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https://www.readbyqxmd.com/read/28719756/medialization-laryngoplasty-in-the-elderly-outcomes-and-expectations
#1
Andrew Jay Bowen, Tiffany L Huang, Michael S Benninger, Paul C Bryson
Objective To describe the profile and outcomes of elderly patients undergoing medialization laryngoplasty for vocal cord paralysis. Study Design Case series with retrospective review. Setting Tertiary care hospital. Subjects and Methods Patients were included in the study if they were >65 years old at the time of medialization laryngoplasty between 2008 and 2015. Patient comorbidities, anticoagulation status, disease etiology, and physical examination findings were recorded with postoperative length of stay, complications, pre- and posttreatment voice outcomes with the Voice Handicap Index (at 6 weeks, 4 months, 8 months, and 1 year), and postprocedural interventions (revision injections, surgery, therapy)...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28718666/atrial-cardiopathy-a-mechanism-of-cryptogenic-stroke
#2
Shadi Yaghi, Hooman Kamel, Mitchell S V Elkind
Cryptogenic stroke accounts for approximately 30% of all ischemic strokes. Recently, atrial cardiopathy diagnosed by the presence of one of its serum, imaging, or electrocardiogram biomarkers has been shown to be associated with ischemic stroke, particularly of embolic subtypes. Areas covered: This paper aims to summarize data on occult atrial fibrillation and stroke, provide an overview on mechanisms, such as inflammation and fibrosis, of stroke in atrial cardiopathy, critically review data on biomarkers of atrial cardiopathy and their association with stroke, and suggest therapeutic implications, including directions for future research...
July 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28701574/antiplatelet-regimen-for-patients-with-breakthrough-strokes-while-on-aspirin-a-systematic-review-and-meta-analysis
#3
Meng Lee, Jeffrey L Saver, Keun-Sik Hong, Neal M Rao, Yi-Ling Wu, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Optimal antiplatelet therapy after an ischemic stroke or transient ischemic attack while on aspirin is uncertain. We, therefore, conducted a systematic review and meta-analysis. METHODS: We searched PubMed (1966 to August 2016) and bibliographies of relevant published original studies to identify randomized trials and cohort studies reporting patients who were on aspirin at the time of an index ischemic stroke or transient ischemic attack and reported hazard ratio for major adverse cardiovascular events or recurrent stroke associated with a switch to or addition of another antiplatelet agent versus maintaining aspirin monotherapy...
July 12, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28698333/research-protocol-for-platelets-in-out-of-hospital-cardiac-arrest-an-observational-case-controlled-feasibility-study-to-assess-coagulation-and-platelet-function-abnormalities-with-rotem-following-out-of-hospital-cardiac-arrest-pohcar
#4
Agnieszka Skorko, Matthew Thomas, Andrew Mumford, Thomas Johnson, Elinor Griffiths, Rosemary Greenwood, Jonathan Benger
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) has an annual incidence of approximately 60 000 in the UK. Less than 10% of those who receive resuscitation survive to hospital discharge. For OHCA of a presumed cardiac cause, the optimal antiplatelet therapy is currently unknown. Previous studies indicate that a procoagulopathic state exists postcardiac arrest which may contribute to the formation of thrombi and contribute to poor outcomes. However, the administration of antiplatelet therapies needs to be balanced against the increased risk of bleeding that these individuals face...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28689954/surgical-intervention-for-peripheral-artery-disease-does-not-improve-patient-compliance-with-recommended-medical-therapy
#5
Tyler R Halle, Jaime Benarroch-Gampel, Victoria J Teodorescu, Ravi R Rajani
INTRODUCTION AND OBJECTIVES: Non-adherence to smoking abstinence, antiplatelet and statin therapies in patients with peripheral artery disease (PAD) is associated with worse long-term outcomes. We hypothesized that patients who underwent invasive revascularization procedures would be more likely to adhere to these therapies than patients who were managed medically. METHODS: Prospective survey-based interviews pertaining to medication and behavioral compliance of patients with symptomatic PAD were performed...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28685623/cardiovascular-disease-prevention-strategies-for-type-2-diabetes-mellitus
#6
Niki Katsiki, Francesco Purrello, Costas Tsioufis, Dimitri P Mikhailidis
Type 2 diabetes mellitus (T2DM) is associated with several cardiovascular (CV) risk factors such as insulin resistance, obesity, hypertension, dyslipidaemia, non-alcoholic fatty liver disease as well as platelet and haemostatic abnormalities increasing the risk of thrombosis. Therefore, T2DM patients are at an increased risk for CV disease (CVD). Areas covered: This narrative review discusses the treatment of T2DM. This includes lifestyle measures (diet, exercise and smoking cessation) as well as hypolipidaemic, antihypertensive, weight reducing, antiplatelet and glucose lowering drugs...
July 7, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28684282/platelets-redox-balance-assessment-current-evidence-and-methodological-considerations
#7
REVIEW
Anna Komosa, Piotr Rzymski, Bartłomiej Perek, Mariola Ropacka-Lesiak, Maciej Lesiak, Jolanta M Siller-Matula, Barbara Poniedziałek
Altered function of platelets can lead to cardiovascular complications in numerous disorders. Various studies aimed to investigate mechanisms triggering platelets activation cascade show a significant role of reactive oxygen species (ROS) in this matter. Moreover, ROS are known causal factor of oxidative stress that can result in DNA, lipid and protein damage. This review aims to comprehensively present the variety of methods that are potentially useful in assessment of platelets redox balance, such as intracellular concentration of particular ROS, activity of antioxidant enzymes, reduced/oxidized glutathione ratio, level of lipid peroxidation, Cu/Zn ratio, and molecular oxygen consumption...
July 3, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28681581/risk-analysis-of-new-oral-anticoagulants-for-gastrointestinal-bleeding-and-intracranial-hemorrhage-in-atrial-fibrillation-patients-a-systematic-review-and-network-meta-analysis
#8
Wei-Wei Xu, Shen-Jiang Hu, Tao Wu
BACKGROUND: Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic review and network meta-analysis using Bayesian inference to analyze the risks of GIB and ICH in AF patients taking NOACs. METHODS: We analyzed data from 20 randomized controlled trials of 91 671 AF patients receiving anticoagulants, antiplatelet drugs, or placebo...
July 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28680766/cerebrovascular-fibromuscular-dysplasia-the-mgh-cohort-and-literature-review
#9
Andrea M Harriott, Eli Zimmerman, Aneesh B Singhal, Michael R Jaff, Mark E Lindsay, Guy A Rordorf
BACKGROUND: Fibromuscular dysplasia (FMD) is a rare noninflammatory, nonatherosclerotic arteriopathy of medium-sized arteries affecting up to 7% of the population. The disease can affect any artery but commonly affects renal, extracranial carotid, and vertebral arteries. The epidemiology and natural course of cerebrovascular FMD is unknown and requires further investigation. METHODS: We present demographic and outcomes data on a case series of 81 patients with cerebrovascular FMD from Massachusetts General Hospital presenting between 2011 and 2015 followed by a review of the peer-reviewed literature...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28676007/the-role-of-n-acetylcysteine-in-platelet-aggregation-and-reperfusion-injury-in-recent-years
#10
Mohammadreza Nikbakht, Farhad Ahmadi, Golnaz Vaseghi, Azita Hajhossein Talasaz, Azadeh Eshraghi, Jamal Naderi, Mohammad Ali Daneshmehr
BACKGROUND: N-acetylcysteine (NAC) is an amino acid that contains a cysteine group and is currently used widely in various fields of medical research especially in cardiology. In this review, potential benefits of NAC in the aggregation of platelet and reperfusion injury are evaluated. METHODS: The available evidence was collected by searching Scopus, Pub-Med, Medline, Cochrane central register of controlled trials, and Cochrane database systematic reviews. Our searching was performed without time limitation and only English language articles were included in this review...
July 4, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28673245/takotsubo-cardiomyopathy-complicated-with-apical-thrombus-formation-on-first-day-of-the-illness-a-case-report-and-literature-review
#11
H M M T B Herath, S P Pahalagamage, Laura C Lindsay, S Vinothan, Sampath Withanawasam, Vajira Senarathne, Milinda Withana
BACKGROUND: Takotsubo cardiomyopathy is characterized by transient systolic dysfunction of the apical and mid segments of the left ventricle in the absence of obstructive coronary artery disease. Intraventricular thrombus formation is a rare complication of Takotsubo cardiomyopathy and current data almost exclusively consists of isolated case reports and a few case series. Here we describe a case of Takotsubo cardiomyopathy with formation of an apical thrombus within 24 h of symptom onset, which has been reported in the literature only once previously, to the best of our knowledge...
July 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28672933/a-systematic-review-and-meta-analysis-of-published-randomized-controlled-trials-of-combination-of-clopidogrel-and-aspirin-in-transient-ischemic-attack-or-minor-stroke
#12
Xingjian Zhou, Jing Tian, Ming Zhen Zhu, Colin K He
The use of antiplatelet agents in patients with ischemic stroke is recommended. In this study, we compared the efficacy and safety of the treatment of clopidogrel plus aspirin (ASA) and that of ASA alone in patients with mild stroke/transient ischemic attack (TIA). Randomized controlled trial (RCT) studies of Clop + ASA vs. ASA therapy in the patients with minor stroke/TIA were identified by electronic bibliographic searches. The primary result was recurrent stroke, while myocardial infarction (MI) as well as vascular mortalities were the secondary result, and major hemorrhagic events were the safety result...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28661936/revisiting-the-role-of-steroids-and-aspirin-in-the-management-of-acute-kawasaki-disease
#13
Anita Dhanrajani, Rae S M Yeung
PURPOSE OF REVIEW: Kawasaki disease is an acute multisystem childhood vasculitis with a predilection for the coronary arteries. The role of corticosteroids and acetyl salicylic acid (ASA) in the treatment of acute Kawasaki disease are matters of ongoing debate and changing attitudes from one extreme to the other. Recent work has provided new evidence to guide our thinking about these two therapeutic agents, which will be the focus of this review. RECENT FINDINGS: Corticosteroids are effective and well tolerated in Kawasaki disease, both as initial adjunctive treatment in those at high-risk for poor outcome, and as rescue therapy after failed intravenous immunoglobulin (IVIG)...
June 28, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28661903/p2y12-receptor-inhibitor-resistance-and-coronary-artery-disease-a-bench-to-bedside-primer-for-cardiovascular-specialists
#14
Derek Y F So, Akshay Bagai, Uyen Tran, Subodh Verma, Shamir R Mehta
PURPOSE OF REVIEW: Platelet P2Y12 receptor inhibitors are routinely prescribed for patients after acute coronary syndromes and percutaneous coronary interventions. Patients may have underresponsiveness (or resistance) to these drugs and in particular to clopidogrel, the most often used type. This review aims to focus on the concept of P2Y12 receptor inhibitor resistance and discuss incidence, mechanisms, novel diagnostic techniques and past and future clinical trials on the topic. RECENT FINDINGS: Patients treated with P2Y12 receptor inhibitors may develop high on-treatment platelet reactivity (HPR), a phenomenon of impaired response toward the drug, which has been associated with ischemic complications...
June 28, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28657457/the-spectrum-of-spontaneous-coronary-artery-dissection-illustrated-review-of-the-literature
#15
Marian Vandamme, Julie De Backer, Tine De Backer, Benny Drieghe, Daniel Devos, Sofie Gevaert
Spontaneous coronary artery dissection or SCAD is a rare and challenging disease that is increasingly diagnosed. It is characterized by a non-traumatic, non-iatrogenic separation of the coronary artery wall and occurs predominantly in young and middle-aged women without traditional cardiovascular risk factors. SCAD is often associated with predisposing conditions such as the peripartum period, systemic inflammatory disease and heritable connective tissue disease. More recently, independent investigators have demonstrated an important association with fibromuscular dysplasia...
June 28, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28652799/direct-oral-anticoagulants-in-patients-with-chronic-kidney-disease-patient-selection-and-special-considerations
#16
REVIEW
Jens Lutz, Kerstin Jurk, Helmut Schinzel
Many patients with chronic kidney disease (CKD) receive anticoagulation or antiplatelet therapy due to atrial fibrillation, coronary artery disease, thromboembolic disease, or peripheral artery disease. The treatment usually includes vitamin K antagonists (VKAs) and/or platelet aggregation inhibitors. The direct oral anticoagulants (DOAC) inhibiting factor Xa or thrombin represent an alternative for VKAs. In patients with acute and chronic kidney disease, caution is warranted, as DOACs can accumulate as they are partly eliminated by the kidneys...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28650591/the-silver-lining-towards-the-responsible-and-limited-usage-of-silver
#17
REVIEW
Kshipra Naik, Meenal Kowshik
Silver has attracted a lot of attention as a powerful, broad spectrum and natural antimicrobial agent since the ancient times because of its non-toxic nature to the human body at low concentrations. It has been used in treatment of various infections and ulcers, storage of water, and prevention of bacterial growth on the surfaces and within materials. However there are numerous medical and health benefits of colloidal or nano silver apart from its microbicidal ability which as yet have not been fully embraced by the medical community...
June 26, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/28650349/new-oral-antiplatelet-medications
#18
Travis Jeffords
New and more potent oral antiplatelet agents have shown better clinical outcomes over the last few years. This article reviews the latest oral antiplatelet therapies available, their indications and contraindications, genetic resistance, and major drug interactions.
June 22, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28645902/the-cause-of-the-stroke-a-diagnostic-uncertainty
#19
Abhishek Dattani, Ava Jackson
A 39-year-old man with a history of sickle cell disease (SCD) presented with left leg weakness. He had a normal CT head and CT angiogram, but MRI head showed multiple acute bilateral cortical infarcts including in the right precentral gyrus. The MRI findings were more in keeping with an embolic source rather than stroke related to SCD, although it could not be ruled out. He also had an echocardiogram which revealed a patent foramen ovale. He was treated with antiplatelet therapy and also had red blood cell exchange transfusion...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28644213/platelet-pathophysiology-pharmacology-and-function-in-coronary-artery-disease
#20
Homam Ibrahim, Neal S Kleiman
Platelets play a key role in the pathophysiology of coronary artery disease and acute coronary syndromes. Our understanding of platelet function in thrombus formation has increased considerably, resulting in the development of clinically effective treatment strategies and identification of new targets. An underappreciated platelet function is their contribution toward acute and chronic inflammatory processes including atherogenesis. In this review, we discuss the role of platelets in atherosclerosis and thrombosis, platelet function testing, and the pharmacology of currently available antiplatelet drugs...
June 21, 2017: Coronary Artery Disease
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