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Primary Prevention Asa

Dong-Hwa Lee, Eun Ju Chun, Tae Jung Oh, Kyoung Min Kim, Jae Hoon Moon, Sung Hee Choi, Kyong Soo Park, Hak Chul Jang, Soo Lim
AIM: Cilostazol is an antiplatelet agent with multiple beneficial metabolic effects via inhibition of phosphodiesterase-3 in vascular smooth muscle cells, cardiomyocytes, adipose tissue, and platelets. We performed a prospective study to evaluate the effect of cilostazol compared with aspirin in Korean diabetic patients with subclinical coronary atherosclerosis. MATERIALS AND METHODS: One hundred diabetic patients who had mild-to-moderate coronary atherosclerosis assessed by coronary computed tomographic angiography were randomly assigned to either 200 mg/day cilostazol(CTZ) or 100 mg/day aspirin(ASA) groups (n=50 each)...
February 13, 2019: Diabetes, Obesity & Metabolism
Anthony S Kim, J Donald Easton
Stroke symptoms can be unsettling, even when symptoms resolve, but focusing on stroke prevention can be empowering provided that effective interventions for appropriate patient populations are available. Current options include interventions for symptomatic carotid artery stenosis, anticoagulation for atrial fibrillation, high-dose statins, new oral anticoagulants, new developments in atrial fibrillation detection, and new therapeutics are in development. For antiplatelet therapy, aspirin monotherapy is effective but dual antiplatelet therapy with the combination of aspirin and clopidogrel increases hemorrhage risks over the long term that outweigh potential benefits...
February 6, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
Jodi R DeGrote, Elizabeth M Olafson, Alexander Drofa, Evgueni Kouznetzov, Michael Manchak, Nathan D Leedahl, David D Leedahl
Background: Dual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y12-receptor antagonist is often used to prevent thrombotic complications after placement of a Pipeline embolization device (PED) for cerebral aneurysm. Although clopidogrel is common in this setting, high rates of nonresponse to this drug have made ticagrelor a potentially attractive alternative. Objective: To describe safety and efficacy outcomes for ticagrelor following PED placement, including measurement of platelet function...
November 2018: Canadian Journal of Hospital Pharmacy
Siddharth Singh, Joseph D Feuerstein, David G Binion, William J Tremaine
Most patients with ulcerative colitis (UC) have mild to moderate disease activity, with low risk of colectomy, and are managed by primary care physicians or gastroenterologists. Optimal management of these patients decreases the risk of relapse and proximal disease extension, and may prevent disease progression, complications and need for immunosuppressive therapy. With several medications (sulfasalazine, diazo-bonded 5-aminosalicylates [ASA], mesalamines, corticosteroids including budesonide, etc.) and complex dosing formulations, regimens and routes, to treat a disease with variable anatomic extent, there is considerable practice variability in the management of patients with mild-moderate UC...
December 18, 2018: Gastroenterology
Nicholas E Burr, Barry Hall, P John Hamlin, Christian P Selinger, Alexander C Ford, Anthony O'Connor
Background and Aims: Surgery is an important treatment for Crohn's disease (CD) but recurrence occurs in up to 80% of individuals post-operatively. The efficacy of several drugs to prevent post-operative recurrence has been studied in previous meta-analyses, but a number of randomised controlled trials (RCTs) have recently been published. We therefore performed an updated systematic review and network meta-analysis to investigate this issue. Methods: We performed a comprehensive literature search through to July 2018 to identify RCTs investigating the endoscopic and clinical recurrence of CD at 12 months post-operatively...
December 14, 2018: Journal of Crohn's & Colitis
Giacomo Zoppellaro, Nicola Veronese, Serena Granziera, Laura Gobbi, Brendon Stubbs, Alexander T Cohen
BACKGROUND: Multiple myeloma (MM) is a common hematological disorder, often complicated by venous thromboembolism, especially during treatment with immunomodulatory drugs. Acetylsalicylic acid (ASA) has been extensively used as thromboprophylaxis but its rationale is unclear and the efficacy versus low-molecular weight heparins (LMWH) is still matter of debate. European and American guidelines suggest different approaches and the optimal antithrombotic strategy is yet to be established...
October 2018: Seminars in Hematology
Egui Zhu, Uno Fors, Åsa Smedberg
BACKGROUND: Antimicrobial resistance (AMR) is a growing public health threat. Primary care physicians are important inducers of the overuse of antimicrobials and inappropriate prescribing. Augmented reality (AR) might provide a potential educational tool in health care. The aim of this study was to identify the need for education and expectations for AR-based education in the context of improving the rational use of antibiotics by primary care physicians in China. METHODS: The study used a qualitative approach based on face-to-face interviews with eleven physicians from three community health service centers and stations in China...
November 14, 2018: BMC Health Services Research
Ilaria Maestrini, Marta Altieri, Laura Di Clemente, Edoardo Vicenzini, Patrizia Pantano, Eytan Raz, Mauro Silvestrini, Leandro Provinciali, Isabella Paolino, Carmine Marini, Matteo Di Giuseppe, Tommasina Russo, Francesco Federico, Cristiana Coppola, Maria Pia Prontera, Domenico Maria Mezzapesa, Vincenzo Lucivero, Lucilla Parnetti, Paola Sarchielli, Maria Peducci, Domenico Inzitari, Giovanna Carlucci, Carlo Serrati, Carla Zat, Anna Cavallini, Alessandra Persico, Giuseppe Micieli, Stefano Bastianello, Vittorio Di Piero
Background: We investigated low-dose aspirin (ASA) efficacy and safety in subjects with silent brain infarcts (SBIs) in preventing new cerebrovascular (CVD) events as well as cognitive impairment. Methods: We included subjects aged ≥45 years, with at least one SBI and no previous CVD. Subjects were followed up to 4 years assessing CVD and SBI incidence as primary endpoint and as secondary endpoints: (a) cardiovascular and adverse events and (b) cognitive impairment...
2018: Stroke Research and Treatment
Davor Stamenovic, Thomas Schneider, Antje Messerschmidt
OBJECTIVES: Acetylsalicylic acid (ASA, aspirin) is a medication widely used for primary and secondary prevention of cardiovascular diseases, which are the leading cause of morbidity and mortality worldwide. Whether aspirin should be continued or paused in the perioperative period remains controversial, especially in thoracic surgical settings. METHODS: A single-centred retrospective study comprised 486 patients. Of these, 329 patients did not use aspirin (group ASA-0) and 157 did (group ASA-1) during the perioperative period after anatomical lung resection at our hospital from January 2013 to December 2016...
October 20, 2018: Interactive Cardiovascular and Thoracic Surgery
Nobuhito Nakamura, Takahiro Mihara, Toshiyuki Hijikata, Takahisa Goto, Koui Ka
BACKGROUND: Emergence agitation (EA) is a frequent phenomenon in children recovering from general anaesthesia and increases the risk of self-injury. Previously, our group reported that stimulating the heart 7 (HT7) acupuncture point bilaterally using two neuromuscular transmission monitoring devices (NTMs) decreased the incidence of EA. However, bilateral stimulation is a barrier to clinical use because two NTMs are needed for one patient. OBJECTIVE: The objective of this study was to examine the efficacy of unilateral electrical stimulation of HT7 using an NTM to prevent EA in children...
2018: PloS One
Tiago Lemos Cerqueira, Armando Fartolino Guerrero, Clara Krystal Pérez Fermin, Ricardo Wang, Evelin Elfriede Balbino, Janis L Breeze, Paola Gonzalez Mego, Daniele Argentina Silva, Walid Ezzeldin Omer, Nathalie Monique Vandevelde
BACKGROUND: End-stage renal disease (ESRD) is the last stage of chronic kidney disease, mainly caused by type 2 diabetes mellitus and characterized by an increased mortality risk related to cardiovascular disease. Low-dose aspirin (acetylsalicylic acid or ASA) seems to effectively prevent cardiovascular events in patients with ESRD. However, the number of interventional studies in this population remains limited and the mechanisms of aspirin-related bleeding remain poorly understood. Aspirin's efficacy and safety may be modified by the presence of type 2 diabetes mellitus or platelet hyperreactivity...
August 9, 2018: JMIR Research Protocols
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Anders Beckman, Patrik Midlöv
BACKGROUND: Drug use among the elderly population is generally extensive and the use of potentially inappropriate medications (PIMs) is common, which increases the risk for drug-related problems (DRP). Medication reviews are one method to improve drug therapy by identifying, preventing and solving DRPs. The aim of this study was to evaluate the effect of medication reviews on total drug use and potentially inappropriate drug use in elderly patients, as well as describe the occurrence and types of drug-related problems...
August 7, 2018: BMC Health Services Research
Malgorzata M Bala, Elżbieta Paszek, Wiktoria Lesniak, Dorota Wloch-Kopec, Katarzyna Jasinska, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by the presence of antiphospholipid (aPL) antibodies that have prothrombotic activity. Antiphospholipid antibodies are associated with an increased risk of pregnancy complications (recurrent miscarriage, premature birth, intrauterine growth retardation) and thrombotic events (both arterial and venous). The most common thrombotic events include brain ischaemia (stroke or transient ischaemic attack) and deep vein thrombosis...
July 13, 2018: Cochrane Database of Systematic Reviews
Beata Krasinska, Angelika Osińska, Maciej Osinski, Aleksandra Krasinska, Piotr Rzymski, Andrzej Tykarski, Zbigniew Krasiński
Introduction: Cardiovascular (CV) diseases remain a leading global cause of death. It has been proven that the use of acetylsalicylic acid (ASA) in secondary prevention reduces the CV risk, while the benefits of ASA in primary prevention have recently been debated. The aim of the study was to compare the antiplatelet effect of standardised tomato extract (STE) and ASA in hypertensive patients with high CV risk. Material and methods: The study involved high-risk patients with arterial hypertension (AH) randomly assigned to one of two groups: group 1 included 33 patients receiving ASA and group 2 included 32 patients receiving STE...
June 2018: Archives of Medical Science: AMS
Ashwin Sunil Tamhankar, Saurabh Ramesh Patil, Puneet Ahluwalia, Gagan Gautam
OBJECTIVE: To evaluate the perioperative outcomes and 90-day complication rates of continuation of low-dose aspirin through surgery in patients undergoing robot-assisted radical prostatectomy (RARP). A significant proportion of patients undergoing RARP are on antiplatelet medications for primary or secondary prevention of cardiovascular events. However, there is still a relative lack of data with regard to the advantages and complications of continuing these medications through surgery...
September 12, 2018: Journal of Endourology
Nguyen Toan Tran, Mary Eluned Gaffield, Armando Seuc, Sihem Landoulsi, Wambi Maurice E Yamaego, Asa Cuzin-Kihl, Seni Kouanda, Blandine Thieba, Désiré Mashinda, Rachel Yodi, James Kiarie, Suzanne Reier
BACKGROUND: Postpartum family planning (PPFP) information and services can prevent maternal and child morbidity and mortality in low-resource countries, where high unmet need for PPFP remains despite opportunities offered by routine postnatal care visits. This study aims to identify a package of PPFP interventions and determine its effectiveness on the uptake of contraceptive methods during the first year postpartum. We hypothesize that implementing a PPFP intervention package that is designed to strengthen existing antenatal and postnatal care services will result in an increase in contraceptive use...
June 11, 2018: BMC Health Services Research
Xi Chen, Shi-Dong Chen, Yi Dong, Qiang Dong
BACKGROUND: Previous review from randomized controlled trials (RCT) showed that patients with cryptogenic stroke may benefit from patent foramen ovale (PFO) closure. However, the findings from the systematic review were not clear when observational studies were also included. METHODS: We searched MEDLINE, Embase, and Cochrane databases. The primary endpoints were recurrent stroke or transient ischemic attack (TIA). The secondary outcomes were all-cause death, atrial fibrillation (AF), and hemorrhagic events...
October 2018: CNS Neuroscience & Therapeutics
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
July 2018: Diseases of the Colon and Rectum
Ahmed S Yassin, Hossam Abubakar, Tushar Mishra, Ahmed Subahi, Melanie Hartman, Abdelrahman Ahmed, Walid Ibrahim, Manmohan Singh, Mohit Pahuja
BACKGROUND: Aspirin (ASA) is the most used medication on the globe. ASA is a primary pillar of the secondary prevention of cardiovascular atherothromboembolic events. However, a fraction of the population does not respond to ASA as expected in a unique phenomenon called ASA resistance. Multiple mechanisms were described and studied in the literature to explain this phenomenon. AREA OF UNCERTAINTY: ASA resistance is an interesting phenomenon that is worth studying and reviewing...
May 3, 2018: American Journal of Therapeutics
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