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https://www.readbyqxmd.com/read/27933569/decision-making-in-clinical-practice-oral-anticoagulant-therapy-in-patients-with-non-valvular-atrial-fibrillation-and-a-single-additional-stroke-risk-factor
#1
REVIEW
Tatjana S Potpara, Nikolaos Dagres, Nebojša Mujović, Dragan Vasić, Milika Ašanin, Milan Nedeljkovic, Francisco Marin, Laurent Fauchier, Carina Blomstrom-Lundqvist, Gregory Y H Lip
Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]...
December 8, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27932871/efficacy-and-safety-outcomes-of-fractional-flow-reserve-in-guiding-clinical-therapy-of-non-st-segment-elevation-myocardial-infarction-compared-with-angiography-alone-in-elderly-chinese-patients
#2
Zhao Zhang, Ke Li, Jinwen Tian
OBJECTIVE: Fractional flow reserve (FFR) is an innovative method for evaluating the physiological significance of a coronary stenosis, but its validity is less certain in patients with non-ST-segment elevation myocardial infarction (NSTEMI). It is important to assess whether FFR is effective and safe in patients, especially elderly Chinese patients, with NSTEMI. As the first one in China, the purpose of this study was to establish the efficacy and safety outcomes of FFR in guiding clinical therapy of NSTEMI compared with angiography alone in elderly Chinese patients...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27931726/meta-analysis-of-impact-of-diabetes-mellitus-on-outcomes-after-transcatheter-aortic-valve-implantation
#3
Yinghao Sun, Xianbao Liu, Yuxin He, Mengyao Tang, Qifeng Zhu, Xiaobin Xu, Dongyu Guo, Keda Shi, Po Hu, Lihan Wang, Huijia Kong, Jubo Jiang, Xiaoping Lin, Qiyuan Xu, Feng Gao, Jian'an Wang
To date, the impact of diabetes mellitus (DM) on prognosis after transcatheter aortic valve implantation (TAVI) is still contradictory and thus merits further investigation. The purpose of this meta-analysis was to evaluate the impact of DM on outcomes after TAVI. A systematic search of the PubMed database was performed. Primary end points were 30-day and 1-year all-cause mortality after TAVI. Risk ratios (RRs) and 95% CIs were calculated using the random-effect or fixed-effect model, depending on heterogeneity between studies, and p values <0...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#4
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931633/complications-of-endoscopic-resection-techniques-for-upper-gi-tract-lesions
#5
REVIEW
D Libânio, P Pimentel-Nunes, M Dinis-Ribeiro
Adverse events can occur during and after the endoscopic resection of upper gastrointestinal lesions. Their incidence can be minimized through the adoption of preventive measures and their final outcomes can be optimized through prompt identification and adequate treatment. In this evidence-based review we describe the risk factors for adverse events, preventive measures to avoid them and their management when they occur. Algorithms of action are also provided. Oesophageal strictures can be prevented with corticosteroids (either locally injected or systemically administered) and treated with endoscopic dilatation...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931632/complications-of-therapeutic-gastroscopy-colonoscopy-other-than-resection
#6
REVIEW
Zaheer Nabi
Gastrointestinal (GI) endoscopy is profoundly utilized for diagnostic and therapeutic purposes. The therapeutic potential of GI endoscopy has amplified many folds with the evolution of novel techniques as well as equipments. However, with the augmentation of therapeutic endoscopy, the extent, likelihood and severity of adverse events have increased as well. The attendant risks and adverse events with therapeutic endoscopy are many folds that of diagnostic endoscopy. Besides endoscopic resection, therapeutic endoscopy is widely utilized for hemostasis in GI bleeds, dilatation of stenosis, enteral stenting, foreign body removal, ablation of Barrett's esophagus etc...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931631/complications-of-diagnostic-colonoscopy-upper-endoscopy-and-enteroscopy
#7
REVIEW
Idan Levy, Ian M Gralnek
Endoscopy is an inherent and an invaluable tool in every gastroenterologist's armamentarium. The prerequisite for quality and safety remains foremost. Adverse events should be minimized and proactive steps should taken before, during and after the endoscopic procedure. Upper endoscopy and colonoscopy are part of basic endoscopy and their major complications will be reviewed here, together with those of enteroscopy. The most common of all endoscopy related complications are cardiopulmonary and thus they will be addressed in detail first...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931184/postprocedural-radial-artery-occlusion-rate-using-a-sheathless-guiding-catheter-for-left-ventricular-endomyocardial-biopsy-performed-by-transradial-approach
#8
Behrouz Kherad, Clemens Köhncke, Frank Spillmann, Heiner Post, Michel Noutsias, Burkert Pieske, Florian Krackhardt, Carsten Tschöpe
BACKGROUND: For coronary interventions the arterial access via the radial artery is associated with fewer vascular access site complications, and has been shown to reduce major bleeding when compared to the femoral approach. But the endomyocardial biopsy (EMB) approach is usually done by a transfemoral or cervical access known to be associated with an increased risk of artery puncture and its potential complications (i.e., false aneurysm, artery-venous fistula) and needs post-procedural immobilization...
December 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27931026/feasibility-of-knife-coagulated-cut-in-gastric-endoscopic-submucosal-dissection-a-case-control-study
#9
Yohei Horikawa, Takashi Toyonaga, Hiroya Mizutamari, Nobuya Mimori, Yuhei Kato, Saki Fushimi, Syunji Okubo
BACKGROUND/AIMS: Intraoperative bleeding remains a challenge during endoscopic submucosal dissection (ESD). Forceps-coagulated cut (FCC) was found to be effective to reduce this bleeding. However, this involved frequent device replacement, and therefore, knife-coagulated cut (KCC) might ensure an easier and smoother procedure. We aimed to assess the effectiveness of KCC with Flushknife-BT at a super-low-output setting. METHODS: In this prospective study, we compared the hemostasis condition during ESD in 40 pairs of gastric lesions treated by FCC (Group F) or KCC (Group K)...
December 9, 2016: Digestion
https://www.readbyqxmd.com/read/27930430/w1-a-novel-oral-antiplatelet-agent-with-less-resistance-than-clopidogrel
#10
Pengxin Ge, Li Du, Chunguang Han, Hui Li, Yanguo Feng, Jie Han, Zhen Wang, Liangzhong Xiong, Meiru Yuan, Yongxue Liu
Clopidogrel is a clinical antiplatelet agent, about which there are major concerns because its antiplatelet efficiency decreases with insufficient metabolic activation, leading to "clopidogrel resistance." We aimed to determine the antiplatelet effects of W1, a novel molecule composed of 2-O-clopidogrel and aspirin (1:1 ratio), on platelet aggregation ex vivo and thrombus formation in vivo, and its susceptibility to "clopidogrel resistance" in combination with other therapies in rats. Platelets were prepared, and an arteriovenous shunt thrombosis model was established using Wistar rats to measure platelet aggregation and thrombus formation, respectively...
November 24, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27929201/the-importance-of-genetic-factors-for-the-development-of-arthropathy-a-longitudinal-study-of-children-and-adolescents-with-haemophilia-a
#11
Edward D Gomperts, John Schwarz, Sharyne M Donfield, Alice E Lail, Jan Astermark, W Keith Hoots, Cheryl A Winkler, Erik Berntorp
Haemophilia A is a congenital bleeding disorder characterised by recurrent haemorrhages into the major joints. Haemophilic arthropathy is a well-established outcome of recurrent joint bleeding; however, it is clear that multiple factors determine the extent and severity of its occurrence. We sought to identify genetic factors related to abnormalities in range of motion (ROM) in the knees, ankles and elbows in a cohort of children and adolescents with haemophilia A not treated primarily with regular prophylaxis...
December 8, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27928886/f376a-m388a-solulin-a-new-promising-antifibrinolytic-for-severe-haemophilia-a
#12
J Parcq, K U Petersen, A Borel-Derlon, P Gautier, M Ebel, D Vivien, Y Repessé
INTRODUCTION: Haemophilia is a major bleeding disorder due to a deficiency of procoagulant factor VIII (type A) or IX (type B). The treatment is substitutive and based on infusion of factor concentrates. Main limitations of this therapy are cost, short factor half-life and the development of inhibitors (up to 30% of severe HA patients). An important aggravating factor of haemophilia is due to a premature fibrinolysis, directing attention to the therapeutic potential of suitable antifibrinolytics...
December 8, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27927609/data-analysis-protocol-for-the-development-and-evaluation-of-population-pharmacokinetic-models-for-incorporation-into-the-web-accessible-population-pharmacokinetic-service-hemophilia-wapps-hemo
#13
Alanna McEneny-King, Gary Foster, Alfonso Iorio, Andrea N Edginton
BACKGROUND: Hemophilia is an inherited bleeding disorder caused by a deficiency in a specific clotting factor. This results in spontaneous bleeding episodes and eventual arthropathy. The mainstay of hemophilia treatment is prophylactic replacement of the missing factor, but an optimal regimen remains to be determined. Rather, individualized prophylaxis has been suggested to improve both patient safety and resource utilization. However, uptake of this approach has been hampered by the demanding sampling schedules and complex calculations required to obtain individual estimates of pharmacokinetic (PK) parameters...
December 7, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27927214/antiplatelet-and-antithrombotic-effects-of-cordycepin-enriched-wib-801ce-from-cordyceps-militaris-ex-vivo-in-vivo-and-in-vitro
#14
Hyuk-Woo Kwon, Jung-Hae Shin, Deok Hwi Lim, Woo Jeong Ok, Gi Suk Nam, Min Ji Kim, Ho-Kyun Kwon, Jun-Hee Noh, Je-Young Lee, Hyun-Hong Kim, Jong-Lae Kim, Hwa-Jin Park
BACKGROUND: A species of the fungal genus Cordyceps has been used as a complementary and alternative medicine of traditional Chinese medicine, and its major component cordycepin and cordycepin-enriched WIB-801CE are known to have antiplatelet effects in vitro. However, it is unknown whether they have also endogenous antiplatelet and antithrombotic effects. In this study, to resolve these doubts, we prepared cordycepin-enriched WIB-801CE, an ethanol extract from Cordyceps militaris-hypha, then evaluated its ex vivo, in vivo, and in vitro antiplatelet and antithrombotic effects...
December 7, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27926773/associations-of-specific-postoperative-complications-with-outcomes-after-elective-colon-resection-a-procedure-targeted-approach-toward-surgical-quality-improvement
#15
John E Scarborough, Jessica Schumacher, K Craig Kent, Charles P Heise, Caprice C Greenberg
Importance: Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective: To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants: Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27925464/risk-factors-for-severity-and-recurrence-of-colonic-diverticular-bleeding
#16
Natércia Joaquim, Paulo Caldeira, Artur G Antunes, Marta Eusébio, Horácio Guerreiro
BACKGROUND: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined. OBJECTIVE: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding. METHODS: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution...
December 7, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27925225/preclinical-study-of-anticoagulation-regimens-in-sheep-after-implantation-of-ch-vad-blood-pump
#17
Chuangye Xu, Guanghui Wu, Xiujian Liu, Yuna He, Xiaotong Hou, Haiyang Li, Chen Chen, Peng Yang, Changyan Lin
Effective anticoagulation regimens are needed to reduce risks of thrombosis and bleeding in animal models of ventricular assist device to verify its hemocompatibility, biologic safety and reliability. This study is to develop a validated anticoagulation procedure for a sheep model to test the newly developed CH-VAD. CH-VAD models were established in six healthy sheep by constructing blood bypass of left ventricle → ventricular assist device → descending aorta. Heparin infusion was used during operation and in the prior 4 days to maintain activated clotting time 1...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#18
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27922911/meta-analysis-of-comparison-of-the-newer-p2y12-inhibitors-oral-preparation-or-intravenous-to-clopidogrel-in-patients-with-acute-coronary-syndrome
#19
Lu Zhang, Jun Lu, Weihua Dong, Huiping Tian, Weiyi Feng, Haisheng You, Hairong He, Jing Ma, Yalin Dong
AIMS: New P2Y12 adenosine diphosphate receptor antagonist that has been used in the treatment of acute coronary syndrome (ACS) with mixed results. This systematic review analyzed and compared the evidence from large, clinical trials regarding the efficacy of clopidogrel relative to that of cangrelor, prasugrel, and ticagrelor in reducing the incidence of cardiovascular events in patients with ACS. METHODS AND RESULTS: This analysis of the findings for comparing newer P2Y12 inhibitors with clopidogrel of 13 clinical trials involving a total of 87,985 patients with ACS ...
November 29, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27920863/balloon-occluded-retrograde-transvenous-obliteration-for-treatment-of-bleeding-gastric-varices-case-report-and-review-of-literature
#20
Sana Basseri, Christopher B Lightfoot
Gastric variceal bleeding is a major complication of portal hypertension and is associated with high morbidity and mortality. While esophageal varices are more common, gastric varices are often more challenging to treat. Balloon-Occluded Retrograde Transvenous Obliteration is an interventional procedure whereby the portosystemic gastrorenal shunt is accessed via the left renal vein and the gastric varix outflow tract obliterated using direct sclerotherapy. Herein, we present a case of a 68-year-old female patient with cirrhosis who presented with bleeding gastric varices and successfully treated...
December 2016: Radiology case reports
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