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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

Direct Oral Anticoagulants in Emergency Trauma Admissions.
CONCLUSION: DOACs in the setting of hemorrhage are a clinical challenge in the traumatological emergency room because of the inadequate validity of the relevant laboratory tests. An emergency antidote is now available only for dabigatran. PMID: 27658470 [PubMed - in process]
Source: Deutsches Arzteblatt International - September 24, 2016 Category: Journals (General) Tags: Dtsch Arztebl Int Source Type: research

Spotlight on unmet needs in stroke prevention: The PIONEER AF-PCI, NAVIGATE ESUS and GALILEO trials.
This article focuses on three randomised controlled trials (RCTs) that are investigating the utility of rivaroxaban, a direct, oral, factor Xa inhibitor, in additional areas of stroke prevention where data for anticoagulants are lacking: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment (PIONEER AF-PCI); New Approach riVaroxoban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE ESUS); and Global study comparing a rivAroxaban-based antithrombo...
Source: Thrombosis and Haemostasis - September 13, 2016 Category: Hematology Authors: Hemmrich M, Peterson ED, Thomitzek K, Weitz JI Tags: Thromb Haemost Source Type: research

Risk of death and stroke associated with anticoagulation therapy after mitral valve repair
Conclusion VKA treatment after mitral valve repair is associated with a markedly lower risk of adverse events as stroke or death without excess major bleeding risk during the first 3 months following surgery.
Source: Heart - April 11, 2016 Category: Cardiology Authors: Valeur, N., Merie, C., Hansen, M. L., Torp-Pedersen, C., Gislason, G. H., Kober, L. Tags: Drugs: cardiovascular system, Interventional cardiology, Epidemiology Valvular heart disease Source Type: research

Neurological damage after transcatheter aortic valve implantation compared with surgical aortic valve replacement in intermediate risk patients
Conclusions TAVI and SAVR were associated with a similar rate of acute silent ischemic cerebral lesions in intermediate risk patients. Although acute lesions occurred very frequently in both strategies, their cognitive impact was not clinically relevant.
Source: Clinical Research in Cardiology - December 8, 2015 Category: Cardiology Source Type: research

Cochrane corner: vitamin K for improved anticoagulation control in patients receiving warfarin
There has been a substantial increase in the use of oral anticoagulants, notably in the ageing population. This is primarily driven by the use of warfarin in people with atrial fibrillation (AF) in order to reduce the risks of thromboembolic events such as stroke.1 In elderly patients with AF, warfarin use has been shown to reduce the relative risk of stroke by >50% compared with aspirin alone.2 Warfarin is also used to treat patients with deep vein thrombosis, mechanical heart valve replacement, cardioversion, cardiomyopathy and antiphospholipid syndrome.1 The clinical benefits of warfarin must also be balanced with po...
Source: Heart - October 11, 2015 Category: Cardiology Authors: Mahtani, K. R., Nunan, D., Heneghan, C. Tags: Drugs: cardiovascular system, Cochrane Corner, Venous thromboembolism, Epidemiology Editorials Source Type: research

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

Aortic infective endocarditis: Value of surgery. About 48 cases.
CONCLUSION: The prognosis of infective endocarditis of the aortic valve is severe due to the fast progression to heart failure. Early medical and surgical approach provides good results on morbidity and mortality in the short- and mid-terms. PMID: 25813653 [PubMed - as supplied by publisher]
Source: Annales de Cardiologie et d'Angeiologie - March 23, 2015 Category: Cardiology Authors: Tribak M, Konaté M, Elhassani A, Mahfoudi L, Jaabari I, Elkenassi F, Boutayeb A, Lachhab F, Filal J, Maghraoui A, Bensouda A, Marmade L, Moughil S Tags: Ann Cardiol Angeiol (Paris) Source Type: research

Changing practice of anticoagulation: will target-specific anticoagulants replace warfarin?
Abstract The target-specific oral anticoagulants are a class of agents that inhibit factor Xa or thrombin. They are effective and safe compared to warfarin for the prevention of stroke and systemic embolism in patients with atrial fibrillation and for the treatment of venous thromboembolism, and they are comparable to low-molecular-weight heparin for thromboprophylaxis after hip or knee arthroplasty. For other indications, however, such as the prevention of stroke in patients with mechanical heart valves, initial studies have been unfavorable for the newer agents, leaving warfarin the anticoagulant of choice. Furt...
Source: Annual Review of Medicine - January 14, 2015 Category: Journals (General) Authors: Arepally GM, Ortel TL Tags: Annu Rev Med Source Type: research

Pontine infarction responsible for wall-eyed bilateral internuclear ophthalmoplegia syndrome
A 68-year-old man with hypertension, cardiac arrhythmia, and a mechanical heart valve replacement treated with vitamin K antagonists was admitted for the acute onset of diplopia. Neuro-ophthalmologic examination showed a bilateral exotropia in primary gaze position (wall-eyed) with bilateral adduction deficit that did not improve by convergence (figure, video at Neurology.org/cp). In lateral gaze, a horizontal nystagmus of the abducting eyes appeared. Vertical saccades were normal (video). Pupils were symmetric and reactive to light. Brain MRI with diffusion-weighted images showed an acute pontine ischemic lesion (figure)....
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Mathis, T., Ducray, F., Tilikete, C., Vighetto, A., Biotti, D. Tags: Clinical neurology examination, All Neuro-ophthalmology, Ocular motility, Diplopia (double vision), All Cerebrovascular disease/Stroke Cases Source Type: research

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