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Top 20 Research Studies of 2022 for Primary Care Physicians
This article summarizes the top 20 research studies of 2022 identified as POEMs (patient-oriented evidence that matters), excluding COVID-19. Statins for primary prevention of cardiovascular disease produce only a small absolute reduction in a person's likelihood of dying (0.6%), having a myocardial infarction (0.7%), or having a stroke (0.3%) over three to six years. Supplemental vitamin D does not reduce the risk of a fragility fracture, even in people with low baseline vitamin D levels or a previous fracture. Selective serotonin reuptake inhibitors are preferred medical therapy for panic disorder, and patients who disco...
Source: Pain Physician - April 13, 2023 Category: Anesthesiology Authors: Roland Grad Mark H Ebell Source Type: research

Neurosurgical intervention in children with ventricular assist devices: A single center case series review
CONCLUSIONS: Perioperative concerns for the anesthesiologist include VAD hemodynamic management, bleeding, VAD thrombosis, and prevention of secondary brain injury. A systematic, multidisciplinary approach to management is paramount to attain favorable outcomes.PMID:34478592 | DOI:10.1111/pan.14287
Source: Paediatric Anaesthesia - September 3, 2021 Category: Anesthesiology Authors: Jane Yu Jenna Murray Chandra Ramamoorthy Sharon Chen Sarah Lee Kathleen Ryan Katsuhide Maeda Manchula Navaratnam Source Type: research

Preoperative Vitamin D Concentration and Cardiac, Renal, and Infectious Morbidity after Noncardiac Surgery
Conclusions Preoperative vitamin D was not associated with a composite of postoperative 30-day cardiac outcomes. However, there was a significant association between vitamin D deficiency and a composite of infectious complications and decreased kidney function. While renal effects were not clinically meaningful, the effect of vitamin D supplementation on infectious complications requires further study.
Source: Anesthesiology - December 13, 2019 Category: Anesthesiology Source Type: research

Four-factor Prothrombin Complex Concentrate for the Management of Patients Receiving Direct Oral Activated Factor X Inhibitors
Direct oral anticoagulants (DOACs) have been approved for the prevention of stroke and systemic embolism in atrial fibrillation, treatment and secondary prevention of venous thromboembolism (VTE), and thromboprophylaxis after major orthopedic surgery. DOACs achieve anticoagulation by inhibiting specific coagulation factors; apixaban, betrixaban, edoxaban, and rivaroxaban inhibit activated factor X, whereas dabigatran inhibits thrombin (factor IIa). In contrast to vitamin K antagonists such as warfarin, DOACs have more predictable pharmacokinetics and pharmacodynamics and fewer interactions with other medications and food, ...
Source: Anesthesiology - October 15, 2019 Category: Anesthesiology Source Type: research

Perioperative venous thromboembolic disease and the emerging role of the novel oral anticoagulants: An analysis of the implications for perioperative management.
Abstract Venous thromboembolism includes 2 inter-related conditions: Deep venous thrombosis and pulmonary embolism. Heparin and low-molecular-weight heparin followed by oral anticoagulation with vitamin K agonists is the first line and current accepted standard therapy with good efficacy. However, this therapeutic strategy has many limitations including the significant risk of bleeding and drug, food and disease interactions that require frequent monitoring. Dabigatran, rivaroxaban, apixaban, and edoxaban are the novel oral anticoagulants that are available for use in stroke prevention in atrial fibrillation and f...
Source: Annals of Cardiac Anaesthesia - October 1, 2015 Category: Anesthesiology Authors: Mookadam M, Shamoun FE, Ramakrishna H, Obeid H, Rife RL, Mookadam F Tags: Ann Card Anaesth Source Type: research

Management of Direct Oral Anticoagulants in the Perioperative Setting
AN INCREASING NUMBER of patients undergoing surgical procedures are treated chronically by oral anticoagulants (OAC). Vitamin K antagonists (VKAs) have been standard practice in chronic anticoagulant therapy for decades. Despite a proved efficacy, they have several disadvantages. Over the past 5 years, direct oral anticoagulants (DOAs) such as dabigatran, rivaroxaban, apixaban, and edoxaban have been approved for several indications for long-term anticoagulation. Consequently, with the aging population and the extension of the indication of anticoagulation for stroke prevention in nonvalvular atrial fibrillation (AF), ther...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 24, 2015 Category: Anesthesiology Authors: Olivier Untereiner, Pierre-François Seince, Vladimir Chterev, Isabelle Leblanc, Clarisse Berroëta, Patrick Bourel, Ivan Philip Tags: Review ArticlesGiovanni Landoni, MDSection Editors? > Source Type: research

Hemorrhagic stroke and new oral anticoagulants.
Abstract The recent release of new oral anticoagulants (NOAC) raises the question of the management of intracranial hemorrhage occurring during treatment with these molecules. Dabigatran, rivaroxaban and apixaban have different pharmacological characteristics that physicians need to know to adjust their prescription to each patient. Studies of efficacy and safety prior to the marketing of these molecules showed a decreased risk of intracranial hemorrhage compared with vitamin K antagonists. However, no reliable data are available regarding the prognosis of these hemorrhages occurring during NOAC treatment. In addi...
Source: Annales Francaises d'Anesthesie et de Reanimation - October 1, 2014 Category: Anesthesiology Authors: Derlon V, Corbonnois G, Martin M, Toussaint-Hacquard M, Audibert G Tags: Ann Fr Anesth Reanim Source Type: research

New oral anticoagulants in perioperative medicine.
Abstract New oral anticoagulants (NOAC) inhibit factor Xa (Stuart-Prower factor) or factor IIa (thrombin) and are alternatives to vitamin K antagonists. Perioperative indications are deep vein thrombosis prophylaxis for prosthetic hip and knee replacement, therapeutic anticoagulation for deep vein thrombosis as well as the prophylaxis of stroke for patients with atrial fibrillation. Patients on NOACs pose multiple perioperative challenges for all medical disciplines involved. For non-emergency surgery, patients should be evaluated by an anesthesiolgist as early as possible to assess an optimal appointment for surg...
Source: Der Anaesthesist - April 4, 2014 Category: Anesthesiology Authors: Giebl A, Gürtler K Tags: Anaesthesist Source Type: research