Last Build Date: Tue, 22 Mar 2016 08:26:52 +0100
Tue, 22 Mar 2016 07:43:43 +0100This study aimed to determine the TTR achievement and incidence of adverse events among pediatric warfarin patients managed by an anticoagulation clinic over 12 months and to compare TTR achievement between patients self-testing (PST) at home and those monitored using routine methods. International normalized ratio (INR) results reported for 2012 for children currently having their warfarin therapy managed by a dedicated pediatric anticoagulation clinic were analyzed. Warfarin-related adverse events were recorded. A total of 164 patients were included. In total, 93 children performed PST and 71 children tested their INR at a hospital or pathology service. TTR achievement for the cohort was 67.1% (95% confidence interval, 64.4-69.7). A total of 69.2% of INR tests conducted at home were with...
Tue, 22 Mar 2016 06:25:50 +0100Conclusion The test dentifrice without SLS was as effective as a regular SLS dentifrice on gingival bleeding scores and plaque scores. There was no significant difference in the incidence of gingival abrasion. Clinical relevance In patients diagnosed with gingivitis, a dentifrice without SLS seems to be equally effective compared to a dentifrice with SLS and did not demonstrate any significant difference in gingival abrasion. In patient with recurrent aphthous ulcers, the absence of SLS may even be beneficial. However, participants indicate that they appreciate the foaming effect of a dentifrice with SLS more. (Source: Clinical Oral Investigations)
Tue, 22 Mar 2016 06:13:02 +0100CONCLUSION: Intravitreal bevacizumab may be a beneficial approach for the management of large submacular hemorrhage secondary to AMD. PMID: 26995076 [PubMed - as supplied by publisher] (Source: Journal Francais d Ophtalmologie)
Tue, 22 Mar 2016 05:43:04 +0100It is well established that chronic kidney disease is a risk factor for ischemic heart disease, with a strong association between reduction in glomerular filtration rate and increase in all-cause and cardiovascular mortality (1). Among those patients with the most severe disease on dialysis, approximately one-half have been shown to have evidence of ischemic heart disease (2). Patients with chronic kidney disease frequently require coronary revascularization, which can pose technical challenges due to the extensive and calcific nature of coronary artery disease. Accordingly, there is concern that percutaneous coronary intervention (PCI) is associated with lower procedural success (3). However, chronic kidney disease patients have historically been excluded from most trials studying PCI. Of...
Mon, 21 Mar 2016 18:22:15 +0100Abstract Haemophilia is a congenital disorder with bleeding episodes as its primary symptom. These episodes can result in negative outcomes including joint damage, loss of active days due to hospitalization and reduced quality of life. Effective treatment, however, can improve the outcome. Registries have been used as a valuable source of information regarding the monitoring of treatment and outcome. The two main aims of this exploratory study were to establish which haemophilia registries publish peer‐reviewed outcome assessment research and then to extract, classify and report the treatment outcomes and their extent of use in the retrieved registries. Using relevant keywords, we searched PubMed and Web of Science databases for publications during the period 1990–2015. Retrieved refer...
Mon, 21 Mar 2016 18:07:27 +0100Conclusion: TPSB under GA without prophylactic catheterisation is well tolerated, carrying acceptable postoperative symptom rates. Interestingly, a significant proportion of patients ejaculate within 7 days, which again suggests good tolerance to the procedure. Patients should be provided with this data preoperatively when they are considering TPSB.Urol Int (Source: Urologia Internationalis)
Mon, 21 Mar 2016 17:39:44 +0100The FDA is considering possible dangers from medical devices that monitor blood clotting producing false readings, according to a report from The Wall Street Journal. The FDA has tracked thousands of cases of malfunctions from such devices over the years, the WSJ reports. Deaths and serious injuries have been linked with the erroneous readings, due to the increased susceptibility of individuals on anticoagulant drugs to strokes and other dangerous events. The federal watchdog brought together a panel of experts to discuss “point of care” clotting monitors last Friday to try and analyze the extent of the problem and help encourage more accurate product development, the WSJ said. The paper reported that the FDA said “serious adverse events” appear to be “linked ...
Mon, 21 Mar 2016 00:00:00 +0100Conclusions Though long-term follow-up is needed to draw a definite conclusion, totally hand-sewn gastrojejunostomy and vagotomy remains a practicable revisional procedure to relieve refractory marginal ulcers. (Source: Obesity Surgery)
Mon, 21 Mar 2016 00:00:00 +0100ConclusionsBoth methods of thin‐flap created LASIK were effective, safe, predicable, and stable. FS group had significant improvements in efficacy and safety, confirmed by the efficacy and safety indices, compared to MK group. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc. (Source: Lasers in Surgery and Medicine)
Mon, 21 Mar 2016 00:00:00 +0100The subxiphoid access became the standard technique for epicardial ablation of ventricular tachycardia. However, it may prove difficult in certain situations. Here, we report an alternative method of epicardial and endocardial ablation performed via submammary minimal thoracotomy guided by pericardioscopy. Two male patients with structural heart disease and incessant ventricular tachycardia were successfully ablated using this technique. The described technique can be considered as an alternative to the standard technique. Moreover, it permits real-time visualization of cardiac vessels and fat tissue, and is safe in terms of damage to the phrenic nerve or potential bleeding complications. (Source: Interactive CardioVascular and Thoracic Surgery)
Mon, 21 Mar 2016 00:00:00 +0100Effectiveness of simulation-based training for improving operating room patient safety is established . Simulation-based education and training are not only effective for acquiring technical skills but also for developing nontechnical skills, such as situation awareness, cooperation, decision making, leadership, and communication in emergency situations. In the operating room, the importance of establishing “perioperative team” training is essential from the viewpoints of crisis management and resuscitation; examples include intraoperative massive bleeding and cardiac arrest . (Source: Journal of Clinical Anesthesia)
Mon, 21 Mar 2016 00:00:00 +0100The purpose of this patient survey was to analyse the knowledge about blood thinning medications relative to gender, age, education, and region of residence in patients with atrial fibrillation (AF). A total of 1147 patients with AF [mean age 66 ± 13 years, 529 (45%) women] from eight European countries responded to this survey. Most patients understood that the indication for anticoagulation therapy was to ‘thin the blood’, but 8.1% responded that the purpose of the medication was to treat the arrhythmia. Patients with college or university grades reported less frequent deviations from their target INR range compared with those without schooling (2.8% vs. 5.1%, P < 0.05). The awareness of anticoagulation-related risk of bleedings was lowest in patients without school...
Mon, 21 Mar 2016 00:00:00 +0100Conclusions The present study suggests that C-VKA is superior to I-VKA for AF patients undergoing RFCA. Rivaroxaban is the highest probability to be the optimal alternative to C-VKA among the three non-VKA oral anticoagulants in AF ablation. (Source: Journal of Interventional Cardiac Electrophysiology)
Mon, 21 Mar 2016 00:00:00 +0100Recently Miglionico et al. published in this Journal an interesting prospective observational study regarding 82 high-risk patients with in-stent restenosis of bare metal stent (BMS), n=48 (59%) or drug-eluting stent (DES), n=34 (41%) .1 All patients had at least one of the following high-risk features: history of hemorrhagic stroke or gastrointestinal bleeding, ischemic stroke not longer of 3 months before, need for oral anticoagulation or non-cardiac surgery or recent surgery, chronic inflammatory disease or neoplasm. (Source: The American Journal of Cardiology)
Mon, 21 Mar 2016 00:00:00 +0100ConclusionsThese safety data represent the largest controlled assessment of a 4F‐PCC to date. For patients requiring urgent VKA reversal, 4F‐PCC had a safety profile similar to that of plasma (AEs, SAEs, thromboembolic events, and deaths), but was associated with fewer fluid overload events. (Source: Academic Emergency Medicine)
Sun, 20 Mar 2016 18:07:27 +0100The objective of this study is to evaluate whether IL4-10 synerkine protects against blood-induced joint damage similarly as the combination of the individual components, both in vitro as well as in vivo. (Source: Osteoarthritis and Cartilage)
Sun, 20 Mar 2016 05:19:02 +0100Authors: Minichsdorfer C, Füreder T, Mähr B, Berghoff AS, Heynar H, Dressler A, Gnant M, Zielinski C, Bartsch R Abstract BACKGROUND: Totally implanted access ports (PACs) are valuable tools for the treatment of patients with cancer because they ease the administration of chemotherapy, stem cells, and supportive care by reducing the rate of peripheral vein punctures. OBJECTIVES: The purpose of this study was to evaluate the satisfaction and impairments of activities of daily living of ambulatory patients with PAC systems receiving chemotherapy. METHODS: This cross-sectional, questionnaire-based study evaluated 202 patients with PAC systems in a comprehensive cancer center and cancer rehabilitation center. From November 2012 to August 2013, patients were invited to answer a...
Sun, 20 Mar 2016 00:00:00 +0100Conclusions 30-day readmission following bariatric surgery is prevalent and closely associated with complications. (Source: The American Journal of Surgery)
Sun, 20 Mar 2016 00:00:00 +0100Conclusions Octogenarian/Nonagenarian patients present differently than younger adults. Reductions in complications, LOS, and cost among surviving older adults allude to a “survivorship tendency” to never give up, despite collectively higher mortality risk. (Source: The American Journal of Surgery)
Sun, 20 Mar 2016 00:00:00 +0100ConclusionThe increase in the ETCO2 during IAC‐CPR is an indicator of the increase in cardiac output following the use of this method of CPR. (Source: Academic Emergency Medicine)
Sat, 19 Mar 2016 21:19:03 +0100CONCLUSIONS: A single preoperative dose of TXA or 2 infusions of a lower dose, preoperatively and then after 3 hours after the start of surgery, resulted in lower blood loss during the first 2 days after surgery and less need for blood transfusion, with good levels of safety. PMID: 26991616 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)
Sat, 19 Mar 2016 20:35:02 +0100Conclusion The current study highlights the use of multiple antithrombotics as a risk factor for haematoma reoperation. Liberal use of drains and evacuation of breast haematomas are, therefore, indicated together with limitation of antithrombotic agents. The highly variable use of antithrombotic agents worldwide call for evidence-based guidelines in standardised free flap breast reconstruction. PMID: 26985624 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Sat, 19 Mar 2016 19:16:01 +0100CONCLUSIONS: Adalimumab and infliximab were similarly effective in treatment of moderate-to-severe UC in the real-world clinical setting. PMID: 26986449 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Sat, 19 Mar 2016 07:00:03 +0100CONCLUSIONS: ALIF with posterior instrumentation in low grade isthmic spondylolisthesis provides satisfactory outcome in patients requiring surgical treatment. The results of pain relief and disability index are comparable to time tested posterolateral fusion. ALIF shows a tendency to faster pain relief and return to activity with less intraoperative blood requirement in low grade isthmic spondylolisthesis. PMID: 26984651 [PubMed - in process] (Source: Acta Orthopaedica Belgica)
Sat, 19 Mar 2016 01:34:48 +0100BACKGROUND CONTEXT: Sacropelvic fixation with iliac screws requires transverse connectors and is associated with risks of prominent metalwork, pelvic pain, pressure necrosis and construct failure. Significant lateral dissection leads to greater risk of bleeding and infection. The S2 alar-iliac (S2AI) screw has been suggested as an alternative to reduce these risks. (Source: The Spine Journal)
Sat, 19 Mar 2016 01:34:48 +0100BACKGROUND CONTEXT: Scoliosis is common in Duchenne muscular dystrophy (DMD). It leads to impaired respiratory function, poor sitting balance and pain. Surgical correction of scoliosis improves sitting balance and prevents deterioration of respiratory function. However, conventional surgery in these patients is associated with significant intraoperative bleeding and risk of infection; percutaneous surgical techniques have the advantage of reducing this. (Source: The Spine Journal)
Sat, 19 Mar 2016 00:00:00 +0100ConclusionOwing to a rigid regular SPT program, implants placed in PSP perform equally well when compared to implants installed in PHS over a mean period of 6‐year follow‐up. (Source: Clinical Oral Implants Research)
Sat, 19 Mar 2016 00:00:00 +0100(Source: American Journal of Hematology)
Sat, 19 Mar 2016 00:00:00 +0100Mean platelet volume (MPV) has been proposed as a marker of platelet reactivity and cardiovascular disease. Chronic kidney disease (CKD) significantly favors the occurrence of cardiovascular events, by increasing the circulating levels of a wide spectrum of pro-oxidant and pro-thrombotic mediators. However, opposite alterations of platelet function, both enhanced aggregability and increased bleeding diathesis have been reported in these patients, with contrasting results on the effects of renal function on MPV and coronary artery disease, that were assessed in present study. (Source: Thrombosis Research)
Sat, 19 Mar 2016 00:00:00 +0100We would like to comment with reference to an earlier article by Van Schoubroeck et al. entitled “Pain and bleeding pattern related to levonorgestrel intrauterine system (LNG-IUS) insertion”. The authors address a serious and underappreciated aspect of intrauterine contraceptive use, i.e. pain during and post insertion and provide the scientific community with interesting ad hoc data. They conclude that pain or bleeding at LNG-IUS insertion and in the 6 weeks following insertion do not predict the position of the LNG-IUS; and also that the mere absence of pain does not assure proper placement. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)
Sat, 19 Mar 2016 00:00:00 +0100Solid organ (liver, spleen and kidney) hemorrhage is often life threatening and can be difficult to stop in critically ill patients. Traditional techniques for arresting this ongoing bleeding include coagulation by high voltage cautery (Bovie), topical hemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a new energy device for arresting persistent solid organ hemorrhage. (Source: Injury)
Sat, 19 Mar 2016 00:00:00 +0100This prospective Phase II study based on 18 patients with symptomatic, obstructing rectal cancer investigated the role of short-course radiation therapy in this setting. Main findings of our study were that patients with obstructing symptoms due to rectal cancer may effectively be treated with short course RT, without substantial acute toxicity. Furthermore, short-course radiation therapy successfully controlled rectal bleeding and pain in most cases and colostomy was avoided in majority of patients. (Source: International Journal of Radiation Oncology * Biology * Physics)
Sat, 19 Mar 2016 00:00:00 +0100Conclusion The technique of en bloc bladder tumor resection with Hybrid Knife® is an effective alternative to bipolar loop transurethral resection. Resection with a Hybrid Knife® is a procedure with little bleeding and good surgical vision and minimizes the risk of bladder perforation and tumor implants. The procedure facilitates determining the positivity of the neoplastic process, vascular infiltration and bladder muscle invasion in the histopathology study. (Source: Actas Urologicas Espanolas)
Sat, 19 Mar 2016 00:00:00 +0100Conclusions The functional and oncological results of our series confirm the safety and efficacy of RPN. RPN offers optimal preservation of renal function and oncological control in the medium term. (Source: Actas Urologicas Espanolas)
Fri, 18 Mar 2016 12:32:02 +0100CONCLUSIONS: Concomitant cervical and transperineal parametrial HDRB boost for locally advanced cervical cancer appears feasible and safe with no specific acute toxicity compare to cervical HDRB alone. Longer follow-up and larger patient cohort will be needed. PMID: 26985194 [PubMed] (Source: Journal of Contemporary Brachytherapy)
Fri, 18 Mar 2016 00:00:00 +0100Conclusions Tissue factor-triggered ROTEM® tests were more sensitive than contact-activated k-TEG® in identifying hyperfibrinolysis in LT patients. Inhibition of platelet-fibrin interaction in FIBTEM® enhanced sensitivity to hyperfibrinolysis detection compared with EXTEM®. (Source: British Journal of Anaesthesia)
Fri, 18 Mar 2016 00:00:00 +0100Conclusion THSD1 is a new regulator of endothelial barrier function during vascular development and protects intraplaque microvessels against haemorrhaging in advanced atherosclerotic lesions. (Source: Cardiovascular Research)
Fri, 18 Mar 2016 00:00:00 +0100Conclusions Women who used vaginal estrogen exhibited a higher incidence of continued pessary use and lower incidence of increased vaginal discharge than women who did not. (Source: International Urogynecology Journal and Pelvic Floor Dysfunction)
Fri, 18 Mar 2016 00:00:00 +0100Conclusion POCUS has a central role in the management of critically-ill elderly patients for making quick (Source: International Journal of Surgery Case Reports)
Fri, 18 Mar 2016 00:00:00 +0100The objective of this study was to assess effectiveness and safety of Depo-Provera (medroxyprogesterone acetate) in treatment of endometrial hyperplasia (EH) and to compare it with norethisterone acetate (NETA) as an oral progestogen treatment. One hundred forty six women aged 35 to 50 years with abnormal uterine bleeding and diagnosed as having EH were randomized to receive either Depo-Provera, one injection every 3 months for 6 months (2 doses), or oral cyclic NETA, 15 mg daily for 14 days per cycle for 6 months. Primary outcome measure was regression of EH. Secondary outcome variables were side effects of treatment, persistence/progression of EH during follow-up period. After 6 months of treatment, Depo-Provera was more successful in achieving regression of nonatypical EH than NETA (67 ...
Fri, 18 Mar 2016 00:00:00 +0100This report describes thromboelastographic evidence of inhibition of fibrinolysis after ε‐aminocaproic acid administration in a dog with suspected acute traumatic coagulopathy. Thromboelastrography may be useful in monitoring therapy with antifibrinolytic drugs. (Source: Journal of Veterinary Emergency and Critical Care)
Fri, 18 Mar 2016 00:00:00 +0100Conclusions: In patients with difficult biliary cannulation, early precut is an effective technique and can significantly reduce the incidence of PEP. Repeated biliary cannulation attempts are a real risk factor for this complication. [...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)
Fri, 18 Mar 2016 00:00:00 +0100Conclusion: EUS-GJ is an emerging procedure that has efficacy and safety comparable with those of current therapies and should hold a place as a new minimally invasive option for patients with gastric outlet obstruction.Clinical trial identification number: NCT01522573[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | open access Full text (Source: Endoscopy International Open)
Fri, 18 Mar 2016 00:00:00 +0100Conclusion: Patients with a continuous-flow LVAD who develop a GIB secondary to GIAD have a higher rate of major bleeding, multiple bleeding events, and require more transfusions to achieve stabilization compared to patients who do not have GIAD.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | open access Full text (Source: Endoscopy International Open)
Fri, 18 Mar 2016 00:00:00 +0100(Source: Archives of Gynecology and Obstetrics)
Fri, 18 Mar 2016 00:00:00 +0100CONCLUSIONS: -In patients with DM, continued thienopyridine beyond 1-year after coronary stenting is associated with reduced risk of MI, although this benefit is attenuated when compared with patients without DM. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT00977938. PMID: 26994121 [PubMed - as supplied by publisher] (Source: Circulation)
Thu, 17 Mar 2016 22:29:39 +0100The FDA today labeled Teleflex‘s (NYSE:TFX) recall of Arrow intra-aortic balloon cath and percutaneous insertion kits as a Class I recall. Class I recall designations, the agency’s most serious classification of recall, are used when there is a reasonable probability that product use could cause serious adverse health consequences or death. The devices are being recalled due to the risk of the sheath body detaching from its hub, after 13 adverse event reports including 6 serious injuries and 1 death. If the sheath body separates from the sheath hub during insertion, the patient may experience significant bleeding and the interruption of the inflating-deflating balloon therapy. The FDA updated numbers for the recall as well, which affects 13,405 units distributed nation wide. In an ...
Thu, 17 Mar 2016 22:15:01 +0100Authors: Berger MD, Lenz HJ Abstract INTRODUCTION: Monoclonal antibodies such as bevacizumab, ramucirumab, cetuximab and panitumumab play an important role in the treatment of metastatic colorectal cancer (mCRC). With the introduction of these drugs considerable improvements in both progression-free survival (PFS) and overall survival (OS) were achieved. However these antibodies are associated with a unique side effect profile. Areas covered: This review provides an overview about drug efficacy of bevacizumab, cetuximab, panitumumab and ramucirumab in the treatment algorithm of mCRC. Additionally, we discuss the most common toxicites of these monoclonal antibodies. Expert opinion: The most common toxicities associated with the VEGF-A directed antibody bevacizumab are hypertension, ...
Thu, 17 Mar 2016 21:34:14 +0100In the circulation, the secreted protein Reelin acts to stem bleeding after injury. Receptors for Reelin are found on the endothelial cells that line blood vessels. Ding et al. – [Read More] (Source: This Week in Science)
Thu, 17 Mar 2016 21:08:30 +0100Studies show routine prophylaxis with Kovaltry helps controls bleeds and reduces frequency of bleeding episodes in children and adults with hemophilia A. FDA Approvals (Source: Medscape Hematology-Oncology Headlines)
Thu, 17 Mar 2016 17:07:01 +0100Authors: Yan Q, Jin G, Qin M, Zhao J, Wang J, Sun J Abstract Intracranial hemorrhage (ICH) is the bleeding induced by parenchyma vascular rupture. In this paper, four novel coils (a contralateral hemisphere cancellation coil, a coaxial coil, a double-end exciting coil, and a Helmholtz coil) were developed to detect the volume change of ICH with the magnetic induction phase shift (MIPS) technique. Both numerical studies on an ICH model and animal experiments on rabbits' hemorrhage model were performed with four coils. Twenty rabbits were measured for each coil. The animal results were consistent with the simulation and the theoretical analysis for each coil. The MIPS first declined and then increased with increasing injection volume, indicating the existence of a turning point. The ...
Thu, 17 Mar 2016 16:00:00 +0100Are bleeding complications associated with TAVR more common in teaching hospitals? The Journal of Invasive Cardiology (Source: Medscape General Surgery Headlines)
Thu, 17 Mar 2016 14:52:02 +0100CONCLUSION: Adequate scientific evidence supports the current recommendations and treatment algorithms for the periprocedural management of oral anticoagulants and platelet aggregation inhibitors in endoscopic procedures. Larger-scale studies are still needed to provide a sound basis for the corresponding recommendations about NOAC. PMID: 26976713 [PubMed - in process] (Source: Deutsches Arzteblatt International)
Thu, 17 Mar 2016 14:36:00 +0100Saline infusion sonohysterography is a minimally invasive adjunctive method to delineate endometrial abnormalities that usually have been detected during transvaginal and/or transabdominal pelvic ultrasound. This procedure also is requested during the work-up for infertility. Of particular importance is the evaluation of patients with abnormal uterine bleeding. The majority of the patients with abnormal uterine bleeding will have benign etiologies including endometrial atrophy, uterine submucosal leiomyomas, endometrial polyps, or endometrial hyperplasia. However, approximately 10% of postmenopausal patients with uterine bleeding will have endometrial carcinoma, which is the most common gynecologic malignancy.1 (Source: Contemporary Diagnostic Radiology)
Thu, 17 Mar 2016 11:57:27 +0100Antidepressants might decrease platelet aggregation, while non-steroidal anti-inflammatory drugs (NSAIDs) may also inhibit platelet function, so both may increase bleeding.1 While antidepressants and NSAIDS are thought to increase gastrointestinal haemorrhage,1 there are contradictory results on the risk of intracranial haemorrhage (ICH) with the coprescription of antidepressants and NSAIDs in case control and population studies.2 ,3 Antidepressants alone are not thought to increase the risk of intracranial haemorrhage.4 A nationwide cohort study of all healthcare insurance claims covering all the population of Korea was carried out. The study examined healthcare claims for people with depression started on antidepressants (including m...
Thu, 17 Mar 2016 04:00:00 +0100Arrow International Inc. is recalling the Intra-Aortic Balloon Catheter Kits and Percutaneous Insertion Kits because the sheath body may separate from the sheath hub during the insertion procedure. This may cause significant bleeding if not addressed... (Source: Food and Drug Adminstration (FDA): CDRHNew)
Thu, 17 Mar 2016 00:00:00 +0100We report maxillary tuberosity fracture and ophthalmologic complications following removal of maxillary third molar. A 35‐year‐old female underwent removal of left maxillary third molar at private dental clinic. Following the complete extraction, excessive haemorrhage occurred and maxillary tuberosity fracture was seen and the patient was brought by ambulance to our hospital. The bleeding was controlled by vacuum‐formed splint and nasal packing. Computed tomography revealed that lateral maxillary tuberosity and posterior wall of the maxillary sinus was defect and there was a slight intraorbital haematoma via the inferior orbital fissure as well as with extension in the maxillary sinus and adjacent spaces such as buccal, masticator, pterygomaxillary and infratemporal spaces. Because a...
Thu, 17 Mar 2016 00:00:00 +0100Conclusions The present study demonstrates that the rate of DVT/PE after liver transplantation is similar to the rate after other major operations. Patients were more likely to develop DVT/PE if they received increased amounts of intraoperative cryoprecipitate/fresh frozen plasma (FFP) or had an elevated postoperative INR. Furthermore, patients with a complicated postoperative course have the highest risk of venous thromboembolism. (Source: The American Journal of Surgery)
Thu, 17 Mar 2016 00:00:00 +0100CONCLUSIONS In patients with INCPH that have normal kidney function or that do not have severe extra‐hepatic conditions, TIPS is an excellent option to treat severe complications of portal hypertension. This article is protected by copyright. All rights reserved. (Source: Hepatology)
Thu, 17 Mar 2016 00:00:00 +0100CONCLUSIONS: LAA occlusion was feasible in non-valvular AF patients with high risk of stroke and hemorrhage. The ACP and Watchman devices were similar in terms of procedural and clinical outcomes. PMID: 26984716 [PubMed - as supplied by publisher] (Source: Circulation Journal)
Thu, 17 Mar 2016 00:00:00 +0100ConclusionThis study improves our understanding of how utilities for the same states can vary across countries. The study shows the importance of capturing utilities that reflect the preferences of the local population. (Source: Asia-Pacific Journal of Clinical Oncology)
Thu, 17 Mar 2016 00:00:00 +0100Whether the association between platelet count (PC) and thrombotic and bleeding risk is independent of or varies by residual platelet reactivity to antiplatelet therapies is unclear. We sought to investigate the independent and combined effects of PC and platelet reactivity on thrombotic and bleeding risk after coronary artery implantation of drug-eluting stents (DES). Patients enrolled in the prospective, multicenter Assessment of Dual Anti-Platelet Therapy with Drug-Eluting Stents (ADAPT-DES) study were stratified by PC tertiles. (Source: The American Journal of Cardiology)
Thu, 17 Mar 2016 00:00:00 +0100Conclusion: Ceftriaxone interacts with warfarin to increase a patient’s INR value more than other commonly administered antibiotics for UTI treatment. Other antibiotics should be preferred for UTI treatment in patients on warfarin. (Source: Journal of Pharmacy Practice)
Thu, 17 Mar 2016 00:00:00 +0100Conclusion: The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients. (Source: Indian Journal of Pharmacology)
Thu, 17 Mar 2016 00:00:00 +0100Warfarin is a vitamin K antagonist (VKA) utilized to treat patients with hypercoagulable disease states, but increases the risk of life-threatening bleeding. Prothrombin complex concentrate (PCC) has been recommended if these bleeds occur. Kcentra®, a four-factor PCC, has been FDA approved for the urgent reversal of VKA-associated major bleeding. Hypotension has been reported with Kcentra® use, but limited information is available about these reactions. Such events may be catastrophic in critically ill patients. (Source: The American Journal of Emergency Medicine)
Thu, 17 Mar 2016 00:00:00 +0100ConclusionsA super‐resolution imaging approach is effective and rapid in objectively differentiating between patients with a platelet bleeding disorder and healthy volunteers. CD63 is a useful marker for predicting Hermansky‐Pudlak syndrome and could be used in the diagnosis of patients suspected of other platelet granule disorders. (Source: Journal of Thrombosis and Haemostasis)
Thu, 17 Mar 2016 00:00:00 +0100Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the ...
Thu, 17 Mar 2016 00:00:00 +0100Platelet and megakaryocyte endocytosis is important for loading certain granule cargo (ie, fibrinogen [Fg] and vascular endothelial growth factor); however, the mechanisms of platelet endocytosis and its functional acute effects are understudied. Adenosine 5'-diphosphate–ribosylation factor 6 (Arf6) is a small guanosine triphosphate–binding protein that regulates endocytic trafficking, especially of integrins. To study platelet endocytosis, we generated platelet-specific Arf6 knockout (KO) mice. Arf6 KO platelets had less associated Fg suggesting that Arf6 affects αIIbβ3-mediated Fg uptake and/or storage. Other cargo was unaffected. To measure Fg uptake, mice were injected with biotinylated- or fluorescein isothiocyanate (FITC)–labeled Fg. Platelets from the in...
Thu, 17 Mar 2016 00:00:00 +0100Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups. (Source: BMJ Open)
Thu, 17 Mar 2016 00:00:00 +0100To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)
Thu, 17 Mar 2016 00:00:00 +0100Direct thrombin inhibitors (DTIs) represented by dabigatran were expected to be available for therapeutic use without the need for routine monitoring, in contrast to warfarin. However, clinical concerns regarding impacts of plasma dabigatran concentrations on the rate of major bleeding have been raised.1 Clinical and basic aspects of DTIs aid in studying how best to address concerns regarding bleeding risk in therapeutic use. Based on enzymatic examinations with a synthetic substrate, S-2238, it has been well recognised that dabigatran and another DTI argatroban reversibly and competitively inhibit thrombin reaction.2 3 However, it still remains unclear whether the type of inhibition by DTIs of thrombin reaction with S-2238 can be applied to the anticoagulant effects. The Clauss assay is c...
Thu, 17 Mar 2016 00:00:00 +0100Conclusions CO2 insufflation in thoracoscopic major lung resection appears to be safe, even in the short term, and can help to control vessel injury. (Source: Surgery Today)
Thu, 17 Mar 2016 00:00:00 +0100The aim of this study was to describe our initial experience with a gold flexible linear fiducial marker and to evaluate the safety and technical and clinical efficacy of stereotactic body radiotherapy using this marker for malignant liver tumors. Between July 2012 and February 2015, 18 patients underwent percutaneous fiducial marker placement before stereotactic body radiotherapy for malignant liver tumors. We evaluated the technical and clinical success rates of the procedure and the associated complications. Technical success was defined as successful placement of the fiducial marker at the target site, and clinical success was defined as the completion of stereotactic body radiotherapy without the marker dropping out of position. All 18 fiducial markers were placed successfully, so the...
Thu, 17 Mar 2016 00:00:00 +0100CONCLUSIONS: NOX1 and NOX2 play differential roles in different platelet activation pathways and in thrombosis. ROS generated by these enzymes promotes platelet activation via the Syk/phospholipase Cγ2/calcium signaling pathway. PMID: 26988594 [PubMed - as supplied by publisher] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)
Thu, 17 Mar 2016 00:00:00 +0100Authors: Fidalgo T, Pinto SC, Corrales I, Borràs N, Oliveira A, Almeida H, Marques D, Oliveira C, Tavares A, Diniz M, Antunes M, Caetano G, Kjöllerström P, Maia R, Martinho P, Gonçalves E, Sevivas T, Salvado R, Vidal F, Ribeiro L Abstract The diagnosis of von Willebrand disease (VWD), the most common inherited bleeding disorder, is characterised by a variable bleeding tendency and heterogeneous laboratory phenotype. The sequencing of the entire VWF coding region has not yet become a routine practice in diagnostic laboratories owing to its high costs. Nevertheless, next-generation sequencing (NGS) has emerged as an alternative to overcome this limitation. We aimed to determine the correlation of genotype and phenotype in 92 Portuguese individuals from 60 unrelated families with ...
Wed, 16 Mar 2016 20:30:00 +0100(MedPage Today) -- Significant hematomas a possible culprit in infection risk, but causality unclear (Source: MedPage Today Cardiovascular)
Wed, 16 Mar 2016 12:03:53 +0100WEDNESDAY, March 16, 2016 -- Though the past 50 years have brought major treatment advances, men with severe hemophilia are still at high risk for bleeding and physical disability, experts say. Hemophilia is a genetic disease that prevents blood... (Source: Drugs.com - Daily MedNews)
Wed, 16 Mar 2016 00:23:17 +0100Contact: Samiha Khanna Phone: 919-419-5069 Email: firstname.lastname@example.org https://www.dukehealth.org FOR IMMEDIATE RELEASE on Monday, March 14 DURHAM, N.C. -- A new study from Duke Health suggests that patients who need to have their thyroid gland removed should seek surgeons who perform 25 or more thyroidectomies a year for the least risk of complications. Thyroidectomy is one of the most common operations performed in the U.S, often due to cancer, over-activity, or enlargement of the gland, which is located at the base of the throat and produces hormones that regulate metabolism. But most consumers would be surprised to learn that about half (51 percent) of surgeons who perform thyroidectomy do so just once a year, according to the study published in the Annals of Surgery. “This is a ve...
Wed, 16 Mar 2016 00:00:00 +0100In conclusion, the combined methods would be in favor of guiding manufacture and quality control of PSS to guarantee its effectiveness and safety. (Source: Carbohydrate Polymers)
Wed, 16 Mar 2016 00:00:00 +0100Conclusion The present study revealed the frequency and distribution of NCs using CBCT image analysis. NCs are important because surgical injury to the neurovascular bundle within these canals can lead to excessive bleeding and postoperative paresthesia. The identification of NC on CBCT images may be useful during the harvesting of bone blocks or placement of endosseous implants in the anterior region of the mandible. (Source: Surgical and Radiologic Anatomy)
Wed, 16 Mar 2016 00:00:00 +0100In conclusion, vitamin D is reduced in autoimmune cytopenias and correlate with disease severity, supporting its possible protective role against the development of autoimmunity. Literature review showed vitamin D deficiency reports both in onco- and in non onco-hematologic diseases with a relationship with disease severity/activity in myeloid and lymphoid neoplasms, as well as in sickle cell disease. Supplementation has produced weak results in autoimmune and hematologic diseases, and further studies are needed. (Source: Autoimmunity Reviews)
Wed, 16 Mar 2016 00:00:00 +0100This article reviews current strategies for risk stratification, diagnostic modalities, localization of bleeding, transfusion strategies, adjunct therapies, and reversal of anticoagulation. (Source: Emergency Medicine Clinics of North America)
Wed, 16 Mar 2016 00:00:00 +0100ConclusionsAlcohol was the commonest etiology of ACLF. Within a mean hospital stay of 8 days, 42% patients died. OFs independently predicted survival. (Source: Journal of Gastroenterology and Hepatology)
Wed, 16 Mar 2016 00:00:00 +0100Conclusion A large component of the caseload of a tertiary colorectal surgery unit is made up of post-colonoscopy, post-operative, and surveillance protocol follow-up, with a significant proportion of patients not requiring any active intervention. The majority of new referrals are undifferentiated and result in a low rate of direct booking for operative intervention. Rationalisation of this resource using evidence-based methods could reduce redundancy, workload, and cost. (Source: International Journal of Colorectal Disease)
Wed, 16 Mar 2016 00:00:00 +0100ConclusionsCollectively, our findings suggest that Lenalidomide constitutes a novel therapeutic option for the management of AVWS associated with MG. The biological mechanism(s) through which Lenalidomide causes a sustained increase in plasma VWF in AVWS independent of paraprotein level requires further study, but is in part modulated through inhibition of enhanced VWF clearance.This article is protected by copyright. All rights reserved. (Source: Journal of Thrombosis and Haemostasis)
Wed, 16 Mar 2016 00:00:00 +0100We describe the case of a man with a long history of AIDS complicated by progressive multifocal leukoencephalopathy (PML), who developed AHA while on stable antiretroviral therapy and then presented with new onset bleeding and hypotension. We treated our patient with incrementally increasing doses of cyclophosphamide resulting in resolution of coagulopathy. We review the medical literature for additional cases of HIV-associated AHA and discuss the challenges in the care of our patient, since the immunosuppression needed to eradicate the FVIII inhibitor had the potential to cause recrudescence of his PML. (Source: Journal of the International Association of Physicians in AIDS Care (JIAPAC))
Wed, 16 Mar 2016 00:00:00 +0100In conclusion, transfemoral temporary aortic balloon occlusion is an effective procedure in the surgical treatment of intramural ectopic pregnancy diagnosed beyond the first trimester. (Source: Journal of Obstetrics and Gynaecology Research)
Wed, 16 Mar 2016 00:00:00 +0100Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination b... (Source: BMC Women's Health)
Wed, 16 Mar 2016 00:00:00 +0100The melanocytic cells of the cervical epithelium are capable of forming the complete spectrum of melanocytic lesions, from benign lentigines to melanoma. Primary malignant melanoma of the uterine cervix is a rare neoplasm with aggressive behavior. The absence of melanin pigment can lead to misdiagnosis as carcinomas, sarcomas, or lymphoma. Immunohistochemical studies should be used for confirmation. In order to consent the cervix as a primary site, exclusion of any other probable primary sites of melanoma is needed. Here, we present a 61‐year‐old female patient with postmenopausal vaginal bleeding. After cervical smear, diagnosis was confirmed by cervical punch biopsy. Diagn. Cytopathol. 2016. © 2016 Wiley Periodicals, Inc. (Source: Diagnostic Cytopathology)
Wed, 16 Mar 2016 00:00:00 +0100We present a series of four patients with cervical hemangioma with an extensive review of the existing literature on the subject. All four cervical hemangiomas were diagnosed incidentally in hysterectomy specimens performed for persistent menorrhagia or pain. The mean age at presentation was 34 years. The mean lesion size was 2.1cm and the dominant location was posterior cervix (3 cases). Immunohistochemistry for estrogen and progesterone receptors showed expression of both markers in endothelial cells and stroma, the latter marker showing a stronger and more diffuse pattern. No other significant uterine abnormality was identified in two cases. The vast majority of cervical hemangiomas reported are in reproductive age women. In addition, these lesions express hormone receptors, indicating ...
Wed, 16 Mar 2016 00:00:00 +0100(Source: ANZ Journal of Surgery)
Wed, 16 Mar 2016 00:00:00 +0100Conclusion: JetStream atherectomy using the XC device has favorable acute results in treating femoropopliteal ISR with high procedure success, no device-stent interaction, and favorably low TLR rates. A multicenter trial is needed to confirm these results. (Source: Journal of Endovascular Therapy)
Wed, 16 Mar 2016 00:00:00 +0100Abstract Atrial fibrillation (AF) is not benign. Cardiovascular diseases and risk factors differ importantly amongst patients. Careful phenotyping with the aim to start tailored therapy may improve outcome and quality of life. Furthermore, structural remodelling plays an important role in initiation and progression of AF. Therapies that interfere in the remodelling processes are promising because they may modify the atrial substrate. However, success is still limited probably due to variations in the underlying substrate in individual patients. The most favourable effects of lifestyle changes on success of rhythm control have been demonstrated in obese patients with AF. Differences in genotype may also play an important role. Common gene variants have been associated with recurrence of AF ...
Wed, 16 Mar 2016 00:00:00 +0100CONCLUSIONS In patients 1 year following bioprosthetic aortic valve replacement, acenocoumarol therapy was associated with a significant increased risk of bleeding events and no reduction in thromboembolic events compared with antiplatelet therapy. These findings support the recommendations of aspirin over VKAs as postoperative thromboprophylaxis. (Source: European Journal of Cardio-Thoracic Surgery)
Wed, 16 Mar 2016 00:00:00 +0100Authors: Liu L, Yuan X Abstract Patients with acute promyelocytic leukemia (APL) are prone to both bleeding and thrombosis. Both of these have a significant impact on the morbidity and mortality of patients with this disease. Here we report a case of a 41-year-old male, who presented with transient ischemic attack (TIA) and early neurological deterioration (END) as initial manifestations prior to an ultimate diagnosis of APL. This patient had no cerebrovascular risk factors or familial cerebrovascular disease. The patient experienced an acute ischemic stroke, verified by magnetic resonance imaging (MRI), in less than 24 h after his second hospital admission. Some APL patients suffer from cerebral ischemia as an initial manifestation or during induction therapy, and patients presen...
Wed, 16 Mar 2016 00:00:00 +0100CONCLUSIONS: This review confirms the effectiveness of antimicrobial CVCs in reducing rates of CRBSI and catheter colonization. However, the magnitude of benefits regarding catheter colonization varied according to setting, with significant benefits only in studies conducted in ICUs. A comparatively smaller body of evidence suggests that antimicrobial CVCs do not appear to reduce clinically diagnosed sepsis or mortality significantly. Our findings call for caution in routinely recommending the use of antimicrobial-impregnated CVCs across all settings. Further randomized controlled trials assessing antimicrobial CVCs should include important clinical outcomes like the overall rates of sepsis and mortality. PMID: 26982376 [PubMed - as supplied by publisher] (Source: Cochrane Database of ...
Wed, 16 Mar 2016 00:00:00 +0100CONCLUSION: NCPF is common in South India. Transient ascites occurs due to decompensation of liver function after variceal bleeding and in long standing cases of NCPF. Our study used Tc-sulphur scan for diagnosing NCPF in patients where liver biopsy was contraindicated in view of severe thrombocytopenia; however, the diagnostic utility of Tc-sulphur nuclear scan to diagnose NCPF in patients with severe hypersplenism needs to be further evaluated in future studies. PMID: 26989144 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Wed, 16 Mar 2016 00:00:00 +0100CONCLUSIONS: Collectively, our findings suggest that Lenalidomide constitutes a novel therapeutic option for the management of AVWS associated with MG. The biological mechanism(s) through which Lenalidomide causes a sustained increase in plasma VWF in AVWS independent of paraprotein level requires further study, but is in part modulated through inhibition of enhanced VWF clearance. This article is protected by copyright. All rights reserved. PMID: 26991062 [PubMed - as supplied by publisher] (Source: Thrombosis and Haemostasis)
Wed, 16 Mar 2016 00:00:00 +0100CONCLUSIONS: In real-word ACS/PCI patients, prasugrel offered better antiischemic protection than clopidogrel, while use of both novel agents is accompanied by more frequent bleeding events. This article is protected by copyright. All rights reserved. PMID: 26990959 [PubMed - as supplied by publisher] (Source: Thrombosis and Haemostasis)
Tue, 15 Mar 2016 19:35:12 +0100We thank Paraskeva et al for their thoughtful comments on our article. Previously, we speculated that the cause of delayed bleeding was related to injury of blood vessels in the submucosa layer caused by snaring. We previously showed that delayed bleeding requiring hemostasis occurred significantly less commonly after cold snare resection than hot snare resection despite continuation of anticoagulants (0% vs 14%; P = .027).1 We were able to confirm that this difference was consistent with the hypothesis that injured submucosal arteries were seen significantly less frequently after cold snare resection than after hot snare resection (22% vs 39%; P = .023). (Source: Gastrointestinal Endoscopy)