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Specialty: Internal Medicine
Condition: Thrombosis

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Total 353 results found since Jan 2013.

Morphology and histology of silent and symptom-causing atherosclerotic carotid plaques - Rationale and design of the Helsinki Carotid Endarterectomy Study 2 (the HeCES2).
This article provides a detailed study design and protocol of HeCES2, an observational prospective cohort study with the objective to investigate the pathophysiology of carotid atherosclerosis. MATERIALS AND METHODS: Recruitment and carotid endarterectomies of the study patients with carotid atherosclerosis were performed from October 2012 to September 2015. After brain and carotid artery imaging, endarterectomised carotid plaques (CPs) and blood samples were collected from 500 patients for detailed biochemical and molecular analyses. Findings to date: We developed a morphological grading for macroscopic characteristic...
Source: Annals of Medicine - July 18, 2018 Category: Internal Medicine Tags: Ann Med Source Type: research

Resolution of left ventricular thrombus by edoxaban after failed treatment with warfarin overdose: A case report
Rationale: Although novel oral-anticoagulants are widely used in patients with atrial fibrillation (AF) for stroke prevention, there was only limited evidence for their use in left ventricular (LV) thrombus. Patient concerns: A 41-year-old man who presented with acute onset of right-hand clumsiness and aphasia even under high international normalized ratio (INR: 7.64) from warfarin use. He was previously treated with warfarin for the LV thrombus and non-valvular AF. Brain magnetic resonance imaging (MRI) showed multiple acute infarction in the cortex of the bilateral frontal lobes, left parietal lobe, and bilateral ce...
Source: Medicine - January 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Management of paradoxical embolism in a patient with coexisting patent foramen ovale and masked pulmonary arteriovenous fistula: A case report
Rationale: Paradoxical embolism (PE) is an important cause of cryptogenic stroke, particularly in young patients, which usually have a relation with an unexpected route in circulation. Here we report a rare case of cryptogenic stroke carried 2 uncommon malformations. Patient concerns: A 48-year-old female experienced double neurological events in just 2 months. Diagnosis: Patent foramen ovale was diagnosed with transesophageal echocardiography and successfully occluded in the first admission due to stroke. In the second admission, chest tomographic angiography found a chordae shadow in the right middle lobe, was th...
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Does the CHA2DS2-VASc scale sufficiently predict the risk of left atrial appendage thrombus in patients with diagnosed atrial fibrillation treated with non-vitamin K oral anticoagulants?
The CHA2DS2-VASc scale does not include potential risk factors for left atrial appendage thrombus (LAAT) formation such as a form of atrial fibrillation (AF) and impaired kidney function. The real risk of thromboembolic complications in AF patients is still unclear as well as an optimal anticoagulant treatment in males with a CHA2DS2-VASc score of 1 and females with a CHA2DS2-VASc score of 2. The aim of this study was to compare the predictive value of the CHA2DS2-VASc scale and other scales to estimate the risk of LAAT formation in AF patients treated with non-vitamin K oral anticoagulants (NOACs) and to assess the preva...
Source: Medicine - June 19, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Anticoagulant management by low-dose of low molecular weight heparin in patients with nonvalvular atrial fibrillation following hemorrhagic transformation and complicated with venous thrombosis: Five case reports and literature review
For patients with nonvalvular atrial fibrillation (NVAF) following hemorrhagic infarction (HI)/hemorrhage transformation (HT) and complicated with venous thrombosis, the management of anticoagulation is controversial. Our study intends to explore the safety and effectiveness of using low-dose of low molecular weight heparin (LMWH) to treat NVAF patients with HI (or HT) and complicated with venous thrombosis. Between January 2018 and January 2019, NVAF related acute ischemic stroke patients with HT/HI, hospitalized in the department of neurology or rehabilitation in our hospital, are enrolled retrospectively. Among them,...
Source: Medicine - February 19, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale: Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization. Patient concerns: A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission. Diagnoses: Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA. Interventions: Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

In recently postmenopausal women, HRT reduced a composite of death, MI, or heart failure at 10 years.
CONCLUSION In recently postmenopausal women, hormone replacement therapy reduced a composite of death, myocardial infarction, or heart failure after 10 years of therapy and an additional 6 years of follow-up.Hormone replacement therapy (HRT) vs no HRT in recently postmenopausal women†OutcomesEvent ratesAfter 10 y of therapyHRTNo HRTRRR (95% CI)NNT (CI)Death, MI, or HF‡3.2%6.5%50% (11 to 72)31 (22 to 144)At 16 yDeath, MI, or HF§6.6%11%37% (4 to 59)26 (17 to 251)†HF = heart failure; MI = myocardial infarction; other abbreviations defined in Glossary. RRR, NNT, and CI calculated from event rates and hazard ratios in ar...
Source: Annals of Internal Medicine - February 19, 2013 Category: Internal Medicine Authors: Cheung AM Tags: Ann Intern Med Source Type: research

Elevated mean platelet volume is associated with silent cerebral infarction
ConclusionMPV is a novel index for SCI regardless of classical cardiovascular risk factors.
Source: Internal Medicine Journal - April 21, 2014 Category: Internal Medicine Authors: Bing Li, Xin Liu, Zhi‐gang Cao, Ying Li, Tie‐min Liu, Rui‐tao Wang Tags: Original Article Source Type: research

Anticoagulant Prescription in Patients With AF
In patients with atrial fibrillation (AF) who are at risk for thromboembolism, anticoagulation therapy with warfarin or the newer novel anticoagulants reduces morbidity and mortality. Because oral anticoagulant use carries a risk of bleeding, the drugs are not recommended in patients with AF who are at a particularly low risk for stroke. Specifically, previous AF guidelines recommend against the use of oral anticoagulation in patients younger than 60 years without heart disease or other known risk factors for thromboembolism, and more recently updated guidelines do not recommend the use of oral anticoagulation in patients ...
Source: JAMA Internal Medicine - April 13, 2015 Category: Internal Medicine Source Type: research

Duration of clopidogrel-based dual antiplatelet therapy and clinical outcomes after endeavor sprint zotarolimus-eluting stent implantation in patients presenting with acute coronary syndrome.
CONCLUSION: DAPT for >6months do not seem to be associated with improved clinical outcomes in patients with ACS undergoing percutaneous coronary intervention (PCI) with ZES. PMID: 26153337 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 4, 2015 Category: Internal Medicine Authors: Song PS, Hahn JY, Kim DI, Song YB, Choi SH, Choi JH, Ryu DR, Hur SH, Jeong JO, Park HS, Kim HS, Gwon HC Tags: Eur J Intern Med Source Type: research

Predictors of left atrial appendage thrombogenic milieu in patients subjected to transesophageal echocardiography prior to cardioversion of persistent atrial fibrillation.
CONCLUSIONS    CHA2DS2 -VASc scores did not discriminate between the presence/absence of TEE surrogate risk factors for thromboembolism in patients scheduled for CV due to persistent AF. Only one component of CHA2DS2 -VASc scale, radiographic evidence of aortic plaques, as well as TTE parameters, augmentation of the left atrium and left ventricular end-diastolic dimension, were independent predictors of TEE markers for LAA thrombogenic milieu. Complex clinical and echocardiographic assessment of individual risk seems to be a valuable approach in subjects scheduled for CV of persistent AF. PMID: 26811148 [PubMed - as...
Source: Polskie Archiwum Medycyny Wewnetrznej - January 28, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy
Abstract: Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy. A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, alt...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

A meta-analysis for efficacy and safety evaluation of transcatheter left atrial appendage occlusion in patients with nonvalvular atrial fibrillation
Objectives: This meta-analysis was conducted to evaluate the efficacy and safety of transcatheter left atrial appendage (LAA) occlusion in patients with nonvalvular atrial fibrillation. Methods: The randomized controlled trials (RCT) or observational studies with any transcatheter LAA occlusion devices were searched in PubMed, Embase, and Cochrane library from inception to November 2015. The incidence rates from individual studies were combined to evaluate the procedural efficacy and safety, including all-cause death, cardiac/neurological death, stroke, transient ischemic attack (TIA), thrombosis, hemorrhagic complication...
Source: Medicine - August 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Oral anticoagulant therapy for older patients with atrial fibrillation: a review of current evidence.
Abstract Atrial fibrillation is more frequent in older patients, who have a higher risk of cardioembolic stroke and thromboembolism. Oral anticoagulant therapy is the standard of treatment for stroke prevention; however, under-prescription is still very common in older patients. The reasons underlying this phenomenon have not been systematically investigated, and true contraindications only partially account for it. An intimate skepticism on the real benefit-risk balance of oral anticoagulant therapy in the oldest patients seems to derive from the fact that most studies supporting it were conducted decades ago and...
Source: European Journal of Internal Medicine - March 24, 2017 Category: Internal Medicine Authors: Bo M, Grisoglio E, Brunetti E, Falcone Y, Marchionni N Tags: Eur J Intern Med Source Type: research

Posterior reversible encephalopathy syndrome in a postpartum hemorrhagic woman without hypertension: A case report
Rationale: Posterior reversible encephalopathy syndrome (PRES), which diagnosis is based on clinical symptoms and radiological features, is a neurotoxic disease characterized by a set of clinical manifestations, such as seizure, headache, visual, and/or consciousness disturbance. It is the first case of PRES followed by postpartum hemorrhage (PPH) without underlying disease. Patient concerns: A 37-year-old healthy woman had PPH after caesarean section. Six days after delivery, headache occurred suddenly, followed by episodes of clonus seizure. Diagnoses: Brain computed tomography showed ischemic stroke. However, magnetic...
Source: Medicine - April 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research