Query: stroke

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Source1: The American Journal of Emergency Medicine
Condition: Bleeding

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Total 8 results found since Jan 2013.

Stroke Prevention for Patients with Atrial Fibrillation: Values and Preferences of Canadian Emergency Medicine Trainees
Atrial Fibrillation (AF) is the most common serious cardiac arrhythmia and it is associated with a five-fold increase in the risk of ischemic stroke[1–3]. This risk can be reduced by up to 64% with oral anticoagulation (OAC)[4]. Many patients are first diagnosed with atrial fibrillation (AF) in the context of visit to the emergency department (ED) and AF can account for 1% or more of ED visits[5–7]. Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 13, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Stroke prevention for patients with atrial fibrillation: values and preferences of Canadian emergency medicine trainees
Atrial fibrillation (AF) is the most common serious cardiac arrhythmia, and it is associated with a 5-fold increase in the risk of ischemic stroke [1 –3] . This risk can be reduced by up to 64% with oral anticoagulation (OAC) [4] . Many patients are first diagnosed with AF in the context of visit to the emergency department (ED), and AF can account for 1% or more of ED visits [5–7] . Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 13, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence
Acute ischemic stroke is leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA.
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher Source Type: research

Dabigatran-related coagulopathy: when can we assume the effect has “worn off”?
This issue of American Journal of Emergency Medicine presents a timely report that should be noted by all practicing emergency physicians. Nzwalo et al [1] describe a 61-year-old man with nonvalvular atrial fibrillation, taking 150 mg dabigatran twice daily for stroke protection, who presented to their emergency department (ED) with an acute ischemic stroke (AIS). The patient had a normal creatinine clearance and a normal thrombin time (TT). He was treated with intravenous recombinant tissue plasminogen activator (rt-PA) with good neurologic outcome and no bleeding complications.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Charles V. Pollack, Jerrold H. Levy, John Eikelboom, Jeffrey I. Weitz, Frank W. Sellke, Menno V. Huisman, Thorsten Steiner, Pieter Kamphuisen, Richard A. Bernstein Tags: Controversies Source Type: research

Preclinical and clinical data for factor Xa and “Universal” reversal agents
Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development.
Source: The American Journal of Emergency Medicine - September 28, 2016 Category: Emergency Medicine Authors: Truman J. Milling, Scott Kaatz Tags: Review Source Type: research

Safety of Direct Oral Anticoagulants: Insights from Postmarketing Studies
Direct oral anticoagulants (DOACs) have been marketed in the United States since 2010. While numerous large-scale prospective phase 3 outcomes studies have documented the effectiveness of DOACs for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the primary safety concern with all of these drugs —as it is with the more established oral anticoagulant warfarin—is the risk of major bleeding. Postmarketing surveillance studies (PMSS) provide the opportunity to evaluate the safety of these recently approved drugs across a spectrum of patients that may be broader than those in...
Source: The American Journal of Emergency Medicine - September 28, 2016 Category: Emergency Medicine Authors: Todd C. Villines, W. Frank Peacock Tags: Review Source Type: research

Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis
This study describes a cohort of patients with FXa inhibitor-associated life-threatening bleeding events, their clinical characteristics, interventions and outcomes.
Source: The American Journal of Emergency Medicine - August 19, 2017 Category: Emergency Medicine Authors: Truman J. Milling, Carol L. Clark, Charles Feronti, Shlee S. Song, Sam S. Torbati, Gregory J. Fermann, Jeffrey Weiss, Dony Patel Source Type: research

Tranexamic acid for treatment of pulmonary hemorrhage after tissue plasminogen activator administration for intubated patient
The risk of tPA in the treatment of stroke, is that approximately 5% of patients may have significant intracranial bleeding, increasing mortality to 45%. Use of tPA can also cause other forms of life-threatening bleeding, most commonly gastrointestinal bleeding. In this case review, we discuss the presentation and management of a patient with post-tPA pulmonary hemorrhage and the use of tranexamic acid (TXA) for the cessation of bleeding.
Source: The American Journal of Emergency Medicine - May 14, 2019 Category: Emergency Medicine Authors: Snaha Sanghvi, Anna Van Tuyl, Josh Greenstein, Barry Hahn Source Type: research