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https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#1
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#2
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#3
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#4
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28075424/managing-challenging-patients-with-venous-thromboembolism-a-practical-case-based-approach
#5
James Douketis, Walter Ageno, Marc Carrier, Clive Kearon
The management of patients with venous thromboembolism is a common clinical scenario that, for the most part, involves well-established, evidence-based treatment pathways. However, important unanswered clinical questions remain that are the focus of ongoing research. The aim of this narrative review is to provide a practical, case-based approach to the following clinical scenarios in which therapeutic management pathways are less well established: How long to anticoagulated patients with a first unprovoked venous thromboembolism? How to manage complex patients with cancer-associated venous thromboembolism? When and how to treat patients with splanchnic vein thrombosis? When to use thrombolytic therapy for deep vein thrombosis?...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28074981/-thrombolysis-in-stroke-mimics-experience-in-10-cases
#6
Alejandro M Brunser, Arnold Hoppe, Paula Muñoz, Pablo M Lavados, Sergio Illanes, Violeta Díaz, Verónica V Olavarría
BACKGROUND: The effectiveness of intravenous thrombolysis (IVT) in cerebral ischemia is time dependent. Stroke mimics (SM) are frequent in emergency rooms. The effort to reduce door to needle time, can lead to administer thrombolytics to SM. AIM: To describe the frequency and prognosis of SM treated with IVT. MATERIAL AND METHODS: Prospective analysis of all patients evaluated in a Chilean private clinic between December 2004 and July 2015 with a suspected acute ischemic stroke (AIS)...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28071140/development-and-characterization-of-polymer-lipid-hybrid-nanoparticles-for-oral-delivery-of-lmwh
#7
Supandeep Singh Hallan, Veerpal Kaur, Vikas Jain, Neeraj Mishra
The present study aimed to develop an improved oral delivery system for low-molecular-weight heparin (LMWH), novel polymer lipid hybrid nanoparticles were developed. LMWH loaded chitosan polymer lipid hybrid nanoparticles (LMWH-CS-PLNs) were developed using double emulsification and solvent evaporation method. The performance of developed formulations was evaluated by using in vitro and in vivo behavior, such as drug release studies, in vitro permeation study, in vivo venous thrombolytic study, in vitro uptake studies by using intestinal epithelium resembling Caco-2 cell lines...
January 10, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28069786/portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-for-morbid-obesity
#8
Leslie S Anewenah, Mohammed Asif, Richard Francesco, Prashanth Ramachandra
Portomesenteric vein thrombosis (PMVT) is a rare, life-threatening pathology associated with increased prevalence in laparoscopic sleeve gastrectomy (LSG) versus other gastric bypass procedures. Gaining popularity, LSG is becoming the first choice of patients and physicians alike due to its low complication profile compared to the gastric bypass procedure. We present the case of a 34-year-old woman who underwent an uncomplicated LSG for the treatment of morbid obesity, and presented on postoperative day 13 with PMVT...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28064304/evaluation-of-ophthalmic-artery-branch-retrograde-intervention-in-the-treatment-of-central-retinal-artery-occlusion-crao
#9
Runsheng Wang, Lu Qian, Yi Wang, Yi Zheng, Shanshuang Du, Tao Lei, Peilin Lv, Tan Long, Wenjun Wang
BACKGROUND Central retinal artery occlusion (CRAO) is the occlusion of the central retinal artery resulting in retinal infarction and acute vision loss. Digital subtraction angiography (DSA)-guided superselective ophthalmic artery or selective carotid thrombolysis remains the preferred treatment method for CRAO. This study aimed to evaluate the safety and clinical efficacy of the novel ophthalmic artery branch retrograde thrombolytic intervention for CRAO. MATERIAL AND METHODS Fifty patients with monocular CRAO were enrolled, including 28 males and 22 females (mean age: 55...
January 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28063771/matrix-metalloproteinase-9-and-recovery-of-acute-ischemic-stroke
#10
Maged M Abdelnaseer, Nervana M Elfauomy, Eman H Esmail, Manal M Kamal, Enji H Elsawy
BACKGROUND: Stroke outcome can be predicted by clinical features, biochemical parameters, and some risk factors. Matrix metalloproteinase-9 (MMP-9) is involved in various stages of stroke pathology. MMP-9 inhibitors are potential stroke therapeutic agents. Little is known about the relation between MMP-9-after the acute stage-and clinical recovery. OBJECTIVE: The study aimed to investigate the serum level of MMP-9 at stroke onset as predictor of stroke outcome and the relation between the level of MMP-9 after 30 days and stroke recovery...
January 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28057998/cisplatin-and-bleomycin-induced-acute-peripheral-vascular-stenosis-in-patient-with-testicular-cancer
#11
Tayyar Alp Ozkan, Ufuk Aydin, Derih Ay, I Oguz Ozden Cebeci
After cisplatin and bleomycin-containing chemotherapy (CTx) for testicular cancer, part of the patients may develop acute or long-term cardiovascular toxicity. In the present case, we reported that a 58-year-old male patient presenting with testicular tumors who developed acute peripheral arterial disease during combination CTx with bleomycin, etoposide, and cisplatin. Superficial femoral artery occlusion not responded to structure thrombolytic and anticoagulators treatment. Left lower extremity was amputated below knee...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28057488/exploring-hemostatic-and-thrombolytic-potential-of-heynein-a-cysteine-protease-from-ervatamia-heyneana-latex
#12
Priyanka Uday, M Maheshwari, P Sharanappa, Zohara Nafeesa, Vivek Hamse Kameshwar, B S Priya, S Nanjunda Swamy
ETHNOPHARMACOLOGIAL RELEVANCE: The latex of Ervatamia heyneana (Wall.) T. Cooke plant has been used for wound healing and various skin diseases by Indian tribes and folklore. AIM OF THE STUDY: To validate the scientific basis of heynein - a key protease of Ervatamia heyneana, in hemostasis and wound healing process. MATERIALS AND METHODS: The latex from E. heyneana was processed and subjected to two step purification. The purified heynein was assayed for proteolytic activity using casein as substrate and also attested by zymography...
January 2, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28051251/observation-of-clinical-efficacy-of-rt-pa-intravenous-thrombolytic-treatment-for-patients-combined-with-grade-0-1-diabetic-foot-by-wagner-classification-and-acute-ischemic-stroke
#13
C-H Li, Y Chen, C-H Zhang, Z Dong, Z Wang, S-N Zhao, Y-X Wang, Z-Y Lv, P-L Zhang
OBJECTIVE: To evaluate the safety and efficacy of rt-PA intravenous thrombolytic treatment for patients with diabetic foot (DF) and acute ischemic stroke. PATIENTS AND METHODS: A retrospective analysis was performed on 76 patients admitted between June 2012 to December 2015 presenting with acute ischemic stroke and Grade 0-1 DF a (Wagner classification). The treatment group consisted of 44 patients who received rt-PA intravenous thrombolytic treatment, while 32 cases in the control group did not...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28038749/structure-and-anticoagulant-property-of-a-sulfated-polysaccharide-isolated-from-the-green-seaweed-monostroma-angicava
#14
Na Li, Xue Liu, Xiaoxi He, Shuyao Wang, Sujian Cao, Zheng Xia, Huali Xian, Ling Qin, Wenjun Mao
An anticoagulant-active polysaccharide PF2 was extracted with boiling water from the green seaweed Monostroma angicava, further purified by anion-exchange and size-exclusion chromatography. PF2 was a rhamnan-type sulfated polysaccharide with molecular weight of about 88.1kDa. Results of chemical and spectroscopic analyses demonstrated that PF2 consisted of→3)-α-l-Rhap-(1→ and →2)-α-l-Rhap-(1→residues, with partially branches at C-2 of→3)-α-l-Rhap-(1→residues. Sulfate groups were substituted at C-3 of →2)-α-l-Rhap-(1→ residues...
March 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28032534/improved-oral-bioavailability-and-therapeutic-efficacy-of-dabigatran-etexilate-via-soluplus-%C3%A2-tpgs-binary-mixed-micelles-system
#15
Mei Hu, Jinjie Zhang, Rui Ding, Yao Fu, Tao Gong, Zhirong Zhang
The clinical use of dabigatran etexilate (DABE) is limited by its poor absorption and relatively low bioavailability. Our study aimed to explore the potential of a mixed micelle system composed of Soluplus(®) and D-alpha tocopheryl polyethylene glycol 1000 succinate (TPGS) to improve the oral absorption and bioavailability of DBAE. DBAE was first encapsulated into Soluplus/TPGS mixed micelles by a simple thin film hydration method. The DBAE loaded micelles displayed an average size distribution of around 83...
December 29, 2016: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28027191/intentional-intra-arterial-injection-of-heroin-a-case-report
#16
Joji Suzuki, Erin S Valenti
Intravenous injection of drugs is associated with a host of medical complications, notably soft-tissue infections. On the contrary, intra-arterial injections of drugs have also been reported, largely restricted to inadvertent injections. Here we describe a patient who engaged in repeated intra-arterial injections of heroin when she exhausted most of her venous access, and presented acutely with a radial artery occlusion requiring thrombolytic therapy. Clinicians should have a high index of suspicion for intra-arterial injection in injection drug users who present with limb pain, ischemia, and motor/sensory deficits...
December 23, 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28025592/mortality-related-risk-factors-in-high-risk-pulmonary-embolism-in-the-icu
#17
Begüm Ergan, Recai Ergün, Taner Çalışkan, Kutlay Aydın, Murat Emre Tokur, Yusuf Savran, Uğur Koca, Bilgin Cömert, Necati Gökmen
Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28011405/platelet-to-lymphocyte-ratio-as-a-novel-marker-of-in-hospital-and-long-term-adverse-outcomes-among-patients-with-acute-pulmonary-embolism-a-single-center-large-scale-study
#18
Elif Hande Ozcan Cetin, Mehmet Serkan Cetin, Ugur Canpolat, Ahmet Akdi, Dursun Aras, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND: The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE...
December 10, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28008093/arterial-obstruction-on-computed-tomographic-or-magnetic-resonance-angiography-and-response-to-intravenous-thrombolytics-in-ischemic-stroke
#19
Grant Mair, Rüdiger von Kummer, Alessandro Adami, Philip M White, Matthew E Adams, Bernard Yan, Andrew M Demchuk, Andrew J Farrall, Robin J Sellar, Eleni Sakka, Jeb Palmer, David Perry, Richard I Lindley, Peter A G Sandercock, Joanna M Wardlaw
BACKGROUND AND PURPOSE: Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. METHODS: We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase...
December 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28005024/a-global-perspective-on-mechanical-prosthetic-heart-valve-thrombosis-diagnostic-and-therapeutic-challenges
#20
Mustafa Ozan Gürsoy, Macit Kalçık, Mahmut Yesin, Süleyman Karakoyun, Emrah Bayam, Sabahattin Gündüz, Mehmet Özkan
Prosthetic valve thrombosis is one of the major causes of primary valve failure, which can be life-threatening. Multimodality imaging is necessary for determination of leaflet immobilization, cause of underlying pathology (thrombus versus pannus or both), and whether thrombolytic therapy attempt in the patient would be successful or surgery is needed. Current guidelines for the management of prosthetic valve thrombosis lack definitive class I recommendations due to lack of randomized controlled trials, and usually leave the choice of treatment to the clinician's experience...
December 2016: Anatolian Journal of Cardiology
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