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https://www.readbyqxmd.com/read/29916929/intravenous-versus-topical-tranexamic-acid-in-total-knee-arthroplasty-both-effective-in-a-randomized-clinical-trial-of-640-patients
#1
Matthew P Abdel, Brian P Chalmers, Michael J Taunton, Mark W Pagnano, Robert T Trousdale, Rafael J Sierra, Yuo-Yu Lee, Friedrich Boettner, Edwin P Su, Steven B Haas, Mark P Figgie, David J Mayman
BACKGROUND: Tranexamic acid (TXA) reduces bleeding and the need for transfusion after total knee arthroplasty. Most literature has focused on intravenous (IV) administration of TXA, with less data available on the efficacy of topically administered TXA. This multicenter randomized clinical trial specifically assessed the efficacy of topical TXA compared with IV TXA as measured by calculated blood loss, drain output, and transfusion rates. Complications, including venous thromboembolism (VTE), were reported...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29916009/lack-of-durable-protection-against-cotton-smoke-induced-acute-lung-injury-in-sheep-by-nebulized-single-chain-urokinase-plasminogen-activator-or-tissue-plasminogen-activator
#2
Satoshi Fukuda, Perenlei Enkhbaatar, Christina Nelson, Robert A Cox, Marla R Wolfson, Thomas H Shaffer, Robert O Williams, Soraya Hengsawas Surasarang, Sahakijpijarn Sawittree, Galina Florova, Andrey A Komissarov, Kathleen Koenig, Krishna Sarva, Harrison T Ndetan, Karan P Singh, Steven Idell
BACKGROUND: Airway fibrin casts are clinically important complications of severe inhalational smoke-induced acute lung injury (ISIALI) for which reliable evidence-based therapy is lacking. Nebulized anticoagulants or a tissue plasminogen activator; tPA, has been advocated, but airway bleeding is a known and lethal potential complication. We posited that nebulized delivery of single chain urokinase plasminogen activator, scuPA, is well-tolerated and improves physiologic outcomes in ISIALI...
June 18, 2018: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/29915780/gastrostomy-tube-insertion-in-pediatric-patients-with-autosomal-recessive-polycystic-kidney-disease-arpkd-current-practice
#3
Kathrin Burgmaier, Joy Brandt, Rukshana Shroff, Peter Witters, Lutz T Weber, Jörg Dötsch, Franz Schaefer, Djalila Mekahli, Max C Liebau
Introduction: Autosomal recessive polycystic kidney disease (ARPKD) is a severe hepatorenal disorder of childhood. Early renal disease in ARPKD may require renal replacement therapy and is associated with failure to thrive resulting in a need for nasogastric tube feeding or gastrostomy. In ARPKD patients, the benefit of a gastrostomy in nutrition and growth needs to be weighed against the potential risk of complications of congenital hepatic fibrosis (CHF) and portal hypertension like variceal bleeding. CHF in ARPKD has thus been considered as a relative contraindication for gastrostomy insertion...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29915635/-diphyllobothrium-latum-mimicking-subacute-appendicitis
#4
Konika Sharma, Karn Wijarnpreecha, Nancy Merrell
Diphyllobothrium latum ( D. latum ) infection in humans is uncommon in the United States. Although there has been a drastic decline in the report of D. latum infection in this region, physicians should be aware of an uncommon presentation and its clinical relevance. We report a case of 55-year-old female of Ecuadorian/Peruvian origin who presented with an unknown cause of chronic right lower quadrant abdominal pain for 2 months without other particular symptoms. Initial workup revealed evidence of iron deficiency anemia, and stool occult blood test was positive...
June 2018: Gastroenterology Research
https://www.readbyqxmd.com/read/29915616/clinical-characteristics-and-type-of-antithrombotic-treatment-in-a-spanish-cohort-of-elderly-patients-with-atrial-fibrillation-according-to-dependency-frailty-and-cognitive-impairment
#5
Jose María Mostaza, Manuel Jesús Romero Jiménez, Fernando José Ruiz Laiglesia, José Antonio Díaz Peromingo, Manuel Beltrán Robles, Ernesto Guevara Sierra, Ana Santander Bilbao, Carmen Suárez
Background: Available data regarding clinical profile and management of elderly patients with atrial fibrillation (AF) according to dependency, fragility and cognitive impairment are scarce. The objective of the study was to analyze the biodemographic data, clinical profile and antithrombotic treatment according to dependency, fragility and cognitive impairment in elderly AF patients. Methods: Cross-sectional and multi-center study performed in consecutive AF patients ≥ 75 years treated with oral anticoagulants ≥ 3 months attended in Internal Medicine Departments in Spain...
April 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29915486/an-alternative-approach-to-life-threatening-gastrointestinal-bleeding-after-corrosive-ingestion
#6
Anand Narayan Singh, Ragini Kilambi, Kumble Seetharama Madhusudhan, Sujoy Pal
Massive gastrointestinal bleeding after corrosive intake is a rare complication that generally mandates a surgical intervention for control. Angioembolization for control of gastrointestinal bleeding in the setting of acute corrosive injury has not been described. Here, we present our experience of a case of acute corrosive injury presenting with massive upper gastrointestinal bleeding in the delayed phase which was successfully managed by angioembolization. We discuss the case in light of the literature available and describe markers which may serve to identify potential candidates for angioembolization...
April 2018: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29914380/vasodilator-stimulated-phosphoprotein-guided-clopidogrel-maintenance-therapy-reduces-cardiovascular-events-in-atrial-fibrillation-patients-requiring-anticoagulation-therapy-and-scheduled-for-percutaneous-coronary-intervention-a-prospective-cohort-study
#7
Chaoyue Hu, Xumin Zhang, Yonghua Liu, Yang Gao, Xiaohong Zhao, Hua Zhou, Yu Luo, Yaling Liu, Xiaodong Wang
BACKGROUND: In a previous study, we found that titrating clopidogrel maintenance doses (MDs) according to vasodilator-stimulated phosphoprotein (VASP) monitoring minimised the rate of major adverse cardiovascular and cerebral events (MACCE) after percutaneous coronary intervention (PCI) without increasing bleeding in patients with high on-treatment platelet reaction to clopidogrel. This study aimed to investigate whether VASP-guided clopidogrel MD could reduce thromboembolism and bleeding in atrial fibrillation (AF) patients requiring anticoagulation and scheduled for PCI...
June 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29914049/anticoagulant-activities-of-indobufen-an-antiplatelet-drug
#8
Jia Liu, Dan Xu, Nian Xia, Kai Hou, Shijie Chen, Yu Wang, Yunman Li
Indobufen is a new generation of anti-platelet aggregation drug, but studies were not sufficient on its anticoagulant effects. In the present study, the anticoagulant activity of indobufen was determined by monitoring the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) in rabbit plasma. We evaluated the anticoagulant mechanisms on the content of the platelet factor 3,4 (PF3,4), and the coagulation factor 1, 2, 5, 8, 10 (FI, II, V, VIII, X) in rabbits, as well as the in vivo bleeding time and clotting time in mice...
June 15, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29913541/cost-effectiveness-of-carbetocin-versus-oxytocin-for-prevention-of-postpartum-hemorrhage-resulting-from-uterine-atony-in-women-at-high-risk-for-bleeding-in-colombia
#9
Yaneth Gil-Rojas, Pieralessandro Lasalvia, Fabián Hernández, Camilo Castañeda-Cardona, Diego Rosselli
OBJECTIVE:  To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/cesarean section in women with risk factors for bleeding. METHODS:  A decision tree was developed for vaginal delivery and another one for cesarean, in which a sequential analysis of the results was obtained with the use of carbetocin and oxytocin for prevention of PPH and related consequences. A third-party payer perspective was used; only direct medical costs were considered...
May 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29913537/evaluation-of-the-utility-of-von-willebrand-factor-propeptide-in-the-differential-diagnosis-of-von-willebrand-disease-and-acquired-von-willebrand-syndrome
#10
Francesca Stufano, Marco Boscarino, Paolo Bucciarelli, Luciano Baronciani, Alberto Maino, Giovanna Cozzi, Flora Peyvandi
An increased von Willebrand factor propeptide (VWFpp) to VWF antigen (VWF:Ag) ratio (VWFpp/VWF:Ag) indicates an enhanced clearance of VWF. This finding has been described in von Willebrand disease (VWD) and in acquired von Willebrand syndrome (AVWS). A distinction between these two diseases, one congenital and the other acquired, is primarily based on family and personal history of bleeding. However, if this information is scanty, the diagnosis might be challenging due to the lack of an effective diagnostic biomarker...
June 18, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29913536/hemostasis-in-the-very-young
#11
Gili Kenet, Assaf Arie Barg, Ulrike Nowak-Göttl
Hemostasis is a dynamic process that starts in utero. The coagulation system evolves with age, as evidenced by marked physiological differences in the concentration of the majority of hemostatic proteins in early life compared with adulthood. This concept, known as "developmental hemostasis," has important biological and clinical implications. Overall, impaired platelet function, along with physiologically reduced levels of vitamin K-dependent and contact coagulation factors, may cause poorer clot firmness even in healthy neonates...
June 18, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29913535/thrombocytopenia-and-platelet-dysfunction-in-acute-tropical-infectious-diseases
#12
Indri Hapsari Putri, Rahajeng N Tunjungputri, Philip G De Groot, Andre J van der Ven, Quirijn de Mast
Thrombocytopenia is a well-known manifestation of acute tropical infectious diseases. The role of platelets in infections has received much attention recently because of their emerging activities in modulation of inflammatory responses, host defense, and vascular integrity. However, while many studies have addressed thrombocytopenia in tropical infections, abnormalities in platelet function have been largely overlooked. This is an important research gap, as platelet dysfunction may contribute to the bleeding tendency that characterizes some tropical infections...
June 18, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29910647/antiangiogenic-therapies-in-non-small-cell-lung-cancer
#13
REVIEW
A Alshangiti, G Chandhoke, P M Ellis
Angiogenesis is frequent in non-small-cell lung cancer (nsclc) and is associated with more aggressive disease. Many clinical trials have evaluated the addition of antiangiogenic therapy to standard therapies for patients with nsclc. Bevacizumab, a monoclonal antibody directed against serum vascular endothelial growth factor, in combination with carboplatin-paclitaxel chemotherapy, has been shown to improve survival for patients with nsclc. However, bevacizumab-based therapy is not suitable for many nsclc patients, including those with squamous histology, poor performance status, brain metastases, and the presence of bleeding or thrombotic disorders...
June 2018: Current Oncology
https://www.readbyqxmd.com/read/29910147/cameron-lesions-a-still-overlooked-diagnosis-case-report-and-systematic-review-of-literature
#14
A Zullo, R Manta, V De Francesco, G Fiorini, E Lahner, D Vaira, B Annibale
Cameron lesions are erosive-ulcerative alterations of gastric mucosa occurring in patients with large hiatal hernia, potentially causing gastrointestinal bleeding and iron deficiency anaemia. Diagnosis may be challenging, and not infrequently erosions are overlooked at endoscopy, so that repeated and unnecessary diagnostic procedures are performed, particularly in those patients with chronic anaemia. We described two peculiar cases of patients with iron deficiency anaemia in whom Cameron lesions were either overlooked or misinterpreted...
June 14, 2018: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29909859/a-meta-analysis-of-outcomes-of-catheter-directed-thrombolysis-for-high-and-intermediate-risk-pulmonary-embolism
#15
REVIEW
Efthymios D Avgerinos, Zein Saadeddin, Adham N Abou Ali, Larry Fish, Catalin Toma, Maria Chaer, Belinda N Rivera-Lebron, Rabih A Chaer
OBJECTIVE: During the past few years, there has been a surge in the use of catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE), in the form of either standard CDT or ultrasound-assisted CDT (usCDT). This is a systematic review and meta-analysis of all published series on contemporary CDT for acute PE seeking to determine their clinical efficacy, stratifying by PE severity and CDT modality. METHODS: A comprehensive MEDLINE and Embase search was performed to identify studies that reported outcomes of CDT for acute PE published from 2009 to July 2017...
July 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29909699/the-benefits-of-prophylaxis-in-patients-with-hemophilia-b
#16
Giancarlo Castaman
The health benefits of prophylactic dosing regimens for clotting factor therapy in patients with hemophilia include reduced joint damage and improved quality of life and, as such, prophylaxis is recommended in treatment guidelines. However, many patients with hemophilia B are treated on demand, and prophylaxis has been utilized less frequently than in hemophilia A. Areas covered: This review discusses the opportunities and evidence for prophylaxis in hemophilia B, in the context of treatment guidelines and with regard to factor IX (FIX) replacement therapies, including long-acting recombinant FIX (rFIX)...
June 18, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29909584/comparison-of-clinical-results-between-novel-percutaneous-pedicle-screw-and-traditional-open-pedicle-screw-fixation-for-thoracolumbar-fractures-without-neurological-deficit
#17
Ming Yang, Qinpeng Zhao, Dingjun Hao, Zhen Chang, Shichang Liu, Xinhua Yin
OBJECTIVES: To compare the efficacy and safety of novel percutaneous minimally invasive pedicle screw fixation and traditional open surgery for thoracolumbar fractures without neurological deficit. METHODS: Sixty adult patients with single thoracolumbar fracture between June 2014 and June 2016 were recruited in this study, randomly divided into open fixation group (group A) or minimally invasive percutaneous fixation group (group B). Clinical and surgical evaluation including surgery time, blood losses, radiation times, hospital stay, and complication were performed...
June 16, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29909576/comparative-risks-of-bleeding-ischemic-stroke-and-mortality-with-direct-oral-anticoagulants-versus-phenprocoumon-in-patients-with-atrial-fibrillation
#18
Mariam Ujeyl, Ingrid Köster, Hans Wille, Thomas Stammschulte, Rebecca Hein, Sebastian Harder, Ursula Gundert-Remy, Julian Bleek, Peter Ihle, Helmut Schröder, Gerhard Schillinger, Anette Zawinell, Ingrid Schubert
PURPOSE: The pivotal trials for stroke prevention in non-valvular atrial fibrillation (NVAF) compared rivaroxaban, dabigatran, and apixaban with warfarin, as did most claims-based studies. Comparisons with phenprocoumon, the most frequently used vitamin K antagonist (VKA) in Germany, are scarce. METHODS: Risk of bleeding, ischemic stroke, and all-cause mortality in patients with NVAF were analyzed using data for 2010 to 2014 from a large German claims database. New users of oral anticoagulants from January 2012 to December 2013 were included and observed over 1 year...
June 16, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29909391/ectopic-varices-a-potential-cause-of-gastrointestinal-bleeding-in-patients-with-portal-hypertension
#19
Indira Bhavsar, Anthony W Rooney, Brooke Corning, Neeral L Shah
A newly diagnosed 53-year-old woman with cirrhosis has repeated gastrointestinal bleeding with resulting symptomatic anaemia. She underwent routine diagnostic endoscopic evaluation without localisation of the aetiology of her bleed. Ultimately, she was found to have ectopic varices in the small bowel as a result of underlying high portal pressures. She underwent transjugular intrahepatic portosystemic shunt for portal system decompression with resolution in her bleeding.
June 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29909210/synchronous-diagnosis-of-intradiploic-epidermoid-cyst-and-anatomically-close-associated-chronic-epidural-hematoma
#20
Jian Zheng, Hong Zhang, Chun Wang
BACKGROUND: Intradiploic epidermoid cyst (IEC) concurrent with chronic epidural hematoma (CEDH) has never been reported in the literature. We report a unique case of IEC concurrent with anatomically close associated CEDH. CASE DESCRIPTION: A 54-year-old man presented with one week history of headache, confusion and drowsiness. Computed tomography (CT) exposed large extraaxial mixed density lesions with bone destruction and substantial mass effect in the left fronto-temporal region...
June 14, 2018: World Neurosurgery
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