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https://www.readbyqxmd.com/read/29332080/radiosurgical-pallidotomy-for-parkinson-s-disease
#1
Leslie D Cahan, Ronald F Young, Francisco Li
Deep brain stimulation (DBS) has been widely accepted as a tool for treating many symptoms of Parkinson's disease (PD); pallidotomy has been nearly abandoned. Concerns about both the safety and efficacy of pallidotomy are based on small series, isolated case reports, and techniques that would now be considered obsolete. The senior author recently reviewed long-term follow-up of a series of patients who had gamma knife pallidotomy (GKP) for advanced PD. GKP leads to durable, clinically significant benefit. Bilateral GKP adds incremental improvement...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29330715/case-series-analysis-of-new-zealand-reports-of-rapid-intense-potentiation-of-warfarin-by-roxithromycin
#2
Ruth L Savage, Michael V Tatley
INTRODUCTION: We undertook an analysis of all the reports to the New Zealand Centre for Adverse Reactions Monitoring of a roxithromycin/warfarin interaction after two recent reports described intense rapid warfarin potentiation. The interaction was first published in 1995. Cytochrome P450 3A4 inhibition has been the proposed mechanism but has limited biologic plausibility. There are suggestions that the clinical significance of the interaction may be increased by severe illness, polypharmacy, renal dysfunction, older age and increased warfarin sensitivity...
January 12, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29327671/tissue-engineered-heart-valves-a-call-for-mechanistic-studies
#3
Kevin Blum, Joseph Drews, Christopher K Breuer
Heart valve disease carries a substantial risk of morbidity and mortality. Outcomes are significantly improved by valve replacement, but currently-available mechanical and biological replacement valves are associated with complications of their own. Mechanical valves have a high rate of thromboembolism and require lifelong anticoagulation. Biological prosthetic valves have a much shorter lifespan, and are prone to tearing and degradation. Both types of valves lack the capacity for growth, making them particularly problematic in pediatric patients...
January 12, 2018: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/29327563/hemodynamic-outcomes-of-the-ross-procedure-versus-other-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#4
Kevin J Um, Graham R McCLURE, Emilie P Belley-Cote, Saurabh Gupta, Ismail Bouhout, Hugo Lortie, Hatim Alraddadi, Ali Alsagheir, Matthias Bossard, William F McINTYRE, Alexandra Lengyel, John W Eikelboom, Maral Ouzounian, Michael W Chu, Dominic Parry, Ismail El-Hamamsy, Richard P Whitlock
INTRODUCTION: Life expectancy in young adults undergoing mechanical or bioprosthetic aortic valve replacement (AVR) may be reduced by up to 20 years compared to age matched controls. The Ross procedure is a durable, anticoagulation-sparing alternative. We performed a systematic review and meta-analysis to compare the valve hemodynamics of the Ross procedure versus other AVR. EVIDENCE ACQUISITION: We searched Cochrane CENTRAL, MEDLINE and EMBASE from inception to February 2017 for randomized controlled trials (RCTs) and observational studies (n≥10 Ross)...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#5
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
January 10, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29321641/antiphospholipid-syndrome
#6
REVIEW
Karen Schreiber, Savino Sciascia, Philip G de Groot, Katrien Devreese, Soren Jacobsen, Guillermo Ruiz-Irastroza, Jane E Salmon, Yehuda Shoenfeld, Ora Shovman, Beverley J Hunt
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin...
January 11, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29320972/rituximab-use-in-pediatric-lupus-anticoagulant-hypoprothrombinemia-syndrome-report-of-three-cases-and-review-of-the-literature
#7
K Cetin Gedik, S Siddique, C L Aguiar
Lupus anticoagulant hypoprothrombinemia syndrome (LA-HPS) is a rare condition that may predispose both to thrombosis and bleeding due to positive lupus anticoagulant (LA) and factor II (FII) deficiency. It can be seen in association with infections or systemic lupus erythematosus (SLE) and may require glucocorticoids (GCs) and/or immunosuppressive medications. Pediatric LA-HPS cases in the literature and three cases that received only rituximab (RTX) for LA-HPS (in addition to GCs) at two institutions between January 2010 and June 2017 were analyzed descriptively...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29318176/venous-thromboembolism-within-professional-american-sport-leagues
#8
Meghan Bishop, Matthew Astolfi, Eric Padegimas, Peter DeLuca, Sommer Hammoud
Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29318007/severe-haematuria-of-lower-urinary-tract-origin-with-low-dose-dabigatran-use-in-three-indian-elderly-patients-unresolved-issues-in-the-safety-of-novel-oral-anticoagulants
#9
Upinder Kaur, Sankha Shubhra Chakrabarti, Sukdev Manna, Indrajeet Singh Gambhir
Dabigatran is a newer oral direct thrombin inhibitor approved by the United States Food and Drug Administration and the European Medicines Agency (EMA). The proper dosage of the drug, the potential for adverse drug reactions and the nature of bleeds with use of this drug as with other novel oral anticoagulants (NOACs), in the elderly population are still areas of uncertainty. Despite the existence of a specific antibody, idarucizumab which is an antidote to dabigatran toxicity, management of dabigatran-induced bleeds is an undefined area especially in resource constrained settings...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29316357/cerebrovascular-events-in-systemic-lupus-erythematosus
#10
John G Hanly, Qiuju Li, Li Su, Murray B Urowitz, Caroline Gordon, Sang-Cheol Bae, Juanita Romero-Diaz, Jorge Sanchez-Guerrero, Sasha Bernatsky, Ann E Clarke, Daniel J Wallace, David A Isenberg, Anisur Rahman, Joan T Merrill, Paul Fortin, Dafna D Gladman, Ian N Bruce, Michelle Petri, Ellen M Ginzler, M A Dooley, Kristjan Steinsson, Rosalind Ramsey-Goldman, Asad A Zoma, Susan Manzi, Ola Nived, Andreas Jonsen, Munther A Khamashta, Graciela S Alarcón, Winn Chatham, Ronald F van Vollenhoven, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, Manuel Ramos-Casals, S Sam Lim, Murat Inanc, Kenneth C Kalunian, Soren Jacobsen, Christine A Peschken, Diane L Kamen, Anca Askanase, Chris Theriault, Vernon Farewell
OBJECTIVE: To determine the frequency, associations and outcomes of cerebrovascular events (CerVEs) in a multi-ethnic/racial, prospective, SLE disease inception cohort. METHODS: Patients were assessed annually for 19 neuropsychiatric (NP) events including 5 types of CerVEs: (i) Stroke; (ii) Transient ischemia; (iii) Chronic multifocal ischemia; (iv) Subarachnoid/intracranial hemorrhage; (v) Sinus thrombosis. Global disease activity (SLEDAI-2K), SLICC/ACR damage index (SDI) and SF-36 scores were collected...
January 5, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29313725/prognostic-risk-model-for-patients-with-high-risk-polycythemia-vera-and-essential-thrombocythemia
#11
Abhishek A Mangaonkar, Katherine P Hoversten, Naseema Gangat
Polycythemia Vera (PV) and essential thrombocythemia (ET) are the most frequent Philadelphia chromosome-negative myeloproliferative neoplasms, the other entity being myelofibrosis. Management of patients with PV and ET is fraught with difficulties as they have an inherent tendency to cause thrombotic and hemorrhagic events. There are no curative treatment options therefore it is important that a risk-adapted treatment approach is applied. Areas covered: This review discusses existing literature about prognosis in PV and ET, and addresses critical aspects related to defining 'high-risk' disease...
January 9, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29310339/an-unusual-case-of-perforation-of-the-alimentary-canal-following-bigu-a-taoist-fasting-technique
#12
Jun Wang, Jun Jin, Xiaofeng Xue, Yan Hao, Dongrong Li, Shan Xu, Fang Huang
RATIONALE: Bigu is a Taoist fasting technique interpreted as avoiding grains in the Encyclopedia of China. This technique has been used from ancient times to the present day in China and other parts of the world to achieve good health, weight loss, longevity, and even immortality. A variety of health problems have been identified in relation to the severe diet during Bigu. However, perforation of the alimentary canal has not been reported to be associated with Bigu. In the present study, we illustrated an unusual case of perforation of the alimentary canal in relation to Bigu...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29310330/can-catheter-ablation-reduce-the-incidence-of-thromboembolic-events-in-patients-with-atrial-fibrillation-protocol-for-a-systematic-review-and-meta-analysis
#13
Menghui Liu, Yuanping Wang, Xiaohong Chen, Xiaohui Li, Xiaodong Zhuang, Lichun Wang
Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major risk factor for thromboembolic events, especially ischemic stroke. Catheter ablation is an effective method to maintain sinus rhythm in patients with AF. Although some observational studies have shown a relatively lower stroke rate after catheter ablation, whether catheter ablation can reduce the thromboembolic risk in patients with AF remains unclear. We aim to perform a systematic review to determine whether catheter ablation can prevent thromboembolism in patients with AF...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306122/exploration-of-adherence-and-patient-experiences-with-doacs-one-year-after-switching-from-vitamin-k-antagonists-insights-from-the-switching-study
#14
John K Bartoli-Abdou, Jignesh P Patel, Jacob Crawshaw, Bipin Vadher, Alison Brown, Lara N Roberts, Raj K Patel, Roopen Arya, Vivian Auyeung
BACKGROUND: Current UK and European guidelines recommend anticoagulated patients prescribed warfarin with time in therapeutic range (TTR) <65% be considered for DOAC therapy. There has been considerable concern that adherence with DOACs may be poor compared with warfarin. Little is known about the patient experience of switching from warfarin to DOAC and how patients manage their DOAC long term. Our aim was to conduct focus groups exploring patient's previous experiences with warfarin, their current experience with DOACs, their adherence to DOACs and the long-term service provision they envisage...
January 2, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29304913/the-mythology-of-anticoagulation-therapy-interruption-for-dental-surgery
#15
Michael J Wahl
BACKGROUND: Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo dental surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal...
January 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29299477/novel-venous-thromboembolic-disease-vted-prophylaxis-for-total-knee-arthroplasty-aspirin-and-fish-oil
#16
Peter M Bonutti, Nipun Sodhi, Yatindra H Patel, Assem A Sultan, Anton Khlopas, Morad Chughtai, Frank R Kolisek, Nick Williams, Michael A Mont
Background: Despite the demonstrated success of multiple anticoagulation therapies for post-operative prophylaxis of thromboembolic disease in lower extremity arthroplasties, each modality comes with a unique set of limitations. Thus, the ideal anticoagulation medication which provides adequate therapy with minimal cost, complications, or added patient work is yet to be defined. One promising novel thrombophylactic supplement is fish oil, as many preliminary clinical trials have demonstrated a protective effect of fish oil against thrombosis in multiple clinical settings...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298792/lemierre-s-syndrome-a-pain-in-the-neck-with-far-reaching-consequences
#17
Thomas James Stubington, Paul James
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#18
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29297661/the-role-of-direct-oral-anticoagulants-in-the-management-of-venous-thromboembolism
#19
Taylor Steuber
Appropriate treatment of venous thromboembolism (VTE) is critical to minimizing long-term morbidity and mortality. The emergence of direct oral anticoagulants (DOACs) has provided clinicians with expanded therapeutic options for patients with VTE, and as a result, updated practice guidelines released by the American College of Chest Physicians favor DOACs over traditional anticoagulants, such as warfarin. The newest DOAC, betrixaban, received FDA approval in 2017, with an indication for VTE prophylaxis in hospitalized adults...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29296829/safety-pharmacokinetics-and-reversal-of-apixaban-anticoagulation-with-andexanet-alfa
#20
Deborah Siegal, Genmin Lu, Janet M Leeds, Mark Karbarz, Janice Castillo, Vandana Mathur, Athiwat Hutchaleelaha, Uma Sinha, Michael Kitt, Matt McClure, Stanley J Hollenbach, John T Curnutte, Pamela B Conley, Mark Crowther
Direct factor Xa (FXa) inhibitors lack a specific reversal agent for emergencies such as major bleeding or urgent surgery. Andexanet alfa, a modified, catalytically inactive, recombinant human FXa derivative, reverses anticoagulant effect by binding and sequestering FXa inhibitors. This original report of safety and dose-finding, phase 1 and 2 randomized, double-blind, placebo-controlled studies, investigated various doses of andexanet in healthy volunteers. Phase 1 evaluated the safety and pharmacokinetics of andexanet (n = 24) or placebo (n = 8)...
September 26, 2017: Blood Advances
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