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Hemorrhage and thrombosis

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https://www.readbyqxmd.com/read/28922656/impact-of-the-number-of-anti-thrombosis-agents-in-hemodialysis-patients-boreas-hd2-study
#1
Marenao Tanaka, Norihito Moniwa, Hirofumi Ohnishi, Tomohisa Yamashita, Masayuki Koyama, Yufu Gocho, Keitaro Nishizawa, Yukishige Kimura, Hirohito Sugawara, Sayaka Murakami, Yusuke Okazaki, Masato Furuhashi, Hideaki Yoshida, Tetsuji Miura
BACKGROUND/AIMS: Relationships between the number of anti-thrombosis agents, clinical benefits and adverse events in hemodialysis (HD) patients are unclear. METHODS: All patients on HD in 22 institutes (n = 1,071) were enrolled and followed up for 3 years. After exclusion of patients with missing data, kidney transplantation or retraction of consent during the follow-up period (n = 204), mortality rate and ischemic and hemorrhagic events were compared between different regimens of anti-thrombosis agents...
September 18, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28918703/a-randomized-multicenter-clinical-trial-of-rph-with-the-simplified-milligan-morgan-hemorrhoidectomy-in-the-treatment-of-mixed-hemorrhoids
#2
Yong-Heng He, Zhi-Jun Tang, Xiang-Tong Xu, De-Quan Huang, Li-Shun Zhang, Qing-Zhu Tang, Zhi-Min Fan, Xian-Jun Zou, Guo-Jun Zou, Chong-Yang Zhang, Fan Hu, Biao Xie, Yan-Hua Li, Yao Tong, Hong-Chang Liu, Ke Li, Yu-Lian Luo, Fei Liu, Guang-Wei Situ, Zuo-Long Liu
PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < ...
September 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28912883/tirofiban-facilitates-the-reperfusion-process-during-endovascular-thrombectomy-in-icas
#3
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#4
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28899640/status-epilepticus-in-pregnancy-etiology-management-and-clinical-outcomes
#5
Keni Ravish Rajiv, Ashalatha Radhakrishnan
BACKGROUND: Status epilepticus (SE) in pregnancy carries significant risk to both mother and fetus. There is limited literature available on SE occurring in pregnancy world-over, with majority being from obstetric centers. METHODS: All women who developed SE related to pregnancy (gestation, labor, or puerperium) between January 2000 and December 2016 were included in the study. Data were collected from our SE registry, maintained, and archived in the institute. The variables influencing the maternal and fetal outcome were compared using Student's t-test for continuous variables and Fisher's exact test for discrete variables...
September 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28894709/prognosis-and-risk-factors-influencing-recurrence-in-surgery-treated-patients-with-primary-sacral-tumors
#6
Xiliang Dang, Liping Lian, Dongsheng Wu
BACKGROUND: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. METHODS: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence...
August 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28893127/successful-presurgical-endovascular-management-of-venous-sinus-thrombosis-associated-with-high-grade-cerebral-arteriovenous-malformation-a-case-report
#7
Yoshinari Osada, Hidenori Endo, Kenichi Sato, Yasushi Matsumoto, Toshiki Endo, Miki Fujimura, Teiji Tominaga
We report a case of a 39-year-old man presenting with a high-grade left parieto-occipital arteriovenous malformation (AVM) complicated by superior sagittal sinus (SSS) stenosis, seven years after the first presentation. Magnetic resonance imaging revealed a newly developed perilesional edema. Venous sinus stenosis acutely progressed to occlusion and induced multiple intracerebral hemorrhages. An emergent balloon venoplasty of the SSS successfully recanalized the thrombosed sinus. Further, multistage transarterial nidus embolization was performed followed by surgical resection, resulting in a complete eradication of the large AVM...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28887621/comparison-of-prescribing-practices-with-direct-acting-oral-anticoagulant-protocols
#8
Evan Draper, Brandon Parkhurst, Blake Carley, Kori Krueger, Tonja Larson, Sara Griesbach
BACKGROUND: The goal of anticoagulation management programs is to prevent thrombosis while minimizing the risks of hemorrhage. Direct acting oral anticoagulants (DOACs) selectively inhibit coagulation proteins to inhibit thrombosis. Previous studies suggest patient monitoring and education provided through anticoagulation services enhance adherence and decrease adverse outcomes in patients receiving DOAC therapy. OBJECTIVE: The objectives of this study were to describe DOAC prescribing adherence to anticoagulation service protocols and to observe whether enrollment in an anticoagulation service resulted in greater prescribing adherence to DOAC protocols...
September 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28884652/the-incidence-of-pregnancy-related-stroke-a-systematic-review-and-meta-analysis
#9
Richard H Swartz, Megan L Cayley, Norine Foley, Noor Niyar N Ladhani, Lisa Leffert, Cheryl Bushnell, J A McClure, M Patrice Lindsay
Background Stroke risk is increased during pregnancy, but estimates of pregnancy-related stroke incidence vary widely. Aims A systematic review and meta-analysis was conducted to assess the incidence of stroke during pregnancy and the puerperium. Ovid Medline, EMBASE, and ISI Web of Science were searched for studies published between 1990 and January 2017 reporting stroke incidence during pregnancy and postpartum, from defined pregnancy populations. Pooled analyses were conducted using a random effects approach and expressed as an incidence rate per 100,000 pregnancies, with 95% confidence intervals...
October 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28883275/successful-management-of-intraperitoneal-bleeding-with-platelet-apheresis-and-von-willebrand-factor-supplementation-in-a-patient-with-essential-thrombocythemia-and-acquired-von-willebrand-syndrome
#10
Toshimitsu Ueki, Kanako Takeshige, Masahiko Sumi, Mayumi Ueno, Naoaki Ichikawa, Hikaru Kobayashi
A 36-year-old woman with essential thrombocythemia (ET) was admitted to our hospital for acute lower abdominal pain. Given no family history of bleeding disorder, she was diagnosed with acquired von Willebrand syndrome. Despite having a medical history of venous thrombosis, she had never been treated for ET because of her preferences. On admission, CT scan revealed massive hemorrhage in the ascending colon with the leakage of a contrast agent. Furthermore, a delayed enhancement of fluid collection in the Douglas fossa followingcontrast CT indicated bloody ascites...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28881141/elongated-plant-virus-based-nanoparticles-for-enhanced-delivery-of-thrombolytic-therapies
#11
Andrzej Stanislaw Pitek, Yunmei Wang, Sahil Gulati, Huiyun Gao, Phoebe L Stewart, Daniel I Simon, Nicole F Steinmetz
Thrombotic cardiovascular disease, including acute myocardial infarction, ischemic stroke, and venous thromboembolic disease, is the leading cause of morbidity and mortality worldwide. While reperfusion therapy with thrombolytic agents reduces mortality from acute myocardial infarction and disability from stroke, thrombolysis is generally less effective than mechanical reperfusion and is associated with fatal intra-cerebral hemorrhage in up to 2-4% of patients. To address these limitations, we propose the tobacco mosaic virus (TMV)-based platform technology for targeted delivery of thrombolytic therapies...
September 7, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28879803/practice-patterns-of-retrievable-inferior-vena-cava-filters-and-predictors-of-filter-retrieval-in-patients-with-pulmonary-embolism
#12
Jieun Kang, Heung-Kyu Ko, Ji Hoon Shin, Gi-Young Ko, Kyung-Wook Jo, Jin Won Huh, Yeon-Mok Oh, Sang-Do Lee, Jae Seung Lee
Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28867175/thrombo-hemorrhagic-liability-in-children-with-congenital-heart-diseases
#13
REVIEW
Shebl Said Shebl, Walid Ahmed Naguib El-Shehaby, Amira Hamed Darwish, Yasmin Shebl Said, Nabeh Helal Elfadaly, Eman Amer
BACKGROUND: The precise mechanisms of the increased incidence of hemostatic abnormalities in congenital heart disease (CHD) have not been determined. The aim of the study was to evaluate some indicators of activation of platelets and vascular endothelial cells in patients with CHD, evaluation of bleeding liability of these patients, and correlation with the clinical presentation of these patients. METHODS: This work was carried out on 20 patients with cyanotic congenital heart disease (CCHD), 20 patients with cyanotic congenital heart disease (ACHD), and 20 healthy children who served as the control group, aged between 1 and 10years...
August 26, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28856989/from-vulnerable-plaque-to-blood-healthy-therapy
#14
Sun Yuhua, Wang Baoping
Cardiovascular atherosclerotic disease is the leading cause of death in China and in Western nations. People with plaque or stenosis in the coronary artery or the carotid artery are the most susceptible population to suffer from acute events. Current investigations showed that plaque with the characteristics of intra-plaque hemorrhage or a thin cap with a large lipid core was causally associated with vulnerable plaque and plaque rupture. Of the many plaque ruptures occurring in patients with atherosclerotic disease, very few will trigger symptomatic events, rendering it exceedingly difficult to predict adverse outcomes...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28835439/management-of-rivaroxaban-or-apixaban-associated-major-bleeding-with-prothrombin-complex-concentrates-a-cohort-study
#15
Ammar Majeed, Anna Ågren, Margareta Holmström, Maria Bruzelius, Roza Chaireti, Jacob Odeberg, Eva-Lotta Hempel, Maria Magnusson, Tony Frisk, Sam Schulman
There is uncertainty regarding the effectiveness and occurrence of thromboembolic events in patients treated with prothrombin complex concentrates (PCC) for management of major bleeding events (MBE) on rivaroxaban or apixaban. We investigated the effectiveness of PCC given for management of MBE on rivaroxaban or apixaban. Between 1/1/2014 and 1/10/2016, we prospectively included patients treated with PCC for management of MBE on rivaroxaban or apixaban. The effectiveness of PCC was assessed using the International Society of Thrombosis and Hemostasis' Scientific and Standardization Subcommittee criteria for the assessment of effectiveness of major bleeding management...
August 23, 2017: Blood
https://www.readbyqxmd.com/read/28831047/flow-induced-elongation-of-von-willebrand-factor-precedes-tension-dependent-activation
#16
Hongxia Fu, Yan Jiang, Darren Yang, Friedrich Scheiflinger, Wesley P Wong, Timothy A Springer
Von Willebrand factor, an ultralarge concatemeric blood protein, must bind to platelet GPIbα during bleeding to mediate hemostasis, but not in the normal circulation to avoid thrombosis. Von Willebrand factor is proposed to be mechanically activated by flow, but the mechanism remains unclear. Using microfluidics with single-molecule imaging, we simultaneously monitored reversible Von Willebrand factor extension and binding to GPIbα under flow. We show that Von Willebrand factor is activated through a two-step conformational transition: first, elongation from compact to linear form, and subsequently, a tension-dependent local transition to a state with high affinity for GPIbα...
August 23, 2017: Nature Communications
https://www.readbyqxmd.com/read/28830290/emergent-loading-dose-of-antiplatelets-for-stenting-after-iv-rt-pa-in-acute-ischemic-stroke-a-feasibility-study
#17
Yun-Fei Han, Qi-Liang Dai, Xiang-Liang Chen, Yun-Yun Xiong, Qin-Yin, Ge-Lin Xu, Wu-Sheng Zhu, Ren-Liang Zhang, Min-Min Ma, Wen-Hua Liu, Xin-Feng Liu
BACKGROUND: A loading dose of antiplatelets reduces in-stent thrombosis after stent implantation. However, whether it is safe in patients undergoing acute stenting after intravenous recombinant tissue plasminogen activator (rt-PA) is unclear. METHODS: A case series of acute ischemic stroke patients treated with intravenous rt-PA followed by emergent stenting were prospectively included in Jinling Hospital Stroke Unit. An emergent loading dose of antiplatelets (aspirin 300mg and clopidogrel 300mg) were administered to all patients through a nasogastric tube immediately before stenting...
August 23, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28828053/ultrasound-prenatal-diagnosis-and-emergency-interventional-radiologic-therapy-of-galen-aneurysmal-malformation-in-a-newborn
#18
Roxana Elena Bohiltea, Natalia Turcan, Cristian Mihalea, Bogdan Dorobat, Eliza Elena Cinteza, Adriana Dan, Magdalena Mihai, Adela Dimitriade, Cristian Boros, Mircea Dumitru, Ionut Gobej, Octavian Munteanu, Monica Mihaela Cirstoiu
Located under the cerebral hemispheres and draining the anterior and central regions of the brain into the sinus of the posterior cerebral fossa, the vein of Galen aneurysmal malformation is considered to be a rare cause of hydrocephaly. The presence of this condition in the neonatal period typically includes intractable heart failure and a poor prognosis. We report a case of aneurysm of the vein of Galen diagnosed prenatally at 28 weeks of gestation, with the delivery at term by caesarean section of a female infant...
December 2016: Mædica
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#19
REVIEW
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818213/the-natural-history-and-outcomes-of-line-associated-upper-extremity-deep-venous-thromboses-in-critically-ill-patients
#20
Joshua Underhill, Matthew A Sherman, Ryan Howard, Anthony Hage, Andrea Obi, Lena Napolitano, Dawn M Coleman
OBJECTIVE: Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries the risk of hemorrhagic complications, possibly more so in surgical patients. Considering the low-risk profile of UEDVT-which is associated with fewer, less severe pulmonary emboli than lower extremity deep venous thrombosis-current UEDVT treatment guidelines may be overly aggressive. The goal of this study was to review outcomes of line-associated UEDVT in critically ill patients and to define the efficacy of current treatment protocols in pulmonary embolism (PE) prevention while avoiding hemorrhagic complications...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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