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Position statement from the Indian Society of Gastroenterology, Cardiological Society of India, Indian Academy of Neurology and Vascular Society of India on gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy
AbstractAntiplatelet and/or anticoagulant agents (collectively known as antithrombotic agents) are used to reduce the risk of thromboembolic events in patients with conditions such as atrial fibrillation, acute coronary syndrome, recurrent stroke prevention, deep vein thrombosis, hypercoagulable states and endoprostheses. Antithrombotic-associated gastrointestinal (GI) bleeding is an increasing burden due to the growing population of advanced age with multiple comorbidities and the expanding indications for the use of antiplatelet agents and anticoagulants. GI bleeding in antithrombotic users is associated with an increase...
Source: Indian Journal of Gastroenterology - June 5, 2023 Category: Gastroenterology Source Type: research

A Review of the Current Literature and Updates on Embolic Stroke of Undetermined Source (ESUS)
AbstractPurpose of ReviewThe initial ESUS construct presumed that atrial fibrillation (AF) would be detected in a substantial percentage of patients, but subsequent studies have determined that the rate of AF detection is much lower than anticipated, thereby highlighting other potential causes of ESUS. To date, there is no clear consensus supporting PFO closure or anticoagulation in ESUS patients. In this review, we discuss the recent studies on potential causes of ESUS and related work-up as well as report the recent trials on the treatment of ESUS.Recent FindingsSome of the potential causes of ESUS are undetected AF, pat...
Source: Current Treatment Options in Neurology - August 6, 2022 Category: Neurology Source Type: research

Epidemiology of young stroke in the ludhiana population-based stroke registry
Conclusion: Hypertension, diabetes mellitus, drug addiction, and tobacco intake were significantly associated with young stroke. Outcome was also better in younger people.
Source: Annals of Indian Academy of Neurology - February 22, 2022 Category: Neurology Authors: Monika Singla Gagandeep Singh Paramdeep Kaur Jeyaraj D Pandian Source Type: research

The Watchman device for preventing stroke in patients with atrial fibrillation
This article discusses the Watchman device, a left atrial appendage occlusion device that provides an option for patients with contraindications for anticoagulation.
Source: Journal of the American Academy of Physician Assistants - October 1, 2021 Category: Primary Care Tags: Review Article Source Type: research

Infarct volumes of patients with acute ischemic stroke receiving direct oral anticoagulants due to non-valvular atrial fibrillation
Conclusion: We observe, while using DOACs, the infarct volumes of patients who experience stroke are smaller than those with NDAF and using ASA, as well as mRS scores at discharge are low and length of hospital stay is short.
Source: Annals of Indian Academy of Neurology - February 16, 2021 Category: Neurology Authors: Nese G Yavasoglu Yasemin Eren Idil G Tatar Irfan Yalcinkaya Source Type: research

Patent foramen ovale closure in the management of cryptogenic stroke: a review of current literature and guideline statements.
CONCLUSION: PFO closure can be considered for the prevention of recurrent cryptogenic stroke in patients aged ≤60 years after a thorough evaluation and discussion about benefits and potential risks (including but not limited to atrial fibrillation) of the procedure. Accumulating evidence supports prognostic, quality of life, and economic benefit from percutaneous PFO closure with newer generation closure devices in the right subset of patients. PMID: 33460329 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - January 20, 2021 Category: Research Tags: Curr Med Res Opin Source Type: research

Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review protocol
DiscussionCurrent guidelines in the treatment of cerebral vein thrombosis dating back to 2011 from the American Heart Association/American Stroke Association endorse the utility of anticoagulation for the treatment of cerebral vein thrombosis; however, they did not support the use of direct oral anticoagulants. Updated guidelines from the European Stroke Organization, endorsed by the European Academy of Neurology in 2017, also refute utilization of direct oral anticoagulants due to a lack of evidence. There have been nearly 10  years of experience with direct oral anticoagulants in the treatment of venous thrombosis and ...
Source: Systematic Reviews - April 17, 2019 Category: International Medicine & Public Health Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in Patients with Atrial Fibrillation and CKD.
PMID: 30932459 [PubMed - in process]
Source: American Family Physician - March 31, 2019 Category: Primary Care Authors: Lax JW, Wood R, Jonas CE Tags: Am Fam Physician Source Type: research

The Singapore Heart Failure Risk Score: Prediction of Survival in Southeast Asian Patients.
CONCLUSION: We provided a risk score based on readily available clinical characteristics to predict 1- and 2-year survival in Southeast Asian patients hospitalised for heart failure via a simple online risk calculator, the Singapore Heart Failure Risk Score. PMID: 30997477 [PubMed - in process]
Source: Annals of the Academy of Medicine, Singapore - February 28, 2019 Category: General Medicine Authors: Yap J, Chia SY, Lim FY, Allen JC, Teo L, Sim D, Go YY, Jaufeerally FR, Seow M, Kwok B, Liew R, Lam CS, Ching CK Tags: Ann Acad Med Singapore Source Type: research

Rate or Rhythm Control of Atrial Fibrillation - Pearls for the Internist.
Abstract Atrial fibrillation is an epidemic in Asia that is increasingly prevalent. Apart from stroke risk stratification and management of anticoagulation, physicians managing this group of patients also need to determine an optimal strategy in terms of rate or rhythm control. With new techniques of catheter ablation to maintain patients in sinus rhythm, patients with atrial fibrillation now have more options for treatment, on top of pharmacological methods. This paper aims to review the current evidence for rate and rhythm control in both general patients and subgroups of interest commonly encountered in clinica...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2017 Category: General Medicine Authors: Huang W, Keng FY, Ching CK Tags: Ann Acad Med Singapore Source Type: research

Use of direct oral anticoagulants for stroke prevention in elderly patients with nonvalvular atrial fibrillation
ConclusionsDOACs are at least as effective as warfarin for stroke prevention in elderly patients with NVAF. Compared with warfarin, DOACs were associated with reduced risk of intracranial hemorrhage, while some DOACs demonstrated an increase in other bleeding events (e.g., gastrointestinal). The faster onset and offset of action and fewer food and drug interactions of DOACs may be an advantage over warfarin for some patients. Implications for practiceDOACs are an alternative to warfarin with overall equivalent safety and efficacy in elderly patients with NVAF, and may be preferable for some. Stroke risk must always be bala...
Source: Journal of the American Academy of Nurse Practitioners - August 14, 2017 Category: Nursing Authors: Lynn B. Oertel, Annemarie E. Fogerty Tags: REVIEW ‐ SPONSORED Source Type: research

Acute ischemic stroke treatment using mechanical thrombectomy: A study of 137 patients
Conclusion: MT is safe treatment and equally effective for both AC and PC LVO. With careful patient selection, clinical outcome in PC was comparable to AC despite delayed presentation and higher baseline NIHSS.
Source: Annals of Indian Academy of Neurology - August 10, 2017 Category: Neurology Authors: Rakeshsingh K Singh Vishal Annaji Chafale Rakesh Shyam Lalla Keyurkumar Chandrakantbhai Panchal Anil Pandurang Karapurkar Satish Vasant Khadilkar Pawan K Ojha Yogesh Godge Rakesh K Singh Rajesh Benny Source Type: research

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