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Total 576 results found since Jan 2013.

Health systems organization for emergency care
Abstract: The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, r...
Source: Best Practice and Research. Clinical Gastroenterology - October 1, 2013 Category: Gastroenterology Authors: Isabel Pedroto, Pedro Amaro, José Manuel Romãozinho Tags: Chapters Source Type: research

Dabigatran Use in the Real World: A Multihospital System Experience
Dabigatran etexilate, an oral direct thrombin inhibitor, was approved by the Food and Drug Administration to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation based on the outcomes of the Randomized Evaluation of Long-term anticoagulant therapY (RE-LY) study. Although this study provides robust data on the efficacy and safety of dabigatran, there may be differences in the drug use and outcomes in routine clinical practice following drug approval. In this retrospective chart review study, we describe the use of dabigatran in 160 patients in 4 adult hospitals (1 academic and 3 c...
Source: Journal of Pharmacy Practice - August 4, 2014 Category: Drugs & Pharmacology Authors: Kimmons, L. A., Kabra, R., Davis, M., Segars, B. V., Oliphant, C. S. Tags: Research Articles Source Type: research

Efficacy and Safety of Novel Oral Anticoagulants in Patients with Cervical Artery Dissections
We report on the use, safety, and efficacy of NOACs in the treatment of CAD. Methods: We retrospectively identified patients diagnosed with CAD at a single academic center between January 2010 and August 2013. Patients were categorized by their antithrombotic treatment at hospital discharge with a NOAC (dabigatran, rivaroxaban, or apixaban), traditional anticoagulant (AC: warfarin or treatment dose low-molecular weight heparin), or antiplatelet agent (AP: aspirin, clopidogrel, or aspirin/extended-release dypyridamole). Using appropriate tests, we compared the baseline medical history, presenting clinical symptoms and initi...
Source: Cerebrovascular Diseases - November 12, 2014 Category: Neurology Source Type: research

Early and late clinical outcomes of endovascular, surgical, and hybrid revascularization strategies of combined carotid and coronary artery diseases: the FRIENDS study group (Finalized Research In ENDovascular Strategies)
The best therapeutic strategy for patients with concomitant carotid obstructive disease (COD) and coronary artery disease (CAD) remains controversial. The aim of the study is to observe post-procedural and 1-year clinical outcomes of patients with COD and CAD after an endovascular, surgical, or a combined (hybrid) revascularization approach, selected by consensus of a multidisciplinary team. Between January 2006 and December 2012, 1043 consecutive patients with COD and concomitant CAD were treated. According to treatment strategies, patients were divided into three groups: surgical: 391 patients (37.1%), endovascular: 502 ...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Castriota, F., Tomai, F., Gabrio Secco, G., Reimers, B., Piccoli, A., De Persio, G., Pesarini, G., Schiavina, G., Borioni, R., Pacchioni, A., Cremonesi, A., Vassanelli, C., Ribichini, F. Tags: Articles Source Type: research

Idaho mom goes the distance to help teen with scoliosis
“You want a hospital with the best technology and the best nurses and doctors in the country. You expect that, and you expect it to be clean. Boston Children’s has all of that,” says Lisa Findlay, a mom from Hayden, Idaho. “What made the difference was how much everyone loves these kids. Everyone who walked into Aaron’s room, from the surgeons to nurses’ aides to janitors and child life specialists, was on a mission to help Aaron.” From the time he was born, Aaron encountered one medical challenge after another. He was born with hypoplastic left heart syndrome (HLHS), a serious congenital heart defect. By...
Source: Thrive, Children's Hospital Boston - April 2, 2015 Category: Pediatrics Authors: Lisa Fratt Tags: Orthopedics Our patients’ stories Source Type: news

Outcome of Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection: As Systematic Review and Meta-Analysis
Abstract: Acute aortic dissections of Stanford type A require emergency surgery repair and present challenges to surgeons. The frozen elephant technique is one of several approaches used to treat aortic arch dissection. The purpose of this meta-analysis was to investigate the clinical effectiveness of the frozen elephant technique for treating acute type A aortic dissection. Medline, Cochrane, Google Scholar, and ClinicalTrials.gov databases were searched up to March 31, 2014, for studies that assessed the use of frozen elephant trunk technique for treating acute type A aortic dissection. The primary outcome was in-hospita...
Source: Medicine - April 1, 2015 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research

HeartWare completes enrollment in Endurance2 HVAD trial
HeartWare International (NSDQ:HTWR) said today it completed enrollment of its Endurance 2 destination therapy trial of its HeartWare ventricular assist system. The trial seeks to examine the rate of stroke in patients treated with HeartWare’s HVAD device as well as optimal blood pressure management, the company said. Data from the 465-patient supplemental cohort trial will be used to support pre-market approval for the HeartWare HVAD as a destination therapy system intended for long term use, according to the Framingham, Mass.-based company. The device is currently FDA approved for bridge-to-transplant applications....
Source: Mass Device - August 10, 2015 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Clinical Trials Regulatory/Compliance Surgical HeartWare International Inc. Source Type: news

A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience
Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on o...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Kumar, R., Smith, R. E., Henry, B. L. Tags: Analytic Reviews Source Type: research

Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial
This study is registered with ClinicalTrials.gov, number NCT01255540. Findings During a median follow-up of 1·53 years of participants recruited between Dec 10, 2010, and Feb 21, 2014, the primary outcome occurred in 93 (40·6%) of 229 patients assigned to the invasive group and 140 (61·4%) of 228 patients assigned to the conservative group (hazard ratio [HR] 0·53 [95% CI 0·41–0·69], p=0·0001). Five patients dropped out of the invasive group and one from the conservative group. HRs for the four components of the primary composite endpoint were 0·52 (0·35–0·76; p=0·0010) for myocardial infarction, 0·19 (0·0...
Source: The Lancet - January 13, 2016 Category: Journals (General) Source Type: research

Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

Managing reversal of direct oral anticoagulants in emergency situations. Anticoagulation Education Task Force White Paper.
This report is based on findings from the Anticoagulation Education Task Force, which brought together patient groups and professionals representing different medical specialties with an interest in patient safety and expertise in AF, VTE, stroke, anticoagulation, and reversal agents, to discuss the current status of anticoagulation reversal and fundamental changes in management of bleeding associated with DOACs occasioned by the approval of idarucizumab, a specific reversal agent for dabigatran, as well as recent clinical data on specific reversal agents for factor Xa inhibitors. Recommendations are given for when there i...
Source: Thrombosis and Haemostasis - August 3, 2016 Category: Hematology Authors: Ageno W, Büller HR, Falanga A, Hacke W, Hendriks J, Lobban T, Merino J, Milojevic IS, Moya F, van der Worp HB, Randall G, Tsioufis K, Verhamme P, Camm AJ Tags: Thromb Haemost Source Type: research

Comparative effectiveness and safety of oral anticoagulants for atrial fibrillation in real-world practice: a population-based cohort study protocol
Introduction Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa. ...
Source: BMJ Open - November 23, 2016 Category: Journals (General) Authors: Holbrook, A., Dormuth, C., Morrow, R., Lee, A., Troyan, S., Li, G., Pullenyegum, E. Tags: Open access, Cardiovascular medicine, Pharmacology and therapeutics Protocol Source Type: research

Anticoagulation therapy in elderly patients with atrial fibrillation: results from the Registry of Atrial Fibrillation To Investigate the Implementation of New Guidelines (RAFTING)
Background: Patients with atrial fibrillation aged 75 years or older have a CHA2DS2VASc score that dictates oral anticoagulants. We recorded physicians’ anticoagulation attitudes in elderly patients with atrial fibrillation and assessed the impact of stroke and bleeding risk. Methods: Atrial Fibrillation To Investigate the Implementation of New Guidelines , a countrywide prospective registry performed in Greece during 2010, a period when only vitamin-K antagonists (VKA) were available, enrolled 1127 patients with atrial fibrillation diagnosis during Emergency Departments visit in 31 representative hospitals; 807 patient...
Source: Journal of Cardiovascular Medicine - May 18, 2017 Category: Cardiology Tags: Research articles Source Type: research

Stent Versus Non-Stent in Treating Intermediate Stenosis Culprit Lesions in Acute ST-Segment Elevation Myocardial Infarction Patients.
Authors: Dai J, Lyu S, Song X, Zhang M, Nie S, Gao H, Zeng Y, Wang W, Zhang M, Zhang D, Tian J Abstract To investigate the efficacy and safety of stent versus non-stent in treating acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel disease and intermediate stenosis culprit lesions.Between September 2009 and May 2015, 475 acute STEMI patients (time from symptom onset < 12 hours) with single vessel disease and intermediate stenosis culprit lesions were retrospectively studied at Beijing Anzhen Hospital. The patients were divided into a stent group (n = 308) and non-stent group (n ...
Source: International Heart Journal - May 26, 2017 Category: Cardiology Tags: Int Heart J Source Type: research

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study
Publication date: Available online 13 June 2017 Source:The Lancet Author(s): Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell Background Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70–90%, uptake is low and guidelines are conflicti...
Source: The Lancet - June 15, 2017 Category: General Medicine Source Type: research