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Short-term Bleeding Events Observed with Clopidogrel Loading in Acute Ischemic Stroke Patients
Discussion: Contrary to our original hypothesis, patients with AIS receiving clopidogrel loading doses within 24 hours of symptom onset did not appear to experience a higher rate of new serious bleeding events during acute hospitalization when compared with patients who did not receive loading doses. The Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke trial is expected to provide insight into the safety of clopidogrel loading as an acute intervention after cerebral ischemia.
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2013 Category: Neurology Authors: Lester Y. Leung, Karen C. Albright, Amelia K. Boehme, Joseph Tarsia, Kamal R. Shah, James E. Siegler, Erica M. Jones, Gayle R. Pletsch, Timothy M. Beasley, Sheryl Martin-Schild Tags: Original Articles Source Type: research

Uptake of Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation in a Single Clinical Commissioning Group in England Without Restrictions to Their Use
ConclusionsThe early use of DOACs, in a CCG without restrictions to their use, was embraced by primary-care prescribers in this particular CCG.
Source: Clinical Drug Investigation - February 25, 2019 Category: Drugs & Pharmacology Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Heparin, grad students, a clinical revolution and giving credit where it's due
The story of a grad student who overcame remarkable odds only to be denied his moment of glory, or a tale of dark deceit and devilish doings? The story of heparin is as complicated as the chemistry itselfBlood is remarkable.A liquid that carries nutrients, waste products and the ever-vigilant cells of the immune system around the body, blood rapidly turns into a solid when it leaves its veins and arteries and becomes exposed to bodily tissues or the air outside. This process of solidification – clotting, or coagulation – is executed and controlled by a complex set of reactions and interactions primarily involving the e...
Source: Guardian Unlimited Science - September 4, 2013 Category: Science Authors: Richard P Grant Tags: theguardian.com Blogposts Science Source Type: news

What Causes Hyperammonemia?
Discussion Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes whic...
Source: PediatricEducation.org - February 20, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research