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https://www.readbyqxmd.com/read/29691259/transdermal-estradiol-for-the-management-of-refractory-uremic-bleeding
#1
Jimmy Gonzalez, Samantha Bryant, Evelyn R Hermes-DeSantis
PURPOSE: The efficacy and thrombogenicity of transdermal estradiol in the management of refractory uremic bleeding in adults are examined. SUMMARY: Platelet dysfunction from chronic kidney disease may induce uremic bleeding. This type of bleeding may involve the skin, oral and nasal mucosa, gingivae, respiratory system, and gastrointestinal or urinary tract. While the mainstay of treatment for uremic bleeding primarily involves dialysis and use of prohemostatic agents such as desmopressin and erythropoiesis-stimulating agents, certain patients may experience bleeding refractory to these interventions...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29691157/transcatheter-aortic-valve-replacement-and-atrial-fibrillation-impact-of-antithrombotic-strategy-on-clinical-outcomes
#2
Samuel Hui, Robert Gooley, Hashrul N Rashid, Sarah Zaman
BACKGROUND: Antithrombotic recommendations following transcatheter aortic valve replacement (TAVR) are largely based on previous trial protocols. The efficacy and risk of anticoagulation has not been systematically assessed. The aim of this study was to determine the efficacy and safety of oral anticoagulation in patients with atrial fibrillation (AF) following TAVR with the Lotus Valve System (Boston Scientific, Malborough, MA, USA). METHODS: Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited (n=164)...
April 4, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29690772/prothrombin-another-clotting-factor-after-fv-that-is-involved-both-in-bleeding-and-thrombosis
#3
Antonio Girolami, Elisabetta Cosi, Silvia Ferrari, Bruno Girolami
Clotting factor defects are usually associated with bleeding. About 2 decades ago, 2 polymorphisms, one of FII (G20210A) and another of FV (Arg506Gln), have been shown to be associated with prothrombotic state and venous thrombosis. As a consequence, FII and FV could be considered both as prohemorrhagic factors and prothrombotic conditions. Recently, it has been shown that missense mutations in the prothrombin gene of amino acid Arg596 of exon 14 to Leu596, Gln596, or Trp596 caused the appearance of a thrombophilic state and venous thrombosis...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29689590/endometrial-ablation-past-present-and-future-part-i
#4
Morris Wortman
Endometrial ablation (EA) is a commonly performed minimally invasive technique to manage intractable uterine bleeding that is unresponsive to medical therapy. It originated in ancient times when chemical astringents were used to control uterine hemorrhage associated with childbirth and a variety of other gynecologic conditions. In the late 19th century, the use of astringents and chemical cauterants gave way to the application of a variety of thermal energy technologies to cause selective destruction of the endometrium...
April 23, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#5
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29687867/cryoablation-for-atrial-fibrillation-and-antiarrhythmic-drug-pretreatment-a-single-referral-center-experience
#6
M Spartalis, E Tzatzaki, E Spartalis, D Moris, I Doulamis, A S Triantafyllis, E Livanis, G Theodorakis
OBJECTIVE: Pulmonary vein isolation (PVI) ablation has emerged as the gold standard of ablative strategies to treat medically refractory paroxysmal and persistent atrial fibrillation (AF). Regardless of the superiority of catheter ablation based on PVI over antiarrhythmic drug therapy, recurrence rates of AF remain higher than desired. PVI via cryoablation has rapidly become a mainstream treatment for AF, due to its effectiveness and fast learning curve. Our objective was to assess the safety and efficacy of cryoablation in a single referral center...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#7
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29686820/biofeedback-efficacy-to-improve-clinical-symptoms-and-endoscopic-signs-of-solitary-rectal-ulcer-syndrome
#8
Mojgan Forootan, Masood Shekarchizadeh, Hamedreza Farmanara, Ahmad Reza Shekarchizadeh Esfahani, Mansooreh Shekarchizadeh Esfahani
Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy...
January 12, 2018: European Journal of Translational Myology
https://www.readbyqxmd.com/read/29686177/bilateral-giant-renal-angiomyolipoma-in-a-patient-with-tuberous-sclerosis-complex-a-case-report
#9
Andika Afriansyah, Abdul M Yusuf, Harry Nusaly
Tuberous sclerosis complex (TSC) has several renal manifestations including angiomyolipomas (AML) and renal epithelial neoplasms. A bilateral giant renal AML is extremely rare. We report a case of giant bilateral AML and discuss the diagnosis and treatment of it. The 22-year-old man was admitted due to bilateral flank pain, gross hematuria, and abdominal fullness. He had history of epilepsy, mental retardation, and delayed development during childhood. He had angiofibroma on his face since 10 years ago. Abdominal CT and MRI revealed large lobulated heterogeneous mass with fatty content...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29685415/preoperative-assessment-of-haemostasis-in-patients-undergoing-stereotactic-brain-biopsy
#10
Christopher Beynon, Shilai Wei, Alexander Radbruch, David Capper, Andreas W Unterberg, Karl L Kiening
Parenchymal hemorrhage is considered a major risk factor for perioperative morbidity in patients undergoing stereotactic brain biopsy. Studies on patients undergoing surgical procedures have suggested that evaluation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) is of limited value with regard to prevention of haemorrhagic complications. However, this issue has not yet been addressed in patients undergoing stereotactic biopsy of intracranial lesions. We retrospectively analysed the medical records of 159 consecutive patients undergoing stereotactic biopsy of supratentorial intracranial lesions during a three-year period...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29684971/-clinical-outcomes-of-angiography-and-transcatheter-arterial-embolization-for-acute-gastrointestinal-bleeding-analyses-according-to-bleeding-sites-and-embolization-types
#11
Soo Min Noh, Ji Hoon Shin, Ha Il Kim, Sun Ho Lee, Kiju Chang, Eun Mi Song, Sung Wook Hwang, Dong Hoon Yang, Byong Duk Ye, Seung Jae Myung, Suk Kyun Yang, Jeong Sik Byeon
Background/Aims: The clinical outcomes of angiography and transcatheter arterial embolization (TAE) for acute gastrointestinal bleeding (GIB) have not been completely assessed, especially according to bleeding sites. This study aimed to assess the efficacy of angiography and safety of TAE in acute GIB. Methods: This was a retrospective study evaluating the records of 321 patients with acute GIB who underwent angiography with or without TAE. Targeted TAE was conducted in 134 patients, in whom angiography showed bleeding sources...
April 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29684627/bioadhesives-for-internal-medical-applications-a-review
#12
REVIEW
Wenzhen Zhu, Yon Jin Chuah, Dong-An Wang
Bioadhesives such as tissue adhesives, hemostatic agents, and tissue sealants have gained increasing popularity in different areas of clinical operations during the last three decades. Bioadhesives can be categorized into internal and external ones according to their application conditions. External bioadhesives are generally applied in topical medications such as wound closure and epidermal grafting. Internal bioadhesives are mainly used in intracorporal conditions with direct contact to internal environment including tissues, organs and body fluids, such as chronic organ leak repair and bleeding complication reduction...
April 20, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29683909/acog-committee-opinion-no-734-the-role-of-transvaginal-ultrasonography-in-evaluating-the-endometrium-of-women-with-postmenopausal-bleeding
#13
(no author information available yet)
Cancer of the endometrium is the most common type of gynecologic cancer in the United States. Vaginal bleeding is the presenting sign in more than 90% of postmenopausal women with endometrial carcinoma. Clinical risk factors for endometrial cancer, including but not limited to age, obesity, use of unopposed estrogen, specific medical comorbidities (eg, polycystic ovary syndrome, type 2 diabetes mellitus, atypical glandular cells on screening cervical cytology), and family history of gynecologic malignancy also should be considered when evaluating postmenopausal bleeding...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683904/acog-committee-opinion-no-734-summary-the-role-of-transvaginal-ultrasonography-in-evaluating-the-endometrium-of-women-with-postmenopausal-bleeding
#14
(no author information available yet)
Cancer of the endometrium is the most common type of gynecologic cancer in the United States. Vaginal bleeding is the presenting sign in more than 90% of postmenopausal women with endometrial carcinoma. Clinical risk factors for endometrial cancer, including but not limited to age, obesity, use of unopposed estrogen, specific medical comorbidities (eg, polycystic ovary syndrome, type 2 diabetes mellitus, atypical glandular cells on screening cervical cytology), and family history of gynecologic malignancy also should be considered when evaluating postmenopausal bleeding...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683812/current-trends-in-aortic-root-surgery-the-mini-bentall-approach
#15
Djamila Abjigitova, Georgia Panagopoulos, Oleg Orlov, Vishal Shah, Konstadinos A Plestis
OBJECTIVE: The mini-sternotomy approach is becoming a widespread technique for aortic valve surgery. However, its safety for aortic root replacement has yet to be established. The aim of the present study was to compare the operative outcomes of patients who underwent aortic root replacement via upper mini-sternotomy (mini-Bentall) to patients who underwent Bentall procedure via median sternotomy (full-sternotomy Bentall). METHODS: Between November 1998 and November 2016, 91 consecutive patients underwent full-sternotomy Bentall procedure and 26 patients underwent mini-Bentall procedure...
April 20, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29683037/pharmacological-differentiation-of-thrombomodulin-alfa-and-activated-protein-c-on-coagulation-and-fibrinolysis-in-vitro
#16
Kosuke Tanaka, Shunsuke Tawara, Kazuhisa Tsuruta, Debra Hoppensteadt, Jawed Fareed
Although thrombomodulin alfa (TM alfa), recombinant human soluble thrombomodulin, exerts antithrombogenic effects through activated protein C (APC), clinical trials suggested that TM alfa has a lower bleeding risk than does recombinant human APC. To address the mechanism explaining this difference, effects of TM alfa and APC on thrombogenic, coagulation, and fibrinolytic processes were compared in vitro. TM alfa and APC inhibited generation of thrombogenic markers, thrombin, and prothrombin fragment F1+2 and prolonged coagulation parameters, activated clotting time (ACT), and activated partial thromboplastin time (APTT)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29682911/detection-of-individual-responses-to-clopidogrel-validation-of-a-novel-rapid-analysis-using-teg-6s
#17
Bartosz Olechowski, Richard T Dalton, Vikram Khanna, Alexander Ashby, Maria Vavyla, Mark Mariathas, Scott Harris, Zoe Nicholas, Michael Mahmoudi, Nick Curzen
INTRODUCTION: There is potential value in testing individual response to P2Y12 inhibitors in order to predict ischaemic and bleeding risk in patients undergoing percutaneous coronary intervention. The aims of this study were:(a) to validate the ability of a novel point of care(POC) assay, TEG 6s, to detect changes in ADP-induced whole blood clotting in volunteers and patients given clopidogrel using TEG 5000 as a reference and (b) to compare a novel, rapid parameter, area under the curve at 15 minutes(AUC15), with the traditional maximum clot amplitude (MA) in TEG 6s...
April 22, 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29682380/lung-middle-lobe-laceration-needing-lobectomy-as-complication-of-nuss-bar-removal
#18
Brice Henry, Valérie Lacroix, Thierry Pirotte, Pierre-Louis Docquier
Minimally invasive procedure for the treatment of pectus excavatum as described by Nuss has been used from 1987. The bar initially introduced blindly is now introduced under thoracoscopic control to increase safety of the procedure. It is usually removed two to three years after its insertion in a one-day procedure. Complications of the bar removal are rare but potentially serious. We report the case of a serious complication which occurred immediately after the Nuss bar removal. A 15-year-old boy underwent a Nuss procedure for a severe pectus excavatum without relevant complication...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#19
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29682267/an-unusual-deceptive-delayed-of-profuse-haemorrhage-after-mandibular-implant-dentistry-risk-planning-and-medico-legal-instruction
#20
R M Gaudio, E El Haddad, G El Haddad, D Lauritano, F Carinci
Mandibular implant placement (MIP) has been accepted and widely used for decades all over the world, and has reached a very high level of therapeutic reliability. MIP is used mostly in elderly edentulous patients who lost their teeth when dentistry was not oriented to fixed or removable prosthetic. Notwithstanding this, every year cases of severe complications during MIP due to haemorrhage causing life-threatening airway's obstruction are reported. These severe complications of MIP need immediate therapy, usually with hospitalization, and may be potentially fatal...
October 2017: Oral & Implantology
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