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https://www.readbyqxmd.com/read/29784753/use-of-direct-oral-anticoagulants-for-treating-venous-thromboembolism-in-patients-with-cancer
#1
Gerald A Soff
For patients with cancer who experience venous thromboembolism (VTE), low-molecular-weight heparin (LMWH) remains the standard of care in the NCCN Guidelines for VTE, but under certain conditions direct oral anticoagulants (DOACs) are acceptable alternatives. A growing body of literature suggests that DOACs may more effective than LMWHs in preventing recurrences, but they do carry some increased risk of bleeding. Most of this risk is seen in patients with gastrointestinal or urinary pathology or implanted devices...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29754836/misoprostol-for-small-bowel-ulcers-in-patients-with-obscure-bleeding-taking-aspirin-and-non-steroidal-anti-inflammatory-drugs-masters-a-randomised-double-blind-placebo-controlled-phase-3-trial
#2
Ali S Taha, Caroline McCloskey, Paula McSkimming, Alex McConnachie
BACKGROUND: The incidence of obscure gastrointestinal bleeding, which originates from the small bowel and is mainly associated with the use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), is rising. We assessed the efficacy and safety of misoprostol for the treatment of small bowel ulcers and erosions in patients taking low-dose aspirin or NSAIDs with obscure gastrointestinal bleeding. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients (aged ≥18 years) with small bowel ulcers who were taking low-dose aspirin, NSAIDs, or both for a minimum of 4 weeks, at University Hospital Crosshouse (Kilmarnock, UK)...
May 10, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29748353/gastrointestinal-bleeding-with-edoxaban-versus-warfarin-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction
#3
James Aisenberg, Prapti Chatterjee-Murphy, Kathryn Friedman Flack, Jeffrey I Weitz, Christian T Ruff, Francesco Nordio, Michele F Mercuri, Youngsook Choi, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail. METHODS AND RESULTS: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29714004/non-bleeding-adverse-events-with-the-use-of-direct-oral-anticoagulants-a-sequence-symmetry-analysis
#4
Géric Maura, Cécile Billionnet, Joël Coste, Alain Weill, Anke Neumann, Antoine Pariente
INTRODUCTION: Postmarketing pharmacovigilance reports have raised concerns about non-bleeding adverse events associated with direct oral anticoagulants (DOACs), but only limited results are available from large claims databases. OBJECTIVE: The aim of this study was to assess the potential association between DOAC initiation and the onset of four types of non-bleeding adverse events by sequence symmetry analysis (SSA). METHODS: SSA was performed using nationwide data from the French National Healthcare databases (Régime Général, 50 million beneficiaries) to assess a cohort of 386,081 DOAC new users for the first occurrence of four types of non-bleeding outcomes: renal, hepatic, skin outcomes identified by using hospitalization discharge diagnoses, and gastrointestinal outcomes by using medication reimbursement...
April 30, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#5
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29691259/transdermal-estradiol-for-the-management-of-refractory-uremic-bleeding
#6
Jimmy Gonzalez, Samantha Bryant, Evelyn R Hermes-DeSantis
PURPOSE: The efficacy and thrombogenicity of transdermal estradiol in the management of refractory uremic bleeding in adults are examined. SUMMARY: Platelet dysfunction from chronic kidney disease may induce uremic bleeding. This type of bleeding may involve the skin, oral and nasal mucosa, gingivae, respiratory system, and gastrointestinal or urinary tract. While the mainstay of treatment for uremic bleeding primarily involves dialysis and use of prohemostatic agents such as desmopressin and erythropoiesis-stimulating agents, certain patients may experience bleeding refractory to these interventions...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29671413/non-variceal-upper-gastrointestinal-bleeding
#7
REVIEW
Angel Lanas, Jean-Marc Dumonceau, Richard H Hunt, Mitsuhiro Fujishiro, James M Scheiman, Ian M Gralnek, Helen E Campbell, Alaa Rostom, Càndid Villanueva, Joseph J Y Sung
Non-variceal upper gastrointestinal bleeding (NVUGIB) is bleeding that develops in the oesophagus, stomach or proximal duodenum. Peptic ulcers, caused by Helicobacter pylori infection or use of NSAIDs and low-dose aspirin (LDA), are the most common cause. Although the incidence and mortality associated with NVUGIB have been decreasing owing to considerable advances in the prevention and management of NVUGIB over the past 20 years, it remains a common clinical problem with an annual incidence of ∼67 per 100,000 individuals in the United States in 2012...
April 19, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29669540/predictive-values-of-upper-gastrointestinal-cancer-alarm-symptoms-in-the-general-population-a-nationwide-cohort-study
#8
Sanne Rasmussen, Peter Fentz Haastrup, Kirubakaran Balasubramaniam, René DePont Christensen, Jens Søndergaard, Dorte Ejg Jarbøl
BACKGROUND: Survival rates for upper gastrointestinal (GI) cancer are poor since many are diagnosed at advanced stages. Fast track endoscopy has been introduced to prompt diagnosis for patients with alarm symptoms that could be indicative of upper GI cancer. However, these symptoms may represent benign conditions and little is known about the predictive values of alarm symptoms of upper GI cancer in the general population. METHODS: The study is a nationwide cohort study of 60,562 individuals aged 45 years or above randomly selected from the Danish general population...
April 18, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29667211/randomised-clinical-trial-gastrointestinal-events-in-arthritis-patients-treated-with-celecoxib-ibuprofen-or-naproxen-in-the-precision-trial
#9
N D Yeomans, D Y Graham, M E Husni, D H Solomon, T Stevens, J Vargo, Q Wang, L M Wisniewski, K E Wolski, J S Borer, P Libby, A M Lincoff, T F Lüscher, W Bao, C Walker, S E Nissen
BACKGROUND: We evaluated GI safety of celecoxib compared with 2 nonselective (ns) NSAIDs, as a secondary objective of a large trial examining multiorgan safety. METHODS: This randomised, double-blind controlled trial analysed 24 081 patients. Osteoarthritis or rheumatoid arthritis patients, needing ongoing NSAID treatment, were randomised to receive celecoxib 100-200 mg b.d., ibuprofen 600-800 mg t.d.s. or naproxen 375-500 mg b.d. plus esomeprazole, and low-dose aspirin or corticosteroids if already prescribed...
April 17, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29665624/risk-of-gastrointestinal-bleeding-and-benefit-from-colorectal-cancer-reduction-from-long-term-use-of-low-dose-aspirin-a-retrospective-study-of-612-509-patients
#10
Kelvin K F Tsoi, Felix C H Chan, Hoyee W Hirai, Joseph J Y Sung
BACKGROUND: Aspirin, commonly used for prevention of cardiovascular and cerebrovascular diseases, is well-known to protect against development of colorectal cancer (CRC) but increases risk of gastrointestinal bleeding (GIB). AIM: This cohort study aims to evaluate the benefit of low-dose aspirin to prevent CRC and its associated risk of GIB. METHOD: A population-based dataset was used to compare incidence and mortality of CRC and GIB among patients receiving low-dose aspirin with sex-and-age matched controls (1:2)...
April 17, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29656974/low-dose-aspirin-is-safe-and-effective-for-venous-thromboembolism-prophylaxis-following-total-knee-arthroplasty
#11
Mhamad Faour, Nicolas S Piuzzi, David P Brigati, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Aspirin is an effective prophylaxis for venous thromboembolism (VTE) after total knee arthroplasty (TKA). The optimal prophylactic aspirin dose has not been established. The study aims to compare 2 aspirin regimens with regard to the incidence of (1) symptomatic deep venous thrombosis (DVT), (2) pulmonary embolism (PE), (3) bleeding, and (4) mortality within 90 days after TKA. METHODS: We retrospectively identified 5666 patients who received aspirin twice daily for 4 to 6 weeks after TKA...
March 8, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29655662/evaluation-of-low-intensity-anti-coagulation-with-a-fully-magnetically-levitated-centrifugal-flow-circulatory-pump-the-magentum-1-study
#12
Ivan Netuka, Peter Ivák, Zuzana Tučanová, Stanislav Gregor, Ondrej Szárszoi, Poornima Sood, Daniel Crandall, Jessica Rimsans, Jean Marie Connors, Mandeep R Mehra
BACKGROUND: The HeartMate 3 left ventricular assist system is engineered to avoid pump thrombosis, yet bleeding complications persist. We investigated the safety of low-intensity anti-coagulation in patients with the HeartMate 3. METHODS: The Minimal AnticoaGulation EvaluatioNTo aUgment heMocompatibility (MAGENTUM 1) pilot study is a prospective, single-arm study of low-intensity warfarin anti-coagulation in patients implanted with the HeartMate 3 pump. After standard warfarin anti-coagulation (international normalized ratio [INR] 2...
March 27, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29628684/thirty-day-mortality-following-total-knee-arthroplasty-over-7-years-at-a-tertiary-referral-centre-of-orthopaedic-excellence
#13
Yuen Chan, Veenesh Selvaratnam, Videsh Raut
Total Knee Arthroplasty (TKA) is one of the most successful orthopaedic procedures. Around 100,000 TKAs are performed yearly in the United Kingdom. The aim of this study was to report the mortality rate within 30 days after a TKA in an Orthopaedic Centre of Excellence. We reviewed prospectively collected data of 7067 TKAs performed between April 2009-November 2016. All mortalities within 30 days of a TKA were recorded. Data such as age, sex, ASA, comorbidities and cause of death was recorded. There were 14 (0...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29624206/paracetamol-acetaminophen-for-patent-ductus-arteriosus-in-preterm-or-low-birth-weight-infants
#14
REVIEW
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal or postnatal exposure to paracetamol and later development of autism or autism spectrum disorder has been reported...
April 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29617053/efficacy-and-safety-of-rivaroxaban-compared-to-enoxaparin-in-treatment-of-cancer-associated-venous-thromboembolism
#15
Benjamin Simmons, Waldemar Wysokinski, Rayya A Saadiq, Dalene Bott-Kitslaar, Stanislav Henkin, Ana Casanegra, Charles Lenz, Paul Daniels, Haraldur Bjarnason, Emily Vargas, David Hodge, Sara J Holton, James R Cerhan, Charles Loprinzi, Robert McBane
BACKGROUND: Low molecular weight heparin (LMWH) is the guideline endorsed treatment for cancer associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. METHODS: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry were compared to contemporary cancer patients receiving enoxaparin...
April 4, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29603408/effect-of-vitamin-d-level-on-clinical-outcomes-in-patients-undergoing-left-ventricular-assist-device-implantation
#16
Fadi Abou Obeid, Gardner Yost, Geetha Bhat, Erin Drever, Antone Tatooles
BACKGROUND: Vitamin D is an important hormone that regulates cardiac myocyte function. Low levels contribute to the development of cardiovascular disease and have been implicated in immune function and the inflammatory cascade. Patients who undergo left ventricular assist device (LVAD) implantation are at risk for driveline infection, stroke, and gastrointestinal (GI) bleeding. We investigated whether serum 25-hydroxy (25-OH) vitamin D levels affect clinical outcomes after LVAD. METHODS: 212 patients who underwent LVAD implantation between 2010 and 2015 were included...
March 30, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29601902/rethinking-what-we-know-about-hemorrhoids
#17
REVIEW
Robert S Sandler, Anne F Peery
Although hemorrhoids are responsible for considerable economic cost and personal suffering, they have received surprisingly little research attention. In the United States, hemorrhoids are the third most common outpatient gastrointestinal diagnosis with nearly 4 million office and emergency department visits annually. The etiology of hemorrhoids is speculative. A low-fiber diet and constipation have historically been thought to increase the risk for hemorrhoids, but not proven. Symptoms commonly attributed to hemorrhoids include bleeding, pain, pruritus, fecal seepage, prolapse and mucus discharge...
March 27, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29572191/high-right-atrial-pressure-and-low-pulse-pressure-predict-gastrointestinal-bleeding-in-patients-with-left-ventricular-assist-device
#18
Joanna M Joly, Ashraf El-Dabh, James K Kirklin, Ramey Marshell, Michelle G Smith, Deepak Acharya, Indranee N Rajapreyar, José A Tallaj, Margaret Tresler, Salpy V Pamboukian
BACKGROUND: Gastrointestinal bleeding (GIB) remains a major morbid event during continuous flow left ventricular assist device (LVAD) support. This study investigated whether a common hemodynamic profile is associated with GIB in patients with LVADs. METHODS AND RESULTS: A single institution analysis reviewed all patients who underwent right heart catheterization (RHC) following LVAD implant between 1/1/2006 and 12/31/2013 with follow-up through 6/2015. Kaplan-Meier and multi-phase hazard statistical methods were employed...
March 20, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29571634/the-effect-of-metabolic-surgery-on-nonobese-patients-bmi-30-kg-m-2-with-type-2-diabetes-a-systematic-review
#19
Zhi-Ping Huang, Yan Guo, Chao-Qian Liu, Lin Qi, Da-Jin Zou, Wei-Ping Zhou
BACKGROUND: The influence of metabolic surgery on the glucose and lipid profiles of nonobese body mass index<30 kg/m2 patients with type 2 diabetes, particularly the effect ≥1 year, remains unknown. METHODS: PubMed and Ovid Embase were used. SETTING: University hospitals. RESULTS: In total, 21 studies including 921 patients were examined in this systematic review, the results of which revealed decrease in body mass index, waist circumference, fasting plasma glucose, glycosylated hemoglobin A1C, fasting C-peptide, fasting insulin, homeostasis model of assessment for insulin resistance index, triglycerides, total cholesterol, and low-density lipoprotein cholesterol...
February 15, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29559181/the-effectiveness-and-safety-of-low-dose-rivaroxaban-in-asians-with-non-valvular-atrial-fibrillation
#20
Hsin-Fu Lee, Yi-Hsin Chan, Hui-Tzu Tu, Chi-Tai Kuo, Yung-Hsin Yeh, Shang-Hung Chang, Lung-Sheng Wu, Lai-Chu See
BACKGROUND: Rivaroxaban (20 mg/15 mg once daily) is an effective and safe alternative to warfarin for stroke prevention in patients with non-valvular AF (NVAF). Low-dose rivaroxaban (15 mg/10 mg once daily) has been only approved for NVAF patients in Japan and Taiwan, although its effectiveness and safety at low doses remain unclear among Asians with NVAF. The objective of the study is to compare the effectiveness and safety of low-dose rivaroxaban to those of warfarin among Asians with NVAF...
March 14, 2018: International Journal of Cardiology
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