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https://www.readbyqxmd.com/read/28941051/no-added-value-of-the-age-adjusted-d-dimer-cut-off-to-the-years-algorithm-in-patients-with-suspected-pulmonary-embolism
#1
L M van der Pol, T van der Hulle, Y W Cheung, A T A Mairuhu, C G Schaar, L M Faber, M Ten Wolde, H M A Hofstee, M M C Hovens, M Nijkeuter, R C J van Klink, M J H A Kruip, S Middeldorp, M V Huisman, F A Klok
BACKGROUND: The YEARS algorithm was designed to simplify the diagnostic work-up of pulmonary embolism (PE) and to reduce the number of necessary computed tomography pulmonary angiography (CTPA) scans. An alternative strategy to reduce the number of CTPAs is the age-adjusted D-dimer cut-off (ADJUST) in patients aged 50 years or older. We aimed to investigate whether a combination of both diagnostic strategies might save additional CTPAs. METHODS: The YEARS algorithm consists of three items (clinical signs of deep venous thrombosis, hemoptysis, "PE most likely diagnosis") with simultaneous D-dimer testing using a pre-test dependent threshold...
September 22, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#2
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28934836/pregnancy-in-women-with-hypertrophic-cardiomyopathy-data-from-the-european-society-of-cardiology-initiated-registry-of-pregnancy-and-cardiac-disease-ropac
#3
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink
Aims: We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results: All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28901563/analysis-of-serum-levels-and-cutaneous-expression-of-lipoprotein-a-in-38-patients-with-livedoid-vasculopathy
#4
Espinel Ds, Di Giacomo Tb, Pincelli Tp, Pereira Nv, Sotto Mn, Kirsner Rs, Criado Pr
BACKGROUND: Coagulation disorders contribute to the development of livedoid vasculopathy (LV). Elevated plasma levels of lipoprotein(a) [Lp(a)] are an independent risk factor for the development of cardiovascular disease and associated with hypercoagulable states. Increased serum Lp(a) levels have been reported in patients with LV and may have an important role in the pathogenesis of LV. OBJECTIVES: To investigate Lp(a) expression in skin lesions and circulating serum Lp(a) levels in patients with LV...
September 13, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28901221/direct-oral-anticoagulant-reversal-how-when-and-issues-faced
#5
Mikhail S Dzeshka, Daniele Pastori, Gregory Y H Lip
The number of atrial fibrillation (AF) patients requiring thrombo-prophylaxis with oral anticoagulation is greatly increasing. The introduction of non-vitamin K oral anticoagulants (NOACs) in addition to standard therapy with dose-adjusted warfarin has increased the therapeutic options for AF patients. Despite a generally better safety profile of the NOACs, the risk of major bleedings still persists, and the management of serious bleeding is a clinical challenge. Areas covered: In the current review, risk of major bleeding in patients taking NOACs and general approaches to manage bleeding depending on severity, with a particular focus on specific reversal agents, are discussed...
September 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28893703/emergent-treatment-of-ruptured-axillary-artery-aneurysm
#6
R L van der Horst, I van den Hoven, J H C Daemen
The axillary artery aneurysm (AxAAs) is a rare entity, with a diverse range of proposed etiologic mechanisms. Although usually asymptomatic, thrombo-embolic or haemorrhagic complications leave many with vascular and neurologic compromise. Both open and endovascular approaches have been reported. However, no consensus has been reached on the management of AxAAs. This case illustrates a unique emergent treatment approach for a ruptured axillary artery aneurysm, involving endovascular plugging, and immediate subsequent open hematoma evacuation...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28870575/usefulness-of-platelet-to-lymphocyte-and-neutrophil-to-lymphocyte-ratios-in-predicting-the-presence-of-cerebral-venous-sinus-thrombosis-and-in-hospital-major-adverse-cerebral-events
#7
Yesim Eylev Akboga, Hesna Bektas, Omer Anlar
BACKGROUND: Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as recently emerging thrombo-inflammatory indicators were significantly associated with both major cerebrovascular/cardiovascular adverse events (MACE) and mortality. Therefore, we aimed to assess the effects of combinations of PLR and NLR in predicting the presence of CVST and in-hospital MACE. METHODS: A total of 277 participants comprising 80 patients with evidence of CVST and 197 controls with similar baseline characteristics were included in this retrospective study...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28867175/thrombo-hemorrhagic-liability-in-children-with-congenital-heart-diseases
#8
REVIEW
Shebl Said Shebl, Walid Ahmed Naguib El-Shehaby, Amira Hamed Darwish, Yasmin Shebl Said, Nabeh Helal Elfadaly, Eman Amer
BACKGROUND: The precise mechanisms of the increased incidence of hemostatic abnormalities in congenital heart disease (CHD) have not been determined. The aim of the study was to evaluate some indicators of activation of platelets and vascular endothelial cells in patients with CHD, evaluation of bleeding liability of these patients, and correlation with the clinical presentation of these patients. METHODS: This work was carried out on 20 patients with cyanotic congenital heart disease (CCHD), 20 patients with cyanotic congenital heart disease (ACHD), and 20 healthy children who served as the control group, aged between 1 and 10years...
August 26, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28862538/postoperative-continuous-catheter-infused-local-anesthetic-reduces-pain-scores-and-narcotic-use-after-lower-extremity-revascularization
#9
William Shutze, William P Shutze, Purvi Prajapati, Gerald Ogola, Jordan Schauer, Emily Biller, Nicholas Douville, Ryan A Shutze
Objective Postoperative pain following lower extremity revascularization procedures is traditionally controlled with narcotic administration. However, this may not adequately control the pain and puts the patient at risk for complications from opiate use. Here we report an alternative strategy for pain management using a continuous catheter-infused local anesthetic into the operative limb. Design Retrospective case-control study. Methods Patients undergoing lower extremity revascularization procedures using continuous catheter-infused local anesthetic were compared to similar patients undergoing similar procedures during the same time period who did not receive continuous catheter-infused local anesthetic...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28846822/extended-pharmacologic-thromboprophylaxis-in-oncologic-liver-surgery-is-safe-and-effective
#10
Bradford J Kim, Ryan W Day, Catherine H Davis, Nisha Narula, Michael H Kroll, Ching-Wei D Tzeng, Thomas A Aloia
BACKGROUND: The incidence of venous thromboembolism remains high after liver surgery. OBJECTIVE: To evaluate the safety and efficacy of extended pharmacologic thromboprophylaxis in liver surgery for the prevention of venous thromboembolism (VTE). PATIENT/METHODS: From August 2013 to April 2015, 124 patients who underwent liver resection for malignancy were placed on an extended pharmacologic thromboprophylaxis protocol. Intraoperative VTE prophylaxis included Thrombo-Embolic Deterrent hose and sequential compression devices...
August 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28825848/defibrotide-for-children-and-adults-with-hepatic-veno-occlusive-disease-post-hematopoietic-cell-transplantation
#11
Selim Corbacioglu, Paul G Richardson
Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a complication that is typically associated with conditioning for hematopoietic stem cell transplantation (HSCT). In patients with concomitant multi-organ dysfunction, mortality may be >80%. Recently, the European Society for Blood and Marrow Transplantation established separate criteria for diagnosis and severity of VOD/SOS for adults and children, to better reflect current understanding of the disease. Areas covered: This review provides an overview of post-HSCT hepatic VOD/SOS and defibrotide, including its pharmacological, clinical, and regulatory profile...
September 4, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28798794/optical-coherence-tomography-improves-the-results-of-balloon-pulmonary-angioplasty-in-inoperable-chronic-thrombo-embolic-pulmonary-hypertension
#12
Aleksander Araszkiewicz, Stanisław Jankiewicz, Magdalena Łanocha, Magdalena Janus, Tatiana Mularek-Kubzdela, Maciej Lesiak
No abstract text is available yet for this article.
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28791214/cavitary-lung-lesions-melioidosis-and-pulmonary-embolism-causing-necrotizing-pneumonia
#13
N Mohammad, W S Wan Ghazali
Cavitary lung lesions of various etiologies may be encountered in patients with respiratory symptoms associated with fever. Non-malignant cavitary lesions may mimic malignant lung lesions on most of radiographic modalities including chest radiographs or thoracic computed tomography (CT). Primary lung malignancy can be detected in as high as one-fifths of CT thorax as cavitary lesions and the remaining aetiologies may be due to bacterial, parasitic, and invasive fungal infections, as well as Granulomatosis with polyangiitis (GPA), sarcoidosis, septic thrombo-embolism, and lung metastasis from extra-pulmonary primaries...
2017: IDCases
https://www.readbyqxmd.com/read/28789672/challenges-in-the-diagnosis-and-management-of-anti-phospholipid-syndrome-a-case-from-cameroon
#14
Ahmadou M Jingi, Liliane Mfeukeu-Kuate, Aurel T Tankeu, Narcisse Assene Ateba, Edvine Wawo Yonta, Jean Jacques Noubiap
BACKGROUND: Anti-phospholipid syndrome (APLS) is a condition characterized by the presence of raised plasma levels of anti-phospholipid antibodies associated with thrombo-embolic disease and/or poor obstetrical outcomes in women. The epidemiology of APLS is unknown in most sub-Saharan African countries due to limited access to diagnosis tools. We report the case of APLS in a 29-year-old obese woman that was preceded by pre-eclampsia and fetal death. The diagnosis of APLS was made during a thrombo-embolic episode 4 years after the poor obstetrical outcome...
August 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28765077/resolution-of-vascular-injury-specialized-lipid-mediators-and-their-evolving-therapeutic-implications
#15
REVIEW
Bian Wu, Giorgio Mottola, Melinda Schaller, Gilbert R Upchurch, Michael S Conte
Acute vascular injury occurs in a number of important clinical contexts, including spontaneous disease-related events (e.g. plaque rupture, thrombosis) and therapeutic interventions such as angioplasty, stenting, or bypass surgery. Endothelial cell (EC) disruption exposes the underlying matrix, leading to a rapid deposition of platelets, coagulation proteins, and leukocytes. A thrombo-inflammatory response ensues characterized by leukocyte recruitment, vascular smooth muscle cell (VSMC) activation, and the elaboration of cytokines, reactive oxygen species and growth factors within the vessel wall...
August 3, 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28758099/platelet-expression-of-pkcepsilon-oncoprotein-in-myelofibrosis-is-associated-with-disease-severity-and-thrombotic-risk
#16
Elena Masselli, Cecilia Carubbi, Giulia Pozzi, Silvia Martini, Franco Aversa, Daniela Galli, Giuliana Gobbi, Prisco Mirandola, Marco Vitale
BACKGROUND: Myelofibrosis (MF) is the most aggressive Philadelphia-negative chronic myeloproliferative neoplasm (MPN) with high morbidity and mortality due to thrombo-hemorrhagic complications and leukemic transformation. MF is characterized by profound alterations of megakaryocytopoiesis, with consequent abnormalities in platelet number and function. We recently showed that the overexpression of the oncoprotein PKCepsilon plays a key role in the aberrant differentiation of MF megakaryocyte clone and that its levels correlate with disease burden...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28751836/anmco-position-paper-direct-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation-clinical-scenarios-and-future-perspectives
#17
Federico Nardi, Michele Massimo Gulizia, Furio Colivicchi, Maurizio Giuseppe Abrignani, Stefania Angela Di Fusco, Andrea Di Lenarda, Giuseppe Di Tano, Giovanna Geraci, Luigi Moschini, Carmine Riccio, Paolo Verdecchia, Iolanda Enea
It is now 4 years since the introduction of the new direct oral anticoagulants into clinical practice. Therefore, the Italian Association of Hospital Cardiologists (ANMCO) has deemed necessary to update the previous position paper on the prevention of thrombo-embolic complications in patients with non-valvular atrial fibrillation, which was published in 2013. All available scientific evidence has been reviewed, focusing on data derived from both clinical trials and observational registries. In addition, all issues relevant to the practical clinical management of oral anticoagulation with the new direct inhibitors have been considered...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28684367/endovascular-therapy-for-the-steal-phenomenon-due-to-the-innominate-artery-severe-stenosis-and-bilateral-internal-carotid-artery-severe-stenosis
#18
Shuta Aketa, Daisuke Wajima, Masahiro Kishi, Yudai Morisaki, Taiji Yonezawa, Ichiro Nakagawa, Hiroyuki Nakase
BACKGROUND: Symptomatic innominate artery stenosis presenting as hemodynamic bilateral cerebral ischemia is uncommon. We present a rare case of the severe stenosis of the origin of an innominate artery and severe stenosis of bilateral internal carotid artery that induced hemodynamic cerebral ischemia after ipsilateral axillary artery-bilateral femoral artery bypass and was treated with stent replacement of the innominate artery and right internal carotid artery. CASE REPORT: A 64-year-old woman who previously had undergone right axillary artery-bilateral femoral artery anastomosis for abdominal aorta high obstruction had been suffering from chronic dizziness and so visited our department...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28667041/placental-fetal-thrombotic-vasculopathy-occurring-in-association-with-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-a-case-report
#19
Anneliese Vélez-Pérez, Pamela Younes, Nina Tatevian
Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a rare disease of functional obstruction affecting the bladder and intestines, characterized by a markedly distended bladder, microcolon, and decreased or absent intestinal peristalsis. Afflicted neonates have very poor prognosis, usually with fatal outcomes in first days to months of life. Placental fetal thrombotic vasculopathy (FTV) is a thrombo-occlusive disorder of the chorionic plate and fetal circulation. Herein, we describe an undocumented association of MMIHS and placental FTV...
May 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28666358/shifting-to-a-non-vitamin-k-antagonist-oral-anticoagulation-agent-from-vitamin-k-antagonist-in-atrial-fibrillation
#20
Emil L Fosbøl, Naja Emborg Vinding, Morten Lamberts, Laila Staerk, Anna Gundlund, Kasper Gadsbøll, Lars Køber, Gunnar H Gislason, Jonas Bjerring Olesen
Aims: After non-vitamin K antagonist (VKA) oral anticoagulation agents (NOAC) have been approved for thrombo-embolic prophylaxis in non-valvular atrial fibrillation (NVAF), utilization of oral anticoagulants (OAC) in NVAF has changed. Contemporary shifting from a VKA to a NOAC (dabigatran, rivaroxaban, or apixaban) has not been quantified, and could help assess whether these drugs are used according to recommendations. Methods and results: Using Danish nationwide registries, we identified all VKA-experienced NVAF patients initiating a NOAC from 22 August 2011 to 31 December 2015 (shifters) and all VKA-experienced NVAF patients who were not switched to NOACs (non-shifters)...
June 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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