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Cessation of Anticoagulation for Bleeding and Thrombosis Events with a Fully Magnetically Levitated Centrifugal Left Ventricular Assist Device
Anticoagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 pump. Current anticoagulation guidelines target a goal INR of 2.0 –3.0 with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HeartMate 3 (HM3), have demonstrated a marked decrease in the incidence of pump thrombosis compared to mechanical bearing axial-f...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: Case Anecdotes, Comments and Opinions Source Type: research

Cessation of anti-coagulation for bleeding and subsequent thrombosis events with a fully magnetically levitated centrifugal left ventricular assist device
Anti-coagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 (HM3) pump. Current anti-coagulation guidelines target a goal international normalized ratio (INR) of 2.0 to 3.0, with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HM3, have demonstrated a marked decrease in the incidence of pump thrombosis compared w...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: CASE ANECDOTES, COMMENTS AND OPINIONS Source Type: research

Harnessing the Four Elements for Mental Health
DiscussionAs detailed above, the “elements” in both a classical and a contemporary sense have effects on our mental health and are potentially modifiable aspects that can be harnessed as therapeutic interventions. The most robust interventional evidence currently available shows tentative support for several use of the elements via horticultural and nature-exposure therapy, green exercise/physical activity, sauna and heat therapy, balneotherapy, and breathing exercises. It should be noted that, in many cases, these interventions were not studied in definitive diagnosed psychiatric disorders and thus it is pre...
Source: Frontiers in Psychiatry - April 23, 2019 Category: Psychiatry Source Type: research

Plant-Derived Alkaloids: The Promising Disease-Modifying Agents for Inflammatory Bowel Disease
Conclusion This paper summarizes the current findings regarding the anti-colitis activity of plant-derived alkaloids and shows how these alkaloids exhibit significant and beneficial effects in alleviating colonic inflammation. These natural alkaloids are not only promising agents for IBD treatment but are also components for developing new wonder drugs. However, the underlying molecular mechanisms or toxicological evaluation of most plant-derived alkaloids still require much scientific research, and their actual efficacies for IBD patients have not been verified well in field research. Thus, further clinical trials to elu...
Source: Frontiers in Pharmacology - April 11, 2019 Category: Drugs & Pharmacology Source Type: research

A Review of the Use of Direct Oral Anticoagulant Use in Orthotopic Heart Transplantation Recipients
Over 60 years ago, the vitamin K antagonist (VKA) warfarin was approved and remained the only oral anticoagulation agent until recently [1]. Currently, within North America and Europe there are four DOACs available. Dabigatran, first approved in Europe and Canada in 2008, then in the United States of America in 2010, followed by rivaroxaban, apixaban, and most recently edoxaban. The introduction of direct oral anticoagulants (DOACs) has been a major advancement and these agents are the preferred to VKAs for many indications [2 –5], including stroke prevention in nonvalvular atrial fibrillation (NVAF), acute treatment and...
Source: Transplantation Reviews - April 16, 2018 Category: Transplant Surgery Authors: Rosaleen Boswell, Glen J. Pearson Tags: Review article Source Type: research

Therapeutic Plasma Exchange for Urgent Rivaroxaban Reversal.
Abstract Direct oral anticoagulants, which include the factor Xa inhibitor rivaroxaban, have some advantages over vitamin K antagonists in regard to stroke prevention in patients with atrial fibrillation. However, no antidotes to reverse the effect of oral anticoagulants are commercially available, which can complicate treating patients in whom reversal is urgent. We faced this challenge in a kidney transplant candidate, a 65-year-old man with end-stage renal disease who had been taking rivaroxaban for paroxysmal atrial fibrillation. When a deceased-donor kidney became available, we needed to rapidly reduce the pa...
Source: Texas Heart Institute Journal - April 1, 2018 Category: Cardiology Authors: Kumar V, Allencherril J, Bracey A, Chen AJ, Lam WW Tags: Tex Heart Inst J Source Type: research

How to Boost Your Stem Cells
A California man named Kris Boesen was completely paralyzed after breaking his neck in a terrible car crash last March. But now he can brush his teeth and hug his family again… He's even started to regain sensation in his legs. And it's all because of a simple procedure he underwent about a month after his accident: stem cell therapy. During Kris' procedure, researchers at the University of Southern California injected 10 million stem cells into his spinal cord. Within two weeks, he could wiggle his fingers. Three months later, he was able to feed himself, write his name and operate his wheelchair. His re...
Source: Al Sears, MD Natural Remedies - March 23, 2017 Category: Complementary Medicine Authors: Al Sears Tags: Anti-Aging Source Type: news

Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
Authors: Robson A, Sturman J, Williamson P, Conboy P, Penney S, Wood H Abstract This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertens...
Source: Journal of Laryngology and Otology - November 15, 2016 Category: ENT & OMF Tags: J Laryngol Otol Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Effectiveness and Safety of Dabigatran, Rivaroxaban, and Apixaban Versus Warfarin in Nonvalvular Atrial Fibrillation Health Services and Outcomes Research
Conclusions In patients with nonvalvular atrial fibrillation, apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin.
Source: JAHA:Journal of the American Heart Association - June 12, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Sangaralingham, L. R., Bellolio, M. F., McBane, R. D., Shah, N. D., Noseworthy, P. A. Tags: Atrial Fibrillation, Secondary Prevention, Anticoagulants, Transplantation, Cerebrovascular Disease/Stroke Health Services and Outcomes Research Source Type: research

Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban
Conclusions We found that patients with AF and AS on oral anticoagulants may have distinctly different efficacy and safety outcomes than patients with MR or AR or no SVD. Trial registration number NCT00403767; Post-results.
Source: Heart - June 9, 2016 Category: Cardiology Authors: Breithardt, G., Baumgartner, H., Berkowitz, S. D., Hellkamp, A. S., Piccini, J. P., Lokhnygina, Y., Halperin, J. L., Singer, D. E., Hankey, G. J., Hacke, W., Becker, R. C., Nessel, C. C., Mahaffey, K. W., Califf, R. M., Fox, K. A. A., Patel, M. R., for th Tags: Open access, Drugs: cardiovascular system, Interventional cardiology, Aortic valve disease, Mitral valve disease Valvular heart disease Source Type: research

Help! My daughter has become a vegetarian!
Q: My daughter has decided to follow a vegetarian diet. Do I need to worry about protein deficiency? ~ Worried Mom This is one of the most common questions that pediatricians are asked. A vegetarian diet, and especially one that includes fish, can be a very healthy option. Learn more about nutrition for vegetarians and ways your family can shift to a vegetarian diet. Q: Does my child need to eat meat to get enough protein? Complete nutrition, including adequate protein, can easily be obtained without eating meat. Meat is completely unnecessary if a diet is high in fruits, vegetables, nuts, beans, fish, whole grains, eggs...
Source: Thrive, Children's Hospital Boston - April 6, 2016 Category: Pediatrics Authors: Carolyn Sax Tags: Parenting Teen Health Dr. Carolyn Sax vegetarian Source Type: news

How to define valvular atrial fibrillation?
Abstract Atrial fibrillation (AF) confers a substantial risk of stroke. Recent trials comparing vitamin K antagonists (VKAs) with non-vitamin K antagonist oral anticoagulants (NOACs) in AF were performed among patients with so-called "non-valvular" AF. The distinction between "valvular" and "non-valvular" AF remains a matter of debate. Currently, "valvular AF" refers to patients with mitral stenosis or artificial heart valves (and valve repair in North American guidelines only), and should be treated with VKAs. Valvular heart diseases, such as mitral regurgitation, aortic stenosis (AS) and aortic insufficiency, do...
Source: Archives of Cardiovascular Diseases - July 13, 2015 Category: Cardiology Authors: Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, Babuty D, Bernard A Tags: Arch Cardiovasc Dis Source Type: research

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