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https://www.readbyqxmd.com/read/28550759/venous-thromboembolism-in-the-elderly-a-narrative-review
#1
REVIEW
T Tritschler, D Aujesky
Persons aged ≥65years not only account for over 60% of venous thromboembolism (VTE) events, they have also a higher mortality and VTE-related morbidity than younger patients, including anticoagulation-related bleeding and the postthrombotic syndrome. However, only few studies have focused specifically on VTE in older persons and practice guidelines commonly extrapolate study results from younger healthier patients to the multimorbid elderly. Evidence suggests that the clinical presentation is more subtle in the elderly with VTE and that commonly used diagnostic modalities, including clinical prediction rules, D-dimer tests, and planar ventilation-perfusion scans are less specific and efficient in older persons...
May 17, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28550758/platelets-and-hemophilia-a-review-of-the-literature
#2
REVIEW
Julia Riedl, Cihan Ay, Ingrid Pabinger
Hemophilia A and B are inherited bleeding disorders due to deficiencies of the clotting factors VIII and IX, respectively. The severity of the disease correlates with remaining factor levels, although individual differences in bleeding tendency are seen despite similar factor levels. While thrombin generation is severely impaired in persons with hemophilia, primary hemostasis, i.e. platelet function, has been generally considered to be normal. However, some studies reported prolonged bleeding times in hemophilia, suggesting that also primary hemostasis is affected...
May 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28550640/endogenous-tissue-factor-pathway-inhibitor-in-vascular-smooth-muscle-cells-inhibits-arterial-thrombosis
#3
Jichun Yang, Kaiyue Jin, Jiajun Xiao, Jing Ma, Duan Ma
Tissue factor pathway inhibitor (TFPI) is the main inhibitor of tissue factor-mediated coagulation. TFPI is expressed by endothelial and smooth muscle cells in the vasculature. Endothelium-derived TFPI has been reported to play a regulatory role in arterial thrombosis. However, the role of endogenous TFPI in vascular smooth muscle cells (VSMCs) in thrombosis and vascular disease development has yet to be elucidated. In this TFPI(Flox) mice crossbred with Sma-Cre mice were utilized to establish TFPI conditional knockout mice and to examine the effects of VSMC-directed TFPI deletion on development, hemostasis, and thrombosis...
May 27, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28550512/duplex-ultrasound-versus-clinical-surveillance-in-the-prediction-of-tips-malfunction-placed-for-refractory-ascites-is-ultrasound-surveillance-useful
#4
Shamar Young, Patrick Scanlon, Prashant Sherestha, Jafar Golzarian, Tina Sanghvi
PURPOSE: Since the advent of expanded polytetrafluoroethylene-covered stents and the improved patency they confer for transjugular intrahepatic portosystemic shunt (TIPS), the need to perform ultrasound surveillance has been debated. Prior reports have failed to separately evaluate patients who had TIPS placed for refractory ascites and variceal bleeding. The difference in morbidity from TIPS malfunction between these cohorts argues for distinction between the two. This retrospective review aims to determine whether Duplex ultrasound or return of symptoms more accurately predicts TIPS dysfunction...
May 26, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#5
REVIEW
C M McCarthy, J Unterscheider, C Burke, J Coulter
We describe a case of a 36-year-old woman presenting with vaginal bleeding and suboptimally rising serum human chorionic gonadotropin levels, who was investigated for a pregnancy of unknown location. Ultrasonography, laparoscopy and dilatation and curettage failed to reveal signs of an intra-uterine or intra-abdominal pregnancy. Following computed tomography imaging, a mediastinal mass was histologically determined to be a gestational choriocarcinoma. Following surgical resection and chemotherapy, the patient recovered and proceeded to have a successful intra-uterine pregnancy...
May 26, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28550352/efficacy-and-safety-of-full-length-pegylated-recombinant-factor-viii-with-extended-half-life-in-previously-treated-patients-with-hemophilia-a-comparison-of-data-between-the-general-and-japanese-study-populations
#6
Keiji Nogami, Midori Shima, Katsuyuki Fukutake, Teruhisa Fujii, Masashi Taki, Tadashi Matsushita, Satoshi Higasa, Tetsuji Sato, Michio Sakai, Morio Arai, Haruhiko Uchikawa, Werner Engl, Brigitt Abbuehl, Barbara A Konkle
Rurioctocog alfa pegol (BAX 855) is a novel third-generation recombinant factor VIII whose active ingredient is chemically modified with polyethylene glycol. A global multicenter phase 2/3 study of the product in 137 patients (including 11 patients from Japan) with severe hemophilia A aged 12-65 years, reported an extended half-life and a good tolerability profile, as well as a significantly lower annualized bleeding rate in the prophylactic treatment arm than in the on-demand treatment arm. Using descriptive statistics, a post hoc analysis was performed to compare the pharmacokinetics, safety, and efficacy profiles of the product in the Japanese subpopulation and the overall population...
May 26, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#7
Per Werner Moller, Berhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Martin Bloch, Soren Sondergaard, Stephan M Matthias Jakob, Jukka Takala, David Christian Berger
The relevance of right atrial pressure (RAP) as the back-pressure for venous return (QVR) and mean systemic filling pressure (MSFP) as up-stream pressure is controversial during dynamic changes of circulation. To examine the immediate response of QVR (sum of caval vein flows) to changes in RAP and pump function we used a closed chest, central cannulation, heart bypass porcine preparation (n=10) with veno-arterial extracorporeal membrane oxygenation (ECMO). MSFP was determined by clamping ECMO tubing with open or closed arterio-venous shunt at Euvolemia, Volume Expansion (9...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28550146/does-painless-rectal-bleeding-equate-to-a-colonic-polyp
#8
Alison Morag Campbell, Ian Sugarman
BACKGROUND: It is often stated that if a patient presents with 'painless rectal bleeding' then a rectal polyp is the probable diagnosis. The aim of this study is to review our experience of children undergoing endoscopy to assess if the above statement is correct. METHODS: The senior author keeps a prospective database of every child undergoing flexible sigmoidoscopy or colonoscopy. As part of this database, the symptoms and signs that the patient presents with, specifically abdominal pain, diarrhoea, mucous per rectum and rectal bleeding, are recorded...
May 26, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28549987/spontaneous-heterotopic-triplets-a-review-of-literature
#9
REVIEW
Pauline Bataille, Augustin Reynard, Guillaume Ducarme
OBJECTIVE: Spontaneous heterotopic triplets, a tubal ectopic pregnancy and a twin pregnancy, are rare disorders. The study aimed to examine all available evidence regarding signs and symptoms, imaging findings, management and newborn outcome of spontaneous heterotopic triplets. DESIGN: A literature search in Medline and EMBASE databases from 2000 to 2016 was conducted. The following key words were employed: 'spontaneous heterotopic pregnancy', OR 'heterotopic triplets'...
May 23, 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28549819/rivaroxaban-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-and-active-cancer
#10
Eva S Laube, Anthony Yu, Dipti Gupta, Yimei Miao, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff, Simon Mantha
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with nonvalvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. The use of rivaroxaban in patients with cancer at the Memorial Sloan Kettering Cancer Center is monitored in the setting of a Quality Assessment Initiative...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28549672/rotational-thromboelastometry-predicts-increased-bleeding-after-off-pump-coronary-bypass-surgery
#11
Sarah Soh, Young-Lan Kwak, Jong-Wook Song, Kyung-Jong Yoo, Hee-Jung Kim, Jae-Kwang Shim
BACKGROUND: We aimed to investigate the ability of rotational thromboelastometry (ROTEM) thresholds for coagulopathy to predict increased perioperative blood loss in off-pump coronary artery bypass graft surgery (OPCABG) and its association with transfusion requirement. METHODS: The data of 303 patients undergoing OPCABG were retrospectively analyzed. Perioperative blood loss and transfusion requirement were compared according to the presence of abnormal ROTEM thresholds, which were tested after anesthesia induction and heparin reversal...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28549534/dabigatran-reversal-in-a-patient-with-end-stage-liver-disease%C3%A2-and-acute-kidney-injury
#12
James E Novak, Khalid Alamiri, Jerry Yee
Dabigatran, a direct thrombin inhibitor and one of the new class of direct oral anticoagulants, is increasingly used in preference to warfarin because of its efficacy and ease of administration. However, because the drug is cleared by the kidneys, it can accumulate in plasma and increase the risk for bleeding in patients with decreased kidney function. We report a patient with end-stage liver disease who developed life-threatening hemorrhage and acute kidney injury while taking dabigatran, 150mg, twice daily...
May 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28549477/surgical-and-survival-outcomes-of-lung-cancer-patients-with-intratumoral-lung-abscesses
#13
Keiji Yamanashi, Norihito Okumura, Ayuko Takahashi, Takashi Nakashima, Tomoaki Matsuoka
BACKGROUND: Intratumoral lung abscess is a secondary lung abscess that is considered to be fatal. Therefore, surgical procedures, although high-risk, have sometimes been performed for intratumoral lung abscesses. However, no studies have examined the surgical outcomes of non-small cell lung cancer patients with intratumoral lung abscesses. The aim of this study was to investigate the surgical and survival outcomes of non-small cell lung cancer patients with intratumoral lung abscesses...
May 26, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28549357/-hip-osteosynthesis-with-im-nail-lateral-decubitus-without-fracture-table
#14
V H Aguirre-Rodríguez, G Inzunza-Enríquez, O Bibiano-Escalante, F J Martínez-Ruiz, F S Valero-González
BACKGROUND: Hip fractures have increased in the last decades, mainly in elderly patients with osteoporosis. The incidence becomes in some countries up to 250 thousand new cases per year, generating millions for health systems costs, so it should be considered a public health problem. They are treated in supine position, with a fracture table, through a lateral approach. However, it is important to know that there are other techniques, which can dispense a table of fractures and in a different position...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549330/impact-of-post-traumatic-stress-disorder-on-oral-health
#15
Ana Cristina de Oliveira Solis, Álvaro Cabral Araújo, Felipe Corchs, Marcio Bernik, Érica Panzani Duran, Cláudio Silva, Francisco Lotufo-Neto
BACKGROUND: The stress experienced as an intense and traumatic event can increase the odds of orofacial pain, affect the biomechanics of masticatory system and compromise the periodontal health. This study was conducted to investigate the impact of post-traumatic stress disorder (PTSD) on oral health. METHODS: A case-control study with a convenience sample was designed. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing, and plaque were recorded at 6 sites per tooth...
May 20, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28549261/small-spontaneously-ruptured-gastrointestinal-stromal-tumor-in-the-small-intestine-causing-hemoperitoneum-a-case-report
#16
Shuichi Fukuda, Yoshinori Fujiwara, Tomoko Wakasa, Keisuke Inoue, Kotaro Kitani, Hajime Ishikawa, Masanori Tsujie, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are clinically asymptomatic until they reach a significant size; therefore, GISTs that are 2cm or less are typically asymptomatic. Patients with symptomatic GISTs typically present with abdominal pain, gastrointestinal bleeding, or a palpable mass but rarely present with hemoperitoneum. PRESENTATION OF CASE: A 72-year-old Japanese man presented to us with acute onset abdominal pain. Physical examination showed peritoneal irritation in the lower abdomen...
May 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#17
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548886/association-of-preventive-maintenance-therapy-compliance-and-peri-implant-diseases-a-cross-sectional-study
#18
Alberto Monje, Hom-Lay Wang, José Nart
AIM: This study was aimed at investigating the association between peri-implant maintenance therapy (PIMT) and the frequency of peri-implant diseases, and to further identify the factors that contribute to failure of PIMT compliance. MATERIAL AND METHODS: A cross-sectional study on healthy partial edentulous patients was conducted. These were grouped in the following categories according to the PIMT compliance: regular compliers (RC) (≥2 PIMT/year), erratic compliers (EC) (<2 PIMT/year), and non-compliers (NC) (0 PIMT/year)...
May 26, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28548883/simultaneous-detection-of-oral-pathogens-in-subgingival-plaque-and-prostatic-fluid-of-men-with-periodontal-and-prostatic-diseases
#19
John Estemalik, Catherine Demko, Nabil F Bissada, Nishant Joshi, Donald Bodner, Eswar Shankar, Sanjay Gupta
BACKGROUND: Chronic prostatitis (CP) and benign prostatic hyperplasia (BPH) are complex inflammatory conditions for which the etiological determinants are still poorly defined. Periodontitis is caused by subgingival colonizing bacteria in the oral cavity. The causal effect of periodontal disease on prostatic inflammation has not been established. The purpose of this study is to isolate oral pathogens from expressed prostatic secretions of patients with periodontal disease and chronic prostatitis or benign prostatic hyperplasia...
May 26, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28548473/initial-experience-with-the-e-ventus%C3%A2-stentgraft-for-endovascular-treatment-of-visceral-artery-aneurysms
#20
Susanne Anton, Erik Stahlberg, Marco Horn, Marcus Wiedner, Markus Kleemann, Joerg Barkhausen, Jan P Goltz
BACKGROUND: To evaluate the safety and efficacy of a novel balloon-expandable stentgraft for endovascular treatment of visceral artery aneurysms (VAA). METHODS: Between 9/2014 and 1/2017 seven patients (69+/-15y) with true (n=4) and false (n=3) VAAs were treated by implantation of balloon-expandable stentgrafts (E-ventus®, Jotec, Germany) using a trans-femoral (n=2) or -brachial (n=5) vascular access. The stentgraft was placed without prior passing of the landing zone with a sheath...
May 26, 2017: Journal of Cardiovascular Surgery
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