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https://www.readbyqxmd.com/read/28930804/venous-thromboembolism-in-gynecological-malignancy
#1
Abigail Cohen, Chung Sim Lim, Alun Huw Davies
OBJECTIVE: Venous thromboembolism (VTE) is a recognized complication of gynecological malignancy and represents a leading cause of morbidity and mortality in these patients. The review aimed to discuss the incidence, risk factors, and clinical presentation of VTE before examining the literature on the diagnosis, prevention, and management in the context of uterine, cervical, ovarian, and vulval cancers. METHODS/MATERIALS: A literature search was performed using Ovid Medline and Embase with the following words: "gynecological malignancy," "pelvic tumor," "venous thromboembolism," "deep vein thrombosis" and "pulmonary embolism...
September 19, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28927205/rare-neurosurgical-complications-of-epidural-injections-an-8-yr-single-institution-experience
#2
Gabriel A Smith, Jonathan Pace, Madeleine Strohl, Anand Kaul, Salim Hayek, Jonathan P Miller
BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28914415/a-randomized-trial-of-restarting-warfarin-at-maintenance-versus-loading-doses-following-an-elective-procedure
#3
Tammy J Bungard, Jay Mutch, Bruce Ritchie
Guidelines suggest restarting warfarin at known maintenance doses, although this may result in a delay to achieving therapeutic anticoagulation. As such, we compared the time to achieve an INR ≥ 2.0 between those restarting warfarin maintenance vs loading doses after transient interruption, and the impact on protein C, S and factor II levels. Patients requiring interruption of warfarin for elective procedures without hospitalization were randomized 1:1 to receive warfarin maintenance or loading doses (1...
September 15, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#4
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#5
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#6
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28911787/pulmonary-embolism-severity-assessment-and-prognostication
#7
Deisy Barrios, Raquel Morillo, Roger D Yusen, David Jiménez
For patients who have acute symptomatic pulmonary embolism (PE), risk of short-term death and adverse outcomes should drive the initial treatment decisions. Practice guidelines recommend that patients who have a high-risk of PE-related death and adverse outcomes, determined by the presence of haemodynamic instability (i.e., shock or hypotension), should receive systemically administered thrombolytic therapy. Intermediate-high risk patients might benefit from close observation, and some should undergo escalation of therapy beyond standard anticoagulation, particularly if haemodynamic deterioration occurs...
September 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28910988/anticoagulation-after-coronary-stenting-a-systemic-review
#8
Zhe Dong, Jingang Zheng
Introduction or background: Anticoagulant therapy is mainly used to prevent patients from suffering coronary and systemic thromboembolism after stenting. Many studies have been done to formulate an optimized regimen of a post-PCI or long-time anticoagulant therapy. Recent advances in the selection and duration of anticoagulant agents will be conducive to the management of patients who are considered to need anticoagulant therapy after stenting. Sources of data: Key recent published literature, including international guidelines and relevant reviews...
September 1, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28902651/anticoagulant-therapy-for-acute-venous-thromboembolism
#9
Hilal Ermiş, Necip Ermiş
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are currently defined as venous thromboembolism (VTE) since they share pathophysiological features and the treatment is similar in many respects. It has been determined that more than 90% of PE cases originate from DVT in the legs. PE, which is difficult to diagnose, has a mortality rate of 12% when untreated. The worldwide increase in obesity, cancer diseases, and average survival time also contribute to the increase in the incidence of VTE. Traditional treatment of VTE includes heparin, low-molecular-weight heparin, and warfarin...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28892413/enhancing-the-real-world-prediction-of-cardiovascular-events-and-major-bleeding-with-the-cha2ds2-vasc-and-has-bled-scores-using-multiple-biomarkers
#10
Vanessa Roldán, José Miguel Rivera-Caravaca, Alena Shantsila, Amaya García-Fernández, María Asunción Esteve-Pastor, Juan Antonio Vilchez, Marta Romera, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
BACKGROUND: Atrial fibrillation (AF)-European guidelines suggest the use of biomarkers to stratify patients for stroke and bleeding risks. We investigated if a multi-biomarker strategy improved the predictive performance of CHA2DS2-VASc and HAS-BLED in anticoagulated AF patients. METHODS: We included consecutive patients stabilized for 6 months on vitamin K antagonists (INRs 2.0-3.0). High sensitivity troponin T, N-proBNP, interleukin 6, von Willebrand factor concentrations and glomerular filtration rate (eGFR; using MDRD-4 formula) were quantified at baseline...
September 11, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28885339/role-of-chemotherapy-and-thrombolysis-in-treatment-of-choriocarcinoma-accompanied-with-pulmonary-embolism-a-case-report-with-literature-review
#11
Mei Yang, Li Peng
RATIONALE: Choriocarcinoma accompanied with pulmonary embolism (PE) is rare and difficult to diagnose and treat. There are about 25 cases reported in literature, which presented variable clinical characteristics and prognosis. PATIENT CONCERNS: We reported a case of choriocarcinoma presenting PE as the first manifestation in a 26-year-old Chinese female. DIAGNOSES: Four months before her admission to our hospital, she presented to a local hospital with respiratory manifestations, and was first diagnosed as bronchitis and treated with antibiotics without improvement, and subsequently suspected of having pulmonary tuberculosis and receive anti-tuberculosis therapy, with no response...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28883793/a-multilevel-analysis-of-real-world-variations-in-oral-anticoagulation-initiation-for-atrial-fibrillation-in-valencia-a-european-region
#12
Aníbal García-Sempere, Daniel Bejarano-Quisoboni, Julián Librero, Clara L Rodríguez-Bernal, Salvador Peiró, Gabriel Sanfélix-Gimeno
Introduction: Beyond clinical trials, clinical practice guidelines, and administrative regulation, treatment decision-making can be influenced by individual and contextual factors. Our goal was to describe variations in the patterns of initiation of anticoagulation therapy in patients with atrial fibrillation by Health Areas (HA) in the region of Valencia in Spain and to quantify the influence of the HAs on variations in treatment choice. Methods: We conducted a population-based retrospective cohort study of all atrial fibrillation patients who started treatment with oral anticoagulants between November 2011 and February 2014 in each of the region's 24 HAs...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28867369/-oral-anticoagulation-in-atrial-fibrillation-what-is-the-guideline-for-using-new-drugs
#13
J A Ibáñez Pérez de Viñaspre, J Gómez Bitrian, R Royo Hernández, M de Azúa Jiménez, C Marco López, L Urieta González
OBJECTIVE: To assess whether there are differences between atrial fibrillation (AF) patients initiating new direct-acting oral anticoagulants (DOAC) therapy and vitamin K antagonist (VKA) therapy in an emergency service. METHODS: Descriptive, observational, prospective study. We enrolled patients with AF who were visited in a hospital emergency service over one year. RESULTS: This study included 492 patients with AF, and 189 subjects received anticoagulant therapy, 104 with VKA (55%), and 85 with DOAC (45%)...
August 31, 2017: Semergen
https://www.readbyqxmd.com/read/28867157/-fine-tuning-of-antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-the-afinva-register
#14
Daniela Dubois Marques, Vicente Mora Llabata, Julián Pacheco Arroyo, Salvador Gasull Insertis, Manuela Vicente Cañizares, Ildefonso Roldán Torres
OBJECTIVE: To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines. DESIGN: Prospective observational study. LOCATION: Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain. PARTICIPANTS: A total of 505 patients with nonvalvular atrial fibrillation were included in the study...
August 31, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28863196/impact-of-inr-monitoring-reversal-agent-use-heparin-bridging-and-anticoagulant-interruption-on-rebleeding-and-thromboembolism-in-acute-gastrointestinal-bleeding
#15
Naoyoshi Nagata, Toshiyuki Sakurai, Shiori Moriyasu, Takuro Shimbo, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Naomi Uemura
BACKGROUND: Anticoagulant management of acute gastrointestinal bleeding (GIB) during the pre-endoscopic period has not been fully addressed in American, European, or Asian guidelines. This study sought to evaluate the risks of rebleeding and thromboembolism in anticoagulated patients with acute GIB. METHODS: Baseline, endoscopy, and outcome data were reviewed for 314 patients with acute GIB: 157 anticoagulant users and 157 age-, sex-, and important risk-matched non-users...
2017: PloS One
https://www.readbyqxmd.com/read/28862960/selection-of-stent-type-in-patients-with-atrial-fibrillation-presenting-with-acute-myocardial-infarction-an-analysis-from-the-action-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#16
Amit N Vora, Tracy Y Wang, Shuang Li, Karen Chiswell, Connie Hess, Renato D Lopes, Sunil V Rao, Eric D Peterson
BACKGROUND: Patients receiving oral anticoagulation in addition to dual-antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug-eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI). METHODS AND RESULTS: From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28860793/evaluation-of-bleeding-in-patients-receiving-direct-oral-anticoagulants
#17
REVIEW
Erika L Hellenbart, Kathleen D Faulkenberg, Shannon W Finks
Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28859022/embolic-stroke-of-undetermined-source-in-latin-america-a-review
#18
Carlos Cantú-Brito, Gisele Sampaio Silva, Sebastián F Ameriso
BACKGROUND: Stroke is a major health concern throughout Latin America. As elsewhere, no precise cause can be determined for a substantial portion of strokes. In 6 studies since 2010 in the region, 16% to 43% of ischemic strokes were identified as cryptogenic. The term embolic stroke of undetermined source (ESUS) has been proposed as more clinically useful and positively defined than the vague term cryptogenic. The epidemiology of ESUS in Latin America is largely unknown. REVIEW SUMMARY: This article aims to provide a description of the epidemiology of ESUS in Latin America and practical information regarding available diagnostic procedures and current guidelines...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28858115/safety-of-catheter-directed-thrombolysis-for-the-treatment-of-acute-lower-extremity-deep-vein-thrombosis-a-systematic-review-and-meta-analysis
#19
Li Wang, Chuanlin Zhang, Shaoyu Mu, Chao Hsing Yeh, Liqun Chen, Zeju Zhang, Xueqin Wang
BACKGROUND: Despite established guidelines, catheter-directed thrombolysis (CDT) for the management of acute lower extremity deep vein thrombosis (DVT) should not be overstated because the risks of CDT are uncertain. We performed a meta-analysis to comprehensively and quantitatively evaluate the safety of CDT for patients with acute lower extremity DVT. METHODS: Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE, and Scopus, were searched up to January 2017...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28844512/meta-analysis-of-usefulness-of-anticoagulation-after-transcatheter-aortic-valve-implantation
#20
REVIEW
Kinjal Banerjee, Kanhaiya Poddar, Stephanie Mick, Jonathon White, Amar Krishnaswamy, Douglas Johnston, Leonardo Rodriguez, E Murat Tuzcu, Samir Kapadia
Since the advent of bioprosthetic valves, the implications of long-term anticoagulation after valve replacement are unclear. There are very little data on outcomes of long-term anticoagulation after transcatheter aortic valve implantation (TAVI). Our aim was to conduct a systematic review of literature regarding anticoagulation after TAVI. The existing literature on anticoagulation after bioprosthetic valve replacement was thoroughly reviewed, including the most recent American College of Cardiology/American Heart Association 2017 guidelines for management of valvular disease, which is based on sparse, nonrandomized retrospective data...
August 1, 2017: American Journal of Cardiology
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