keyword
https://read.qxmd.com/read/38290880/oropharyngeal-hemorrhage-and-difficult-airway-management-a-decision-not-to-intubate
#1
JOURNAL ARTICLE
Rui A Ramos, Ana Rita Aguiar, Clara Gaio Lima, Rita Resende
BACKGROUND: Bleeding in the upper airways is an important cause of airway-related death. A higher incidence of airway management failure and complications after intubation attempts in the emergency department (ED) had been suggested. Airway management of patients with active oropharyngeal hemorrhage may be challenging, leading the clinician to modify the approach. CASE REPORT: A 57-year-old woman presented to the ED with oropharyngeal hemorrhage after an extensive invasive dental procedure...
October 30, 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/38023666/endoscopic-submucosal-dissection-for-early-gastric-cancer-in-a-patient-after-left-ventricular-assist-device-implantation-a-case-report
#2
Shinji Kuriki, Yoshiki Tsujii, Hirotsugu Saiki, Takahiro Amano, Ryotaro Uema, Minoru Kato, Takeo Yoshihara, Yoshito Hayashi, Hayato Hikita, Tetsuo Takehara
The use of left ventricular assist device (LVAD) implantation has increased in recent years. Here, we report the first case of gastric endoscopic submucosal dissection (ESD) following LVAD implantation. A 69-year-old man who previously underwent LVAD implantation for severe heart failure underwent esophagogastroduodenoscopy, which revealed a 15-mm flat-elevated cancerous lesion at the greater curvature of the gastric angle. Before ESD, antithrombotic drugs were discontinued and replaced with 10,000 units of heparin...
April 2024: DEN Open
https://read.qxmd.com/read/37882319/heterogeneous-distributions-in-clinical-events-preceding-anticoagulant-treatment-nonpersistence-in-patients-with-venous-thromboembolism-stratified-by-active-cancer-a-nationwide-cohort-study
#3
JOURNAL ARTICLE
Dongwon Yoon, Han Eol Jeong, Songhwa Choi, Daye Lee, Ju-Young Shin, Soo-Mee Bang
BACKGROUND: Nonpersistence in anticoagulation therapy is common and associated with undesirable clinical outcomes in patients with venous thromboembolism (VTE). METHODS: We investigated preceding clinical events of treatment nonpersistence (e.g., switching, discontinuing, or restarting) in VTE patients with and without active cancer using Korean claims database. RESULTS: Clinically significant events including thromboembolic events, hepatic function change and surgery preceded treatment nonpersistence, but heterogeneous distributions of clinical events were observed in the presence of active cancer...
October 26, 2023: Cancer Medicine
https://read.qxmd.com/read/37670818/a-super-geriatric-patient-with-gastrostomy-underwent-life-threatening-prothrombin-time-international-normalized-ratio-prolongation-by-warfarin-following-fasting-and-antibiotic-therapy
#4
Misa Saeki, Ayako Watanabe, Kenji Momo, Yuka Kashiwabara, Tatsuki Iha, Takuya Nagata, Akiko Fujiwara, Katsumi Tanaka
KEY CLINICAL MESSAGE: A 97-year-old woman with gastrostomy had a drastic enhancement for PT-INR after starting antibiotic therapy. Possible causes include (1) vitamin K deficiency due to fasting and (2) a combination of warfarin and antibiotics. ABSTRACT: Geriatric and Asian-descent patients are more sensitive to the effects of warfarin, a key anticoagulant drug. In this report, we present a 97-year-old bedridden woman being treated with warfarin for cardiogenic cerebral infarction and femoral neck replacement as part of in-home medical care with a gastrostomy and was admitted to our hospital after developing pneumonia...
September 2023: Clinical Case Reports
https://read.qxmd.com/read/37658660/impact-of-antithrombotic-therapy-on-postpancreatectomy-hemorrhage-in-7116-patients-a-project-study-by-the-japanese-society-of-hepato-biliary-pancreatic-surgery
#5
JOURNAL ARTICLE
Kota Nakamura, Minako Nagai, Ippei Matsumoto, Sohei Satoi, Fuyuhiko Motoi, Manabu Kawai, Yasuo Hosouchi, Ryota Higuchi, Shugo Mizuno, Takao Ohtsuka, Keiichi Akahoshi, Kenichi Hakamada, Michiaki Unno, Hiroki Yamaue, Masafumi Nakamura, Itaru Endo, Masayuki Sho
BACKGROUND: We previously reported an association between antithrombotic therapy and an increased risk of postpancreatectomy hemorrhage (PPH). To validate our findings, we conducted a large-scale multicenter retrospective study from 63 high-volume centers in Japan. METHODS: Between 2015 and 2018, 7116 patients who underwent pancreatectomy were enrolled. The antithrombotic group consisted of 920 patients (12.9%) who received preoperative antithrombotic agents including aspirin, clopidogrel, ticlopidine, prasugrel, warfarin, and direct oral anticoagulants...
September 1, 2023: Journal of Hepato-biliary-pancreatic Sciences
https://read.qxmd.com/read/36969833/efficacy-and-safety-of-anticoagulation-in-atrial-fibrillation-patients-with-intracranial-hemorrhage-a-systematic-review-and-meta-analysis
#6
REVIEW
Qiang Zhou, Xiang Liu, Xian Yang, Xiao-Hui Huang, Yan-Zi Wu, Ying-Ying Tao, Meng Wei
Background: The benefits and risks of starting anticoagulation therapy, such as direct oral anticoagulations (DOACs) or warfarin, in atrial fibrillation (AF) patients with a history of intracranial hemorrhage (ICH) remain controversial. We performed a systematic review and meta-analysis to compare the safety and efficacy of starting oral anticoagulation (OAC) and non-oral anticoagulation in these patients. Methods: PubMed, Cochrane Library, and Embase were searched from inception to 01 May 2022 for randomized controlled trials and cohort studies, reporting effectiveness and safety outcomes for anticoagulation therapy in atrial fibrillation patients with intracranial hemorrhage...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/36730667/management-of-anticoagulation-antiplatelet-medication-and-venous-thromboembolism-prophylaxis-in-elective-spine-surgery-concise-clinical-recommendations-based-on-a-modified-delphi-process
#7
JOURNAL ARTICLE
Scott L Zuckerman, Sigurd Berven, Michael B Streiff, Mena Kerolus, Ian A Buchanan, Alex Ha, Christopher M Bonfield, Avery L Buchholz, Jacob M Buchowski, Shane Burch, Clinton J Devin, John R Dimar, Jeffrey L Gum, Christopher Good, Han Jo Kim, Jun S Kim, Joseph M Lombardi, Christopher E Mandigo, Mohamad Bydon, Mark E Oppenlander, David W Polly, Gregory Poulter, Suken A Shah, Kern Singh, Khoi D Than, Alex C Spyropoulos, Scott Kaatz, Amit Jain, Richard W Schutzer, Tina Z Wang, Derek C Mazique, Lawrence G Lenke, Ronald A Lehman
STUDY DESIGN: Delphi method. OBJECTIVE: To gain consensus on the following questions: (1) When should anticoagulation/antiplatelet (AC/AP) medication be stopped before elective spine surgery?; (2) When should AC/AP medication be restarted after elective spine surgery?; (3) When, how, and in whom should venous thromboembolism (VTE) chemoprophylaxis be started after elective spinal surgery? SUMMARY OF BACKGROUND DATA: VTE can lead to significant morbidity after adult spine surgery, yet postoperative VTE prophylaxis practices vary considerably...
March 1, 2023: Spine
https://read.qxmd.com/read/36504262/perioperative-management-in-chronically-anticoagulated-children-undergoing-tonsillectomy
#8
JOURNAL ARTICLE
Inbal Hazkani, Kathleen R Billings, Evan Edwards, Eli Stein, Bhat Rukhmi, Jennifer Lavin
BACKGROUND: Tonsillectomy is a common procedure in children. Patients at high risk for thrombosis who require chronic anticoagulation therapy pose a special challenge when undergoing tonsillectomy, as bleeding may occur up to two weeks after surgery. Due to a lack of evidence-based data, there is no consensus on the best management for such patients. The objective of our manuscript is to review perioperative anticoagulation bridging strategies in children undergoing tonsillectomy. METHODS: Retrospective case series of chronically anticoagulated patients at high risk for a thromboembolic event, who underwent tonsillectomy from 2010 to 2021...
December 11, 2022: Pediatrics International: Official Journal of the Japan Pediatric Society
https://read.qxmd.com/read/36478807/acute-compartment-syndrome-after-restarting-warfarin-therapy-following-polyethylene-exchange-in-unicompartmental-knee-arthroplasty-case-report
#9
Jae-Hyuk Yang, Jae Hoon Kim, Sang Won Lee, Jooyoung You, Sojung Marissa Park, Sang-Gyun Kim
BACKGROUND: Acute compartment syndrome (ACS) is one of the true emergencies in orthopedics and traumatology. It can lead to permanent damage to skeletal muscles and neurovascular structures if not promptly treated. Although ACS usually occur after major trauma or invasive surgery, it can develop without trauma or after minimally invasive operation in anticoagulated patients. CASE REPORT: A 76-year-old woman underwent a polyethylene exchange in unicompartmental knee arthroplasty (UKA)...
December 2022: Heliyon
https://read.qxmd.com/read/36424229/kidney-transplantation-for-a-patient-with-protein-c-deficiency-using-activated-protein-c-concentrate-a-case-report
#10
JOURNAL ARTICLE
Yoshihiro Ikehata, Yuki Nakagawa, Katsuhito Yuzawa, Tomoya Shirakawa, Azusa Yoshiyama, So Nakamura, Yuki Nagashima, Keisuke Ishikawa, Naoya Nagaya, Takeshi Ashizawa, Toshiyuki China, Haruna Kawano, Fumitaka Shimizu, Masayoshi Nagata, Shuji Isotani, Satoru Muto, Masayuki Maiguma, Yusuke Suzuki, Shigeo Horie
BACKGROUND: Thrombophilia causes thrombosis after kidney transplantation (KT). Protein C deficiency is a rare form of hereditary thrombophilia. To our knowledge, there are few reports on KT for patients with protein C deficiency, and there are no reports of KT in patients with protein C deficiency administered with activated protein C concentrate. METHOD: Here we reported the case of a patient with protein C deficiency who underwent KT without the occurrence of any fresh thrombosis after administration of an activated protein C concentrate...
November 21, 2022: Transplantation Proceedings
https://read.qxmd.com/read/36244152/successful-management-of-postpartum-hemorrhage-and-surgical-site-infection-in-a-pregnant-woman-under-warfarin-for-heart-valve-replacement-a-case-report
#11
Alina Tandukar, Kritika Jha, Roshan Aryal, Pooja Paudyal, Neeta Katuwal, Suniti Joshi Rawal
INTRODUCTION AND IMPORTANCE: Pregnant women under warfarin for mechanical heart valves can pose a variety of challenges which requires fine tuning of various anticoagulants throughout the pregnancy and in the postpartum period as hemorrhage can lead to maternal and fetal morbidity and mortality. CASE PRESENTATION: A 36-year-old woman gravida two, para one at 35 weeks 5 days gestation, with hypothyroidism with mitral valve replacement and tricuspid valve repair due to rheumatic heart disease underwent emergency lower section cesarean section for fetal bradycardia...
October 13, 2022: International Journal of Surgery Case Reports
https://read.qxmd.com/read/36154315/bleeding-after-hemorrhoidectomy-in-patients-on-anticoagulation-medications
#12
JOURNAL ARTICLE
Hordur M Kolbeinsson, Maxwell Otto, Benjamin Kogelschatz, Usman Virk, Martin A Luchtefeld, James W Ogilvie
BACKGROUND: Post-hemorrhoidectomy bleeding is a serious complication after hemorrhoidectomy. In the setting of a new wave of anticoagulants, we aimed to investigate the relationship of post-operative anticoagulation timing and delayed bleeding. METHODS: We performed a retrospective analysis of all patients undergoing hemorrhoidectomy at a single institution over a 10-year period. Fisher's exact and Wilcoxon Rank Sum tests were utilized to test for association between delayed bleeding and anticoagulation use...
September 25, 2022: American Surgeon
https://read.qxmd.com/read/36111326/long-term-withdrawal-of-anticoagulation-and-antiplatelet-therapy-in-a-heartmate-3-left-ventricular-assist-device
#13
Kristina Menchaca, Catherine A Ostos Perez, Nemanja Draguljevic, Jennifer Paciletti, Waqas Ghumman, Cristiano Faber, Sajid Mirza
A 73-year-old male with end-stage heart failure underwent insertion of the HeartMate 3 (Abbott, North Chicago, IL, USA) device. Systemic anticoagulation and antiplatelets were discontinued for 52 days due to postoperative bleeding. After hemorrhage resolution, we restarted warfarin monotherapy targeting an international normalized ratio of 1.8-2.5. Eight months later, there are no reports of pump thrombosis, thromboembolism, and bleeding.
September 2022: Curēus
https://read.qxmd.com/read/36085017/double-trouble-management-of-perinephric-hematoma-and-renal-vein-thrombosis-post-percutaneous-renal-biopsy
#14
JOURNAL ARTICLE
Muhammad Imran Kamarudin, Chandran Nadarajan, Mohamed Ashraf Mohamed Daud
BACKGROUND: Performing percutaneous renal biopsy procedures in lupus nephritis (LN) and nephrotic syndrome presents a unique challenge to the nephrologist because of the risk of bleeding from the procedure and the hypercoagulable state in hypoalbuminemia. The management of a patient with venous thrombosis with perinephric hematoma post renal biopsy can be difficult if occurred. CASE PRESENTATION: We are presenting a case of perinephric hematoma following percutaneous renal biopsy in a 23-year-old man with lupus nephritis, nephrotic syndrome, and lower limbs deep vein thrombosis (DVT)...
September 9, 2022: BMC Nephrology
https://read.qxmd.com/read/35655532/restarting-anticoagulant-therapy-after-intracranial-hemorrhage-in-patients-with-atrial-fibrillation-a-nationwide-retrospective-cohort-study
#15
JOURNAL ARTICLE
Jong Youn Moon, Gi Hwan Bae, Jaehun Jung, Dong Hoon Shin
Background: Resuming anticoagulation after an intracranial hemorrhage (ICH) poses a clinical conundrum. The absence of relevant guidelines has led to wide variations in the decision on resuming anticoagulation therapies after ICH. This study aimed to evaluate the risks of an anticoagulation therapy on severe thrombotic events (STE) and severe hemorrhage events (SHE) in Korea and compare the effects of novel direct oral anticoagulants (NOACs) and warfarin in patients with AF. Methods: This study was performed using the Korean national health insurance claims data obtained between 2002 and 2017 from individuals who had recently survived an ICH with comorbid AF...
June 2022: IJC Heart & Vasculature
https://read.qxmd.com/read/35120766/characteristics-and-management-of-patients-with-stroke-and-major-hemorrhagic-episodes-with-atrial-fibrillation-under-vitamin-k-antagonist-therapy-eventho-study
#16
JOURNAL ARTICLE
Olga Gavín, Vanessa Roldán, Pilar Llamas-Sillero, Amparo Santamaría, Daniel Arumí, Susana Fernández de Cabo
INTRODUCTION AND OBJECTIVE: In Spain, vitamin K antagonists (VKA) remain the standard treatment for the prevention of thromboembolic and hemorrhagic complications in patients with atrial fibrillation (AF), despite the high risks of suffering adverse effects. The objective of this study was to characterize the profile of VKA-treated patients suffering from stroke/systemic embolism (SE) or major hemorrhagic episodes, their evolution and the actions taken after those episodes. MATERIALS AND METHODS: EVENTHO was an observational multicenter study conducted in 22 Anticoagulation Spanish Units...
February 1, 2022: Medicina Clínica
https://read.qxmd.com/read/34962835/anticoagulation-changes-following-major-and-clinically-relevant-nonmajor-bleeding-events-in-non-valvular-atrial-fibrillation-patients
#17
JOURNAL ARTICLE
Thane Feldeisen, Constantina Alexandris-Souphis, Brian Haymart, Xiaowen Kong, Eva Kline-Rogers, Faheem Handoo, Kaatz Scott, Mona Ali, Jay Kozlowski, Vinay Shah, Gregory Krol, James B Froehlich, Geoffrey D Barnes
BACKGROUND: Bleeding events are common complications of oral anticoagulant drugs, including both warfarin and the direct oral anticoagulants (DOACs). Some patients have their anticoagulant changed or discontinued after experiencing a bleeding event, while others continue the same treatment. Differences in anticoagulation management between warfarin- and DOAC-treated patients following a bleeding event are unknown. METHODS: Patients with non-valvular atrial fibrillation from six anticoagulation clinics taking warfarin or DOAC therapy who experienced an International Society of Thrombosis and Haemostasis (ISTH)-defined major or clinically relevant non-major (CRNM) bleeding event were identified between 2016 and 2020...
December 28, 2021: Journal of Pharmacy Practice
https://read.qxmd.com/read/34928442/off-pump-coronary-artery-bypass-with-heparin-in-a-patient-with-a-history-of-heparin-induced-thrombocytopenia-a-case-report
#18
JOURNAL ARTICLE
Yuya Ito, Aya Saito, Yuki Shirai, Noboru Motomura
BACKGROUND: Cardiovascular surgery for patients with a history of heparin-induced thrombocytopenia (HIT) with thrombosis requires careful perioperative anticoagulation therapy. When cardiovascular surgery is required for patients having 'remote' HIT, such as those who had a history of HIT and platelet factor-4/heparin antibodies turned out to be negative, it is recommended that re-exposure to heparin should be limited only to the intraoperative phase. However, few case reports have described detailed strategies for perioperative anticoagulation regimens...
December 20, 2021: Surgical Case Reports
https://read.qxmd.com/read/33883776/warfarin-induced-skin-necrosis-a-rare-condition
#19
JOURNAL ARTICLE
Josephine Nsaful, Yaw Ofori Adjei, Florence Dedey, Nelson Agboadoh, Edem Anyigba, Warigbani Pieterson
Warfarin induced skin necrosis is a rare debilitating and, in some cases, life-threatening complication. A 47-year-old male on life-long anticoagulation omits his medication and develops extensive skin necrosis of the left leg complicated by acute renal failure three days after restarting warfarin. Investigations reveal possible Protein S deficiency which is known to be a predisposing condition. Various mechanisms have been proposed as the underlying cause. He was managed on heparin, wound debridement and skin grafting...
December 2020: Ghana Medical Journal
https://read.qxmd.com/read/33522831/the-effect-of-anticoagulation-and-antiplatelet-use-in-trauma-patients-on-mortality-and-length-of-stay
#20
JOURNAL ARTICLE
Nisha Narula, Savas Tsikis, Sayuri P Jinadasa, Charles S Parsons, Charles H Cook, Bonnie Butt, Stephen R Odom
BACKGROUND: Though many trauma patients are on anticoagulation or antiplatelet therapy (AAT), there are few generalizable data on the risks for these patients. The purpose of this study was to analyze the impact of anticoagulation (AC) and antiplatelet (AP) therapy on mortality and length of stay (LOS) in general trauma patients. METHODS: A retrospective review was performed of patients in the institutional trauma registry during 2019 to determine AAT use on admission and discharge...
June 2022: American Surgeon
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