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https://www.readbyqxmd.com/read/28510336/epistaxis-in-anticoagulated-patients-fewer-hospital-admissions-and-shorter-hospital-stays-on-rivaroxaban-compared-to-phenprocoumon
#1
Thomas C Sauter, Karim Hegazy, Wolf E Hautz, Gert Krummrey, Meret E Riklin, Michael Nagler, Urs Borner, Aristomenis K Exadaktylos
OBJECTIVES: Treatment of epistaxis in patients on anticoagulants is challenging and associated with higher admission rates and longer hospital stays compared to patients without anticoagulation. However, there is little information about epistaxis in patients taking new direct oral anticoagulants such as rivaroxaban compared to patients on traditional vitamin-K antagonists such as phenprocoumon. DESIGN: Retrospective cohort study. SETTING: The study was conducted at the emergency department of the University Hospital Inselspital, Bern, Switzerland...
May 16, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28508924/intractable-epistaxis-which-arteries-are-responsible-an-angiographic-study
#2
Guillaume de Bonnecaze, Y Gallois, P Chaynes, F Bonneville, A Dupret-Bories, E Chantalat, E Serrano
PURPOSE: Epistaxis constitutes a significant proportion of the Otolaryngologist's emergency workload. Optimal management differs in relation to the anatomic origin of the bleeding. The outcome of our study was to determine which artery(ies) could be considered as the cause of severe bleeding in the context of severe epistaxis. METHODS: Fifty-five procedures of embolization preceded by angiography were reviewed. Medical records of interventionally treated patients were analysed for demographics, medical history, risk factors and clinical data...
May 16, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28503128/a-confounding-case-of-inherited-factor-v-deficiency-complicated-by-inhibitors-at-first-presentation
#3
Hema Subramanian, Rakhee Kar, Deepak Charles, Hitha Babu, Pagadalu Ambika, Tarun Kumar Dutta
INTRODUCTION: Inherited factor V deficiency / Owren's disease has varied clinical manifestations ranging from asymptomatic laboratory abnormalities to massive hemorrhage. The acquired form due to inhibitors following antibiotic therapy, infection, or surgery is less common, and spontaneous development of inhibitors is not known. CASE REPORT: An 18-year-old boy presented with bleeding axillary and groin ulcers. At the age of 15, due to recurrent epistaxis and gum bleed, he was diagnosed with acquired factor V deficiency with positive inhibitor screen and treated with fresh frozen plasma (FFP) transfusion and temporary azathioprine...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28492120/a-rare-case-of-massive-hepatosplenomegaly-due-to-acute-lymphoblastic-leukemia-in-pregnancy
#4
Ricardo Gonçalves, Ruchika Meel
Acute lymphoblastic leukaemia (ALL) is rarely seen in pregnancy. Massive hepatosplenomegaly as a presentation of ALL has not been described previously in any patient population. A 30-year-old pregnant woman presented at 16 weeks' gestation with epistaxis, jaundice, diffuse abdominal pain and distension, massive hepatosplenomegaly and peripheral oedema. On the basis of blood tests, bone marrow biopsy and imaging, a diagnosis of ALL complicated by massive hepatosplenomegaly with splenic infarctions was made. The patient was referred to oncology for appropriate chemotherapy...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28490409/endoscopic-guided-coblation-treatment-of-nasal-telangiectasias-in-hereditary-hemorrhagic-telangiectasia-how-i-do-it
#5
David M Poetker
INTRODUCTION: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease that leads to frequent epistaxis. It can have a significant impact on quality of life. Many reports exist regarding various therapies to address the epistaxis. MATERIALS AND METHODS: We presented our technique for addressing the epistaxis associated with HHT. RESULTS: Patients are treated in the operating room while they are under general anesthesia...
May 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#6
Ncedile Mankahla, David LeFeuvre, Allan Taylor
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28465443/phase-i-and-preliminary-phase-ii-study-of-trc105-in-combination-with-sorafenib-in-hepatocellular-carcinoma
#7
Austin Duffy, Chi Ma, Susanna Ulahannan, Osama E Rahma, Oxana Makarova-Rusher, Liang Cao, Yunkai Yu, David Kleiner, Jane Trepel, Min-Jung Lee, Yusuke Tomita, Seth M Steinberg, Theo Heller, Baris Turkbey, Peter L Choyke, Cody J Peer, William D Figg, Bradford J Wood, Tim F Greten
Endoglin (CD105) is an endothelial membrane receptor expressed on tumor vasculature. Endoglin expression is induced by VEGF pathway inhibition. TRC105 is a chimeric IgG1 CD105 monoclonal antibody that inhibits angiogenesis, causes antibody-dependent cellular cytotoxicity (ADCC) and apoptosis of proliferating endothelium. <br /><br />Experimental Design: Patients with HCC (Childs Pugh A/B7), ECOG 0/1, were enrolled in a phase I study of TRC105 at 3, 6, 10, 15mg/kg q 2wks given with sorafenib 400mg bid...
May 2, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28465267/outcome-of-endoscopic-transsphenoidal-surgery-for-acromegaly
#8
Jung Hee Kim, Kyu Yeon Hur, Jung Hyun Lee, Ji Hyun Lee, Young-Bem Se, Hey In Kim, Seung Hoon Lee, Do-Hyun Nam, Seong Yeon Kim, Kwang-Won Kim, Doo-Sik Kong, Yong Hwy Kim
OBJECTIVE: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in two referral centers in Korea. METHODS: We enrolled 134 patients with acromegaly (microadenomas, n=15; macroadenomas, n=119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n=74) and Samsung Medical center (n=60) between Jan 2009 and Mar 2016. Remission was defined as having a normal IGF-1 and a suppressed GH less than 1 ng/mL during an oral glucose tolerance test...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28463569/early-and-late-recurrent-epistaxis-admissions-patterns-of-incidence-and-risk-factors
#9
Oded Cohen, Hagit Shoffel-Havakuk, Meir Warman, Sharon Tzelnick, Yaara Haimovich, Gavriel D Kohlberg, Doron Halperin, Yonatan Lahav
Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28449465/application-of-bronchoscope-for-the-placement-of-nasoenteric-feeding-tube-in-patients-with-esophagectomy-a-novel-technique
#10
Hai-Xia Cao, Wei Zhang, Jun Zhang, Xiong-Huai Hua, Jian-Jun Qin, Yin Li
BACKGROUND: Currently the available techniques for the placement of nasoenteric feeding tube (NET), utilizing transnasal gastroscope are fast and tolerable, which is known as the most popular method. However, lots of hospitals don't have this endoscopic system. Bronchoscope, which is the basic respiratory endoscope, not only has the advantages of transnasal endoscopy, but also is popular in common hospitals. We used oxygen instillation as air supply plant of the bronchoscope, which broke its application limitation in digestive tract...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28447100/f7-gene-variants-modulate-protein-levels-in-a-large-cohort-of-patients-with-factor-vii-deficiency-results-from-a-genotype-phenotype-study
#11
Gabriele Quintavalle, Federica Riccardi, Gianna Franca Rivolta, Davide Martorana, Caterina Di Perna, Antonio Percesepe, Annarita Tagliaferri
Congenital factor VII (FVII) deficiency is a rare bleeding disorder caused by mutations in F7 gene with autosomal recessive inheritance. A clinical heterogeneity with poor correlation with FVII:C levels has been described. It was the objective of this study to identify genetic defects and to evaluate their relationships with phenotype in a large cohort of patients with FVII:C<50 %. One hundred twenty-three probands were genotyped for F7 mutations and three polymorphic variants and classified according to recently published clinical scores...
April 27, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28444800/endoscopic-meatus-scoring-scale-versus-sniff-test-to-predict-insertability-before-transnasal-endoscopy-a-prospective-randomized-study
#12
Chi-Tan Hu, Wei-Yi Lei, Jen-Shung Lin, Jui-Sheng Hung
BACKGROUND AND AIM: Sniff test is a common method before unsedated transnasal EGD (UT-EGD) to select a nostril insertion site. Yet, there is no objective method to select a more specific meatus insertion tract for anesthesia and insertion. We devised a endoscopic meatus scoring scale by anterior meatuscopy to select the most optimal meatus insertion tract. We hypothesized that meatuscopy instead of sniff test might improve tolerance and reduce adverse events during nasal anesthesia and UT-EGD...
April 26, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28442409/sinonasal-mucosal-melanoma-a-44-case-study-and-literature-analysis
#13
M Dréno, M Georges, F Espitalier, C Ferron, A Charnolé, B Dréno, O Malard
OBJECTIVES: Sinonasal mucosal melanoma is a rare disease, representing 4% of nasal cavity and paranasal sinus malignancies. The aim of this study was to assess the clinical characteristics, progression and treatment of this disease and to identify prognostic factors. MATERIAL AND METHODS: This retrospective review presents a cohort of 44 patients treated for a melanoma arising from the nasal cavity and paranasal sinuses, in the ENT Head and Neck Surgery Department of the University Hospital of Nantes (France) between 1988 and 2015...
April 22, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28434017/recurrent-epistaxis-predicting-risk-of-30-day-readmission-derivation-and-validation-of-rhino-ooze-score
#14
A Addison, C Paul, R Kuo, A Lamyman, P Martinez-Devesa, R Hettige
BACKGROUND: To derive and validate a predictive scoring tool (RHINO-ooze score) with good sensitivity and specificity in identifying patients with epistaxis at high risk of 30 day readmission and to enable risk stratification for possible definitive intervention. METHODS: Using medical databases, we searched for factors influencing recurrent epistaxis. The information ascertained together with our analysis of retrospective data on patients admitted with epistaxis between October 2013 and September 2014, was used as the derivation cohort to develop the predictive scoring model (RHINO-ooze score)...
April 23, 2017: Rhinology
https://www.readbyqxmd.com/read/28418273/thalidomide-for-epistaxis-in-patients-with-hereditary-hemorrhagic-telangiectasia-a-preliminary-study
#15
Jia Fang, Xiaomeng Chen, Bijun Zhu, Haibo Ye, Weitian Zhang, Jian Guan, Kaiming Su
To evaluate the effectiveness of thalidomide for epistaxis in hereditary hemorrhagic telangiectasia (HHT), 7 HHT patients with recurrent epistaxis were treated with thalidomide at an initial dose of 50 mg/d, gradually increasing to 100 mg/d if needed. The Epistaxis Severity Score (ESS) was used to evaluate the treatment effects. Patients reported that epistaxis improved 1 to 3 weeks after starting thalidomide. The mean ESS before treatment, at the end of treatment, and 3 months after stopping treatment was 5...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28415913/characteristics-and-management-of-primary-and-other-immune-thrombocytopenias-spanish-registry-study
#16
Javier Palau, Esther Sancho, Magdalena Herrera, Sol Sánchez, María Eva Mingot, Rosa Isabel Upegui, Mª José Rodríguez Salazar, Fátima de la Cruz, Mª Cristina Fernández, Tomás José González López, José Julio Hernández, Eduardo Ríos, Mª Fernanda López-Fernández, Marta García, José-Ángel Hernández, Miguel A Sanz
BACKGROUND: The natural history and its modulation by treatments administered for immune thrombocytopenia (ITP) in the clinical practice remains unknown. In addition, little information is available on the characteristics and management of ITP in Spain. METHODS: We conducted an observational, multicenter, registry in 70 Hematology Services from Spain between 2009 and 2011, which included children from 2 months of age and adults with primary ITP or another ITP diagnosed within the last 6 months (platelet count [PC] < 100 × 10(9)/l)...
April 17, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28414669/a-case-of-hepatosplentic-t-cell-lymphoma-a-rare-aggressive-tumor-of-the-young
#17
S Cingam, S Patel, N Koshy
INTRODUCTION: Hepatosplenic T-cell lymphoma (HSTCL); is an unusual entity first described in 1990 that predominantly affects middle-aged men and is classified by WHO under peripheral T-cell lymphomas. We present a 26-year-old man with HSCTL treated with a non-CHOP regimen. CASE: A 26 year old immigrant from Cameroon without significant past medical history presented with abdominal discomfort that was first noted 1 month prior at which time he was elbowed in abdomen during a basketball game...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28395494/-diagnosis-and-treatment-of-traumatic-optic-neuropathy-with-internal-carotid-artery-trauma
#18
Q J Fan, L Y Ni, X J Liu, Y Zeng, L F Jiang, B Zheng
Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness...
March 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28389160/features-of-sinonasal-hemangioma-a-retrospective-study-of-31-cases
#19
Shinya Takaishi, Daiya Asaka, Tsuguhisa Nakayama, Jiro Iimura, Yoshinori Matsuwaki, Shinichi Hirooka, Hiroyuki Takahashi, Hiromi Kojima, Nobuyoshi Otori
OBJECTIVE: Although hemangiomas are common lesions of the head and neck, sinonasal hemangiomas are rare. The purpose of this study was to analyze the clinical features (sex, age, symptoms, and size and anatomical location of the lesion) and the histological findings of sinonasal hemangioma cases, to assess preoperative transarterial embolization, and to evaluate the outcome (recurrence or no recurrence) of endoscopic sinus surgery. METHODS: Clinical records of 31 patients who underwent endoscopic sinus surgery for resection of sinonasal hemangioma between January 2010 and June 2015 were retrospectively reviewed...
April 4, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28387092/-hereditary-hemorrhagic-telangiectasia-and-pulmonary-arteriovenous-malformations-in-children
#20
M Thimmesch, K El Abd, D Brisbois, J Khamis, M Lewin, P Philippet
Hereditary hemorrhagic telangiectasia is a constitutional vascular dysplasia characterized by chronic epistaxis, mucocutaneous and visceral telangiectasias and arteriovenous malformations. Apart from family screenings, the disease is rarely diagnosed during the pediatric age given the late advent of typical clinical symptoms. Nevertheless, arteriovenous malformations are sometimes already present at a young age with significant morbidity risk. Therefore, it is important to establish an early diagnosis. We describe two pediatric cases of hereditary hemorrhagic telangiectasia and pulmonary arteriovenous malformations with divergent clinical presentation...
December 2016: Revue Médicale de Liège
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