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https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#1
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28214948/reduced-anticoagulation-variability-in-patients-on-warfarin-monitored-with-fiix-prothrombin-time-associates-with-reduced-thromboembolism-the-fiix-trial
#2
Alma Rut Oskarsdóttir, Brynja R Gudmundsdottir, Olafur S Indridason, Sigrun H Lund, David O Arnar, Einar S Bjornsson, Magnus K Magnusson, Hulda M Jensdottir, Brynjar Vidarsson, Charles W Francis, Pall T Onundarson
Fiix-prothrombin time (Fiix-PT) differs from traditional PT in being affected by reduced factor (F) II or FX only. In the randomized controlled Fiix-trial, patients on warfarin monitored with Fiix-PT (Fiix-warfarin patients) had fewer thromboembolisms (TE), similar major bleeding (MB) and more stable anticoagulation than patients monitored with PT (PT-warfarin patients). In the current Fiix-trial report we analyzed how reduced anticoagulation variability during Fiix-PT monitoring was reflected in patients with TE or bleeding...
February 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28214640/the-art-of-mimicry-anterior-clinoid-dural-based-cavernous-hemangioma-mistaken-for-a-meningioma
#3
Tarek R Mansour, Yacine Medhkour, Pouya Entezami, Robert Mrak, Jason Schroeder, Azedine Medhkour
BACKGROUND: Cavernous hemangiomas account for 5-13% of central nervous system vascular lesions. They are usually found intra-axially but rarely involve extra-axial structures, most commonly the middle cranial fossa. A cavernous hemangioma presenting as a clinoid meningioma is extremely rare. CASE DESCRIPTION: We present a 36-year-old male with an asymptomatic intracranial mass found incidentally after an ATV accident. Preoperative MRI revealed a well-defined dural-based lesion arising from the right anterior clinoid process which was nearly homogenously enhancing, with a radiological diagnosis of meningioma...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28214484/hybrid-operative-thrombectomy-is-noninferior-to-percutaneous-techniques-for-the-treatment-of-acute-iliofemoral-deep-venous-thrombosis
#4
Limael E Rodríguez, Aihab Aboukheir-Aboukheir, Ricardo Figueroa-Vicente, Hiram Soler-Bernardini, Guillermo Bolanos-Avila, Luis J Torruella-Bartolomei, Anthony J Comerota, Jorge L Martinez-Trabal
OBJECTIVE: Hybrid operative thrombectomy (HOT) is a novel technique for the treatment of acute iliofemoral deep venous thrombosis (IFDVT) and is an alternative to percutaneous techniques (PTs) that use thrombolytics. In this study, we compare perioperative and intermediate outcomes of HOT vs PT as interventions for early thrombus removal. METHODS: From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb IFDVT...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214483/systemic-thrombolysis-increases-hemorrhagic-stroke-risk-without-survival-benefit-compared-with-catheter-directed-intervention-for-the-treatment-of-acute-pulmonary-embolism
#5
Nathan L Liang, Efthymios D Avgerinos, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Systemic thrombolysis (ST) and catheter-directed intervention (CDI) are both used in the treatment of acute pulmonary embolism (PE), but the comparative outcomes of these two therapies remain unclear. The objective of this study was to compare short-term mortality and safety outcomes between the two treatments using a large national database. METHODS: Patients presenting with acute PE were identified in the National Inpatient Sample (NIS) from 2009 to 2012...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#6
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#7
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28213942/pge2-ep4-attenuated-mucosal-injury-via-%C3%AE-arr1-src-egfr-mediated-proliferation-in-portal-hypertensive-gastropathy
#8
Siwei Tan, Xiaoliang Chen, Minyi Xu, Xiaoli Huang, Huiling Liu, Jie Jiang, Yu Lu, Xiaojie Peng, Bin Wu
BACKGROUND AND PURPOSE: Portal hypertensive gastropathy (PHG) is a serious complication of liver cirrhosis and a potential cause of bleeding in patients associated with cirrhosis. Suppressed mucosal epithelial proliferation is a crucial pathological characteristic of PHG. Our studies demonstrated an important role of prostaglandin E2 (PGE2 ) and its E-type prostanoid 4 (EP4 ) receptor in the promotion of mucosal proliferation. However, whether β-arrestin1 (β-arr1), a well-established mediator of G-protein-coupled receptors (GPCRs), is involved in the PGE2 /EP4 -mediated mucosal proliferation complex in PHG remains unclear...
February 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#9
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213819/conditional-knockout-of-activin-like-kinase-1-alk-1-leads-to-heart-failure-without-maladaptive-remodeling
#10
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, Richard H Karas, S Paul Oh, Navin K Kapur
Activin like kinase-1 (AlK-1) mediates signaling via the transforming growth factor beta (TGFβ) family of ligands. AlK-1 activity promotes endothelial proliferation and migration. Reduced AlK-1 activity is associated with arteriovenous malformations. No studies have examined the effect of global AlK-1 deletion on indices of cardiac remodeling. We hypothesized that reduced levels of AlK-1 promote maladaptive cardiac remodeling. To test this hypothesis, we employed AlK-1 conditional knockout mice (cKO) harboring the ROSA26-CreER knock-in allele, whereby a single dose of intraperitoneal tamoxifen triggered ubiquitous Cre recombinase-mediated excision of floxed AlK-1 alleles...
February 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28213685/prasugrel-for-japanese-patients-with-acute-coronary-syndrome-in-short-term-clinical-practice-prasfit-practice-i-a-postmarketing-observational-study
#11
Masato Nakamura, Tomoko Iizuka, Kei Sagawa, Kenji Abe, Shuichi Chikada, Miyuki Arai
: Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment ≥1 month before the end of the study period...
February 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28213669/aspirin-use-prior-to-coronary-artery-bypass-grafting-surgery-a-systematic-review
#12
REVIEW
Ayman Elbadawi, Marwan Saad, Ramez Nairooz
PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28213624/oligometastatic-colorectal-cancer-is-single-site-bony-colorectal-metastasis-a-treatable-condition
#13
Noel Cassar, Adrian Ben Cresswell, Brendan Moran
INTRODUCTION: A potentially resectable bony metastasis in the context of oligometastatic colorectal cancer is uncommon. Bony metastases are usually considered a late event with poor prognosis and generally associated with liver and/or lung metastases. INDEX CASE: A previously healthy 33-year-old gentleman, with no family history of colorectal cancer, presented with rectal bleeding and at colonoscopy had a biopsy-proven adenocarcinoma of the rectum, 7 cm from the anal verge...
February 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28213573/rivaroxaban-versus-dabigatran-or-warfarin-in-real-world-studies-of-stroke-prevention-in-atrial-fibrillation-systematic-review-and-meta-analysis
#14
Ying Bai, Hai Deng, Alena Shantsila, Gregory Y H Lip
BACKGROUND AND PURPOSE: This study was designed to evaluate the effectiveness and safety of rivaroxaban in real-world practice compared with effectiveness and safety of dabigatran or warfarin for stroke prevention in atrial fibrillation through meta-analyzing observational studies. METHODS: Seventeen studies were included after searching in PubMed for studies reporting the comparative effectiveness and safety of rivaroxaban versus dabigatran (n=3), rivaroxaban versus Warfarin (n=11), or both (n=3) for stroke prevention in atrial fibrillation...
February 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28213368/effects-of-dabigatran-according-to-age-in-atrial-fibrillation
#15
Mandy N Lauw, John W Eikelboom, Michiel Coppens, Lars Wallentin, Salim Yusuf, Michael Ezekowitz, Jonas Oldgren, Juliet Nakamya, Jia Wang, Stuart J Connolly
OBJECTIVE: The prevalence of atrial fibrillation (AF) and the risk of stroke and bleeding vary according to age. To estimate effects of dabigatran, compared with warfarin, on stroke, bleeding and mortality in patients with AF in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial according to age, we analysed treatment effects using age as a continuous variable and using age categories. METHODS: RE-LY included 10 855 (59.9%) patients aged <75 years, 4231 patients (23...
February 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28213164/carvedilol-use-is-associated-with-improved-survival-in-patients-with-liver-cirrhosis-and-ascites
#16
Rohit Sinha, Khalida A Lockman, Nethmee Mallawaarachchi, Marcus Robertson, John N Plevris, Peter C Hayes
BACKGROUND AND AIMS: Carvedilol, a non-selective beta-blocker (NSBB) with additional anti-alpha 1 receptor activity, is a potent portal hypotensive agent. It has been used as prophylaxis against variceal bleed. However, its safety in decompensated liver cirrhosis with ascites is still disputed. In this study, we examined whether long-term use of carvedilol in the presence of ascites is a risk factor for mortality. METHODS: This was a single-centre retrospective analysis of 325 consecutive patients with liver cirrhosis and ascites presenting to our Liver Unit between 1(st) of January 2009 to 31(st) August 2012...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28213102/comparison-of-multiplate-and-verifynow-platelet-function-tests-in-predicting-clinical-outcome-in-patients-with-acute-coronary-syndromes
#17
Peter D Larsen, Ana S Holley, Alexander Sasse, Ali Al-Sinan, Sarah Fairley, Scott A Harding
INTRODUCTION: This study examined the ability of two widely used "point of care" platelet function assays, VerifyNow and Multiplate, to predict adverse outcomes in patients with acute coronary syndromes (ACS). METHODS: We examined platelet reactivity using VerifyNow and Multiplate P2Y12 assays in patients with ACS and the relationship between platelet reactivity and both MACE (defined as a composite of death, myocardial infarction, stroke, stent thrombosis and unplanned revascularisation) and TIMI major bleeding at 1year...
February 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28212975/budget-impact-analysis-of-prolonged-half-life-recombinant-fviii-therapy-for-hemophilia-in-the-united-states
#18
Suzanne McMullen, Brieana Buckley, Eric Hall, Jon Kendter, Karissa Johnston
BACKGROUND: Hemophilia A is a factor VIII deficiency, associated with spontaneous, recurrent bleeding episodes. This may lead to comorbidities such as arthropathy and joint replacement, which contribute to morbidity and increased health care expenditure. Recombinant factor VIII Fc fusion protein (rFVIIIFc), a prolonged half-life factor therapy, requires fewer infusions, resulting in reduced treatment burden. OBJECTIVE: Use a budget impact analysis to assess the potential economic impact of introducing rFVIIIFc to a formulary from the perspective of a private payer in the United States...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212854/delayed-radiographic-manifestation-of-renal-pseudoaneurysms-after-blunt-trauma
#19
Michael Froehner, Felix Schaab, Thomas Hofmockel, Ralf-Thorsten Hoffmann, Dirk Fahlenkamp, Manfred P Wirth
Pseudoaneurysms may cause recurrent hematuria after blunt renal trauma. We report on an 18-year old patient with radiographic manifestation of pseudoaneurysm 41 days after blunt renal trauma. Initial and follow-up imaging for recurrent hematuria including angiography was without signs of pseudoaneurysm or active bleeding. This case illustrates that recurrent gross hematuria as a typical symptom of pseudoaneurysm may be present initially in the absence of radiographic signs. Repeat angiography should be taken into consideration if recurrent bleeding persists...
February 14, 2017: Urology
https://www.readbyqxmd.com/read/28212842/pathophysiological-consequences-of-receptor-mistraffic-tales-from-the-platelet-p2y12-receptor
#20
Margaret R Cunningham, Riyaad Aungraheeta, Stuart J Mundell
Genetic variations in G protein-coupled receptor (GPCR) genes can disrupt receptor function in a wide variety of human genetic diseases, including platelet bleeding disorders. Platelets are critical for haemostasis with inappropriate platelet activation leading to the development of arterial thrombosis, which can result in heart attack and stroke whilst decreased platelet activity is associated with an increased risk of bleeding. GPCRs expressed on the surface of platelets play key roles in regulating platelet activity and therefore function...
February 14, 2017: Molecular and Cellular Endocrinology
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