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https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#1
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29773763/initial-experience-with-endoscopic-sleeve-gastroplasty-in-poland
#2
Aleksander Sowier, Przemysław Pyda, Anna-Maria Borucka, Sebastian Sowier, Jacek Białecki, Joanna Kapturzak, Stanisław Wójtowicz
INTRODUCTION: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29773120/age-specific-association-between-blood-pressure-and-vascular-and-non-vascular-chronic-diseases-in-0%C3%A2-5-million-adults-in-china-a-prospective-cohort-study
#3
Ben Lacey, Sarah Lewington, Robert Clarke, Xiang Ling Kong, Yiping Chen, Yu Guo, Ling Yang, Derrick Bennett, Fiona Bragg, Zheng Bian, Shaojie Wang, Hua Zhang, Junshi Chen, Robin G Walters, Rory Collins, Richard Peto, Liming Li, Zhengming Chen
BACKGROUND: The age-specific association between blood pressure and vascular disease has been studied mostly in high-income countries, and before the widespread use of brain imaging for diagnosis of the main stroke types (ischaemic stroke and intracerebral haemorrhage). We aimed to investigate this relationship among adults in China. METHODS: 512 891 adults (59% women) aged 30-79 years were recruited into a prospective study from ten areas of China between June 25, 2004, and July 15, 2008...
June 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29771155/cardiac-events-within-one-year-after-a-subarachnoid-haemorrhage-the-predictive-value-of-troponin-elevation-after-aneurysm-occlusion
#4
Annemarie Akkermans, Linda M Peelen, Judith A van Waes, Gabriël J Rinkel, Wilton A van Klei
Background Patients who survive after an aneurysmal subarachnoid haemorrhage (ASAH) have an increased incidence of cardiovascular events compared with the general population. We assessed whether troponin elevation after aneurysm occlusion, as marker of myocardial injury, can predict long-term cardiac events. Methods We analysed a prospectively collected cohort of 159 patients with ASAH and early aneurysm occlusion, in whom routine post-intervention troponin I (TnI) measurements were performed. With competing risk regression modelling we estimated the association between TnI elevation after aneurysm occlusion and major adverse cardiac events within one year...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29766335/ticagrelor-versus-clopidogrel-as-part-of-dual-or-triple-antithrombotic-therapy-a-systematic-review-and-meta-analysis
#5
Ioannis Andreou, Alexandros Briasoulis, Christos Pappas, Ignatios Ikonomidis, Dimitrios Alexopoulos
PURPOSE: Clopidogrel is the standard P2Y12 receptor inhibitor used in patients requiring both antiplatelet therapy and oral anticoagulation (OAC). We investigated the safety and efficacy of ticagrelor as an alternative to clopidogrel in patients on OAC. METHODS: A systematic electronic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library for randomised controlled studies that examined the relative safety and efficacy of clopidogrel versus ticagrelor among patients requiring therapy with antiplatelet agents plus OAC...
May 15, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29764930/closure-of-large-bore-9-f-arterial-puncture-sites-with-the-angioseal-sts-device-in-acute-stroke-patients-after-intravenous-recombinant-tissue-plasminogen-activator-rt-pa
#6
Hendrik Janssen, Monika Killer-Oberpfalzer, Ruediger Lange
PURPOSE: This retrospective analysis was performed to evaluate whether large bore 9 F puncture sites can be safely closed with the 8 F AngioSeal STS device after endovascular stroke procedures in patients who did or did not receive recombinant tissue plasminogen activator (rt-PA). METHODS: Out of 161 consecutive endovascular stroke procedures we identified 72 patients who met the inclusion criteria, of whom 46 received rt-PA before the endovascular procedure and 26 did not...
May 15, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#7
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29751278/pregnancy-related-acute-kidney-injury-requiring-dialysis-as-an-indicator-of-severe-adverse-maternal-morbidity-at-a-tertiary-center-in-southwest-nigeria
#8
Ibraheem O Awowole, Oluseyi S Omitinde, Fatiu A Arogundade, Sekinah B Bola-Oyebamiji, Olumide A Adeniyi
OBJECTIVE: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29747143/posttraumatic-stress-disorder-related-to-postpartum-haemorrhage-a-systematic-review
#9
REVIEW
Tjitske R Zaat, Minouk E van Steijn, Jiska M de Haan-Jebbink, Miranda Olff, Claire A I Stramrood, Mariëlle G van Pampus
In some cases childbirth leads to negative psychological responses such as posttraumatic stress disorder (PTSD). Postpartum hemorrhage (PPH) is a common and major complication of childbirth, which occasionally requires emergency hysterectomy in severe cases. Patients often describe these complications as a traumatic experience. It is unknown whether PPH is a risk factor for developing PTSD. In this systematic review we summarize the current knowledge about the association between PPH with or without emergency hysterectomy and posttraumatic stress symptoms or PTSD...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29745965/stroke-distribution-patterns-and-characteristics-in-kenya-s-leading-public-health-tertiary-institutions-kenyatta-national-hospital-and-moi-teaching-and-referral-hospital
#10
Lydia Kaduka, Anne Korir, Chrispine Owuor Oduor, Judith Kwasa, Jane Mbui, Sylvanos Wabwire, Robai Gakunga, Nathan Okerosi, Yvonne Opanga, Isaac Kisiang'ani, Mercy Rotich Chepkurui, Erastus Muniu, Scot C Remick
BACKGROUND: Cardiovascular diseases are the second leading cause of morbidity and mortality in Kenya. However, there is limited clinic-epidemiological data on stroke to inform decision making. This study sought to establish stroke distribution patterns and characteristics in patients seeking care at Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH), with the ultimate aim of establishing the first national stroke registry in Kenya. METHODS: This was a prospective multicentre cohort study among stroke patients...
March 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29743940/delayed-anxiety-and-depressive-morbidity-among-dengue-patients-in-a-multi-ethnic-urban-setting-first-report-from-sri-lanka
#11
Nayana Gunathilaka, Miyuru Chandradasa, Layani Champika, Shirom Siriwardana, Lakmini Wijesooriya
Background: Although the physical consequences of dengue are well documented, delayed psychological co-morbidities are not well studied to date. Therefore, the objective of the present study was to determine the prevalence of depressive, anxiety and stress symptoms among past dengue patients. Methods: A community-based, case-control study in a multi-ethnic urban setting was conducted in Sri Lanka involving adults who were diagnosed to have dengue fever by a positive dengue IgM antibody response between 6 and 24 months ago...
2018: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/29741208/induction-of-labour-for-improving-birth-outcomes-for-women-at-or-beyond-term
#12
REVIEW
Philippa Middleton, Emily Shepherd, Caroline A Crowther
BACKGROUND: Beyond term, the risks of stillbirth or neonatal death increase. It is unclear whether a policy of labour induction can reduce these risks. This Cochrane review is an update of a review that was originally published in 2006 and subsequently updated in 2012 OBJECTIVES: To assess the effects of a policy of labour induction at or beyond term compared with a policy of awaiting spontaneous labour or until an indication for birth induction of labour is identified) on pregnancy outcomes for infant and mother...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29741099/economic-evaluation-of-prescribing-conventional-and-newer-oral-anticoagulants-in-older-adults
#13
Syed Shahzad Hasan, Chia Siang Kow, Louise E Curley, Darrin L Baines, Zaheer-Ud-Din Babar
Anticoagulants refer to a variety of agents that inhibit one or more steps in the coagulation cascade. Generally, clinical conditions that require the prescribing of an oral anticoagulant increase in frequency with age. However, a major challenge of anticoagulation use among older patients is that this group of patients also experience the highest bleeding risk. To date, economic evaluation of prescribing of anticoagulants that includes the novel or newer oral anticoagulants (NOACs) in older adults has not been conducted and is warranted...
May 9, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29736284/a-case-of-placenta-percreta-managed-with-sequential-embolisation-procedures
#14
Shannon Armstrong-Kempter, Supuni Kapurubandara, Brian Trudinger, Noel Young, Naim Arrage
Background: The incidence of morbidly adherent placenta, including placenta percreta, has increased significantly over recent years due to rising caesarean section rates. Historically, abnormally invasive placenta has been managed with caesarean hysterectomy; however nonsurgical interventions such as uterine artery embolisation (UAE) are emerging as safe alternative management techniques. UAE can be utilised to decrease placental perfusion and encourage placental resorption, thereby reducing the risk of haemorrhage and other morbidities...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29730594/adverse-effects-of-small-for-gestational-age-differ-by-gestational-week-among-very-preterm-infants
#15
Erik A Jensen, Elizabeth E Foglia, Kevin C Dysart, Rebecca A Simmons, Zubair H Aghai, Alison Cook, Jay S Greenspan, Sara B DeMauro
OBJECTIVE: To characterise the excess risk for death, grade 3-4 intraventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD) and stage 3-5 retinopathy of prematurity independently associated with birth small for gestational age (SGA) among very preterm infants, stratified by completed weeks of gestation. METHODS: Retrospective cohort study using the Optum Neonatal Database. Study infants were born <32 weeks gestation without severe congenital anomalies...
May 5, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29729820/tachycardic-and-non-tachycardic-responses-in-trauma-patients-with-haemorrhagic-injuries
#16
Andrew T Reisner, Shwetha Edla, Jianbo Liu, Jiankun Liu, Maxim Y Khitrov, Jaques Reifman
BACKGROUND: Analyses of large databases have demonstrated that the association between heart rate (HR) and blood loss is weaker than what is taught by Advanced Trauma Life Support training. However, those studies had limited ability to generate a more descriptive paradigm, because they only examined a single HR value per patient. METHODS: In a comparative, retrospective analysis, we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage, based on documented injuries and transfusion of ≥3 units of red blood cells (RBCs)...
April 30, 2018: Injury
https://www.readbyqxmd.com/read/29728903/tenecteplase-versus-alteplase-in-acute-ischemic-stroke-systematic-review-and-meta-analysis
#17
A Thelengana, Divya M Radhakrishnan, Manya Prasad, Amit Kumar, Kameshwar Prasad
Tenecteplase is a product of genetic modification of recombinant tissue plasminogen activator with superior pharmacodynamic and pharmacokinetic properties. This meta-analysis was to determine whether intravenous thrombolysis with tenecteplase in patients with acute ischemic stroke has better efficacy and safety outcomes than with intravenous alteplase. PubMed, Cochrane Central Register of Controlled Trials, WHO International clinical trials registry platform (ICTRP), Australian New Zealand Clinical Trials Registry (ANZCTR), EU Clinical Trials Register (EU-CTR) and ClinicalTrials...
May 4, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29728657/major-ocular-trauma-in-taiwan-2002-2004-versus-2012-2014
#18
Yi-Sheng Chang, Yu-Ti Teng, Yi-Hsun Huang, Mei-Ling Liu, Jia-Horung Hung, Sheng-Min Hsu, Fu-Chin Huang, Min-Hsiu Shih, Wan-Ju Chen, Chun-Chieh Lai, Shu-Fang Hsiao, Shih-Hao Wang, Sung-Huei Tseng
We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002-2004 and 2012-2014. A total of 169 eyes (161 patients) during 2002-2004 and 121 eyes (120 patients) during 2012-2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002-2004, and 51.8 ± 19.3 years in 2012-2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls...
May 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29728411/prehospital-haemostatic-dressings-for-trauma-a-systematic-review
#19
Adam J Boulton, Christopher T Lewis, David N Naumann, Mark J Midwinter
BACKGROUND: Haemorrhage is a major cause of mortality and morbidity following both military and civilian trauma. Haemostatic dressings may offer effective haemorrhage control as part of prehospital treatment. AIM: To conduct a systematic review of the clinical literature to assess the prehospital use of haemostatic dressings in controlling traumatic haemorrhage, and determine whether any haemostatic dressings are clinically superior. METHODS: MEDLINE and EMBASE databases were searched using predetermined criteria...
May 4, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29726010/lower-versus-higher-oxygen-concentrations-titrated-to-target-oxygen-saturations-during-resuscitation-of-preterm-infants-at-birth
#20
REVIEW
Kei Lui, Lisa J Jones, Jann P Foster, Peter G Davis, See Kwee Ching, Ju Lee Oei, David A Osborn
BACKGROUND: Initial resuscitation with air is well tolerated by most infants born at term. However, the optimal fractional inspired oxygen concentration (FiO2 - proportion of the breathed air that is oxygen) targeted to oxygen saturation (SpO2 - an estimate of the amount of oxygen in the blood) for infants born preterm is unclear. OBJECTIVES: To determine whether lower or higher initial oxygen concentrations, when titrated according to oxygen saturation targets during the resuscitation of preterm infants at birth, lead to improved short- and long-term mortality and morbidity...
May 4, 2018: Cochrane Database of Systematic Reviews
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