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Pulmonary embolism treatment

Wenyu Hu, Yanguo Xin, Xin Chen, Zhuyin Song, Zhiyi He, Yinan Zhao
BACKGROUND: Tranexamic acid functions as an antifibrinolytic medication and is widely used to treat or prevent excessive blood loss in menorrhagia and during the perioperative period. The efficacy of tranexamic acid in reducing mortaligy and disability, and the occurrence of complications during treatment of cerebral hemorrhage remains controversial. OBJECTIVE: The objective of this systematic literature review and meta-analysis was to evaluate the efficacy and safety of tranexamic acid in patients with cerebral hemorrhage, aiming to improve the evidence-based medical knowledge of treatment options for such patients...
February 11, 2019: CNS Drugs
Atilla Sarac
OBJECTIVES: This study aims to present the early results of a prospective study of the use of novel n-butyl-2 cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. METHODS: Five hundred and seventy-three patients with lower-limb venous insufficiency were treated within in the previous four years. The study enrolled adults aged 21-70 years with symptomatic moderate to severe varicosities (C2-C6 patients clinical, etiological, anatomical, and pathophysiological classification) and great saphenous vein reflux lasting longer than 0...
February 10, 2019: Vascular
Huyen A Tran, Harry Gibbs, Eileen Merriman, Jennifer L Curnow, Laura Young, Ashwini Bennett, Tan Chee Wee, Sanjeev D Chunilal, Chris M Ward, Ross Baker, Harshal Nandurkar
INTRODUCTION: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disease and, globally, more than an estimated 10 million people have it yearly. It is a chronic and recurrent disease. The symptoms of VTE are non-specific and the diagnosis should actively be sought once considered. The mainstay of VTE treatment is anticoagulation, with few patients requiring additional intervention. A working group of experts in the area recently completed an evidence-based guideline for the diagnosis and management of DVT and PE on behalf of the Thrombosis and Haemostasis Society of Australia and New Zealand (www...
February 10, 2019: Medical Journal of Australia
Eugene R Viscusi, Tong J Gan, Sergio Bergese, Neil Singla, Randall J Mack, Stewart W McCallum, Wei Du, Sue Hobson
BACKGROUND AND OBJECTIVES: To describe the safety and tolerability of intravenous meloxicam compared with placebo across all phase II/III clinical trials. METHODS: Safety data and opioid use from subjects with moderate to severe postoperative pain who received ≥1 dose of intravenous meloxicam (5-60 mg) or placebo in 1 of 7 studies (4 phase II; 3 phase III) were pooled. Data from intravenous meloxicam 5 mg, 7.5 mg and 15 mg groups were combined (low-dose subset)...
February 7, 2019: Regional Anesthesia and Pain Medicine
Jeff S Ehresman, Tomas Garzon-Muvdi, Davis Rogers, Michael Lim, Gary L Gallia, Jon Weingart, Henry Brem, Chetan Bettegowda, Kaisorn L Chaichana
Object  Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods  Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed...
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Hang Zhang, Juan Zhang, Mengxuan Chen, Du-Jiang Xie, Jing Kan, Wande Yu, Xiao-Bo Li, Tian Xu, Yue Gu, Jianzeng Dong, Hong Gu, Yaling Han, Shao-Liang Chen
OBJECTIVES: The authors sought to assess the benefits of pulmonary artery denervation (PADN) among combined pre- and post-capillary pulmonary hypertension (CpcPH) patients in a prospective, randomized, sham-controlled trial. BACKGROUND: PADN has been shown to improve hemodynamics of pulmonary arterial hypertension in a series of patients. Additionally, benefits of targeted medical therapy for patients with CpcPH secondary to left-sided heart failure are unknown...
February 11, 2019: JACC. Cardiovascular Interventions
Benoist Chibaudel, Jean-Baptiste Bachet, Thierry André, Dominique Auby, Jérôme Desramé, Gaël Deplanque, Cédric Lecaille, Christophe Louvet, Christophe Tournigand, Valérie Lebrun-Ly, Jérôme Dauba, Gérard Lledo, Marie-Line Garcia, Olivier Dubreuil, Nabil Baba Hamed, Aurélia Meurisse, Annette K Larsen, Annemilaï Tijeras-Raballand, Franck Bonnetain, Aimery De Gramont
Aflibercept in combination with 5‑fluorouracil (5‑FU)/irinotecan improves overall survival in the second‑line therapy of patients with metastatic colorectal cancer (mCRC). In this study, we evaluated the effects of aflibercept in first‑line therapy with FOLFOX followed by maintenance with fluoropyrimidine. VELVET was a prospective, single‑arm multicenter phase II study (completed). Patients with previously untreated, unresectable, evaluable or measurable mCRC, with an age ≥18 years, and an ECOG performance status of 0‑2 received 6 cycles of modified FOLFOX7 (5‑FU/folinic acid and oxaliplatin) with aflibercept at 4 mg/kg every 2 weeks followed by maintenance therapy with fluoropyrimidine with aflibercept until disease progression or limiting toxicity...
February 1, 2019: International Journal of Oncology
Charles S Fuchs, Kohei Shitara, Maria Di Bartolomeo, Sara Lonardi, Salah-Eddin Al-Batran, Eric Van Cutsem, David H Ilson, Maria Alsina, Ian Chau, Jill Lacy, Michel Ducreux, Guillermo Ariel Mendez, Alejandro Molina Alavez, Daisuke Takahari, Wasat Mansoor, Peter C Enzinger, Vera Gorbounova, Zev A Wainberg, Susanna Hegewisch-Becker, David Ferry, Ji Lin, Roberto Carlesi, Mayukh Das, Manish A Shah
BACKGROUND: VEGF and VEGF receptor 2 (VEGFR-2)-mediated signalling and angiogenesis can contribute to the pathogenesis and progression of gastric cancer. We aimed to assess whether the addition of ramucirumab, a VEGFR-2 antagonist monoclonal antibody, to first-line chemotherapy improves outcomes in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma. METHODS: For this double-blind, randomised, placebo-controlled, phase 3 trial done at 126 centres in 20 countries, we recruited patients aged 18 years or older with metastatic, HER2-negative gastric or gastro-oesophageal junction adenocarcinoma, an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and adequate organ function...
February 1, 2019: Lancet Oncology
Lisa Duffett, Clive Kearon, Marc Rodger, Marc Carrier
BACKGROUND:  The optimal first line treatment for patients with isolated superficial venous thrombosis (SVT) of the lower extremity is unknown. OBJECTIVE:  This article reports estimates of the rate of venous thromboembolic complications among patients with SVT according to treatment. MATERIALS AND METHODS:  A systematic review and meta-analysis was performed using unrestricted searches of electronic databases. Reported events were transformed to event per 100 patient-years of follow-up and a random effects model was used to calculate pooled rates according to pre-specified treatment categories...
February 4, 2019: Thrombosis and Haemostasis
Ahmet Öz, Tufan Çınar, Mert İlker Hayıroğlu, Şahin Avşar, Muhammed Keskin, Ahmet Lütfüllah Orhan
INTRODUCTION AND OBJECTIVES: Prior studies demonstrated that plasma osmolality may have a predictive value for in-hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in-hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in-hospital mortality in patients with APE...
February 3, 2019: Clinical Respiratory Journal
Gergely Varga, Zsolt Nagy, Judit Demeter, Szabolcs Kosztolányi, Árpád Szomor, Hussain Alizadeh, Beáta Deák, Tamás Schneider, Márk Plander, Tamás Szendrei, László Váróczy, Árpád Illés, Árpád Bátai, Mónika Pető, Gábor Mikala
Ixazomib-Revlimid-Dexamethasone is an all-oral treatment protocol for multiple myeloma with a manageable tolerability profile which was available through a named patient program for Hungarian patients from December 2015 to April 2017. We analyzed the clinical characteristics and survival of 77 patients treated at 7 centers within this program. The majority of patients responded, we found complete response in 9, very good partial response in 8, partial response in 32, minor response or stable disease in 13 and progressive disease in 11 patients...
February 2, 2019: Pathology Oncology Research: POR
Melina Stüssi-Helbling, Mattia Arrigo, Lars C Huber
Significant improvement has been achieved in diagnostic accuracy, validation of probability scores and standardized treatment algorithms for patients with suspected acute pulmonary embolism. These developments have provided the tools for a safe and cost-effective management for most of these patients. To our experience, however, the presence of medical myths and ongoing controversies appear to hinder the implementation of these tools in everyday clinical practice. This review provides a selection of such dilemmas and controversies and discusses the published evidence beyond them...
January 30, 2019: American Journal of Medicine
Catarina Faria, Henedina Antunes, Teresa Pontes, Ana Antunes, Sofia Martins, Susana Carvalho
Background Venous thromboembolism (VTE) - which includes deep venous thrombosis (DVT) and pulmonary embolism (PE) - has been increasingly recognized in the pediatric population. The estimated incidence is 0.07-0.14 cases per 10,000 children. Most cases are associated with two or more risk factors. Medium and long-term complications include recurrence and post-thrombotic syndrome (PTS). Objective To characterize the adolescent population with the diagnosis of DVT of lower limbs in a tertiary hospital, regarding its clinical presentation, associated risk factors, treatment and outcome...
February 1, 2019: International Journal of Adolescent Medicine and Health
Teemu V Karjalainen, Nitin B Jain, Cristina M Page, Tuomas A Lähdeoja, Renea V Johnston, Paul Salamh, Lauri Kavaja, Clare L Ardern, Arnav Agarwal, Per O Vandvik, Rachelle Buchbinder
BACKGROUND: Surgery for rotator cuff disease is usually used after non-operative interventions have failed, although our Cochrane Review, first published in 2007, found that there was uncertain clinical benefit following subacromial decompression surgery. OBJECTIVES: To synthesise the available evidence of the benefits and harms of subacromial decompression surgery compared with placebo, no intervention or non-surgical interventions in people with rotator cuff disease (excluding full thickness rotator cuff tears)...
January 17, 2019: Cochrane Database of Systematic Reviews
David Jiménez, Alvar Agustí, Manuel Monreal, Remedios Otero, Menno V Huisman, José Luis Lobo, Andrés Quezada, Luis Jara-Palomares, Ascensión Hernando, Eva Tabernero, Pedro Marcos, Pedro Ruiz-Artacho, Aitor Ballaz, Laurent Bertoletti, Francis Couturaud, Roger Yusen
INTRODUCTION: Some previous studies have suggested a high prevalence of pulmonary embolism (PE) during exacerbations of chronic obstructive pulmonary disease (ECOPD). The SLICE trial aims to assess the efficacy and safety of an active strategy for the diagnosis and treatment of PE (vs. usual care) in patients hospitalized because of ECOPD. METHODS AND ANALYSES: SLICE is a phase III, prospective, international, multicenter, randomized, open-label, parallel-group trial...
February 1, 2019: Clinical Cardiology
Atsuna Fukuda, Takeshi Isoda, Naoya Sakamoto, Keisuke Nakajima, Tetsuya Ohta
BACKGROUND: Finding an abdominal mass or hematuria is the initial step in diagnosing Wilms tumor. As the first manifestation of Wilms tumor, it is exceedingly rare for pulmonary tumor embolism to present with cardiac arrest. A case of a patient whose sudden cardiac arrest due to massive pulmonary tumor embolism of Wilms tumor was not responsive to resuscitation is presented. CASE PRESENTATION: The patient was a five-year-old girl who collapsed suddenly during activity in nursery school and went into cardiac arrest in the ambulance...
January 31, 2019: BMC Pediatrics
P L Song, X H Wang, H Chen
No abstract text is available yet for this article.
February 12, 2019: Chinese Journal of Tuberculosis and Respiratory Diseases
Alejandro Brañes, Matias Orellana, Rodrigo Muñoz
INTRODUCTION: Venous thromboembolism (VTE) in bariatric surgery is a low incidence disease; however, it is the first cause of morbimortality in this group of patients. PRESENTATION OF THE CASE: We present the case of a female patient with morbid obesity who was readmitted due to an acute submassive bilateral pulmonary embolism (PE) nineteen days after a laparoscopic Roux-en-Y gastric bypass (RYGB). After diagnosis, anticoagulation was initiated, and decision to add mechanical and pharmacological thrombolysis was made with the patient been successfully treated, as shown by normalization of pulmonary hypertension...
January 19, 2019: International Journal of Surgery Case Reports
C Kamath, J Witczak, M A Adlan, L D Premawardhana
Thymic enlargement (TE) in Graves' disease (GD) is often diagnosed incidentally when chest imaging is done for unrelated reasons. This is becoming more common as the frequency of chest imaging increases. There are currently no clear guidelines for managing TE in GD. Subject 1 is a 36-year-old female who presented with weight loss, increased thirst and passage of urine and postural symptoms. Investigations confirmed GD, non-PTH-dependent hypercalcaemia and Addison's disease (AD). CT scans to exclude underlying malignancy showed TE but normal viscera...
January 31, 2019: Endocrinology, Diabetes & Metabolism Case Reports
A L Melikyan, I N Subortseva, E A Gilyazitdinova, T I Koloshejnova, E I Pustovaya, E K Egorova, A M Kovrigina, A B Sudarikov, A O Abdullaev, E G Lomaia, N T Siordiya, A Yu Zaritskey, V G Savchenko
AIM: A comparative evaluation of the effectiveness of different therapeutic strategies in patients with polycythemia vera (PV) and essential thrombocythemia (ET). MATERIALS AND METHODS: Patients with PV or ET, diagnosed according to the criteria WHO 2016 were included in the study. The primary endpoint - 6 months of therapy (clinical-hematological and molecular responses). The secondary endpoint - 12 months of therapy (clinico-hematologic, molecular, histological responses)...
August 17, 2018: Terapevticheskiĭ Arkhiv
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