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Source: Internal and Emergency Medicine

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Total 120 results found since Jan 2013.

NOAC in “real world” patients with atrial fibrillation in Italy: results from the ISPAF-2 (Indagine Sicoa Paziente Con Fibrillazione Atriale) survey study
AbstractIn the past few years, new oral anticoagulants (NOACs) targeting directly a single activated clotting factor, have been developed for the treatment of non-valvular atrial fibrillation (AF), which are currently recommended as first-line therapy in AF. The aim of this study is to provide an overall picture on the extent to which oral anticoagulation (OAC) with NOACs correspond to actually prescribed OAC therapy in an unselected, real world, population of consecutive patients with AF in Italy. Compliance with the therapy and quality of life were also assessed. A 50 cardiology unit network located in different geograph...
Source: Internal and Emergency Medicine - June 28, 2018 Category: Emergency Medicine Source Type: research

Influence of frailty on anticoagulant prescription and clinical outcomes after 1-year follow-up in hospitalised older patients with atrial fibrillation
AbstractFrailty is an important prognostic factor in older adults with cardiovascular diseases. We aim to describe the characteristics of elderly hospitalised frail patients with non-valvular atrial fibrillation (NVAF) and to assess the influence of frailty, along with other functional and health status variables on anticoagulation prescription, 1-year all-cause mortality, and the incidence of ischemic and bleeding complications. An observational, prospective multicentre study was carried out on patients with NVAF over the age of 75, who were admitted to the Internal Medicine departments in Spain. A total of 615 patients w...
Source: Internal and Emergency Medicine - September 6, 2018 Category: Emergency Medicine Source Type: research

Primary stroke centers: are they worthy of an upgrade?
Source: Internal and Emergency Medicine - December 12, 2018 Category: Emergency Medicine Source Type: research

Is social support associated with hypertension control among Ghanaian migrants in Europe and non-migrants in Ghana? The RODAM study
This study assessed the association between multiple proxies for social support and HTN control among Ghanaians resident in Ghana and Europe. The Research on Obesity and Diabetes among African Migrants (RODAM) study participants with HTN and who self-reported HTN (n = 1327) were included in this analysis. Logistic regression was used to assess the association between proxies of social support and HTN control (SBP <  140 mmHg and DBP <  90 mmHg) with adjustments for age and socioeconomic status (SES). Among Ghanaian males in both Europe and Ghana, cohabiting with more than two persons was associated with...
Source: Internal and Emergency Medicine - March 25, 2019 Category: Emergency Medicine Source Type: research

Real-world 2-year outcome of atrial fibrillation treatment with dabigatran, apixaban, and rivaroxaban in patients with and without chronic kidney disease
AbstractPatients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) are at increased risk of stroke and bleeding. Although direct oral anticoagulant (DOAC) trials excluded patients with severe CKD, a growing portion of CKD patients have been starting DOACs and limited data from real-world outcome in this high-risk setting are available. The INSigHT registry included 632 consecutive NVAF patients that started apixaban (256 patients, 41%), dabigatran (245, 39%) and rivaroxaban (131, 20%) between 2012 and 2015. Based on creatinine clearance, two sub-cohorts were defined: (1) non-CKD group (CrCl 60 ...
Source: Internal and Emergency Medicine - May 8, 2019 Category: Emergency Medicine Source Type: research

The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study
AbstractThe primary  study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible partecipants were patients taking oral anticoagulant drugs (vitamin K antagonist or direct oral anticoagulants), residents in the Vicenza and Cremona districts from February 1st, 2016 to June 30th, 2017. Patients were identified by accessing the administrative databases of patient drug prescripti...
Source: Internal and Emergency Medicine - July 14, 2019 Category: Emergency Medicine Source Type: research

Female sex and stroke in atrial fibrillation: an intriguing relationship
Source: Internal and Emergency Medicine - August 7, 2019 Category: Emergency Medicine Source Type: research

Is there a link between venous and arterial thrombosis? A reappraisal
In conclusion, recent evidence provides compelling evidence in support of the link between venous and arterial thrombosis. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.
Source: Internal and Emergency Medicine - November 25, 2019 Category: Emergency Medicine Source Type: research

Vertebral artery halo sign to detect giant cell arteritis causing posterior circulation ischemic stroke
Source: Internal and Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Management of antithrombotic therapy in gray areas of venous thromboembolism: a Delphi consensus panel
We report a Delphi Consensus on DOAC use in VTE patients. The consensus dealt with seven main topics: (1) clinical superiority of DOACs compared to VKAs; (2) therapeutic opt ions for patients with intermediate risk PE; (3) therapeutic management of patients with deep vein thrombosis (DVT); (4) DOACs’ role in oncological patients with VTE; (5) role of the reversal agent; (6) safety of low doses of DOACs in VTE patients; (7) DOACs long-term therapy (more than 12 months ) in VTE patients; Forty-six physicians (cardiologists, internists, angiologists, oncologists, hematologists, and geriatricians) from Italy expressed their...
Source: Internal and Emergency Medicine - March 29, 2020 Category: Emergency Medicine Source Type: research

Diagnosis and management of acute aortic syndromes in the emergency department
AbstractAcute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill p...
Source: Internal and Emergency Medicine - April 30, 2020 Category: Emergency Medicine Source Type: research

Reperfusion treatments for acute ischemic stroke in nonagenarians
Source: Internal and Emergency Medicine - May 5, 2020 Category: Emergency Medicine Source Type: research

Design and rationale of a randomized, placebo-controlled trial on the efficacy and safety of sulodexide for extended treatment in elderly patients after a first venous thromboembolism
AbstractHow to prevent recurrences after a first venous thromboembolic (VTE) event in elderly patients is still an open issue, especially because of the high bleeding risk of anticoagulation in these patients. The placebo-controlled “Jason” study aims at assessing the efficacy and safety for secondary VTE prevention in elderly patients of oral Sulodexide (Vessel®) administration, a mixture of glycosaminoglycans (Alfasigma, Bologna, Italy) which proved effective against recurrences in a general population (SURVET study) without major bleeding (MB) complications. 1450 patients, aged  ≥ 75 years, after at least 3...
Source: Internal and Emergency Medicine - May 24, 2020 Category: Emergency Medicine Source Type: research

Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry
The objective of this study is to determine the prevalence of cognitive impairment (CogI) in patients hospitalized for congestive heart failure, and the influence of CogI on mortality and hospital readmission. This is a multicenter cohort study of patients hospitalized for congestive heart failure enrolled in the RICA registry. The patients were divided into 3 groups according to their Short Portable Mental Status Questionnaire score: 0 –3 errors (no CogI or mild CogI), 4–7 (moderate CogI) and 8–10 (severe CogI). A total of 3845 patients with a mean (SD) age of 79 (8.6) years were included; 2038 (53%) were women. A t...
Source: Internal and Emergency Medicine - June 14, 2020 Category: Emergency Medicine Source Type: research