Sup Bae
The edible grasshopper Oxya chinensis sinuosa is consumed worldwide for its various medicinal effects. The purpose of this study was to investigate potential bioactive antithrombotic and antiplatelet compounds from O. chinensis sinuosa. Five N-acetyldopamine dimers (1-5) were isolated from O. chinensis sinuosa and compounds 1 and 2 were identified as new chemicals with chiral centers at H-2 and H-3 of the benzo-1,4-dioxane structure. Compounds 1-4 were found to have both FXa and platelet aggregation inhibitory activities...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#7
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28796769/medication-related-patient-harm-in-new-zealand-hospitals
#8
MULTICENTER STUDY
Gillian Robb, Elizabeth Loe, Ashika Maharaj, Richard Hamblin, Mary E Seddon
AIM: The purpose of this study is to identify patterns of medication-related harm from a national perspective, and to use this information to inform decisions on where to focus medication safety efforts. This study updates a 2013 study using the same methodology. METHOD: District health boards (DHBs) still actively using either the Adverse Drug Event (ADE) Trigger Tool (TT) or the Global Trigger Tool (GTT), submitted two years of anonymised ADE data (1 July 2013-30 June 2015) to the Health Quality & Safety Commission (the Commission) using a standard template...
August 11, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28789568/temporal-trends-in-the-use-of-antiplatelet-therapy-in-patients-with-acute-coronary-syndromes
#9
María Asunción Esteve-Pastor, Juan Miguel Ruíz-Nodar, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Miriam Quintana-Giner, Andrea Véliz-Martínez, Antonio Tello-Montoliu, Vicente PerniasEscrig, Miriam Sandín Rollán, Nuria Vicente-Ibarra, Manuel Jesús MacíasVillanego, Elena Candela Sánchez, Luna Carrillo Alemán, Teresa Lozano, Mariano Valdés, Francisco Marín
BACKGROUND: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. PURPOSE: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. METHODS: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28780575/subclinical-leaflet-thrombosis-after-transcatheter-aortic-valve-implantation
#10
REVIEW
Satoshi Nakatani
Although clinically significant valve thrombosis after transcatheter aortic valve implantation (TAVI) is rare, the incidence of subclinical leaflet thrombosis has been reported to be up to about 10%-15%. It is mostly found 1-3 months after procedure in any type of transcatheter heart valve. Leaflet thrombosis is detected by high-resolution CT in the form of limited valve opening/closure and hypoattenuated leaflet thickening. Transthoracic or transesophageal echocardiography is capable of detecting limitations of valve motion, leaflet thickening, increased flow velocity across the valve...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28780550/improving-discharge-care-the-potential-of-a-new-organisational-intervention-to-improve-discharge-after-hospitalisation-for-acute-stroke-a-controlled-before-after-pilot-study
#11
Dominique A Cadilhac, Nadine E Andrew, Enna Stroil Salama, Kelvin Hill, Sandy Middleton, Eleanor Horton, Ian Meade, Sarah Kuhle, Mark R Nelson, Rohan Grimley
OBJECTIVE: Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. SETTING: Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28777978/clovamide-and-clovamide-rich-extracts-of-three-trifolium-species-as-antioxidants-and-moderate-antiplatelet-agents-in-vitro
#12
Joanna Kolodziejczyk-Czepas, Justyna Krzyżanowska-Kowalczyk, Malgorzata Sieradzka, Pawel Nowak, Anna Stochmal
This in vitro study provides a new insight into the phytochemical, antioxidant, antiplatelet and cytotoxic profiles of commercial trans-clovamide and clovamide-rich extracts, isolated from aerial parts of three Trifolium species (i.e. T. clypeatum L., T. obscurum Savi and T. squarrosum L.). Under inorganic experimental conditions, the EC50 for the investigated substances varied between 4.87 (clovamide) and 7.91 μg/ml (T. clypeatum) according to the DPPH(•) assay. The most effective 1 mM ONOO(-) scavenger was clovamide (IC50 = 19...
August 1, 2017: Phytochemistry
https://www.readbyqxmd.com/read/28776320/cost-effectiveness-of-support-for-people-starting-a-new-medication-for-a-long-term-condition-through-community-pharmacies-an-economic-evaluation-of-the-new-medicine-service-nms-compared-with-normal-practice
#13
Rachel A Elliott, Lukasz Tanajewski, Georgios Gkountouras, Anthony J Avery, Nick Barber, Rajnikant Mehta, Matthew J Boyd, Asam Latif, Antony Chuter, Justin Waring
BACKGROUND: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. METHODS: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients' non-adherence...
August 3, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28775075/first-selective-12-lox-inhibitor-ml355-impairs-thrombus-formation-and-vessel-occlusion-in-vivo-with-minimal-effects-on-hemostasis
#14
Reheman Adili, Benjamin E Tourdot, Katherine Mast, Jennifer Yeung, John Cody Freedman, Abigail Green, Diane K Luci, Ajit Jadhav, Anton Simeonov, David J Maloney, Theodore R Holman, Michael Holinstat
OBJECTIVE: Adequate platelet reactivity is required for maintaining hemostasis. However, excessive platelet reactivity can also lead to the formation of occlusive thrombi. Platelet 12(S)-lipoxygenase (12-LOX), an oxygenase highly expressed in the platelet, has been demonstrated to regulate platelet function and thrombosis ex vivo, supporting a key role for 12-LOX in the regulation of in vivo thrombosis. However, the ability to pharmacologically target 12-LOX in vivo has not been established to date...
August 3, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28766881/angiographic-and-clinical-performance-of-polymer-free-biolimus-eluting-stent-in-patients-with-st-segment-elevation-acute-myocardial-infarction-in-a-metropolitan-public-hospital-the-besami-mucho-study
#15
Gregory A Sgueglia, Fabrizio D'Errico, Gaetano Gioffrè, Antonella De Santis, Francesco Summaria, Fabiana Piccioni, Achille Gaspardone
OBJECTIVES: This study aimed at assessing the performance of a new generation polymer-free biolimus-eluting stent (BES) in real-world patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Polymers components of early-generation drug-eluting stents have been implicated in the pathogenesis of delayed arterial healing, vessel remodeling, and delayed stent thrombosis. Recently, a novel polymer-free BES has shown excellent clinical performance in clinical trial setting...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#16
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28760303/analysis-of-efficacy-and-tolerability-of-bruton-tyrosine-kinase-inhibitor-ibrutinib-in-various-b-cell-malignancies-in-the-general-community-a%C3%A2-single-center-experience
#17
Naveed Ali, Faizan Malik, Syed Imran Mustafa Jafri, Mary Naglak, Mark Sundermeyer, Peter V Pickens
BACKGROUND: Ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase (BTK), is a novel drug that has shown significant efficacy and survival benefit for treatment of various B-cell malignancies. The primary objective of the present study was to investigate the efficacy of ibrutinib therapy in various B-cell malignancies in the general community. The secondary objectives included studying the adverse effects, ibrutinib-induced peripheral lymphocytosis, and effect on immunoglobulin levels...
July 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28756016/pharmacological-stroke-prevention-in-the-elderly-with-atrial-fibrillation-in-poland-results-of-polsenior-study
#18
Beata Łabuz-Roszak, Michał Skrzypek, Agnieszka Machowska-Majchrzak, Małgorzata Mossakowska, Jerzy Chudek, Andrzej Więcek, Krystyna Pierzchała, Beata Łącka-Gaździk, Tomasz Grodzicki
INTRODUCTION: Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland. OBJECTIVES: The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors...
July 11, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28751840/clinical-pathways-and-management-of-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-acs-a-consensus-document-from-the-italian-association-of-hospital-cardiologists-anmco-italian-society-of-cardiology-sic-italian-society-of-emergency-medicine
#19
Leonardo De Luca, Furio Colivicchi, Michele Massimo Gulizia, Francesco Rocco Pugliese, Maria Pia Ruggieri, Giuseppe Musumeci, Gian Alfonso Cibinel, Francesco Romeo
Antiplatelet therapy is the cornerstone of the pharmacologic management of patients with acute coronary syndrome (ACS). Over the last years, several studies have evaluated old and new oral or intravenous antiplatelet agents in ACS patients. In particular, research was focused on assessing superiority of two novel platelet ADP P2Y12 receptor antagonists (i.e., prasugrel and ticagrelor) over clopidogrel. Several large randomized controlled trials have been undertaken in this setting and a wide variety of prespecified and post-hoc analyses are available that evaluated the potential benefits of novel antiplatelet therapies in different subsets of patients with ACS...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28743214/management-of-dental-patients-receiving-antiplatelet-therapy-or-chronic-oral-anticoagulation-a-review-of-the-latest-evidence
#20
Csaba András Dézsi, Balázs Bence Dézsi, András Döme Dézsi
The perioperative management of patients treated with antithrombotic medications who undergo surgical procedures represents a common clinical problem. Dental interventions are usually associated with a low risk of bleeding; however, the dental implications of new antithrombotic agents are not yet fully understood. The present review is based on the latest evidence and recommendations published on the periprocedural management of dental patients treated with single or dual antiplatelet therapy, vitamin K antagonists, or direct oral anticoagulants for a variety of indications...
December 2017: European Journal of General Practice
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