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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

Clopidogrel versus ticagrelor in high-bleeding risk patients presenting with acute coronary syndromes: insights from the multicenter START-ANTIPLATELET registry
AbstractOptimal dual antiplatelet therapy (DAPT) strategy in high-bleeding risk (HBR) patients presenting with acute coronary syndrome remains debated. We sought to investigate the use of clopidogrel versus ticagrelor in HBR patients with acute coronary syndrome and their impact on ischemic and bleeding events at 1  year. In the START-ANTIPLATELET registry (NCT02219984), consecutive patients with ≥ 1 HBR criteria were stratified by DAPT type in clopidogrel versus ticagrelor groups. The primary endpoint was net adverse clinical endpoints (NACE), defined as a composite of all-cause death, myocardial infarct ion, stroke,...
Source: Internal and Emergency Medicine - June 14, 2020 Category: Emergency Medicine Source Type: research

Concomitant Aspirin and Anticoagulation Is Associated With Increased Risk for Major Bleeding in Surgical Patients Requiring Postoperative Intensive Care*
Conclusions: Concomitant aspirin and anticoagulation in critically ill surgical patients was associated with an increased rate of major bleeding. Future investigations are warranted to further define optimal management of antiplatelet therapy during anticoagulation in surgical patients.
Source: Critical Care Medicine - June 20, 2020 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Ticagrelor-Aspirin Combo: Fewer Repeat Strokes, but More Bleeds Ticagrelor-Aspirin Combo: Fewer Repeat Strokes, but More Bleeds
The combination of ticagrelor and aspirin prevents secondary stroke and cuts mortality, but it also appears to increase the risk for severe bleeding.Medscape Medical News
Source: Medscape Emergency Medicine Headlines - July 20, 2020 Category: Emergency Medicine Tags: Neurology & Neurosurgery News Source Type: news

Short-Term Efficacy and Safety of Different Mechanical Hemodynamic Support Devices for Cardiogenic Shock or High-Risk Pci: a Network Meta-Analysis of Thirty-Seven Trials
Conclusion: Following this analysis, ECMO+IABP might be a more suitable intervention measure in improving short-term mortality for patients with CS and who underwent HS-PCI. However, the result was limited by the lack of sufficient direct comparisons and evidence from randomized controlled trials. Moreover, bleeding and other device-related complications should be considered in clinical applications.
Source: Shock - December 21, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research

Flight Medics, Nurses in NM Provide Crucial Rural Lifeline
This article originally appeared on Las Cruces Sun-News: Healers & Builders 2021: Flight medics and nurses provide crucial rural lifeline ___ (c)2020 the Las Cruces Sun-News (Las Cruces, N.M.) Visit the Las Cruces Sun-News (Las Cruces, N.M.) at www.lcsun-news.com Distributed by Tribune Content Agency, LLC. The post Flight Medics, Nurses in NM Provide Crucial Rural Lifeline appeared first on JEMS.
Source: JEMS Patient Care - January 3, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Coronavirus News News Feed Flight Medic New Mexico Source Type: news

Idarucizumab (PRADAXA ®) as a sole reversal agent in an unstable hemorrhagic shock patient on an unknown anticoagulant with elevated protime/international normalized ratio (PT/INR).
We present a case of an 85-year-old female with an unknown medication history, shortness of breath and severe anemia due to an upper gastrointestinal bleed. Laboratory abnormalities were significant for INR 6.43 and serum creatinine 2.21  mg/dL.
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Sara Kutner, Nicholas Scaturo, Brett Williams Source Type: research

Appropriate Treatment of Ischemic Stroke That Is Essential for the Reduction of Mortality and Morbidity: Should We Use Hyperbaric Oxygen Therapy Together With Recombinant Tissue Plasminogen Activator for Improving Brain Oxygenation and Before Recombinant Tissue Plasminogen Activator to Minimize the Risk of Massive Bleeding?
No abstract available
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Rhythm- or rate-control strategies according to 4S-AF characterization scheme and long-term outcomes in atrial fibrillation patients: the FAMo (Fibrillazione Atriale in Modena) cohort
AbstractThe 4S-AF scheme [Stroke risk, Symptom severity, Severity of atrial fibrillation (AF) burden, Substrate severity] was recently proposed to characterize AF patients. In this post hoc analysis we evaluated the agreement between the therapeutic strategy (rate or rhythm control, respectively), as suggested by the 4S-AF scheme, and the actual strategy followed in a patients cohort. Outcomes of interest were as follows: all-cause death, a composite of all-cause death/any thromboembolism/acute coronary syndrome, and a composite of all-cause death, any thrombotic/ischemic event, and major bleeding (net clinical outcome). W...
Source: Internal and Emergency Medicine - December 2, 2021 Category: Emergency Medicine Source Type: research

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