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https://www.readbyqxmd.com/read/29474205/perioperative-management-of-a-patient-with-glanzmann-thrombasthenia-undergoing-a-coronary-artery-bypass-graft-surgery-a-case-report
#1
Mohamad Kurdi, Corinne Frère, Julien Amour, Caren Brumpt, Josée Delort, Guillaume Lebreton, Laure Croisille, Roseline d'Oiron, Isabelle Martin-Toutain
: We report herein the successful perioperative management of a 57-year-old man with a type I Glanzmann thrombasthenia undergoing coronary artery bypass graft surgery and right carotid endarterectomy. The patient suffered from several lesions in the three major coronary arteries and in the right carotid necessitating surgery. Prophylactic human leukocyte antigen (HLA)-matched platelets transfusions were continuous administrated before, and through the immediate perioperative period. Posttransfusion platelet recovery was monitored using flow cytometry to determine the percentage of circulating platelet expressing CD61 (β3)...
February 22, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29474204/mean-platelet-volume-and-risk-of-thrombotic-and-bleeding-complications-in-patients-with-philadelphia-chromosome-negative-myeloproliferative-neoplasms
#2
Eilon Krashin, Oren Cohen, David Pereg, Michael Lishner, Avi Leader
: Philadelphia chromosome negative myeloproliferative neoplasms (MPNs) are associated with increased thrombosis and bleeding risk. Mean platelet volume (MPV) is associated with thrombosis in nonmalignant settings. This study evaluates the association between MPV and thrombosis and bleeding in MPN. Patients with MPN without prior thrombosis, nonhematologic malignancy or anticoagulant use were included in this retrospective analysis. The primary endpoint was arterial or venous thrombosis. The secondary endpoints were any bleeding and major bleeding...
February 22, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29473375/evaluation-of-the-complications-in-laparoscopic-retroperitoneal-radical-nephrectomy-an-experience-of-high-volume-centre
#3
Ali Serdar Gozen, Vitalie Gherman, Yigit Akin, Mustafa Suat Bolat, Muhammad Elmussareh, Jens Rassweiler
OBJECTIVES: To provide a standardised report of complications after retroperitoneal laparoscopic radical nephrectomy (rLRN) in a high-volume centre using Clavien-Dindo classification. MATERIALS AND METHODS: We analysed records maintained in a prospective database of 330 consecutive patients that underwent rLRN between March 1995 and September 2016. All complications were graded according to the modified Clavien-Dindo classification. Three generations of surgeons were defined and the learning curve in rLRN was evaluated by comparing the first 100 cases (Group A) performed by firstgeneration surgeons with the last 100 cases (Group B) by thirdgeneration surgeons...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/29471554/-day-surgery-for-endoscopic-inguinal-hernia-repair
#4
Ulrich Steger, Markus Bisping, Jennifer Urban, Thorsten Vowinkel, Aloys Wiesmann, Jonathan Ryll
BACKGROUND: Whereas international guidelines recommend day surgery for endoscopic inguinal hernia repair, this approach is still controversial in Germany. In the light of international guidelines and at the request of patients, we have established total extraperitoneal patch plastic (TEP) surgery in the outpatient setting in our hospital. METHODS: A retrospective analysis of all unilateral TEP procedures carried out between January 2013 and December 2015 in our outpatient surgery, focused on postoperative complications, conversion to admission and rate of recurrence...
February 22, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29469638/cost-comparison-of-continued-anticoagulation-with-rivaroxaban-versus-placebo-based-on-the-one-year-einstein-extension-trial-efficacy-and-safety-results
#5
Philip S Wells, Anthonie W A Lensing, Lloyd Haskell, Bennett Levitan, François Laliberté, Michael Durkin, Veronica Ashton, Yongling Xiao, Concetta Crivera, Dominique Lejeune, Jeff Schein, Patrick Lefebvre
AIMS: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (versus placebo) after 6-12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo based on the EINSTEIN-EXT event rates. METHODS: Total healthcare cost was calculated as sum of treatment and clinical event costs from a US managed care perspective...
February 22, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29469030/the-efficacy-of-early-versus-delayed-p2y12-inhibition-in-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#6
Anne Bellemain-Appaix, Céline Bégué, Deepak L Bhatt, Kenneth Ducci, Robert A Harrington, Matthew Roe, Stephen D Wiviott, Michel Cucherat, Johanne Silvain, Jean-Philippe Collet, François Bernasconi, Gilles Montalescot
AIMS: To compare the benefit of "Early" vs "Delayed" P2Y12 inhibition in patients undergoing Percutaneous Coronary intervention(PCI) for ST-Elevation Myocardial Infarction(STEMI). METHODS AND RESULTS: We conducted a meta-analysis including seven randomized controlled trials(RCTs) which compared early vs delayed P2Y12 inhibition in STEMI patients scheduled for PCI, providing data on Major Adverse Cardiac Events (MACE), all cause death, and major bleeding...
February 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29468911/reality-of-obesity-paradox-results-of-percutaneous-coronary-intervention-in-middle-eastern-patients
#7
Mohamad Jarrah, Ayman J Hammoudeh, Yousef Khader, Ramzi Tabbalat, Eyas Al-Mousa, Osama Okkeh, Imad A Alhaddad, Loai Issa Tawalbeh, Issa M Hweidi
Objective The aim of this study was to assess the baseline clinical characteristics, coronary angiographic features, and adverse cardiovascular events during hospitalization and at 1 year of follow-up in obese patients compared with overweight and normal/underweight patients. Methods A prospective, multicenter study of consecutive patients undergoing percutaneous coronary intervention was performed. Results Of 2425 enrolled patients, 699 (28.8%) were obese, 1178 (48.6%) were overweight, and 548 (22.6%) were normal/underweight...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29468734/in-patients-undergoing-percutaneous-coronary-intervention-with-rotational-atherectomy-radial-access-is-safer-and-as-efficient-as-femoral-access
#8
Piotr Kübler, Wojciech Zimoch, Michał Kosowski, Brunon Tomasiewicz, Artur Telichowski, Krzysztof Reczuch
INTRODUCTION: Transfemoral approach (TFA) may be preferred access site in order to facilitate complex percutaneous procedures such as rotational atherectomy (RA). Notwithstanding, there is a growing evidence that transradial approach (TRA) is associated with lower access site complication rates and even lower mortality. The aim was to assess in-hospital and 1-year outcomes in patients undergoing RA using TRA, in comparison to TFA. METHODS: A single center observational study included all consecutive patients, who underwent RA from 2010 to 2015...
February 21, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29468094/chobs-color-histogram-of-block-statistics-for-automatic-bleeding-detection-in-wireless-capsule-endoscopy-video
#9
Tonmoy Ghosh, Shaikh Anowarul Fattah, Khan A Wahid
Wireless capsule endoscopy (WCE) is the most advanced technology to visualize whole gastrointestinal (GI) tract in a non-invasive way. But the major disadvantage here, it takes long reviewing time, which is very laborious as continuous manual intervention is necessary. In order to reduce the burden of the clinician, in this paper, an automatic bleeding detection method for WCE video is proposed based on the color histogram of block statistics, namely CHOBS. A single pixel in WCE image may be distorted due to the capsule motion in the GI tract...
2018: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29467183/the-search-for-new-antithrombotic-mechanisms-and-therapies-that-may-spare-hemostasis
#10
Edward F Plow, Yunmei Wang, Daniel I Simon
Current antithrombotic drugs, including widely used antiplatelet agents and anticoagulants, are associated with significant bleeding risk, which increases morbidity and mortality. Nevertheless, there is emerging experimental evidence that suggests that the molecular and cellular mechanisms of hemostasis and thrombosis can be separated, thereby raising the possibility of new antithrombotic therapeutic targets with reduced bleeding risk. We summarize some recently emerging examples of agents with antithrombotic activities that seem to spare hemostasis...
February 21, 2018: Blood
https://www.readbyqxmd.com/read/29466159/aspirin-or-rivaroxaban-for-vte-prophylaxis-after-hip-or-knee-arthroplasty
#11
David R Anderson, Michael Dunbar, John Murnaghan, Susan R Kahn, Peter Gross, Michael Forsythe, Stephane Pelet, William Fisher, Etienne Belzile, Sean Dolan, Mark Crowther, Eric Bohm, Steven J MacDonald, Wade Gofton, Paul Kim, David Zukor, Susan Pleasance, Pantelis Andreou, Steve Doucette, Chris Theriault, Abongnwen Abianui, Marc Carrier, Michael J Kovacs, Marc A Rodger, Doug Coyle, Philip S Wells, Pascal-Andre Vendittoli
BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty...
February 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29465250/continuous-esomeprazole-infusion-versus-bolus-administration-and-second-look-endoscopy-for-the-prevention-of-rebleeding-in-children-with-a-peptic-ulcer
#12
Oana Belei, Laura Olariu, Maria Puiu, Cristian Jinca, Cristina Dehelean, Tamara Marcovici, Otilia Marginean
INTRODUCTION: the majority of studies of acute gastrointestinal bleeding in children are retrospective, focusing on therapeutic endoscopy. Previous studies performed in adult patients have demonstrated that both scheduled second look endoscopy and high dose continuous omeprazole infusion are effective in the prevention of peptic ulcer rebleeding. The aim of this study was to compare the efficacy of these two strategies using esomeprazole for the prevention of rebleeding following primary endoscopic hemostasis in children with peptic ulcers...
February 21, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29464846/real-life-experience-of-a-stent-less-revascularization-strategy-using-a-combination-of-excimer-laser-and-drug-coated-balloon-for-patients-with-acute-coronary-syndrome
#13
Ayako Harima, Akinori Sairaku, Ichiro Inoue, Kenji Nishioka, Toshiharu Oka, Yasuharu Nakama, Kazuoki Dai, Kuniomi Ohi, Haruki Hashimoto, Yasuki Kihara
OBJECTIVES: We aimed to test a novel stent-less revascularization strategy using a combination of excimer laser coronary angioplasty (ELCA) and drug-coated balloon (DCB) for patients with acute coronary syndrome (ACS). BACKGROUND: Percutaneous coronary intervention with drug eluting stents is a standard invasive treatment for ACS. Some unsolved issues however remain, such as stent thrombosis and bleeding risks associated with dual antiplatelet therapy. METHODS: Consecutive ACS patients were planned to receive either a DCB application following ELCA without a stent implantation or conventional revascularization with a coronary stent...
February 20, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29464206/improved-cuff-technique-and-intraoperative-detection-of-vascular-complications-for-hind-limb-transplantation-in-mice
#14
Minhyung Kim, Daniel T Fisher, Colin A Powers, Elizabeth A Repasky, Joseph J Skitzki
Background: Vascularized composite tissue allotransplantation (VCA) from a cadaveric donor has now become a clinical reality and the treatment modality of choice for patients with devastating injuries, deformities, and complex tissue defects. However, many VCA patients experience severe toxicities due to the strong immunosuppression required secondary to high antigenicity of the grafts. To improve immunosuppressive protocols for VCA, feasible and reliable preclinical models are necessary...
February 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29463272/colonic-perineurioma-benign-fibroblastic-polyp-case-report-and-review-of-the-literature
#15
Abraham Christoffel van Wyk, Hennie van Zyl, Jonathan Rigby
BACKGROUND: Colorectal perineuriomas are uncommon benign mucosal-based proliferations of mesenchymal cells that express perineurial markers, often associated with colonic crypts displaying a serrated/hyperplastic architecture. The vast majority of cases arise distal to the splenic flexure and have been described as sessile polyps. Using molecular analysis, BRAF mutations have been demonstrated in the serrated crypt epithelium. We report a new case of perineurioma presenting as a pedunculated polyp in the transverse colon, with prominent hemosiderin deposits in the uninvolved lamina propria that separated the perineurial proliferation from the surface epithelium, a previously unreported histological finding...
February 20, 2018: Diagnostic Pathology
https://www.readbyqxmd.com/read/29462086/emergency-sternal-intraosseous-access-for-warm-fresh-whole-blood-transfusion-in-damage-control-resuscitation-sternal-intraosseous-access-in-dcr
#16
Christopher Kalhagen Bjerkvig, Theodor Fosse, Torunn Oveland Apelseth, Joar Sivertsen, Hanne Braathen, Håkon Skogrand Eliassen, Anne Berit Guttormsen, Andrew P Cap, Geir Strandenes
BACKGROUND: Intraosseous (IO) vascular access is increasingly used as an emergency tool for achieving access to the systemic circulation in critically ill patients. The role of IO transfusion of blood in Damage Control Resuscitation is however questionable due to possible inadequate flow rate and hemolysis. Some experts claim that IO transfusion is contraindicated. In this study we have challenged this statement by looking at flow rates of autologous fresh whole blood reinfusion and hemolysis using two of the commonly used FDA-approved and CE-marked sternal needles...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29462053/vitamin-k-antagonists-and-emergencies
#17
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29462026/anticoagulant-therapy-for-venous-thromboembolism-in-patients-with-inflammatory-bowel-disease
#18
Jose L Lobo, Julia A Garcia-Fuertes, Javier Trujillo-Santos, Adel Merah, María Á Blanco-Molina, Ignacio Casado, Jana Hirmerova, Javier De Miguel, Estuardo Salgado, Manuel Monreal
BACKGROUND: There is lack of evidence to guide the type, intensity, and the duration of anticoagulation following venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS: Registro Informatizado Enfermedad Trombo Embólica (RIETE) is an ongoing, multicenter, observational registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We used the RIETE database to compare the rate of VTE recurrences and major bleeding during the course of anticoagulation in noncancer patients with or without IBD...
February 16, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29461977/mosaic-ras-mapk-variants-cause-sporadic-vascular-malformations-which-respond-to-targeted-therapy
#19
Lara Al-Olabi, Satyamaanasa Polubothu, Katherine Dowsett, Katrina A Andrews, Paulina Stadnik, Agnel P Joseph, Rachel Knox, Alan Pittman, Graeme Clark, William Baird, Neil Bulstrode, Mary Glover, Kristiana Gordon, Darren Hargrave, Susan M Huson, Thomas S Jacques, Gregory James, Hannah Kondolf, Loshan Kangesu, Kim M Keppler-Noreuil, Amjad Khan, Marjorie J Lindhurst, Mark Lipson, Sahar Mansour, Justine O'Hara, Caroline Mahon, Anda Mosica, Celia Moss, Aditi Murthy, Juling Ong, Victoria E Parker, Jean-Baptiste Rivière, Julie C Sapp, Neil J Sebire, Rahul Shah, Branavan Sivakumar, Anna Thomas, Alex Virasami, Regula Waelchli, Zhiqiang Zeng, Leslie G Biesecker, Alex Barnacle, Maya Topf, Robert K Semple, E Elizabeth Patton, Veronica A Kinsler
BACKGROUND: Sporadic vascular malformations (VMs) are complex congenital anomalies of blood vessels that lead to stroke, life-threatening bleeds, disfigurement, overgrowth, and/or pain. Therapeutic options are severely limited and multi-disciplinary management remains challenging, particularly for high-flow arteriovenous malformations (AVM). METHODS: To investigate the pathogenesis of sporadic intracranial and extracranial VMs in 160 children in which known genetic causes had been excluded, we sequenced DNA from affected tissue and optimised analysis for detection of low mutant allele frequency...
February 20, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29460789/percutaneous-endoscopic-gastrostomy-peg-versus-radiologically-inserted-gastrostomy-rig-a-comparison-of-outcomes-at-an-australian-teaching-hospital
#20
Chandran Vidhya, Dunsmuir Phoebe, Chandran Dhina, Sandford Jayne, Fraser Robert
OBJECTIVE: Gastrostomy tubes for enteral nutrition are most commonly inserted via percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) techniques. The current study aimed to compare clinical outcomes and complication rates in patients who underwent PEG and RIG procedures at a tertiary teaching hospital in Australia. METHODS: A retrospective review was conducted on patients who underwent PEG or RIG tube insertion between February 2013 and February 2015 at Flinders Medical Centre, Australia...
February 2018: Clinical Nutrition ESPEN
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