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https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#1
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29301756/outcomes-of-patients-with-atrial-fibrillation-newly-recommended-for-oral-anticoagulation-under-the-2014-american-heart-association-american-college-of-cardiology-heart-rhythm-society-guideline
#2
Matthew P Gray, Samir Saba, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: In March 2014, the American Heart Association updated their guidelines for the management of oral anticoagulation (OAC) in atrial fibrillation, recommending OAC for all patients with CHA2DS2-VASc ≥2. Previously, only patients with CHADS2 ≥2 were recommended for anticoagulation. This study compared effectiveness and safety outcomes of OAC among patients who would receive OAC using the 2014 guidelines but not the 2011 guidelines. METHODS AND RESULTS: Using claims data from a 5% sample of 2013-2014 Medicare beneficiaries, we identified patients with initially diagnosed atrial fibrillation between 2013 and 2014 and selected those who would receive OAC under the 2014 guidelines but not the 2011 guidelines (those with CHA2DS2-VASc score ≥2 or CHADS2 score <2)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29290177/health-care-resource-utilization-and-costs-among-newly-diagnosed-and-oral-anticoagulant-naive-nonvalvular-atrial-fibrillation-patients-treated-with-dabigatran-or-warfarin-in-the-united-states
#3
Rahul Jain, An-Chen Fu, Jonathan Lim, Cheng Wang, Jessica Elder, Stephen D Sander, Hiangkiat Tan
BACKGROUND: Warfarin has a long history of use to reduce the risk of stroke in patients with atrial fibrillation (AF), but it requires frequent laboratory monitoring to maintain international normalized ratio levels in the therapeutic range. Dabigatran, a novel oral anticoagulant (OAC), has demonstrated efficacy in reducing the risk of stroke and systemic embolism and does not require laboratory monitoring. OBJECTIVE: To compare health care resource utilization (HCRU) and costs of OAC-naive patients newly diagnosed with nonvalvular atrial fibrillation (NVAF), using dabigatran or warfarin...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29283976/decreased-tidal-volume-with-increased-height-but-not-colloid-transfusion-is-associated-with-worse-outcomes-and-postoperative-pneumonia-after-coil-embolization-of-aneurysmal-subarachnoid-hemorrhage-a-retrospective-study
#4
Li-Min Zhang, Rui Li, Xiao-Chun Zhao, Ming-Li Wang
BACKGROUND: The tidal volume setting as well as colloid transfusion during the peri-operative period after intracranial aneurysm is controversial. A multicenter retrospective study was conducted to determine whether or not an increased tidal volume setting and colloid transfusion are associated with poor outcomes and postoperative pulmonary complications after intracranial aneurysm. METHOD: Data from endovascular coiling to treat intracranial aneurysms that took place between 30 March 2014 and 30 March 2016 were collected in a multicenter chart...
December 27, 2017: Shock
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#5
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29226891/the-relationship-between-right-ventricular-outflow-tract-fractional-shortening-and-pulmonary-embolism-severity-index-in-acute-pulmonary-embolism
#6
Ekrem Şahan, Murat Karamanlıoğlu, Suzan Şahan, Murat Gül, Ahmet Korkmaz, Omaç Tüfekçioğlu
OBJECTIVE: Right ventricular (RV) functions are clinically important in acute pulmonary embolism (APE). Measurement of systolic function of the right ventricular outflow tract (RVOT) with echocardiography is a simple method to evaluate RV function. The aim of this study was to determine the relationship between RVOT systolic function and the Pulmonary Embolism Severity Index (PESI). METHODS: A total of 151 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were included...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29223441/edoxaban-for-the-management-of-elderly-japanese-patients-with-atrial-fibrillation-ineligible-for-standard-oral-anticoagulant-therapies-rationale-and-design-of-the-eldercare-af-study
#7
RANDOMIZED CONTROLLED TRIAL
Ken Okumura, Gregory Y H Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita
Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29201194/protective-effect-of-zoledronic-acid-on-articular-cartilage-and-subchondral-bone-of-rabbits-with-experimental-knee-osteoarthritis
#8
Guorong She, Ziqi Zhou, Zhengang Zha, Fei Wang, Xiaoting Pan
Subchondral bone reabsorption and remodeling are responsible for the initiation and progression of osteoarthritis (OA). Zoledronic acid (ZOL), a third-generation bisphosphonate (BIS), is an inhibitor of bone reabsorption. However, the intervention effect of ZOL on OA has not been fully characterized and remains to be directly demonstrated in animal experiments. The present study examined the microscopic and macroscopic changes in the anterior cruciate ligament transection (ACLT) model of OA in rabbits and evaluated the effects of ZOL on cartilage degeneration and subchondral bone loss...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29196972/proximal-total-splenic-artery-embolization-for-refractory-hepatic-encephalopathy
#9
Harufumi Maki, Junichi Kaneko, Junichi Arita, Nobuhisa Akamatsu, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Sumihito Tamura, Hidemasa Takao, Eisuke Shibata, Norihiro Kokudo
A Japanese woman with a history of Kasai operation for biliary atresia had living-donor liver transplantation at the age of 22. The first episode of refractory HE and late cellular rejection was treated by a high dose of methylprednisolone. The second episode of refractory HE was treated by balloon-occluded retrograde transvenous obliteration for a spleno-renal shunt. However, the third episode of refractory HE occurred 11 years after liver transplantation. The liver cirrhosis and hypersplenism were present with a Child-Pugh score of C-10...
December 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29180170/money-well-spent-a-cost-and-utilization-analysis-of-prophylactic-inferior-vena-cava-filter-placement-in-high-risk-trauma-patients
#10
Margo Nicole Carlin, Alireza Daneshpajouh, Joseph Catino, Marko Bukur
BACKGROUND: Inferior vena cava filters (IVCF) for venous thromboembolic prophylaxis in high-risk trauma patients is a controversial practice. Utilization of IVCF prophylaxis was evaluated at a level 1 trauma center. Daily cost of IVCF prophylaxis, time to IVCF, duration between IVCF and chemoprophylaxis, and number of patients needed to treat (NNT) to prevent pulmonary embolism (PE) was calculated. METHODS: A retrospective review of prophylactic IVCF over a 5-year period (2010-2014)...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29177015/clinical-significance-of-atrial-high-rate-episodes-for-thromboembolic-events-in-japanese-population
#11
Hiroshi Kawakami, Takayuki Nagai, Makoto Saito, Shinji Inaba, Fumiyasu Seike, Kazuhisa Nishimura, Katsuji Inoue, Takafumi Okura, Takumi Sumimoto, Shigeki Uemura, Jitsuo Higaki, Shuntaro Ikeda
Objective: The clinical significance of atrial high-rate episodes (AHREs) detected by cardiac devices among patients with implantable pacemakers has recently emerged. However, the relationship between AHREs and ischaemic stroke and systemic embolism (SE) is not well understood in the Japanese population. Methods: This study included 343 patients with pacemakers capable of continuous atrial rhythm monitoring (167 males; mean age, 80±7 years). Atrial tachyarrhythmia detection was programmed to the nominal setting of each device, and AHRE was defined as any episode of sustained atrial tachyarrhythmia lasting for more than 6 min...
2017: Heart Asia
https://www.readbyqxmd.com/read/29158179/prognostic-factors-affecting-outcomes-in-patients-with-malignant-gi-bleeding-treated-with-a-novel-endoscopically-delivered-hemostatic-powder
#12
Rapat Pittayanon, Rungsun Rerknimitr, Alan Barkun
BACKGROUND AND AIM: Endoscopic hemostatic techniques remain poorly effective for GI tumor bleeding. We assessed Tc-325 (Hemospray) for this indication and determined possible predictors of decreased recurrent bleeding and improved 6-month survival in affected patients. METHODS: This retrospective study identified 99 patients with active malignant GI bleeding (primary or metastatic) treated with Tc-325. Eleven patients were excluded because of incomplete data. Data on patient characteristics and possible predictive factors of early (72-hour) and delayed (7, 14 and 30-day) recurrent bleeding, as well as six-month survival, were collected...
November 17, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29137051/neutrophil-to-lymphocyte-and-aspartate-to-alanine-aminotransferase-ratios-predict-hepatocellular-carcinoma-prognosis-after-transarterial-embolization
#13
Chang Liu, Bang-Sheng Jia, Bing-Wen Zou, Hua Du, Lu-Nan Yan, Jia-Yin Yang, Li Jiang, Tian-Fu Wen, Wu-Sheng Lu
The neutrophil-to-lymphocyte ratio (NLR) reflects the systematic inflammatory status, and the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) is a biomarker of liver fibrosis and cirrhosis. These values can be conveniently obtained from routine blood tests; however, their combined clinical utility has not been extensively studied in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). This study aimed to investigate the prognostic value of NLR-AAR in patients with unresectable HCC undergoing TACE...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29116691/hyperbaric-oxygen-in-patients-with-ischemic-stroke-following-cardiac-surgery-a-retrospective-observational-trial
#14
Viktoria Heide-Marie Weixler, Ameli Elisabeth Yates, Markus Puchinger, Birgit Zirngast, Prisca Pondorfer, Beatrice Ratzenhofer-Komenda, Andrea Amegah-Sakotnik, Freyja-Maria Smolle-Juettner, Otto Dapunt
BACKGROUND: Hyperbaric oxygenation (HBO₂) involves breathing 100% oxygen under elevated ambient pressure in a hyperbaric chamber, thereby dissolving oxygen in the plasma. This results in an increase of arterial partial pressure of oxygen (pO₂). Though well established in experimental studies, HBO₂ treatment for ischemic stroke is still under discussion. METHODS: From 2002-2014 HBO₂ (2.2 bar, 90 minutes one/day; average number per patient: 4.7) was applied in 49 consecutive patients (32 males, 17 females, mean age: 68...
2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29101916/pulmonary-embolism-an-update
#15
Steven Doherty
BACKGROUND: Pulmonary embolism is a common condition and can be the source of significant morbidity and mortality. OBJECTIVE: This article reviews the approach to the diagnostic assessment and management of patients with suspected pulmonary embolism. DISCUSSION: Various clinical decision rules and algorithms are available to assist in the diagnosis of pulmonary embolism, and the Wells score and Pulmonary Embolism Rule-out Criteria rule are presented in this article...
November 2017: Australian Family Physician
https://www.readbyqxmd.com/read/29080097/hydromorphone-hydrochloride-use-during-various-interventional-radiology-procedures-pain-control-and-adverse-events-a-case-series-audit-analysis
#16
Thea Moran, Amit Prabhakar, James H Diaz, Alan David Kaye
INTRODUCTION: This project studied pain control and the development of adverse events before, during, and after the administration of hydromorphone hydrochloride for various interventional radiology (IR) procedures. METHODS: We performed a retrospective analysis of 100 patients (men = 58; women = 42) sedated with peri-procedural intravenous (IV) hydromorphone in association with various IR procedures. We stratified the procedures as follows: abscess drainages (M = 8; F = 8), arteriograms (M = 1; F = 0), biliary interventions (M = 3; F = 2), bone biopsies (M = 2; F = 2), non-bone biopsies (M = 26; F = 19), non-tunneled venous catheters (M = 1; F = 1), tunneled venous catheters (M = 7; F = 5), embolization (M = 4; F = 0), IVC filter placement (M = 1; F = 1), nephrostomy tube placement (M = 1; F = 4), and percutaneous nephrolithotomy tube placements (M = 4; F = 0)...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29047304/real-world-comparison-of-all-cause-hospitalizations-hospitalizations-due-to-stroke-and-major-bleeding-and-costs-for-nonvalvular-atrial-fibrillation-patients-prescribed-oral-anticoagulants-in-a-us-health-plan
#17
Alpesh Amin, Allison Keshishian, Lien Vo, Qisu Zhang, Oluwaseyi Dina, Chad Patel, Kevin Odell, Jeffrey Trocio
AIMS: Compare the risk of all-cause hospitalization and hospitalizations due to stroke/systemic embolism (SE) and major bleeding as well as associated health care costs for nonvalvular atrial fibrillation (NVAF) patients initiating apixaban, dabigatran, rivaroxaban, or warfarin. MATERIALS AND METHODS: NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin were selected from the OptumInsight Research Database from 01JAN2013-30SEP2015. Propensity score matching (PSM) was performed between apixaban and each oral anticoagulant...
October 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29045463/submillisievert-standard-pitch-ct-pulmonary-angiography-with-ultra-low-dose-contrast-media-administration-a-comparison-to-standard-ct-imaging
#18
COMPARATIVE STUDY
Saravanabavaan Suntharalingam, Christian Mikat, Elena Stenzel, Youssef Erfanian, Axel Wetter, Thomas Schlosser, Michael Forsting, Kai Nassenstein
OBJECTIVES: To evaluate the image quality and radiation dose of submillisievert standard-pitch CT pulmonary angiography (CTPA) with ultra-low dose contrast media administration in comparison to standard CTPA. MATERIALS AND METHODS: Hundred patients (56 females, 44 males, mean age 69.6±15.4 years; median BMI: 26.6, IQR: 5.9) with suspected pulmonary embolism were examined with two different protocols (n = 50 each, group A: 80 kVp, ref. mAs 115, 25 ml of contrast medium; group B: 100 kVp, ref...
2017: PloS One
https://www.readbyqxmd.com/read/29016692/benefit-of-early-discharge-among-patients-with-low-risk-pulmonary-embolism
#19
Li Wang, Onur Baser, Phil Wells, W Frank Peacock, Craig I Coleman, Gregory J Fermann, Jeff Schein, Concetta Crivera
Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index...
2017: PloS One
https://www.readbyqxmd.com/read/28993088/hip-and-knee-arthroplasty-orthopedic-literature-in-medical-journals-is-it-negatively-biased
#20
Ronald E Delanois, Chukwuweike U Gwam, Nicolas S Piuzzi, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Michael A Mont
BACKGROUND: Healthcare policy is often determined by well-designed studies most often published in high-impact medical journals. However, concern about the presence of publication bias against lower-extremity arthroplasty-related studies has called into question some of the validity of certain reports. There are only a few studies investigating the presence of the bias in high-impact medical journals against lower-extremity arthroplasty intervention, particularly in the Journal of American Medical Association (JAMA), New England Journal of Medicine (NEJM), and the Lancet...
September 19, 2017: Journal of Arthroplasty
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