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https://www.readbyqxmd.com/read/28911787/pulmonary-embolism-severity-assessment-and-prognostication
#1
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/28902639/the-role-of-specialized-prevention-clinics-for-the-short-term-follow-up-of-acute-coronary-syndromes
#2
Salih Kılıç, Evrim Şimşek, Hatice Soner Kemal, Elif İlkay Yüce, Cüneyt Türkoğlu, Meral Kayıkçıoğlu
OBJECTIVE: This study aimed to investigate the effect of specialized prevention clinics and standard clinics follow-ups on secondary protection after acute coronary syndrome (ACS) on cardiovascular risk factors. METHODS: A total of 118 patients who received thrombolytic therapy after being diagnosed with ST-segment elevation myocardial infarction were followed up for 6 months. After ACS, patients in a specialized prevention clinic (Group 1) (n=67) and those in a standard clinic (Group 2) (n=51) were compared in terms of the change in their lifestyle, management of risk factors, and drug compliance...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28900446/endothelial-progenitor-cells-for-ischemic-stroke-update-on-basic-research-and-application
#3
REVIEW
Shaohua Liao, Chunxia Luo, Bingzhen Cao, Huaiqiang Hu, Suxia Wang, Huili Yue, Lin Chen, Zhenhua Zhou
Ischemic stroke is one of the leading causes of human death and disability worldwide. So far, ultra-early thrombolytic therapy is the most effective treatment. However, most patients still live with varying degrees of neurological dysfunction due to its narrow therapeutic time window. It has been confirmed in many studies that endothelial progenitor cells (EPCs), as a kind of adult stem cells, can protect the neurovascular unit by repairing the vascular endothelium and its secretory function, which contribute to the recovery of neurological function after an ischemic stroke...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28886856/outcome-of-patients-receiving-thrombolytic-therapy-while-on-rivaroxaban-for-nonvalvular-atrial-fibrillation-from-rivaroxaban-once-daily-oral-direct-factor-xa-inhibition-compared-with-vitamin-k-antagonism-for-prevention-of-stroke-and-embolism-trial-in-atrial
#4
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
The safety of intravenous thrombolysis in patients taking rivaroxaban has not been well established. We retrospectively analyzed the outcomes of all patients who received thrombolytic therapy in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). A review of medical and adverse event records for patients receiving thrombolytic therapy while enrolled in ROCKET AF was performed to determine their baseline characteristics, indications for thrombolysis, and type of agent used...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28881141/elongated-plant-virus-based-nanoparticles-for-enhanced-delivery-of-thrombolytic-therapies
#5
Andrzej Stanislaw Pitek, Yunmei Wang, Sahil Gulati, Huiyun Gao, Phoebe L Stewart, Daniel I Simon, Nicole F Steinmetz
Thrombotic cardiovascular disease, including acute myocardial infarction, ischemic stroke, and venous thromboembolic disease, is the leading cause of morbidity and mortality worldwide. While reperfusion therapy with thrombolytic agents reduces mortality from acute myocardial infarction and disability from stroke, thrombolysis is generally less effective than mechanical reperfusion and is associated with fatal intra-cerebral hemorrhage in up to 2-4% of patients. To address these limitations, we propose the tobacco mosaic virus (TMV)-based platform technology for targeted delivery of thrombolytic therapies...
September 7, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28875864/pulmonary-embolism-with-cardiac-arrest-a-stemi-patient-s-unexpected-course
#6
Zoë Piggott, Tomislav Jelic
We describe the successful use and complications of bolus-dose alteplase to treat strongly suspected pulmonary embolism (PE) with cardiac arrest in a patient initially presenting as ST-elevation myocardial infarcation (MI). Case description is followed by a review of the indications, safety, and dosing of systemic thrombolytic therapy for high-risk PE in the emergency department (ED). Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED...
September 6, 2017: CJEM
https://www.readbyqxmd.com/read/28867523/drip-and-ship-thrombolytic-therapy-for-acute-ischemic-stroke
#7
Ichiro Deguchi, Satoko Mizuno, Shinya Kohyama, Norio Tanahashi, Masaki Takao
BACKGROUND: Neuroendovascular therapy is a common treatment for patients with acute ischemic stroke of the anterior circulation who fail to respond to recombinant tissue plasminogen activator. However, although most hospitals can provide recombinant tissue plasminogen activator therapy, many cannot perform neuroendovascular therapy. Thus, use of a drip-and-ship treatment-liaison system allowing recombinant tissue plasminogen activator-treated patients to be transferred to facilities offering neuroendovascular therapy is important...
August 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28864991/evaluating-safety-of-thrombolysis-in-chronic-kidney-disease-patients-presenting-with-pulmonary-embolism-using-propensity-score-matching
#8
Brijesh Patel, Naveen Sablani, Mahek Shah, Lohit Garg, Manyoo Agarwal, Sahil Agrawal, Susan Steigerwalt, Raman Dusaj
To assess the safety of thrombolytic therapy in chronic kidney disease (CKD) patients who present with pulmonary embolism (PE). We used the Nationwide Inpatient Sample Database to identify patients who underwent thrombolysis for PE between 2010 and 2014. The patients were divided into two groups: (1) No CKD and (2) CKD. Patients with and without CKD were matched using 1:1 propensity score matching and a caliper width of 0.01. The primary outcomes were in-hospital mortality and hemorrhagic events. The secondary outcomes were blood transfusions, length of stay and total hospitalization charge...
September 1, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28861632/margination-and-adhesion-of-micro-and-nanoparticles-in-the-coronary-circulation-a-step-towards-optimised-drug-carrier-design
#9
Mohamadamin Forouzandehmehr, Amir Shamloo
Obstruction of left anterior descending artery (LAD) due to the thrombosis or atherosclerotic plaques is the leading cause of death worldwide. Targeted delivery of drugs through micro- and nanoparticles is a very promising approach for developing new strategies in clot-busting or treating restenosis. In this work, we modelled the blood flow characteristics in a patient-specific reconstructed LAD artery by the fluid-solid interaction method and based on physiological boundary conditions. Next, we provided a Lagrangian description of micro- and nanoparticles dynamics in the blood flow considering their Brownian motion and the particle-particle interactions...
August 31, 2017: Biomechanics and Modeling in Mechanobiology
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
#10
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/28845108/the-role-of-endovascular-therapy-in-acute-mesenteric-ischemia
#11
Anna Maria Ierardi, Dimitrios Tsetis, Sara Sbaraini, Salvatore Alessio Angileri, Nikolaos Galanakis, Mario Petrillo, Francesca Patella, Silvia Panella, Federica Balestra, Natalie Lucchina, Gianpaolo Carrafiello
BACKGROUND: Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. METHODS: An online review using PubMed was carried out to identify all English articles about this topic in the time interval from 2005 to 2016...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28838459/thromboembolism-induced-by-umbilical-cord-mesenchymal-stem-cell-infusion-a-report-of-two-cases-and-literature-review
#12
Z Wu, S Zhang, L Zhou, J Cai, J Tan, X Gao, Z Zeng, D Li
OBJECTIVE: To investigate the thromboembolism induced by blood-mediated inflammatory reactions against infused cells during the clinical application of stem cells. METHODS: Two patients with renal transplantation and chronic kidney disease, respectively, experienced thromboembolism after umbilical cord mesenchymal stem cell (UCMSC) infusion. The clinical manifestations and the laboratory test results were collected and analyzed. RESULTS: The patients received stem cell infusion through the peripheral veins and presented with a swollen and painful forearm postinfusion...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28834883/effect-of-charted-mental-illness-on-reperfusion-therapy-in-hospitalized-patients-with-an-acute-myocardial-infarction-in-florida
#13
Thomas R Campi, Sharon George, Diego Villacís, Melissa Ward-Peterson, Noël C Barengo, Juan C Zevallos
Patients with mental illness carry risk factors that predispose them to excess cardiovascular mortality from an acute myocardial infarction (AMI) compared to the general population. The aim of this study was to determine if patients with AMI and charted mental illness (CMI) received less reperfusion therapy following an AMI, compared to AMI patients without CMI in a recent sample population from Florida.A secondary analysis of data was conducted using the Florida Agency for Health Care Administration (FL-AHCA) hospital discharge registry...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28828935/a-retrospective-review-of-patients-with-massive-and-submassive-pulmonary-embolism-treated-with-angiojet-rheolytic-thrombectomy-with-decreased-complications-due-to-changes-in-thrombolytic-use-and-procedural-modifications
#14
Sundeep Das, Nikhil Das, Harvey Serota, Sriram Vissa
Objectives A retrospective review of treatment of patients with massive or submassive pulmonary embolism (PE) using AngioJet rheolytic thrombectomy (ART) system with procedural modifications to improve on the previously reported outcomes. Materials and Methods Thirteen patients underwent emergent pulmonary artery thrombectomy for massive and submassive PE using ART with pharmacological and procedural modification, in comparison to prior reports. The modifications included the selective use of the Solent Omni AngioJet device in all subjects, distal contrast angiography via the AngioJet catheter before device activation, and limited short run times...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28826879/on-chip-preparation-of-streptokinase-entrapped-in-chitosan-nanoparticles-used-in-thrombolytic-therapy-potentially
#15
Mohammad Shamsi, Payam Zahedi
The objective of this work was to prepare the streptokinase (SK) entrapped in chitosan nanoparticles (CS NPs) using bulk mixing (BM) and microfluidic (MF) techniques. The physicochemical properties of the samples were characterized by means of scanning electron microscopy and dynamic light scattering analysis for optimizing CS and SK solution concentrations as well as pH values. The obtained results showed that CS NPs fabricated using MF chip have the most uniform morphology, spherical shape, and average diameter of 67 ± 13 nm along with a narrow polydispersity...
August 18, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28818211/evaluation-of-thrombolysis-using-tissue-plasminogen-activator-in-lower-extremity-deep-venous-thrombosis-with%C3%A2-concomitant-femoral-popliteal-venous-segment%C3%A2-involvement
#16
Mayin Lin, John C F Hsieh, Mian Hanif, Alan McDaniel, David K Chew
OBJECTIVE: Current guidelines recommend thrombolytic therapy for iliofemoral deep venous thrombosis (DVT). Anticoagulation is the standard treatment for femoral-popliteal and tibial-level DVT. The objective of this study was to evaluate the efficacy of catheter-directed thrombolysis (CDT) using tissue plasminogen activator vs standard anticoagulation alone in patients with lower extremity DVT involving the femoral-popliteal segment. METHODS: A retrospective review was performed of patients referred to the vascular surgery service with lower extremity DVT from 2006 to 2015...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28813763/simultaneous-onset-of-deep-vein-thrombosis-pulmonary-embolism-cerebral-infarction-and-myocardial-infarction-in-a-patient-with-patent-foramen-ovale
#17
Jimmy Yee, Vishesh Kumar, Alex Pham, Kashif Shaikh, Muhammad Omar, Adam Stys, Marian Petrasko
Paradoxical embolism is a known complication with intra-cardiac shunts. It should be considered in the differential as the pathophysiologic mechanism of simultaneous thromboembolism in the venous and systemic vasculature. We present a case of simultaneous deep venous thrombosis, pulmonary embolism and myocardial infarction in the presence of a confirmed patent foramen ovale on echocardiography. Thrombolytic therapy was administered. Subsequent concerns of intracranial hemorrhage on imaging of the brain complicated the management and added to the challenge of co-managing the clot burden in our patient...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28807710/inferior-vena-cava-filters-in-stable-patients-with-acute-pulmonary-embolism-who-receive-thrombolytic-therapy
#18
Paul D Stein, Fadi Matta, Mary J Hughes
BACKGROUND: There is a need for further analyses of subgroups of patients with pulmonary embolism who might benefit from vena cava filters. In the present investigation, we analyze mortality with vena cava filters in the subgroup of stable patients with pulmonary embolism who received thrombolytic therapy. We use a different database than used previously, and we analyze data in more recent years. METHODS: Administrative data were analyzed from the Premier Healthcare Database, 2010-2014, in hospitalized stable patients with pulmonary embolism who received thrombolytic therapy, and may or may not have received a vena cava filter...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28806993/successful-intravenous-thrombolysis-for-ischemic-stroke-after-reversal-of-dabigatran-anticoagulation-with-idarucizumab-a-case-report
#19
Sergio Agosti, Laura Casalino, Enrico Rocci, Gabriele Zaccone, Eugenia Rota
BACKGROUND: Non-vitamin K antagonist oral anticoagulants, including dabigatran, are currently widely used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment for immediate reversal of dabigatran-induced anticoagulation, has been introduced into the market to be used in life-threatening bleeding or urgent surgery, allowing for rapid normalization of clotting parameters. The use of idarucizumab is not yet well established in patients presenting with acute ischemic stroke on dabigatran who are candidates for thrombolytic therapy...
August 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#20
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
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