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https://www.readbyqxmd.com/read/28545283/-clinical-efficacy-and-safety-of-thrombolytic-treatment-with-reteplase-in-patients-with-intermediate-risk-acute-pulmonary-embolism
#1
H G Zhao, S X Wang, Z N Lu, X X Yan, Z C Lyu, F H Peng, Y Wu, X Gao, L Hua, Z C Jing, X Q Xu
Objective: To assess the efficacy and safety of thrombolytic treatment with reteplase in patients with intermediate-risk acute pulmonary embolism. Methods: Ten consecutive patients with intermediate-risk acute pulmonary embolism who received thrombolytic treatment with reteplase at Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and biochemical markers were assessed before and after thrombolytic therapy with reteplase, and bleeding complications were also observed during 3 months follow up...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28544979/preoperative-left-hepatic-lobe-devascularisation-to-minimize-perioperative-bleeding-in-a-jehovah-s-witness-undergoing-left-hepatectomy
#2
Laurence Weinberg, Georgina Hanus, Jonathan Banting, Diana Abu-Ssaydeh, Manfred Spanger, Su Kah Goh, Vijayaragavan Muralidharan
INTRODUCTION: Major liver resection in a Jehovah's Witness presents unique clinical challenges requiring multimodal blood minimization strategies to reduce perioperative complications. We report a case where complete left hepatic lobe devascularisation was undertaken to minimize bleeding in a Jehovah's Witness undergoing left hepatectomy. PRESENTATION OF CASE: A 65-year-old male Jehovah's Witness presented for open left hepatectomy for a large left-sided hepatocellular carcinoma involving segment IV of the liver...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28544422/assessment-of-clinically-relevant-bleeding-as-a-surrogate-outcome-for-major-bleeding-validation-by-meta-analysis-of-randomized-controlled-trials
#3
S Laporte, C Chapelle, L Bertoletti, E Ollier, P Zufferey, J-C Lega, A Merah, H Décousus, S Schulman, G Meyer, M Cucherat, P Mismetti
BACKGROUND: Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials, but its validity for estimating compromise between thrombotic and bleeding events has never been assessed. METHODS: We systematically reviewed randomized phase III trials comparing new anticoagulants with standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates...
May 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28544320/influence-of-radial-versus-femoral-access-site-on-coronary-angiography-and-intervention-outcomes-a-systematic-review-and-meta-analysis
#4
Michael I Brener, Aaron Bush, Julie M Miller, Rani K Hasan
OBJECTIVES: Systematic review and meta-analysis of randomized clinical trials (RCT) to compare procedural outcomes between radial access (RA) and femoral access (FA). BACKGROUND: Recent RCTs suggest RA for coronary angiography and percutaneous coronary intervention reduces bleeding complications, but controversy exists regarding other benefits and risks relative to FA. METHODS: Searches of MEDLINE, EMBASE, CENTRAL, LILACS, and major conference abstracts identified relevant studies published from 1985-2016...
May 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543770/the-comparative-safety-of-abciximab-versus-eptifibatide-in-patients-on-dialysis-undergoing-percutaneous-coronary-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#5
Devraj Sukul, Milan Seth, Theodore Schreiber, George Hanzel, Akshay Khandelwal, Louis A Cannon, Thomas A Lalonde, Hitinder S Gurm
OBJECTIVES: We sought to evaluate the patterns of use and outcomes associated with eptifibatide and abciximab administration among dialysis patients who underwent percutaneous coronary intervention (PCI). BACKGROUND: Contraindicated medications are frequently administered to dialysis patients undergoing PCI often resulting in adverse outcomes. Eptifibatide is a glycoprotein IIb/IIIa inhibitor that is often used during PCI and is contraindicated in dialysis. METHODS: We included dialysis patients who underwent PCI from January 2010 to September 2015 at 47 hospitals in Michigan...
May 22, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#6
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543515/thrombocytopenia-associated-with-localized-scleroderma-report-of-four-pediatric-cases-and-review-of-the-literature
#7
Ankur Kumar Jindal, Anju Gupta, Sunil Dogra, Amit Rawat, Deepti Suri, Jasmina Ahluwalia, Surjit Singh
We report on four children with localized scleroderma (morphea) and thrombocytopenia. All four had the en coup de sabre subtype of morphea and had varying degrees of thrombocytopenia (8 × 10(9) /L to 120 × 10(9) /L). None of them had major bleeding manifestations, and thrombocytopenia resolved with treatment of morphea. (One patient was also given an injection of anti-D immunoglobulin.) We propose that thrombocytopenia associated with localized scleroderma is usually benign and requires no specific therapy...
May 23, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28543216/bridging-with-tirofiban-during-oral-antiplatelet-interruption-a-single-center-case-series-analysis-including-patients-on-hemodialysis
#8
Elizabeth A Walker, William E Dager
INTRODUCTION: Surgical patients requiring an interruption in dual-antiplatelet therapy (DAPT) within 6 months of cardiac stenting are at risk for thrombotic events. Bridging with short-acting intravenous antiplatelet agents has been proposed to minimize the risk of thrombotic and hemorrhagic complications. METHODS: This was a retrospective analysis of a tirofiban bridging strategy that did not use an initial bolus loading dose. Tirofiban infusions were initiated 24to 48 hours after the last oral antiplatelet dose at a rate of 0...
May 23, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28542316/antithrombotic-therapy-of-patients-with-atrial-fibrillation-discharged-after-major-non-cardiac-surgery-1-year-follow-up-sub-analysis-of-prague-14-study
#9
Martina Ondrakova, Zuzana Motovska, Petr Waldauf, Jiri Knot, Lukas Havluj, Lukas Bittner, Radek Bartoska, Robert Gűrlich, Martin Krbec, Valer Dzupa, Robert Grill, Petr Widimsky
BACKGROUND: The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. METHODS: A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. RESULTS: Antithrombotics (interrupted due to surgery) were resumed until discharge in 51...
2017: PloS One
https://www.readbyqxmd.com/read/28541629/adult-granulosa-cell-tumors-of-the-ovary-a-retrospective-study-of-30-cases-with-respect-to-the-expression-of-steroid-synthesis-enzymes
#10
Sachiko Kitamura, Kaoru Abiko, Noriomi Matsumura, Hidekatsu Nakai, Yumiko Akimoto, Hirotoshi Tanimoto, Ikuo Konishi
OBJECTIVE: Some, but not all, granulosa cell tumors are characterized by estrogen production. This study was designed to determine whether there are clinical or pathological variations in granulosa cell tumors in relation to the expression of sex steroid synthesis enzymes. METHODS: Clinical symptoms, serum hormonal values, and histology of 30 granulosa cell tumor patients who underwent surgery between 2002 and 2014 were retrospectively reviewed. RESULTS: Most patients presented with abnormal genital bleeding including abnormal menstrual cycles...
July 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/28541452/clopidogrel-reloading-for-patients-with-acute-myocardial-infarction-already-on-clopidogrel-therapy
#11
Jacob A Doll, Shuang Li, Karen Chiswell, Matthew T Roe, Mikhail Kosiborod, Benjamin M Scirica, Tracy Y Wang
Aims: We sought to determine the association of clopidogrel reloading with in-hospital bleeding and mortality in contemporary practice. Methods and results: We examined clopidogrel reloading for ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) patients on pre-admission clopidogrel therapy in the ACTION Registry-GWTG from 2009 to 2014. We used inverse probability weighted propensity adjustment to compare in-hospital mortality and major bleeding risks between patients reloaded in the first 24 h with ≥300 mg of clopidogrel vs...
May 25, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28540976/antithrombotic-treatment-after-stroke-due-to-intracerebral-haemorrhage
#12
REVIEW
Luke A Perry, Eivind Berge, Joshua Bowditch, Elisabeth Forfang, Ole Morten Rønning, Graeme J Hankey, Elmer Villanueva, Rustam Al-Shahi Salman
BACKGROUND: Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of thromboembolism. Antithrombotic (antiplatelet or anticoagulant) treatments may lower the risk of thromboembolism after ICH, but they may increase the risks of bleeding. OBJECTIVES: To determine the overall effectiveness and safety of antithrombotic drugs for people with ICH. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (24 March 2017)...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28540312/rivaroxaban-as-an-antithrombotic-agent-in-a-patient-with-st-segment-elevation-myocardial-infarction-and-left-ventricular-thrombus-a-case-report
#13
Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Naveen Anand Seecheran
The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28540205/clinicopathological-spectrum-of-snake-bite-induced-acute-kidney-injury-from-india
#14
Sanjay Vikrant, Ajay Jaryal, Anupam Parashar
AIM: To study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI). METHODS: A retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient's information on demographic, clinical characteristics, complications and outcome. Outcomes of duration of hospital stay, requirement for intensive care unit support, treatment with dialysis, survival and mortality were analyzed...
May 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#15
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539861/a-5-year-review-of-pattern-of-placenta-previa-in-ilorin-nigeria
#16
L O Omokanye, A W O Olatinwo, A G Salaudeen, A D Ajiboye, K A Durowade
BACKGROUND: Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. METHODOLOGY: This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. RESULTS: There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1...
April 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28539569/stent-versus-non-stent-in-treating-intermediate-stenosis-culprit-lesions-in-acute-st-segment-elevation-myocardial-infarction-patients
#17
Jing Dai, Shuzheng Lyu, Xiantao Song, Min Zhang, Shaoping Nie, Hai Gao, Yujie Zeng, Wei Wang, Mingduo Zhang, Dongfeng Zhang, Jinfan Tian
To investigate the efficacy and safety of stent versus non-stent in treating acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel disease and intermediate stenosis culprit lesions.Between September 2009 and May 2015, 475 acute STEMI patients (time from symptom onset < 12 hours) with single vessel disease and intermediate stenosis culprit lesions were retrospectively studied at Beijing Anzhen Hospital. The patients were divided into a stent group (n = 308) and non-stent group (n = 167) based on whether they received stent implantation or not during primary coronary angiography...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538780/anatomic-pulmonary-resection-via-video-assisted-thoracic-surgery-analysis-of-117-cases-at-a-referral-center-in-brazil
#18
Stephan Adamour Soder, Frederico Barth, Fabiola Adelia Perin, José Carlos Felicetti, José de Jesus Peixoto Camargo, Spencer Marcantônio Camargo
Objective: To describe our experience with video-assisted thoracic surgery (VATS) for anatomic pulmonary resection at a referral center for thoracic surgery in Brazil. Methods: All patients who underwent anatomic pulmonary resection by VATS between 2010 and 2015 were included. Clinical and pathological data, as well as postoperative complications, were analyzed. Results: A total of 117 pulmonary resections by VATS were performed, of which 98 were lobectomies and 19 were anatomic segmentectomies...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#19
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28537413/two-stage-surgical-treatment-of-inferior-vena-cava-traumatic-rupture-including-urgent-transport-to-a-specialized-unit
#20
J Kristek, P Hromádka, M Konarik, J Froněk
Inferior vena cava injury as well as major liver injury remains a formidable treatment challenge. The most imminent danger is life-threatening bleeding. In this report, we present a case of polytrauma (Injury Severity Score 35) with arupture of the juxtahepatic inferior vena cava which was successfully treated using two-stage approach. The first part of the treatment consisted of damage control laparotomy at a level I trauma center. After stabilization, the patient was air-transported to receive the definitive treatment at a tertiary care facility experienced in hepatopancreatobiliary and transplantation surgery...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
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