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https://www.readbyqxmd.com/read/29775206/prospective-determination-of-aspirin-sensitivity-in-patients-resistant-to-low-dose-aspirin-a-proof-of-concept-study
#1
Erica S Westphal, Michelle Rainka, Michelle Amsler, Traci Aladeen, Caitlin Wisniewski, Vernice Bates, Fran M Gengo
This study tested the capability of an assay to predict aspirin response and reduce ischemic events, and healthcare costs, and delays to optimal treatment. Patients who needed aspirin in the course of normal medical care were included. Patients were excluded if they had disorders affecting platelet function, alcohol use within 24 hours of a test, or NSAID use. Dose escalation of chewable aspirin from 81 mg, to 162 mg, to 325 mg daily occurred based on the results of whole blood impedance aggregation testing to the agonists, collagen (1ug/mL, 5 ug/mL) and arachidonate (0...
May 18, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29775202/the-development-of-an-in-vitro-assay-for-the-prospective-determination-of-aspirin-sensitivity
#2
Erica S Westphal, Caitlin Wisniewski, Michelle Rainka, Nicholas M Smith, Vernice Bates, Fran M Gengo
Aspirin remains the standard for stroke prophylaxis. However, as many as 20%-25% of patients may fail to show a full response to aspirin. Ideally, patients who are resistant to aspirin could be identified, then receive an increased dose of aspirin or be changed to an alternative therapy more efficiently. We have developed an in vitro assay that may make this possible. Healthy volunteers (n = 13) between 18 and 50 years of age were tested for both ex vivo and in vivo responses to aspirin. Dimethyl sulfoxide (DMSO) was selected as the solvent for aspirin in the assay...
May 18, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29775142/aspirin-for-primary-prevention-of-stroke-in-traumatic-cerebrovascular-injury-association-with-increased-risk-of-transfusion
#3
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29772108/reduced-dose-direct-oral-anticoagulants-in-the-extended-treatment-of-venous-thromboembolism-a-systematic-review-and-meta-analysis
#4
Lakshman Vasanthamohan, Kochawan Boonyawat, Chatree Chai-Adisakopha, Mark Crowther
BACKGROUND: Extended duration anticoagulation is beneficial for preventing recurrent venous thromboembolism (VTE). Reduced dose direct oral anticoagulants (DOACs) may be preferable if they preserve efficacy and cause less bleeding. We conducted a systematic review and meta-analysis of trials comparing reduced dose DOACs with full dose DOACs and aspirin or placebo in the extended phase of VTE treatment. METHODS: A literature search was conducted using the MEDLINE, EMBASE and CINAHL databases supplemented by hand-searching...
May 17, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29771821/the-effects-of-exercise-aspirin-and-celecoxib-in-an-atherogenic-environment
#5
Heather Grimm, Jan Kretzschmar, Marc D Cook, Michael D Brown
INTRODUCTION: Optimal vascular function is a hallmark of cardiovascular health. Specifically, the balance of vasoconstricting and vasodilating substances is recognized as a marker of vascular health. One of the greatest challenges to vascular health and vasodilatory balance is tumor necrosis factor alpha (TNFα) mediated inflammation. Uncovering effective strategies that maintain a vascular environment that is more vasodilatory and anti-thrombotic in the face of an inflammatory challenge is favorable...
April 30, 2018: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/29771194/preconception-antiphospholipid-antibodies-and-risk-of-subsequent-early-pregnancy-loss
#6
K J Gibbins, S L Mumford, L A Sjaarda, D W Branch, N J Perkins, A Ye, E F Schisterman, R M Silver
Objectives To prospectively estimate the association of preconception antiphospholipid antibodies (aPL) with subsequent pregnancy loss using a cohort design. aPL have been associated with recurrent early pregnancy loss (EPL) prior to 10 weeks in previous case-control studies. Prospective ascertainment of pregnancy loss is challenging, as most women do not seek care prior to EPL. Methods Secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial of preconception low-dose aspirin. Preconception anticardiolipin (aCL) and anti-β2-glycoprotein-I (a-β2-I) were assessed in 1208 women with one or two prior pregnancy losses and no more than two prior live births...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29770171/risk-of-gastric-cancer-development-after-eradication-of-helicobacter-pylori
#7
REVIEW
Ka-Shing Cheung, Wai K Leung
Helicobacter pylori ( H. pylori ) infection is the most important risk factor for gastric cancer (GC) development through the Correa's gastric carcinogenesis cascade. However, H. pylori eradication alone does not eliminate GC, as pre-neoplastic lesions (atrophic gastritis, intestinal metaplasia and dysplasia) may have already developed in some patients. It is therefore necessary to identify patients at high-risk for gastric cancer after H. pylori eradication to streamline the management plan. If the patients have not undergone endoscopy with histologic assessment, the identification of certain clinical risk factors and non-invasive testing (serum pepsinogen) can predict the risk of atrophic gastritis...
May 15, 2018: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29769213/chemopreventive-efficacy-of-the-cyclooxygenase-2-cox-2-inhibitor-celecoxib-is-predicted-by-adenoma-expression-of-cox-2-and-15-pgdh
#8
Jiping Wang, Nancy L Cho, Ann G Zauber, Meier Hsu, Dawn Dawson, Amitabh Srivastava, Kisha A Mitchell-Richards, Sanford D Markowitz, Monica M Bertagnolli
BACKGROUND: The APC trial showed that cyclooxygenase-2 (Cox-2) inhibitor, celecoxib, decreased adenoma development in patients at high risk for colorectal cancer. A prospectively planned analysis of the APC trial tested the hypothesis that expression of target enzymes in adenomas removed before beginning study treatment would identify individuals at high risk of adenoma development, and/or predict response to Cox-2 inhibition. METHODS: Pre-treatment adenomas were examined using immunohistochemistry (IHC) to assess expression of Cox-2 (high vs...
May 16, 2018: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/29768511/12-year-trends-in-cardiovascular-risk-factors-2002-2005-through-2011-2014-in-patients-with-cardiovascular-diseases-tehran-lipid-and-glucose-study
#9
SeyedHossein Rabani, Mahsa Sardarinia, Samaneh Akbarpour, Fereidoun Azizi, Davood Khalili, Farzad Hadaegh
BACKGROUND: To examine the trend of cardiovascular diseases (CVD) risk factors among a Middle Eastern population with prevalent CVD during a median follow up of 12 years. METHODS: Patients with prevalent CVD (n = 282, men = 167), with a mean age of 60.76 years were evaluated in four study phases of the TLGS (Tehran lipid glucose study), 2002-2005, 2005-2008, 2008-2011, and 2011-2014. Trends of CVD risk factors were estimated using generalized estimation equation (GEE) models, by adjusting for gender, age and propensity scores...
2018: PloS One
https://www.readbyqxmd.com/read/29767694/shorter-time-to-pregnancy-with-increasing-preconception-carotene-concentrations-among-women-with-1-to-2-previous-pregnancy-losses
#10
Keewan Kim, Enrique F Schisterman, Robert M Silver, Brian D Wilcox, Anne M Lynch, Neil J Perkins, Richard W Browne, Laurie L Lesher, Joseph B Stanford, Aijun Ye, Jean Wactawski-Wende, Sunni L Mumford
Although maternal nutrition may impact fecundity, associations between preconception micronutrients and time to pregnancy (TTP) has not been examined. We assessed the relationship between preconception fat-soluble micronutrient concentrations and TTP among women with 1-2 prior pregnancy losses. This is a prospective cohort study of 1,228 women set in the EAGeR Trial (US, 2007-2011), which assessed the effect of preconception-initiated daily low dose aspirin on reproductive outcomes. We measured preconception zeaxanthin, cryptoxanthin, lycopene, α- and β-carotene, and α- and γ-tocopherol in serum...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29766772/rivaroxaban-for-stroke-prevention-after-embolic-stroke-of-undetermined-source
#11
Robert G Hart, Mukul Sharma, Hardi Mundl, Scott E Kasner, Shrikant I Bangdiwala, Scott D Berkowitz, Balakumar Swaminathan, Pablo Lavados, Yongjun Wang, Yilong Wang, Antonio Davalos, Nikolay Shamalov, Robert Mikulik, Luis Cunha, Arne Lindgren, Antonio Arauz, Wilfried Lang, Anna Czlonkowska, Jens Eckstein, Rubens J Gagliardi, Pierre Amarenco, Sebastian F Ameriso, Turgut Tatlisumak, Roland Veltkamp, Graeme J Hankey, Danilo Toni, Daniel Bereczki, Shinichiro Uchiyama, George Ntaios, Byung-Woo Yoon, Raf Brouns, Matthias Endres, Keith W Muir, Natan Bornstein, Serefnur Ozturk, Martin J O'Donnell, Matthys M De Vries Basson, Guillaume Pare, Calin Pater, Bodo Kirsch, Patrick Sheridan, Gary Peters, Jeffrey I Weitz, W Frank Peacock, Ashkan Shoamanesh, Oscar R Benavente, Campbell Joyner, Ellison Themeles, Stuart J Connolly
Background Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. Methods We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29766750/clopidogrel-and-aspirin-in-acute-ischemic-stroke-and-high-risk-tia
#12
S Claiborne Johnston, J Donald Easton, Mary Farrant, William Barsan, Robin A Conwit, Jordan J Elm, Anthony S Kim, Anne S Lindblad, Yuko Y Palesch
Background Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population. Methods In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29765396/acute-in-stent-thrombosis-after-carotid-angioplasty-and-stenting-a-case-report-and-literature-review
#13
Wei Hu, Li Wang, GuoPing Wang
Background: Based on the results of a recent randomized controlled trial, carotid artery stenting (CAS) was regarded as a relatively safe, less invasive treatment of internal carotid artery stenosis. However, cerebral thromboembolic events are the most common complications of CAS. Especially acute stent thrombosis following CAS will be fatal without prompt diagnosis and revascularization. Case Report: We report a case of acute stent thrombosis in whom carotid revascularization was performed successfully via arterial thrombolysis and balloon postdilation...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765392/carotid-stenting-for-treatment-of-symptomatic-carotid-webs-a-single-center-case-series
#14
Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764706/atrial-fibrillation-and-ischemic-events-with-rivaroxaban-in-patients-with-stable-coronary-artery-disease-afire-protocol-for-a-multicenter-prospective-randomized-open-label-parallel-group-study
#15
Satoshi Yasuda, Koichi Kaikita, Hisao Ogawa, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui
BACKGROUND: In atrial fibrillation (AF) patients with coronary artery disease (CAD), anticoagulants are commonly used in combination with antiplatelet drugs. However, dual therapy can increase the risk of bleeding, and the potential therapeutic benefits must be weighed against this. Therefore, it is recommended that dual therapy is only used for a limited time, and that monotherapy with anticoagulants should start from 1 year after percutaneous coronary intervention (PCI). However, there is a lack of evidence on the use of monotherapy, in particular with direct oral anticoagulants, in this group of patients...
May 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29763272/colorectal-cancer-screening-and-prevention
#16
Thad Wilkins, Danielle McMechan, Asif Talukder
Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of age. Randomized controlled trials show evidence of reduced colorectal cancer-specific mortality with guaiac-based fecal occult blood tests and flexible sigmoidoscopy. There are no randomized controlled trials on the effectiveness of colonoscopy to reduce colorectal cancer-specific mortality; however, several randomized controlled trials comparing colonoscopy with other strategies are in progress...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762678/using-statistical-anomaly-detection-models-to-find-clinical-decision-support-malfunctions
#17
Soumi Ray, Dustin S McEvoy, Skye Aaron, Thu-Trang Hickman, Adam Wright
Objective: Malfunctions in Clinical Decision Support (CDS) systems occur due to a multitude of reasons, and often go unnoticed, leading to potentially poor outcomes. Our goal was to identify malfunctions within CDS systems. Methods: We evaluated 6 anomaly detection models: (1) Poisson Changepoint Model, (2) Autoregressive Integrated Moving Average (ARIMA) Model, (3) Hierarchical Divisive Changepoint (HDC) Model, (4) Bayesian Changepoint Model, (5) Seasonal Hybrid Extreme Studentized Deviate (SHESD) Model, and (6) E-Divisive with Median (EDM) Model and characterized their ability to find known anomalies...
May 11, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29760146/copper-acyl-salicylate-has-potential-as-an-anti-cryptococcus-anti-fungal-agent
#18
Adepemi O Ogundeji, Boitumelo F Porotloane, Carolina H Pohl, Pravin S Kendrekar, Olihile M Sebolai
The in vitro anti-fungal activity of aspirin against cryptococcal cells has been reported. However, its undesired effects may limit its clinical application. Conceivably, a derivative of aspirin could overcome this challenge. Toward this end, this paper considered the usage of an aspirinate-metal complex viz. copper acyl salicylate (CAS) as an anti- Cryptococcus anti-fungal agent. Additionally, the paper examined the influence of this compound on macrophage function. The in vitro susceptibility results revealed that cryptococcal cells were vulnerable (in a dose-dependent manner) to CAS, which may have effected growth inhibition by damaging cryptococcal cell membranes...
May 14, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29759668/incidence-characteristics-and-clinical-course-of-device-related-thrombus-after-watchman-left-atrial-appendage-occlusion-device-implantation-in-atrial-fibrillation-patients
#19
Shunsuke Kubo, Yukiko Mizutani, Krissada Meemook, Yoshifumi Nakajima, Asma Hussaini, Saibal Kar
OBJECTIVES: This study investigated characteristics and clinical impact of device-related thrombus formation after Watchman device implantation in atrial fibrillation (AF) patients. BACKGROUND: Left atrial appendage occlusion using the Watchman device is an effective alternative to anticoagulation for stroke prevention in AF patients. However, device-related thrombus formation remains an important concern after Watchman implantation. METHODS: From 2006 to 2014, 119 consecutive AF patients underwent Watchman implantation...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29757761/aspirin-resistance-cardiovascular-risk-game-changer
#20
Ahmed S Yassin, Hossam Abubakar, Tushar Mishra, Ahmed Subahi, Melanie Hartman, Abdelrahman Ahmed, Walid Ibrahim, Manmohan Singh, Mohit Pahuja
BACKGROUND: Aspirin (ASA) is the most used medication on the globe. ASA is a primary pillar of the secondary prevention of cardiovascular atherothromboembolic events. However, a fraction of the population does not respond to ASA as expected in a unique phenomenon called ASA resistance. Multiple mechanisms were described and studied in the literature to explain this phenomenon. AREA OF UNCERTAINTY: ASA resistance is an interesting phenomenon that is worth studying and reviewing...
May 3, 2018: American Journal of Therapeutics
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