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https://www.readbyqxmd.com/read/29221961/prevalence-of-high-on-treatment-aspirin-and-clopidogrel-platelet-reactivity-in-patients-with-critical-limb-ischemia
#1
Leonardo C Clavijo, Noor Al-Asady, Ashwat Dhillon, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVES: The goal of this study is to establish the prevalence of high on-treatment platelet reactivity to aspirin (HPRA) and clopidogrel (HPRC) in patients with critical limb ischemia (CLI). BACKGROUND: CLI is associated with an increased risk of death and cardiovascular events. Unlike other patient populations with atherosclerotic cardiovascular disease, previous studies failed to demonstrate a benefit of antiplatelet therapy in patients with CLI. METHODS: From June 2014 to November 2016, we performed platelet reactivity studies for P2Y12 and thromboxane A2 (TXA2) inhibition in 100 CLI patients receiving daily treatment with aspirin and clopidogrel...
October 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221927/st2-as-a-novel-prognostic-marker-in-end-stage-renal-disease-patients-on-hemodiafiltration
#2
Evgenija Homsak, Robert Ekart
BACKGROUND: Patients with end-stage renal disease (ESRD) are prone to severe heart failure (HF) and to several life-threatening events. Therefore, the ability to assess disease prognosis and the risk of short-term events or death is of great importance. The role of soluble ST2 (sST2) as a potential new prognostic marker in ESRD patients is not yet known. The aim of our study was to assess the prognostic value of sST2 in ESRD patients on hemodiafiltration (HDF) and compare it with NT-proBNP, an established prognostic marker for HF and renal disease...
December 5, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29221652/-acyclovir-resistant-perineal-hsv-infection-revealing-chronic-lymphoid-leukaemia
#3
E A Casassa, P Nicol, R Viraben, C Gaudin, C Bulai Livideanu, C Mengelle, L Lamant, F Fortenfant, C Paul, M P Konstantinou
BACKGROUND: Chronic HSV infection is a cause of chronic perineal ulcerations. We report a case of a chronic and refractory HSV infection revealing chronic lymphoid leukaemia. PATIENTS AND METHODS: An 85-year-old woman with an 8-month history of chronic perineal ulcerations was referred to our dermatology department. She had no previous medical history of herpes infection. Skin biopsies ruled out carcinoma but were consistent with HSV infection. A local swab was positive for HSV2...
December 5, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29219795/-platelet-function-tests-tailored-antiplatelet-therapy-for-vascular-patients
#4
A R T Brand, S J A Korporaal, R T Urbanus, G Pasterkamp, G J de Borst
- Platelet aggregation inhibitors, also known as antiplatelet therapy (APT), are prescribed for the prevention of secondary cardiovascular events (CVE) after endovascular revascularization procedures.- Platelet aggregation inhibitors are not equally effective in all patients. The phenomenon of high residual platelet reactivity despite APT is called 'high on-treatment platelet reactivity' (HTPR); it bears an increased risk of secondary CVE.- Platelet function tests (PFT) can be used to diagnose HTPR. There are various tests available; of those, light transmission aggregometry (LTA) is considered the gold standard...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29217816/wunderlich-s-syndrome-or-spontaneous-retroperitoneal-hemorrhage-in-a-patient-with-tuberous-sclerosis-and-bilateral-renal-angiomyolipoma
#5
Sara Catarino Santos, Liliana Duarte, Fernando Valério, Júlio Constantino, Jorge Pereira, Carlos Casimiro
BACKGROUND Wunderlich's syndrome, or spontaneous non-traumatic retroperitoneal hemorrhage, can be a life-threatening event. Renal angiomyolipoma is a rare benign tumor that can occur sporadically, or in association with tuberous sclerosis. A case of spontaneous retroperitoneal hemorrhage in a patient with tuberous sclerosis and bilateral renal angiomyolipoma is presented. CASE REPORT A 33-year-old female Caucasian patient, with a known medical history of tuberous sclerosis, was admitted to hospital as an emergency, with right-sided abdominal pain...
December 8, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#6
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29217251/effectiveness-and-safety-of-aprotinin-use-in-thoracic-aortic-surgery
#7
Pierpaolo Chivasso, Vito D Bruno, Roberto Marsico, Anilkumar Sankanahalli Annaiah, Alexander Curtis, Carlo Zebele, Gianni D Angelini, Alan J Bryan, Cha Rajakaruna
OBJECTIVE: To determine the effectiveness and safety of aprotinin use in adult patients undergoing thoracic aortic surgery. DESIGN: Single-center, retrospective study. SETTING: All cases performed at a single university hospital. PARTICIPANTS: Between January 2004 and December 2014, 846 adult patients underwent thoracic aortic surgery. Due to missing or duplicated data on primary outcomes, 314 patients were excluded...
June 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29214442/shiga-toxin-triggers-endothelial-and-podocyte-injury-the-role-of-complement-activation
#8
REVIEW
Carlamaria Zoja, Simona Buelli, Marina Morigi
Shiga toxin (Stx)-producing Escherichia coli (STEC) is the offending agent in post-diarrhea-associated hemolytic uremic syndrome (HUS), a disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney failure, with thrombi occluding the renal microvasculature. Endothelial dysfunction has been recognized as the trigger event in the development of microangiopathic processes. Glomerular endothelial cells are susceptible to the toxic effects of Stxs that, via nuclear factor kappa B (NF-κB) activation, induce the expression of genes encoding for adhesion molecules and chemokines, culminating in leukocyte adhesion and platelet thrombus formation on the activated endothelium...
December 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29214305/cardiovascular-outcomes-according-to-urinary-albumin-and-kidney-disease-in-patients-with-type-2-diabetes-at-high-cardiovascular-risk-observations-from-the-savor-timi-53-trial
#9
Benjamin M Scirica, Ofri Mosenzon, Deepak L Bhatt, Jacob A Udell, Ph Gabriel Steg, Darren K McGuire, KyungAh Im, Estella Kanevsky, Christina Stahre, Mikaela Sjöstrand, Itamar Raz, Eugene Braunwald
Importance: An elevated level of urinary albumin to creatinine ratio (UACR) is a marker of renal dysfunction and predictor of kidney failure/death in patients with type 2 diabetes. The prognostic use of UACR in established cardiac biomarkers is not well described. Objective: To evaluate whether UACR offers incremental prognostic benefit beyond risk factors and established plasma cardiovascular biomarkers. Design, Setting, and Participants: The Saxagliptin Assessment of Vascular Outcomes Recorded in Patients With Diabetes Mellitus-Thrombolysis in Myocardial Infarction (SAVOR-TIMI) 53 study was performed from May 2010 to May 2013 and evaluated the safety of saxagliptin vs placebo in patients with type 2 diabetes with overt cardiovascular disease or multiple risk factors...
December 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#10
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29212760/large-scale-molecular-dynamics-simulation-of-coupled-dynamics-of-flow-and-glycocalyx-towards-understanding-atomic-events-on-an-endothelial-cell-surface
#11
Xi Zhuo Jiang, Haipeng Gong, Kai Hong Luo, Yiannis Ventikos
The glycocalyx has a prominent role in orchestrating multiple biological processes occurring at the plasma membrane. In this paper, an all-atom flow/glycocalyx system is constructed with the bulk flow velocity in the physiologically relevant ranges for the first time. The system is simulated by molecular dynamics using 5.8 million atoms. Flow dynamics and statistics in the presence of the glycocalyx are presented and discussed. Complex dynamic behaviours of the glycocalyx, particularly the sugar chains, are observed in response to blood flow...
December 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#12
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210862/renal-sympathetic-denervation-in-sweden-a-report-from-the-swedish-registry-for-renal-denervation
#13
Sebastian Völz, Jonas Spaak, Johan Elf, Christina Jägrén, Christer Lundin, Anna Stenborg, Jonas Andersson, Bengt Rundqvist, Thomas Kahan, Bert Andersson
BACKGROUND: Renal denervation (RDN) is a catheter-based intervention to treat patients with resistant hypertension. The biological effects of RDN are not fully understood, and randomized controlled trials have generated conflicting evidence. This report presents data from the Swedish Registry for Renal Denervation, an investigator-driven nationwide registry. PURPOSE: To assess the safety and efficacy of RDN on patients with resistant hypertension in a real-world clinical setting...
January 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29208768/caspase-independent-programmed-cell-death-triggers-ca2po4-deposition-in-an-in-vitro-model-of-nephrocalcinosis
#14
Giovanna Priante, Federica Quaggio, Lisa Gianesello, Monica Ceol, Rosalba Cristofaro, Liliana Terrin, Claudio Furlan, Dorella Del Prete, Franca Anglani
Nephrocalcinosis involves the deposition of microscopic crystals in the tubular lumen or interstitium. While the clinical, biochemical and genetic aspects of the diseases causing nephrocalcinosis have been elucidated, little is known about the cellular events in this calcification process. We previously reported a phenomenon involving the spontaneous formation of Ca2PO4 nodules in primary papillary renal cells from a patient with medullary nephrocalcinosis harboring a rare GDNF gene variant. We also demonstrated that cultivating GDNF -silenced HK-2 cells in osteogenic conditions for 15 days triggered Ca2PO4 deposits...
December 5, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/29208453/comparison-of-survival-between-hemodialysis-and-peritoneal-dialysis-patients-with-end-stage-renal-disease-in-the-era-of-icodextrin-treatment
#15
I-Kuan Wang, Cheng-Li Lin, Tzung-Hai Yen, Shih-Yi Lin, Fung-Chang Sung
BACKGROUND: Icodextrin could reduce the risk of technique failure and improve patient survival in peritoneal dialysis (PD) patients. This study compared the survival between incident hemodialysis (HD) and PD patients, with and without diabetes, in the era of icodextrin treatment. METHODS: From the Taiwan health insurance database, 53,103 incident end-stage renal disease patients undergoing dialysis were identified from 2005 to 2010. The mortality risks among HD and PD patients with or without icodextrin treatment were compared...
December 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29207228/-clinical-practice-for-the-diagnosis-of-cardiac-arrhythmias-in-patients-on-renal-replacement-therapy-data-from-a-lombard-survey
#16
Simonetta Genovesi, Elisa Nava, Alice Pasa, Enzo Corghi, Patrizia Ondei, Elisabetta Marta, Antonio Bellasi, Fabio Malberti, Ugo Teatini, Carlo Maria Guastoni, Leonardo Spatola, Maria Carmen Luise, Renza Tiboldo, Silvio Bertoli, Piergiorgio Messa, Maria Doria, Maurizio Gallieni, Mario Cozzolino, Donatella Spotti, Valeria Sala, Elisabetta Sironi, Giuseppe Boriani
Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29206932/novel-oral-anticoagulants-in-patients-with-chronic-kidney-disease-and-atrial-fibrillation
#17
Eleni Stamellou, Jürgen Floege
Atrial fibrillation (AF) is the most frequent arrhythmia in common clinical practice and its prevalence is markedly increased among patients with chronic kidney disease (CKD). The presence of CKD increases the incidence of AF and vice versa. Both AF and CKD increase the risk of stroke or systemic thromboembolism and oral anticoagulation is the mainstay for thromboembolic event prevention in patients with AF. Novel oral anticoagulants (NOACs) are nowadays often used in patients with AF and CKD, but they display a variable degree of renal elimination and the risk of accumulation and bleeding increases among patients with CKD in particular as kidney disease progresses...
December 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29206696/the-perioperative-significance-of-systemic-arterial-diastolic-hypertension-in-adults
#18
Daniel I Asher, Edwin G Avery
PURPOSE OF REVIEW: Hypertension affects approximately one third of the U.S. population and is the most common preventable medical reason that surgical cases are postponed or cancelled. However, subtypes of hypertension and their perioperative risks are poorly studied and understood. We will review the natural history and pathophysiology of essential hypertension and discuss the perioperative significance of diastolic blood pressure elevation. RECENT FINDINGS: There is evidence that elevated preoperative diastolic blood pressures are associated with an increased perioperative risk of cardiovascular and cerebrovascular events and increased postoperatively 30-day mortality...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29205264/diet-physical-activity-or-both-for-prevention-or-delay-of-type-2-diabetes-mellitus-and-its-associated-complications-in-people-at-increased-risk-of-developing-type-2-diabetes-mellitus
#19
REVIEW
Bianca Hemmingsen, Gabriel Gimenez-Perez, Didac Mauricio, Marta Roqué I Figuls, Maria-Inti Metzendorf, Bernd Richter
BACKGROUND: The projected rise in the incidence of type 2 diabetes mellitus (T2DM) could develop into a substantial health problem worldwide. Whether diet, physical activity or both can prevent or delay T2DM and its associated complications in at-risk people is unknown. OBJECTIVES: To assess the effects of diet, physical activity or both on the prevention or delay of T2DM and its associated complications in people at increased risk of developing T2DM. SEARCH METHODS: This is an update of the Cochrane Review published in 2008...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29203590/a-first-in-human-phase-1-study-of-subcutaneous-outpatient-recombinant-human-il-15-rhil-15-in-adults-with-advanced-solid-tumors
#20
Jeffrey S Miller, Chihiro Morishima, Douglas G McNeel, Manish R Patel, Holbrook E Kohrt, John A Thompson, Paul M Sondel, Heather A Wakelee, Mary L Disis, Judith C Kaiser, Martin A Cheever, Howard Streicher, Stephen P Creekmore, Thomas A Waldmann, Kevin C Conlon
PURPOSE: Preclinical data established Interleukin-15 as a homeostatic factor and powerful stimulator of NK and CD8+ T cell function, the basis for clinical testing. EXPERIMENTAL DESIGN: A first-in-human outpatient phase I dose escalation trial of subcutaneous (SC) rhIL-15 was conducted in refractory solid tumor cancer patients. Therapy consisted of daily (Monday - Friday) SC injections of rhIL-15 for two consecutive weeks (10 total doses/cycle). Clinical response was assessed by RECIST...
December 4, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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