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Transcranial Doppler 6 h after Successful Reperfusion as a Predictor of Infarct Volume.

J Stroke Cerebrovasc Dis 2021 Oct 20;31(1):106149. Epub 2021 Oct 20.

Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, Madrid, 28040, Spain.

Objectives: The aim of the study is to analyze the hemodynamic changes in the middle cerebral artery (MCA) after endovascular revascularization in acute ischemic stroke (AIS) due to large vessel occlusion and its association with the infarct volume size in the control head CT.

Materials And Methods: Prospective study of patients with AIS due to internal carotid artery terminus or M1 segment of the MCA occlusion, who underwent endovascular treatment with a final TICI 2b-3 score, without concomitant stenosis ≥50% in both cervical carotid arteries. Transcranial Doppler ultrasound (TCD) of both MCAs was carried out at 6 h after the endovascular procedure. Read More

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October 2021

Prognostic capacity of inferior vena cava diameter for severe postpartum hemorrhage.

Eur J Obstet Gynecol Reprod Biol 2021 Oct 16;267:6-10. Epub 2021 Oct 16.

Department of Gynecology and Obstetrics, Aksaray University Education and Research Hospital, Aksaray, Turkey. Electronic address:

Purpose: This study sought to evaluate whether or not the sonographic measurement of the inferior vena cava (IVC) diameter predicts severe bleeding in women with postpartum hemorrhage (PPH). It further compared the efficacy of the IVC diameter, shock index, and serum lactate levels in this prediction.

Methods: This prospective study included female patients with ≥500 mL of bleeding after vaginal delivery between September 1, 2019 and May 31, 2021. Read More

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October 2021

Molecular signature of brain arteriovenous malformation hemorrhage: a systematic review.

World Neurosurg 2021 Oct 20. Epub 2021 Oct 20.

Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Background: The mechanisms of brain arteriovenous malformation (bAVM) development, formation and progress are still poorly understood. By gaining more knowledge about the molecular signature of bAVM in relation to hemorrhage, we might be able to find biomarkers associated with this serious complication, which can function as a goal for further research and can be a potential target for gene therapy.

Aims: To provide a comprehensive overview of the molecular signature of bAVM-related hemorrhage We conducted a systematic review, following PRISMA guidelines, of articles published in Embase, Medline, Cochrane central, Scopus, and Chinese databases (CNKI, Wanfang). Read More

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October 2021

Novel Clinical Insights on Spinal Hemangioblastoma in Adults: A Systematic Review.

World Neurosurg 2021 Oct 20. Epub 2021 Oct 20.

Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA. Electronic address:

Background: Hemangioblastomas are well vascularized, benign CNS tumors and the third most common primary spinal cord tumor after astrocytoma/ependymoma, occurring sporadically or as a part of an autosomal dominant von Hippel-Lindau disease in which tumors are often multiple and prone to relapse. Spinal hemangioblastomas are commonly located in the cervical cord and associated with a syrinx formation. Due to location and growth trends, they may cause significant neurological deficit, impairing patient quality of life. Read More

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October 2021

Development of a Preoperative Clinical Risk Assessment Tool for Postoperative Complications After Hysterectomy.

J Minim Invasive Gynecol 2021 Oct 20. Epub 2021 Oct 20.

the Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA. Electronic address:

Study Objective: To develop a preoperative risk assessment tool that quantifies the risk of postoperative complications within 30 days of hysterectomy.

Design: Retrospective analysis.

Setting: Michigan Surgical Quality Collaborative hospitals. Read More

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October 2021

Anticoagulation Therapy is Associated with Increased Access-related Wound Infections after Hemodialysis Access Creation.

Ann Vasc Surg 2021 Oct 20. Epub 2021 Oct 20.

Division of Vascular and Endovascular Surgery, Department of Surgery, NYU Langone Medical Center, New York, NY. Electronic address:

Objective: The effect of anticoagulation therapy (AC) on hemodialysis access patency and related complications is not well defined. Patients on long-term or chronic AC due to their underlying comorbid conditions may be particularly susceptible to access-related bleeding and complications from repetitive cannulation. Our goal is to assess the effect of anticoagulation therapy on outcomes after access creation. Read More

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October 2021

Effects of a supervised therapeutic exercise program on musculoskeletal health and gait in patients with haemophilia: A pilot study.

Haemophilia 2021 Oct 22. Epub 2021 Oct 22.

Division of Sport Physiology, Department of Physiology, Faculty of Medicine, Çukurova University, Adana, Turkey.

Introduction: Episodes of bleeding in patients with haemophilia (PwH) are associated with haemophilic arthropathy, limitations in physical performance, reduced quality of life (QoL), and gait disorders.

Aim: This non-randomized, controlled, interventional, prospective, single-centre pilot study aimed to assess the effects of an 8-week supervised therapeutic exercise program on musculoskeletal health, gait kinematic parameters (GKP), functional capacity, and QoL in adult PwH.

Methods: Nineteen PwH were allocated to an exercise group (n = 10) or a control group (n = 9). Read More

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October 2021

Evaluation of Cardiac Troponin and Adverse Outcomes After Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.

Neurocrit Care 2021 Oct 22. Epub 2021 Oct 22.

Department of Neurosurgery and Neurology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.

Several studies have demonstrated the usefulness of cardiac troponin I (cTn) levels in predicting adverse clinical outcomes of patients with anerusmal subarachnoid hemorrhage (aSAH). However, it remains unclear whether cTn levels can be a useful factor in predicting adverse neurologic and cardiovascular outcomes regarding follow-up duration. The study aimed to evaluate the clinical value of cTn elevation among patients with aSAH. Read More

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October 2021

Prediction of bleb formation in intracranial aneurysms using machine learning models based on aneurysm hemodynamics, geometry, location, and patient population.

J Neurointerv Surg 2021 Oct 22. Epub 2021 Oct 22.

Department of Bioengineering, George Mason University, Fairfax, Virginia, USA.

Background: Bleb presence in intracranial aneurysms (IAs) is a known indication of instability and vulnerability.

Objective: To develop and evaluate predictive models of bleb development in IAs based on hemodynamics, geometry, anatomical location, and patient population.

Methods: Cross-sectional data (one time point) of 2395 IAs were used for training bleb formation models using machine learning (random forest, support vector machine, logistic regression, k-nearest neighbor, and bagging). Read More

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October 2021

Successful repeated uterine artery embolization in postpartum hemorrhage with disseminated intravascular coagulation: a case report and literature review.

BMC Pregnancy Childbirth 2021 Oct 22;21(1):710. Epub 2021 Oct 22.

Departments of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan.

Background: Postpartum hemorrhage (PPH) is a potentially fatal condition requiring urgent and appropriate intervention. Uterine artery embolization (UAE) has a high hemostatic capacity for PPH, but it may fail. Disseminated intravascular coagulation (DIC) has been reported as a risk factor associated with the failure of UAE. Read More

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October 2021

A Novel Likely Pathogenic Variant in the Gene Associated with Hermansky-Pudlak Syndrome Type 11 and an Overview of Human BLOC-1 Deficiencies.

Cells 2021 Oct 1;10(10). Epub 2021 Oct 1.

Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.

Hermansky-Pudlak syndrome (HPS) is a heterogeneous disorder combining oculocutaneous albinism (OCA) and a platelet function disorder of varying severity as its most prominent features. The genes associated with HPS encode for different BLOC- (biogenesis of lysosome-related organelles complex) complexes and for the AP-3 (adaptor protein-3) complex, respectively. These proteins are involved in maturation, trafficking, and the function of lysosome-related organelles (LROs) such as melanosomes and platelet δ-granules. Read More

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October 2021

Dabigatran Etexilate Induces Cytotoxicity in Rat Gastric Epithelial Cell Line via Mitochondrial Reactive Oxygen Species Production.

Cells 2021 Sep 22;10(10). Epub 2021 Sep 22.

Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan.

Dabigatran is a novel oral anticoagulant that directly inhibits free and fibrin-bound thrombins and exerts rapid and predictable anticoagulant effects. While the use of this reagent has been associated with an increased risk of gastrointestinal bleeding, the reason why dabigatran use increases gastrointestinal bleeding risk remains unknown. We investigated the cytotoxicity of dabigatran etexilate and tartaric acid, the two primary components of dabigatran. Read More

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September 2021

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies.

Life (Basel) 2021 Oct 17;11(10). Epub 2021 Oct 17.

Department of Neurology, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal.

Recent attention has been focused on the field of inflammatory biomarkers associated with vascular disorders, regarding diagnosis, prognosis, and possible therapeutical targets. In this study, we aimed to perform a comprehensive review of the literature regarding the use of inflammatory biomarkers in stroke patients. We searched studies that evaluated inflammation biomarkers associated with Cerebrovascular Disease (CVD), namely, ischemic Stroke (IS), Intracerebral Hemorrhage (ICH) and Cerebral Venous Thrombosis (CVT). Read More

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October 2021

Arguments for Using Direct Oral Anticoagulants in Cancer-Related Venous Thromboembolism.

Healthcare (Basel) 2021 Sep 28;9(10). Epub 2021 Sep 28.

Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.

(1) Background: Patients with cancer with a hypercoagulable state present an increased incidence of venous thromboembolism (VTE). Neoplastic patients with concurrent VTE undergoing anticoagulant treatment face a series of issues. (2) The aim of the present paper is to systematically summarize current VTE management in patients with neoplasia and to review the current clinical evidence from meta-analyses of randomized controlled trials and guidelines regarding the administration of direct oral anticoagulants (DOACs) for cancer-associated VTE. Read More

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September 2021

Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice.

J Clin Med 2021 Oct 11;10(20). Epub 2021 Oct 11.

Department of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, Japan.

Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited.

Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. Read More

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October 2021

Individualized versus Standardized Risk Assessment in Patients at High Risk for Adverse Drug Reactions (The IDrug Randomized Controlled Trial)-Never Change a Running System?

Pharmaceuticals (Basel) 2021 Oct 18;14(10). Epub 2021 Oct 18.

Institute of Clinical Pharmacology, University Hospital RWTH Aachen, 52074 Aachen, Germany.

The aim of this study was to compare effects of an individualized with a standardized risk assessment for adverse drug reactions to improve drug treatment with antithrombotic drugs in older adults. A randomized controlled trial was conducted in general practitioner (GP) offices. Patients aged 60 years and older, multi-morbid, taking antithrombotic drugs and at least one additional drug continuously were randomized to individualized and standardized risk assessment groups. Read More

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October 2021

Ventriculitis: Infection or Inflammation.

Antibiotics (Basel) 2021 Oct 14;10(10). Epub 2021 Oct 14.

School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia.

Ventriculitis, or infection of the cerebrospinal fluid, in the presence of external ventricular drains (EVD), is an important complication and associated with substantial mortality, morbidity, and healthcare costs. Further, the conditions that require the insertion of an EVD, such as neurotrauma and subarachnoid hemorrhage, are themselves associated with inflammation of the cerebrospinal fluid. Phenotypically, patients with inflammation of the cerebrospinal fluid can present with very similar symptoms, signs, and laboratory findings to those with infection. Read More

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October 2021

Use of Intravesical Injections of Platelet-Rich Plasma for the Treatment of Bladder Pain Syndrome: A Comprehensive Literature Review.

Antibiotics (Basel) 2021 Oct 1;10(10). Epub 2021 Oct 1.

Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Umbria, IT Viale Tristano di Joannuccio, 05100 Terni, Italy.

Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) or primary bladder pain syndrome (PBPS) is a complex and poorly understood condition. This comprehensive review aimed to discuss the potential application of platelet-rich plasma (PRP) in the treatment of BPS/IC. The pathophysiology of BPS/IC is characterized by urothelial damage that triggers a chain of events leading to chronic inflammation and other conditions. Read More

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October 2021

Anticoagulation with Factor Xa Inhibitors Is Associated with Improved Overall Response and Progression-Free Survival in Patients with Metastatic Malignant Melanoma Receiving Immune Checkpoint Inhibitors-A Retrospective, Real-World Cohort Study.

Cancers (Basel) 2021 Oct 12;13(20). Epub 2021 Oct 12.

Department of Dermatology, University Medical Center of the Johannes-Gutenberg University Mainz, 55131 Mainz, Germany.

Immune checkpoint inhibitors (ICI) significantly improved the prognosis of advanced melanoma patients. However, many patients do not derive long-term benefit from ICI therapy due to primary and acquired resistance. In this regard, it has been shown that coagulation factors contribute to cancer immune evasion and might therefore promote resistance to ICI. Read More

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October 2021

Factors Affecting Route Selection of Balloon-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study.

Diagnostics (Basel) 2021 Oct 10;11(10). Epub 2021 Oct 10.

Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea.

Balloon-assisted enteroscopy (BAE) is an important diagnostic modality for ongoing obscure gastrointestinal bleeding (OGIB). However, it is difficult to determine the optimal insertion route. We retrospectively analyzed the records of patients with OGIB contained in a multicenter enteroscopy database of 1108 balloon-assisted enteroscopy (BAE) procedures (875 patients) to find out factors affecting BAE route selection in patients with OGIB. Read More

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October 2021

Clinical Value of Bronchoscopy in Acute Respiratory Failure.

Diagnostics (Basel) 2021 Sep 24;11(10). Epub 2021 Sep 24.

Pulmonology and Respiratory Intensive Care Unit, S. Donato Hospital, Via Nenni, 52100 Arezzo, Italy.

Bronchoscopy may be considered the "added value" in the diagnostic and therapeutic pathway of different clinical scenarios occurring in acute respiratory critically ill patients. Rigid bronchoscopy is mainly employed in emergent clinical situations due to central airways obstruction, haemoptysis, and inhaled foreign body. Flexible bronchoscopy (FBO) has larger fields of acute applications. Read More

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September 2021

Admission Hyperglycemia Predicts Long-Term Mortality in Critically Ill Patients With Subarachnoid Hemorrhage: A Retrospective Analysis of the MIMIC-III Database.

Front Neurol 2021 5;12:678998. Epub 2021 Oct 5.

Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.

Subarachnoid hemorrhage (SAH) is a severe subtype of stroke with high mortality. Hyperglycemia is a common phenomenon in critically ill patients and associated with poor clinical outcome. However, the predictive value of admission hyperglycemia for 30 and 90-day all-cause mortality in critically ill patients with SAH remains controversial. Read More

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October 2021

Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study.

Front Psychol 2021 5;12:710602. Epub 2021 Oct 5.

Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, United States.

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. Read More

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October 2021

Successful Treatment of Factor X Deficiency in a Patient with Lymphoplasmacytic Lymphoma with Bendamustine Plus Rituximab Regimen: A Case Report and Literature Review.

J Blood Med 2021 7;12:875-881. Epub 2021 Oct 7.

Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Acquired factor X deficiency is an uncommon condition, and affected individuals have severe and spontaneous bleeding. The associated conditions include malignancy, infection, burn, and inflammatory bowel disease. Many previous studies reported association between lymphoproliferative disease and factor X disappearance. Read More

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October 2021

Adherence to Non-Selective Beta Blockers for Prevention of Variceal Bleeding in Cirrhotic Patients.

Int J Gen Med 2021 13;14:6713-6724. Epub 2021 Oct 13.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, 110840, People's Republic of China.

Background And Aim: Long-term use of non-selective beta blockers (NSBBs) is essential for the prevention of esophageal variceal bleeding in liver cirrhosis but may impair the patient's adherence. The present study aimed to investigate the adherence to NSBBs to prevent variceal bleeding in cirrhotic patients.

Methods: All patients who had an indication of NSBBs for the prophylaxis of variceal bleeding between February 2018 and June 2019 were screened. Read More

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October 2021

Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry.

Clin Interv Aging 2021 12;16:1835-1846. Epub 2021 Oct 12.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.

Purpose: Hypertension is associated with incident atrial fibrillation (AF) and AF-related complications. We investigated the associations between average systolic blood pressure (SBP) and outcomes in a nationwide cohort of Asian patients with non-valvular atrial fibrillation (NVAF).

Patients And Methods: A multicenter nationwide registry of patients with NVAF in Thailand was conducted during 2014-2017. Read More

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October 2021

Thromboembolic and bleeding events in ICU patients with COVID-19: results from a Brazilian tertiary hospital.

Int J Infect Dis 2021 Oct 17. Epub 2021 Oct 17.

BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil; BRICnet - Brazilian Research in Intensive Care Network.

Objectives: Describe the incidence of thromboembolic events in adult patients with severe COVID-19 and identify clinical and laboratory correlates factors associated with these events.

Design: Observational retrospective cohort of 243 adult patients with severe COVID-19 who were admitted to an intensive care unit at a Brazilian tertiary hospital.

Results: The incidence of all thromboembolic events was 14. Read More

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October 2021

Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease.

N Engl J Med 2021 10;385(17):1559-1569

From the Virginia Commonwealth University School of Medicine, Richmond (A.J.S.); the Bloomberg School of Public Health, Johns Hopkins University, Baltimore (M.L.V.N., J.C., L.A.W., K.P.Y., P.B., M.L., J.T.), and the Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda (D.E.K.) - both in Maryland; Saint Louis University, St. Louis (B.A.N.-T.); Duke University, Durham, NC (A.M.D.); Cleveland Clinic, Cleveland (S.D.); the University of California, San Diego, School of Medicine, La Jolla (R.L., C.B.), and the University of California, San Francisco, School of Medicine, San Francisco (B.H.); Indiana University School of Medicine, Indianapolis (N.C.); and the Liver Institute Northwest, Seattle (K.K.).

Background: The prognoses with respect to mortality and hepatic and nonhepatic outcomes across the histologic spectrum of nonalcoholic fatty liver disease (NAFLD) are not well defined.

Methods: We prospectively followed a multicenter patient population that included the full histologic spectrum of NAFLD. The incidences of death and other outcomes were compared across baseline histologic characteristics. Read More

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October 2021

Adverse event profile and associated factors following surgical voluntary medical male circumcision in two regions of Namibia, 2015-2018.

PLoS One 2021 20;16(10):e0258611. Epub 2021 Oct 20.

Department of Global Health, International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, United States of America.

Introduction: Monitoring clinical safety of voluntary medical male circumcision (VMMC) is critical to minimize risk as VMMC programs for HIV prevention are scaled. This cross-sectional analysis describes the adverse event (AE) profile of a large-scale, routine VMMC program and identifies factors associated with the development, severity, and timing of AEs to provide recommendations for program quality improvement.

Materials And Methods: From 2015-2018 there were 28,990 circumcisions performed in International Training and Education Center for Health (I-TECH) supported regions of Namibia in collaboration with the Ministry of Health and Social Services. Read More

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October 2021

Comparison of Bivalirudin Versus Unfractionated Heparin for Anticoagulation in Adult Patients on Extracorporeal Membrane Oxygenation.

ASAIO J 2021 Oct 19. Epub 2021 Oct 19.

From the Department of Pharmacy Services, ProMedica Toledo Hospital, Toledo, Ohio, Division of Cardiothoracic Surgery, University of Kentucky Healthcare, Lexington, Kentucky, Department of Pharmacy Services, University of Kentucky Healthcare, Lexington, Kentucky, College of Pharmacy, University of Kentucky, Lexington, Kentucky and Kentucky Children's Hospital, University of Kentucky Healthcare, Lexington, Kentucky, USA.

Extracorporeal membrane oxygenation (ECMO) contributes to coagulopathy, necessitating systemic anticoagulation to prevent thrombosis. Traditionally, unfractionated heparin (UFH) has been the anticoagulant of choice, however, due to many inadequacies new evidence suggests benefit with the use of direct thrombin inhibitors. This retrospective cohort sought to evaluate the safety and efficacy of bivalirudin compared to UFH in ECMO patients. Read More

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October 2021