‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF

Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below are 10 important take-aways from the 2018 EHRA NOAC Practical Guide:NOACs can generally be used in patients withvalvular heart disease except patients with mechanical heart valves or rheumatic mitral stenosis.TheEHRA NOAC card is recommended to be distributed to patients on NOACs at initiation and during follow-up.Proper education and patient-tailored approaches (e.g. pill-box; calendar; electronic reminders) should be used toensure optimal adherence to the prescribed NOAC regimen.Whenever possible, the tested standard dose of NOACs should be used to provide optimal benefit for the patient.Dose reduction of NOACs is primarily guided by the dose reduction criteria used in the large phase III trials.Check for possibledrug –drug interactions in every patient (started) on a NOAC. Explore alternative drugs (NOACs and others) in case of relevant inte...
Source: European Heart Journal - Category: Cardiology Source Type: research

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Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
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Source: Sensing and Bio Sensing Research - Category: Research Source Type: research
Publication date: Available online 14 October 2019Source: NeuroImage: ClinicalAuthor(s): Robert Loughnan, Diego L. Lorca-Puls, Andrea Gajardo-Vidal, Valeria Espejo-Videla, Céline R. Gillebert, Dante Mantini, Cathy J. Price, Thomas M.H. HopeAbstractAround a third of stroke survivors suffer from acquired language disorders (aphasia), but current medicine cannot predict whether or when they might recover. Prognostic research in this area increasingly draws on datasets associating structural brain imaging data with outcome scores for ever-larger samples of stroke patients. The aim is to learn brain-behavior trends from ...
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
ConclusionAs expected, the postoperative hip function is similar, but patients’ preference is not. The latter result might be true or possibly influenced by preoperative psychological factors and mental health. The DAA and the posterolateral or direct lateral approaches have shown to lead to a similar hip function, but a majority of patients subjectively prefer the DAA.Level of evidenceIII.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Publication date: November–December 2019Source: Journal of Orthopaedics, Volume 16, Issue 6Author(s): Bhaveen H. Kapadia, Barrett B. Torre, Nicholas Ullman, Andrew Yang, Matthew A. Harb, Preston W. Grieco, Jared M. Newman, Steven F. Harwin, Aditya V. MaheshwariAbstractTotal hip and knee arthroplasties may be associated with a significant amount of perioperative blood loss. The severity of blood loss may be great enough to require the use of blood transfusions to treat perioperative anemia. Various methods of blood preservation have been studied. The use of antifibrinolytics and antifibrinolytic-like agents to reduce ...
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
Publication date: Available online 14 October 2019Source: Journal of Orthopaedic TranslationAuthor(s): Bing Chen, Bin Zi, Ling Qin, Qiaosheng PanAbstractAgeing population is now a global challenge, where physical deterioration is the common feature in elderly people. In addition, the diseases, such as spinal cord injury, stroke, and injury, could cause a partial or total loss of the ability of human locomotion. Thus, assistance is necessary for them to perform safe activities of daily living. Robotic hip exoskeletons are able to support ambulatory functions in elderly people and provide rehabilitation for the patients with...
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
Authors: Aoun J, Hattar L, Dgaily K, Wong G, Bhat T Abstract Introduction: Transradial cardiac catheterization (TRA) was introduced in 1989 and has been universally used as an alternative approach to the traditional transfermoral access (TFA). Complications of TRA include asymptomatic and less likely symptomatic radial artery occlusion, nonocclusive radial artery injury, radial artery spasm, radial arterial perforation, radial artery pseudoaneurysm, arteriovenous fistula, granuloma formation, access-site bleeding, nerve damage, complex regional pain syndrome along with other rare complications. Areas covered: A lit...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
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Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionThis study supports the strong association between high BMI and endometrial cancer. Despite obesity presenting significant surgical challenges, complication rates are low considering the patient demographic. The shortest median length of stay was with vaginal and laparoscopic hysterectomy. Preoperative grading and staging are relatively accurate in our department. Confirmed recurrence rates are low, although a significant proportion of patients are still in follow-up. Clinical follow-up is not useful in detecting recurrence in the majority of patients, which supports a Self Directed Aftercare approach in the majo...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: November–December 2019Source: Journal of Minimally Invasive Gynecology, Volume 26, Issue 7, SupplementAuthor(s): T Guo, C Liu, Z ZhangStudy ObjectiveThe aim of this study was to examine the applicability of the Caprini risk assessment model and gynecologic Caprini risk assessment model for postoperative venous thromboembolism risk assessment in gynecologic surgical patients and make a comparison between the two risk assessment models.DesignA database of a randomized controlled trial was employed. Scores of Caprini and gynecologic Caprini risk assessment model were calculated for each patient. Patien...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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