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Evidence-Based Minireview: Mortality and thrombosis in patients receiving prothrombin complex concentrates or andexanet alfa for the management of direct oral factor Xa inhibitor-associated major bleeding.
Authors: Kimpton M, Siegal DM Abstract A 77-year-old man with atrial fibrillation and a CHA2DS2Vasc score of 6 for hypertension, age, diabetes, and previous stroke is brought to the emergency department with decreased level of consciousness. He is anticoagulated with rivaroxaban (a direct oral factor Xa inhibitor [FXaI]) and received his last dose about 4 hours before presentation. Urgent computed tomography of the head shows intracerebral hemorrhage. Because of his previous stroke, the patient's family is concerned about treating the bleed with pharmacological agents that may increase the risk of stroke. What are ...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - October 1, 2018 Category: Cancer & Oncology Source Type: research

Intracerebral Hemorrhage: The 'Other' Stroke
J Mocco, MD, MS Professor and Vice Chair for Education Director, Cerebrovascular Center Residency Program Director Department of Neurological Surgery Mount Sinai Health System Intracerebral Hemorrhage: The 'Other' Stroke A recent patient of mine, 48-year-old "Joe" (not his real name), was eating with his family at an Italian restaurant. Suddenly, he stood up, cursed, and collapsed. They brought him to the hospital, and he could not talk, move, or do anything we asked him to do. It turned out that Joe had suffered the second-most common, but deadliest, form of stroke: intracerebral hemorrhage. When people hear "stroke,...
Source: Healthy Living - The Huffington Post - November 7, 2016 Category: Consumer Health News Source Type: news

Summary: International Kidney Cancer Symposium
Conclusions:  Ideal ischemia time is 20-25 minutes or less improves short and long term renal function.  >25 minutes carried 5 year risk of new onset stage 4 CKD No differences on GFR for cold vs. warm ischemia times Preoperative GFR and the percent of kidney preserved was a better predictor of post op GFR.  No ischemia preserves renal function better than warm. Longer cold ischemia times were equivalent to shorter warm ischemia times. Quality and quantity of the remaining kidney is associated with ultimate renal function. Robotics in RCC Surgery Gennady Bratslavsky, MD The...
Source: Kidney Cancer Association - December 15, 2011 Category: Urology & Nephrology Source Type: news