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https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#1
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28320118/prothrombin-complex-concentrate-administration-for-bleeding-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-the-samurai-nvaf-study
#2
Sohei Yoshimura, Shoichiro Sato, Kenichi Todo, Yasushi Okada, Eisuke Furui, Takayuki Matsuki, Hiroshi Yamagami, Masatoshi Koga, Jun C Takahashi, Kazuyuki Nagatsuka, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: Antidotes appropriate for non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are not yet in widespread clinical use. Efficacy of prothrombin complex concentrate (PCC) in NOAC-associated bleeding remains unclarified. METHODS: Ten NOAC users (4 women, median 74years old) who developed major bleeding and received PCC were prospectively enrolled. Eight single-center NOAC users (0 women, median 74years old) with intracerebral hemorrhage, who over the same period did not receive PCC, were studied for comparison...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#3
Xiaoyan Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28284460/the-impact-of-prolonged-waiting-time-for-coronary-care-unit-admission-on-patients-with-non-st-elevation-acute-coronary-syndrome
#4
Chien-Chih Chen, I-Min Chiu, Fu-Jen Cheng, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). METHODS: Patients were divided into 2 groups according to the CCU waiting time (<12h and >12h)...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28272736/reintroduction-of-anti-thrombotic-therapy-after-a-gastrointestinal-haemorrhage-if-and-when
#5
REVIEW
Martin J Scott, Andrew Veitch, Jecko Thachil
Gastrointestinal haemorrhage is a common clinical scenario and, in those using antithrombotic agents, the risk is significantly increased. Management of these patients, in terms of initial resuscitation is well established and numerous guidelines exist in this area. However, few studies have addressed the subsequent dilemma of if and when antithrombotic agents should be reintroduced. Consequently, practice is variable and not necessarily evidenced-based. Overall, for patients that are either anticoagulated or using antiplatelet drugs for secondary prophylaxis, there is a clear benefit to restarting these agents...
March 8, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28268536/segmentation-of-angiodysplasia-lesions-in-wce-images-using-a-map-approach-with-markov-random-fields
#6
Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima
This paper deals with the segmentation of angiodysplasias in wireless capsule endoscopy images. These lesions are the cause of almost 10% of all gastrointestinal bleeding episodes, and its detection using the available software presents low sensitivity. This work proposes an automatic selection of a ROI using an image segmentation module based on the MAP approach where an accelerated version of the EM algorithm is used to iteratively estimate the model parameters. Spatial context is modeled in the prior probability density function using Markov Random Fields...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226712/segmentation-of-angiodysplasia-lesions-in-wce-images-using-a-map-approach-with-markov-random-fields
#7
Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima, Pedro M Vieira, Bruno Goncalves, Carla R Goncalves, Carlos S Lima, Pedro M Vieira, Carla R Goncalves, Bruno Goncalves, Carlos S Lima
This paper deals with the segmentation of angiodysplasias in wireless capsule endoscopy images. These lesions are the cause of almost 10% of all gastrointestinal bleeding episodes, and its detection using the available software presents low sensitivity. This work proposes an automatic selection of a ROI using an image segmentation module based on the MAP approach where an accelerated version of the EM algorithm is used to iteratively estimate the model parameters. Spatial context is modeled in the prior probability density function using Markov Random Fields...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226352/-postoperative-complication-registration-in-gastric-cancer-surgery-from-2005-to-2016-a-learning-curve-in-our-institution
#8
Zhouqiao Wu, Jinyao Shi, Fei Shan, Ziyu Li, Jiafu Ji
OBJECTIVE: To analyze the change in postoperative complication rate after gastric cancer surgery registered in the Peking University Cancer Hospital in recent 11 years and the learning curve of complication registration, and to investigate how to improve the complication registration and evaluation in gastric cancer surgery. METHODS: Patients who underwent open or laparoscopic gastric cancer surgery between April 14, 2005 and February 15, 2016 in our institution were included in the study, and those without essential clinical and administrative data were excluded...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28224113/intensity-modulated-radiation-therapy-with-stereotactic-body-radiation-therapy-boost-for-unfavorable-prostate-cancer-a-report-on-3-year-toxicity
#9
Ima Paydar, Abigail Pepin, Robyn A Cyr, Joseph King, Thomas M Yung, Elizabeth G Bullock, Siyuan Lei, Andrew Satinsky, K William Harter, Simeng Suy, Anatoly Dritschilo, John H Lynch, Thomas P Kole, Sean P Collins
BACKGROUND: Recent data suggest that intensity-modulated radiation therapy (IMRT) plus brachytherapy boost for unfavorable prostate cancer provides improved biochemical relapse-free survival over IMRT alone. Stereotactic body radiation therapy (SBRT) may be a less invasive alternative to brachytherapy boost. Here, we report the 3-year gastrointestinal (GI) and genitourinary (GU) toxicities of IMRT plus SBRT boost. MATERIALS AND METHODS: Between March 2008 and September 2012, patients with prostate cancer were treated with robotic SBRT (19...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28216977/implications-of-small-bowel-transit-time-in-the-detection-rate-of-capsule-endoscopy-a-multivariable-multicenter-study-of-patients-with-obscure-gastrointestinal-bleeding
#10
Carlo Maria Girelli, Marco Soncini, Emanuele Rondonotti
AIM: To define the role of small-bowel transit time in the detection rate of significant small-bowel lesions. METHODS: Small-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings)...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#11
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#12
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28213685/prasugrel-for-japanese-patients-with-acute-coronary-syndrome-in-short-term-clinical-practice-prasfit-practice-i-a-postmarketing-observational-study
#13
Masato Nakamura, Tomoko Iizuka, Kei Sagawa, Kenji Abe, Shuichi Chikada, Miyuki Arai
Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment ≥1 month before the end of the study period...
February 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28212588/colorectal-polypectomy-and-endoscopic-mucosal-resection-emr-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#14
Monika Ferlitsch, Alan Moss, Cesare Hassan, Pradeep Bhandari, Jean-Marc Dumonceau, Gregorios Paspatis, Rodrigo Jover, Cord Langner, Maxime Bronzwaer, Kumanan Nalankilli, Paul Fockens, Rawi Hazzan, Ian M Gralnek, Michael Gschwantler, Elisabeth Waldmann, Philip Jeschek, Daniela Penz, Denis Heresbach, Leon Moons, Arnaud Lemmers, Konstantina Paraskeva, Juergen Pohl, Thierry Ponchon, Jaroslaw Regula, Alessandro Repici, Matthew D Rutter, Nicholas G Burgess, Michael J Bourke
1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation...
March 2017: Endoscopy
https://www.readbyqxmd.com/read/28210867/management-and-outcome-of-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-or-antiplatelet-drugs
#15
Sven Pannach, Julia Goetze, Sandra Marten, Thomas Schreier, Luise Tittl, Jan Beyer-Westendorf
BACKGROUND: Non-vitamin K dependent oral anticoagulants (NOACs) significantly decrease overall major bleeding rates compared with vitamin K antagonists (VKAs) but there is conflicting evidence regarding the relative risk of gastrointestinal bleeding. Since data regarding the types, the management, and the outcome of NOAC-associated gastrointestinal bleeding are scarce, we aimed to fill this gap by comparing cases of gastrointestinal bleeding associated with NOAC, VKA, or antiplatelet therapy...
February 16, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28206731/thrombus-resolution-and-right-ventricular-functional-recovery-using-ultrasound-accelerated-thrombolysis-in-acute-massive-and-submassive-pulmonary-embolism
#16
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28205386/nonvariceal-upper-gastrointestinal-bleeding-in-the-elderly-clinical-outcomes-and-prognostic-factors
#17
Josè Alberto González-González, Roberto Monreal-Robles, Diego García-Compean, Jonathan Paz-Delgadillo, Martín Wah-Suárez, Héctor Jesús Maldonado-Garza
AIM: To analyze the clinical characteristics, outcomes and prognostic factors in elderly patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). METHODS: From a database prospectively collected from 2006 to 2013, the clinical characteristics and outcomes of patients aged 75 years or older consecutively admitted with acute nonvariceal UGIB undergoing upper gastrointestinal endoscopy were compared with those younger than 75 years. RESULTS: There were1136 patients included in the study; 276 (24...
February 16, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#18
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28205029/stray-energy-transfer-during-endoscopy
#19
Edward L Jones, Amin Madani, Douglas M Overbey, Asimina Kiourti, Satheesh Bojja-Venkatakrishnan, Dean J Mikami, Jeffrey W Hazey, Todd R Arcomano, Thomas N Robinson
INTRODUCTION: Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. METHODS AND PROCEDURES: A gastroscope was introduced into the stomach of an anesthetized pig...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28196608/management-of-major-bleeding-events-in-patients-treated-with-dabigatran-for-nonvalvular-atrial-fibrillation-a-retrospective-multicenter-review
#20
Truman J Milling, Christian Fromm, Michael Ganetsky, Daniel J Pallin, Julie Cong, Adam J Singer
STUDY OBJECTIVE: There are limited data on the clinical presentations and management of dabigatran-associated major bleeding outside the clinical trial setting. The aim of this study is to describe clinical characteristics, interventions, and outcomes in patients with dabigatran-associated major bleeding who present to the emergency department (ED). METHODS: We performed a retrospective observational chart review study of dabigatran-treated patients with nonvalvular atrial fibrillation who presented with acute major bleeding to the ED...
February 3, 2017: Annals of Emergency Medicine
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