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https://www.readbyqxmd.com/read/28918617/right-ventricular-thrombosis-combined-with-fetal-death-and-acrocyanosis-in-pregnancy
#1
Feridoun Sabzi, Aghigh Heidari
Prepartum or postpartum right ventricular thrombosis (RVT) is an exceedingly rare and potentially lethal phenomenon in pregnancy. We here report a case of a pregnant patient with near term pregnancy admitted for dyspnea, amniotic fluids discharge and labor pain in a gynecology center that an eight-month dead fetus was diagnosed and delivered vaginally by induction. A post delivery period was complicated by aggravation of her dyspnea and pleuritic chest pain that she referred for further evaluation in our cardiac center...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28918569/highlights-from-the-ninth-international-symposium-of-thrombosis-and-anticoagulation-ista-ix-october-15-2016-salvador-bahia-brazil
#2
REVIEW
Renato D Lopes, Patricia O Guimarães, Elaine Hylek, Gilson S Feitosa-Filho, Luiz Ritt, Nivaldo Filgueiras, Eduardo Darzé, Mario S Rocha, Luis P Magalhães, Antonio Carlos Sobral Sousa, Luis Claudio Correia, Lucas Hollanda Oliveira, David A Garcia
To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Ninth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, on October 15, 2016. This scientific program was developed by clinicians for clinicians and was promoted by two major clinical research institutes-the Brazilian Clinical Research Institute and the Duke Clinical Research Institute of the Duke University School of Medicine. Comprising academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists...
September 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#3
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28918086/confidence-in-the-use-of-direct-oral-anticoagulants-in-the-acute-phase-of-nonvalvular-atrial-fibrillation-related-ischemic-stroke-over-the-years-a-real-world-single-center-study
#4
Federico Moroni, Luca Masotti, Vieri Vannucchi, Raffaella Chiarelli, Cristiana Seravalle, Alessandra Pesci, Francesca Pallini, Silvia Puliti, Barbara Cimolato, Lamberto Fattorini, Cornelia Scerra, Francesca Ristori, Maria Letizia Imbalzano, Stefano Spolveri, Giancarlo Landini, Elisa Grifoni, Maurizio Paciaroni
BACKGROUD AND AIM: The use of direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) is controversial. The aims of our study were to analyze physicians' confidence in prescribing DOACs in NVAF-related AIS, the characteristics of patients receiving DOACs, and their 90-day prognosis. MATERIAL AND METHODS: Clinical records of consecutive patients admitted to our wards for NVAF-related AIS over the years 2014-2016 were reviewed...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#5
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917114/prolonged-anticoagulant-treatment-in-patients-with-cancer-where-do-we-stand
#6
EDITORIAL
Mariasanta Napolitano, Sergio Siragusa
No abstract text is available yet for this article.
September 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28916674/anticoagulation-in-patients-with-atrial-fibrillation-in-the-setting-of-prior-hemorrhage-an-ongoing-dilemma
#7
REVIEW
Larry B Goldstein
No abstract text is available yet for this article.
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#8
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28916484/blood-loss-at-the-time-of-dilation-and-evacuation-at-16-to-22weeks-gestation-in-women-using-low-molecular-weight-heparin-a-case-series
#9
Mary Tschann, Alison Edelman, Jeffrey Jensen, Paula Bednarek, Bliss Kaneshiro
OBJECTIVE: Describe blood loss with surgical abortion≥16weeks gestation in anticoagulated patients. STUDY DESIGN: Clinicians involved in a professional listserv (2011-2013) reported cases of abortion≥16weeks gestation in anticoagulated women. RESULTS: All 7 patients were using or had recently discontinued low molecular weight heparin (LMWH). One patient was reported to have greater than anticipated blood loss for gestational age. No patients required transfusion and no complications were reported...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28916305/unusual-causes-of-venous-thrombosis-bladder-distension-and-uterine-mass
#10
Michael L Caparelli, Sepehr Lalezari, Steven Perlman
Thrombosis of the inferior vena cava (IVC) continues to be a rare event and there is a scarcity of evidence with regard to its etiology. One source for IVC thrombosis is external compression from adjacent structures. In this case series we present one case of IVC thrombosis caused by a severely distended bladder and a case of external iliac thrombosis caused by external compression from an abnormally enlarged uterus. The treatment of each case is varied and included novel oral anticoagulation (NOAC), catheter-directed thrombolysis in conjunction with mechanical thrombectomy, or a combination of these...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28916213/delayed-surgery-in-patients-with-acute-type-a-aortic-dissection-who-are-receiving-novel-oral-anticoagulants
#11
Raphael Hamad, Gilles Amr, Philippe Demers
No abstract text is available yet for this article.
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28915306/cost-utility-study-of-warfarin-genotyping-in-the-vachs-affiliated-anticoagulation-clinic-of-puerto-rico
#12
Carlos Martes-Martinez, Cristian Méndez-Sepúlveda, Joel Millán-Molina, Matthew French-Kim, Heriberto Marín-Centeno, Giselle C Rivera-Miranda, José J Hernández-Muñoz, Jorge Duconge-Soler
OBJECTIVE: To evaluate the cost-utility of the pharmacogenetic-guided dosing of warfarin (PGx), when compared to the current dosing strategy. METHODS: A Markov model was developed to assess the impact of the genotypingguided warfarin dosing in a hypothetical cohort of patients. The model was based on the percentage of time patients spent within the therapeutic international normalized ratio (INR) range (PTTR). PTTR estimates and genotype distribution were derived from a cohort of patients (n = 206) treated in the Veteran Affairs Caribbean Healthcare System (VACHS) and from results of other research study...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28915260/obesity-is-not-associated-with-recurrent-venous-thromboembolism-in-elderly-patients-results-from-the-prospective-switco65-cohort-study
#13
Carolin Mueller, Andreas Limacher, Marie Méan, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Whether obesity is associated with recurrent venous thromboembolism (VTE) in elderly patients is unknown. OBJECTIVES: To examine the association between two obesity measures, the body mass index (BMI) and the waist circumference (WC), and recurrent VTE in elderly patients. PATIENTS/METHODS: We studied 986 patients aged ≥65 years with an acute VTE from a prospective multicenter cohort study (09/2009-12/2013). The BMI was determined and categorized as <25, 25 to <30, or ≥30 kg/m2...
2017: PloS One
https://www.readbyqxmd.com/read/28914572/bleeding-and-thrombosis-in-pediatric-extracorporeal-membrane-oxygenation-can-we-improve-anticoagulation-strategies
#14
Shannon M Buckvold, John P Kinsella
No abstract text is available yet for this article.
September 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28914438/antihypercholesterolemic-antioxidant-and-renal-protective-effects-of-mengkudu-rubiaceae-fruit-in-nephropathy-induced-albino-rats
#15
U S Mahadeva Rao, C Shanmuga Sundaram
OBJECTIVE: To assess the modulatory impact of alcoholic extract of fruit of Mengkudu (AEFM, Morinda citrifolia L., Rubiaceae) on renal oxido-lipidemic stress in hypercholesterolemic albino rats. METHODS: Twenty-four male albino rats were randomly divided into four groups with six rats in each group: group I as control, group II fed with hypercholesterolemic diet (HCD) for 45 days (4% cholesterol and 1% cholic acid), Group III rats fed with HCD for 45 days + AEFM (300 mg/kg body weight/day orally) for last 30 days and group IV normal rats fed AEFM alone...
September 15, 2017: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28914415/a-randomized-trial-of-restarting-warfarin-at-maintenance-versus-loading-doses-following-an-elective-procedure
#16
Tammy J Bungard, Jay Mutch, Bruce Ritchie
Guidelines suggest restarting warfarin at known maintenance doses, although this may result in a delay to achieving therapeutic anticoagulation. As such, we compared the time to achieve an INR ≥ 2.0 between those restarting warfarin maintenance vs loading doses after transient interruption, and the impact on protein C, S and factor II levels. Patients requiring interruption of warfarin for elective procedures without hospitalization were randomized 1:1 to receive warfarin maintenance or loading doses (1...
September 15, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28914339/do-we-need-randomized-clinical-trials-in-extracorporeal-respiratory-support-yes
#17
EDITORIAL
Alain Combes, Antonio Pesenti, Daniel Brodie
Extracorporeal respiratory support, also known as extracorporeal gas exchange, may be used to rescue the most severe forms of acute hypoxemic respiratory failure with high blood flow venovenous extracorporeal membrane oxygenation. Alternatively, lower flow extracorporeal carbon dioxide removal might be applied to reduce the intensity of mechanical ventilation in patients with less severe forms of the disease. However, critical reading of the results of the randomized trials and case series published to date reveals major methodological biases...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#18
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#19
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914213/-medical-treatment-of-people-with-dementia-requires-dealing-with-uncertainty
#20
J P J Slaets
Here we report on a number of medical dilemmas during the final 6 years of life of a 78-year-old woman with dementia. Questions concerning both diagnostic procedures and treatment options are discussed. The first dilemma concerns mild symptoms leading to the diagnosis of paroxysmal atrial fibrillation and the requirement for anticoagulation; the second dilemma concerns vague symptoms of tiredness with anaemia leading to the diagnosis of colon cancer and the requirement for surgery. The conclusion is that there are no protocols that can be used to solve questions of this nature, and we need careful reflection with colleagues, the patient and important people in the patient's life in order to make decisions in the best interest of the quality of life as experienced by the patient...
2017: Nederlands Tijdschrift Voor Geneeskunde
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