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chronic thromboembolism g

Tatsuro Ibe, Hiroshi Wada, Kenichi Sakakura, Miyuki Ito, Yusuke Ugata, Kei Yamamoto, Yousuke Taniguchi, Shin-Ichi Momomura, Hideo Fujita
Recently, long-term outcomes of pre-capillary pulmonary hypertension (PH) have been improved, whereas morbidity and mortality are still high because of right-sided heart failure (HF). Right-sided HF is closely related to right ventricular (RV) function and hemodynamics such as RV stroke work index (RVSWI). However, the association between RVSWI and long-term outcomes in pre-capillary PH has not been well investigated. The aims of this study were to compare clinical characteristics between low RVSWI and high RVSWI and to investigate the association between low RVSWI and long-term outcomes in patients with pre-capillary PH...
August 11, 2018: International Heart Journal
S G Kanorskiy
Conducting anticoagulant therapy for atrial fibrillation, combined with diabetes mellitus and/or chronic kidney disease, can create certain difficulties for practicing doctors due to a simultaneous increase in the risk of thromboembolic and hemorrhagic complications. The presence of diabetes mellitus and renal dysfunction can influence the results of antithrombotic therapy in patients with atrial fibrillation. The review provides information on the differences in efficacy and safety of individual oral anticoagulants in the prevention of thromboembolic complications of atrial fibrillation in patients with diabetes mellitus, impaired renal function...
2018: Kardiologiia
S R Quadery, A J Swift, C Billings, Aar Thompson, C A Elliot, J Hurdman, A Charalampopoulos, I Sabroe, I Armstrong, N Hamilton, P Sephton, S Garrod, J Pepke-Zaba, D P Jenkins, N Screaton, A M Rothman, A Lawrie, T Cleveland, S Thomas, S Rajaram, C Hill, C Davies, C S Johns, J M Wild, R Condliffe, D G Kiely
BACKGROUND: Pulmonary endarterectomy (PEA) is the gold standard treatment for operable chronic thromboembolic pulmonary hypertension (CTEPH). However, a proportion of patients with operable disease decline surgery. There are currently no published data on this patient group. The aim of this study was to identify outcomes and prognostic factors in a large cohort of consecutive patients with CTEPH. METHODS: Data were collected for consecutive, treatment-naïve CTEPH patients between 2001-2014 identified from the ASPIRE registry...
July 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
K L Cheung, N A Zakai, P W Callas, G Howard, B K Mahmoodi, C A Peralta, S E Judd, M Kurella Tamura, M Cushman
BACKGROUND: Chronic kidney disease (CKD) is associated with venous thromboembolism (VTE) risk via unknown mechanisms. Whether factors associated with reduced VTE in the general population might also be associated with reduced risk in CKD is unknown. OBJECTIVES: To determine whether thrombosis biomarkers attenuate VTE risk and if factors associated with reduced VTE are similarly effective in CKD. METHODS: Baseline biomarkers were measured in a case-cohort (294 VTE cases, 939 non-cases) from the REGARDS study, a nationwide prospective cohort of 30,239 persons age ≥45 with 4...
July 8, 2018: Journal of Thrombosis and Haemostasis: JTH
C Schwahn-Schreiber, F X Breu, E Rabe, I Buschmann, W Döller, G R Lulay, A Miller, E Valesky, S Reich-Schupke
Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed...
June 27, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Jing Tao, Elena N Bukanova, Shamsuddin Akhtar
Background: Although factor Xa inhibitors have become a popular choice for chronic oral anticoagulation, effective drug reversal remains difficult due to a lack of specific antidote. Currently, 4-factor prothrombin complex concentrate (4F-PCC) is considered the treatment of choice for factor Xa inhibitor-related major bleeding. However, safety of 4F-PCC and its risk of thrombosis when used for this off-label purpose remain unclear. The purpose of this retrospective study is to determine the rate of thromboembolism when 4F-PCC is used for the emergent reversal of factor Xa inhibitors...
2018: Journal of Intensive Care
Damien G Noone, Kazumoto Iijima, Rulan Parekh
The incidence of idiopathic nephrotic syndrome (NS) is 1·15-16·9 per 100 000 children, varying by ethnicity and region. The cause remains unknown but the pathogenesis of idiopathic NS is thought to involve immune dysregulation, systemic circulating factors, or inherited structural abnormalities of the podocyte. Genetic risk is more commonly described among children with steroid-resistant disease. The mainstay of therapy is prednisone for the vast majority of patients who are steroid responsive; however, the disease can run a frequently relapsing course, necessitating the need for alternative immunosuppressive agents...
July 7, 2018: Lancet
S Harikrishnan, G Sanjay, M Ashishkumar, Jaideep Menon, Gopalan Nair Rajesh, Raman Krishna Kumar, A George Koshy, Thankachan V Attacheril, Raju George, Eapen Punnoose, S M Ashraf, S R Arun, Mohammed Cholakkal, Panniyammakal Jeemon
BACKGROUND: Epidemiological data on pulmonary hypertension (PH) are scarce from developing countries including India. METHODS: We established a multi-center registry of PH, the PRO-KERALA registry, in Kerala, India. Fifty hospitals enrolled consecutive adult (>18 years) patients for one year. Echocardiographic criteria (right ventricular systolic pressure - RVSP > 50 mmHg) or invasively obtained mean pulmonary artery pressure > 25 mmHg was the criteria for entry...
August 15, 2018: International Journal of Cardiology
Stuart Jamieson, G Victor Pretorius
Chronic thromboembolic pulmonary hypertension occurs when acute thromboemboli fail to dissolve completely. The resulting fibrotic scar tissue within the pulmonary arteries is obstructive and eventually leads to right heart failure. Medical therapy for this condition is supportive, but surgery with pulmonary artery endarterectomy is curative, and carries a low mortality at experienced centers.
June 2018: Seminars in Interventional Radiology
Elena A Kochmareva, Valentin A Kokorin, Ivan G Gordeev
OBJECTIVE: Pulmonary embolism (PE) remains one of the leading causes of mortality among cardiovascular diseases. We aimed at investigating risk factors of PE complications in patients with intermediate risk and integrate them into a simple model for its' bedside prediction. METHODS: Among 173 patients with PE, 136 were classified as high or intermediate risk. Patients were retrospectively divided into groups of complicated (n = 44) or uncomplicated (n = 92) course...
June 1, 2018: European Journal of Internal Medicine
Harald Breivik, Hilde Norum, Christian Fenger-Eriksen, Seppo Alahuhta, Gísli Vigfússon, Owain Thomas, Michael Lagerkranser
BACKGROUND AND AIMS: Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory...
April 25, 2018: Scandinavian Journal of Pain
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
V V Ermilov, A V Smirnov, G L Snigur, R S Dudin, S S Popov
Larval paragonimiasis is a parasitic disease caused by lung fluke larvae. Unlike the classic form of paragonimiasis, the larval form occurs with a large number of clinical manifestations. However, this fact only complicates the diagnosis of larval paragonimiasis, for the abundance of clinical manifestations results in the misdiagnosis of other diseases. Another feature of this form of paragonimiasis is the tendency to generalize and mimic the clinical presentation of malignant neoplasms. The performed diagnostic measures failed to give an accurate view of the nature of the disease, therefore diagnostic thoracoscopy was carried out and biopsy specimens were taken from the subpleural region of dissemination, followed by urgent histologic examination suggestive of glandular cancer...
2018: Arkhiv Patologii
Jeremy A Slivnick, Raymond Y Yeow, Colin McMahon, David G Paje, Jacob E Kurlander, Geoff D Barnes
For warfarin-treated patients with atrial fibrillation (AF) at low thromboembolic risk, recent studies have shown harm associated with periprocedural bridging using low-molecular-weight heparin. Clinician surveys have indicated a preference toward excessive bridging, especially among noncardiologists; however, little is known about actual practice patterns in these patients. We performed a retrospective evaluation of bridging in the setting of gastrointestinal endoscopy. We identified 938 patients with AF on warfarin who underwent esophagogastroduodenoscopy or colonoscopy between 2012 and 2016 at a tertiary health center...
June 15, 2018: American Journal of Cardiology
Kenneth Chan, John G Coghlan, Margaret Hall, Jamanda Haddock, Alan Bates, Benjamin E Schreiber
Pulmonary hypertension is a serious condition with multiple underlying aetiologies which require different treatment strategies. We present a case of severe idiopathic pulmonary arterial hypertension in a 20-year-old patient with ongoing breathlessness. She was initially diagnosed with asthma and panic attacks in community care. As the symptoms became progressively worse, she was referred for pulmonary hypertension clinic assessment. Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) showed grossly abnormal perfusion defects which were mismatched to the ventilation scan, suggestive of chronic thromboembolic disease...
January 31, 2018: Heart, Lung & Circulation
Ahmed M L Bedewy, Salah Showeta, Mostafa Hasan Mostafa, Lamia Saeed Kandil
Warfarin is the most commonly used drug for chronic prevention of thromboembolic events, it also ranks high among drugs that cause serious adverse events. The variability in dose requirements has been attributed to inter-individual differences in medical, personal, and genetic factor. Cytochrome P-450 2C9 is the principle enzyme that terminates the anticoagulant effect of warfarin by catalyzing the conversion of the pharmacologically more potent S-enantiomer to its inactive metabolites. Warfarin exerts its effect by inhibition of vitamin K epoxide reductase...
April 2018: Indian Journal of Hematology & Blood Transfusion
Erik R Dong, David G Ng, Danny Ramzy, Joshua S Chung, Oren Friedman, Alain Combes, Francisco A Arabia, Michael Nurok
A retrospective review of three patients with acute respiratory distress syndrome (ARDS) and normal baseline right ventricular function admitted to the Cardiac Surgery Intensive Care Unit whom developed acute cor pulmonale while on veno-venous extracorporeal membrane oxygenation. These patients were diagnosed with ARDS using Berlin Criteria definitions and cannulated with a dual lumen (Avalon) cannula. Despite variations in history, presentation, and course, findings of acute cor pulmonale were encountered 4 to 6 weeks after extracorporeal membrane oxygenation cannulation...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
M J Courtney, T J Royle
PURPOSE: Elective inguinal hernia repair (IHR) is one of the most commonly performed operations in the UK. As with all procedures, informed consent is essential. Pre-made consent forms have been suggested to improve consenting practice. This study aimed to assess the usage and quality of pre-made hernia-specific consent forms (PCF) in the UK. METHODS: A freedom of information request was sent to all UK NHS Trusts asking: (1) does the trust perform IHRs; (2) do they have a PCF; and (3) to send a copy...
June 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Boyoung Joung
Regulatory approvals of non-vitamin K antagonist oral anticoagulants (NOACs) have been based on large randomized phase III trials evaluating dabigatran, rivaroxaban, apixaban, or edoxaban relative to warfarin for atrial fibrillation (AF). The results of the trials showed that all NOACs were at least non-inferior to warfarin in the prevention of stroke/thromboembolism and showed lower rates of intracranial bleeding than those associated with warfarin. However, the trials were designed differently, varied in the inclusion/exclusion criteria, and used either one dose or a low/high dose of the NOAC drug...
November 2017: Korean Circulation Journal
Anna Licata, Fania Puccia, Vania Lombardo, Antonietta Serruto, Maria G Minissale, Ilaria Morreale, Lydia Giannitrapani, Maurizio Soresi, Giuseppe Montalto, Piero L Almasio
AIM/OBJECTIVE/BACKGROUND: Direct-acting oral anticoagulant drugs are marketed worldwide for the primary and secondary prevention and treatment of thromboembolic disorders. Rivaroxaban, an oral, direct factor Xa inhibitor, is one of the most used. Rivaroxaban-induced hepatotoxicity is unusual, although a number of adverse reports have recently been reported. Here, we report two new cases of rivaroxaban-induced hepatitis. METHODS: A systematic search of case reports on the MEDLINE database encompassing the years 2008-2016 was carried out...
February 2018: European Journal of Gastroenterology & Hepatology
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