46,447 results match your criteria major bleeding

Prevention of Bleeding After Percutaneous Biopsy with a Small Intestinal Submucosa Hemostatic Plug.

Acta Biomater 2021 Oct 20. Epub 2021 Oct 20.

Department of Biomedical Engineering, Universidad de los Andes; Research Department Fundación Cardioinfantil - Instituto de Cardiología. Electronic address:

Percutaneous biopsies (PBs) are the gold standard diagnostic procedures indicated for renal and hepatic disorders. Nevertheless, they can cause hemorrhages and are contraindicated for coagulopathic patients. In this study we designed, fabricated, and evaluated a small intestinal submucosa (SIS) plug to reduce, and potentially cease, bleeding to decrease death risk after percutaneous hepatic and renal biopsies in healthy and coagulopathic in vivo models. 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

Anticoagulation versus antiplatelet therapy after percutaneous left atrial appendage closure-subanalysis from the multicenter LAARGE registry.

J Interv Card Electrophysiol 2021 Oct 23. Epub 2021 Oct 23.

Klinik Für Kardiologie, Pneumologie Und Intern. Intensivmed., Klinikum Neuperlach, Oskar-Maria-Graf-Ring 51, 81737, München, Germany.

Purpose: Data regarding post-procedural antithrombotic therapy following percutaneous left atrial appendage (LAA) in real-world populations using various occluder systems is limited. In the present analysis, anticoagulation (AC) was compared against antiplatelet therapy (APT) using data from the real-world multi-center LAARGE study.

Methods: Patients following LAA closure enrolled in the LAARGE study were assigned to two groups depending on initial post-implantation antithrombotic regime consisting of either AC or APT. Read More

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October 2021

Blume and Siebold & Zucc Mixed Extract Suppress Platelet Aggregation and Thrombosis.

Medicina (Kaunas) 2021 Oct 18;57(10). Epub 2021 Oct 18.

Department of Oriental Pharmacy, College of Pharmacy, Wonkwang University and Wonkwang-Oriental Medicines Research Institute, Iksan 54538, Korea.

Blood vessel thrombosis causes blood circulation disorders, leading to various diseases. Currently, various antiplatelet and anticoagulant drugs, such as aspirin, warfarin, heparin, and non-vitamin K antagonist oral anticoagulants (NOACs), are used as the major drugs for the treatment of a wide range of thrombosis. However, these drugs have a side effect of possibly causing internal bleeding due to poor hemostasis when taken for a long period of time. Read More

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October 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

Reversal Activity and Toxicity of Heparin-Binding Copolymer after Subcutaneous Administration of Enoxaparin in Mice.

Int J Mol Sci 2021 Oct 15;22(20). Epub 2021 Oct 15.

Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2c, 15-089 Bialystok, Poland.

Uncontrolled bleeding after enoxaparin (ENX) is rare but may be life-threatening. The only registered antidote for ENX, protamine sulfate (PS), has 60% efficacy and can cause severe adverse side effects. We developed a diblock copolymer, heparin-binding copolymer (HBC), that reverses intravenously administered heparins. Read More

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October 2021

Overview of Acute Ischemic Stroke Evaluation and Management.

Biomedicines 2021 Oct 16;9(10). Epub 2021 Oct 16.

Department of Neurology, Ochsner Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA.

Stroke is a major contributor to death and disability worldwide. Prior to modern therapy, post-stroke mortality was approximately 10% in the acute period, with nearly one-half of the patients developing moderate-to-severe disability. The most fundamental aspect of acute stroke management is "time is brain". Read More

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October 2021

Robert's Intragastric Alcohol-Induced Gastric Lesion Model as an Escalated General Peripheral and Central Syndrome, Counteracted by the Stable Gastric Pentadecapeptide BPC 157.

Biomedicines 2021 Sep 23;9(10). Epub 2021 Sep 23.

Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.

We redefined Robert's prototypical cytoprotection model, namely the intragastric administration of 96% alcohol in order to generate a general peripheral and central syndrome similar to that which occurs when major central or peripheral veins are occluded in animal models. With this redefinition, we used Robert's model to examine the cytoprotective effects of the stable gastric pentadecapeptide BPC 157. The intragastric administration of alcohol induced gastric lesions, intracranial (superior sagittal sinus) hypertension, severe brain swelling and lesions, portal and vena caval hypertension, aortal hypotension, severe thrombosis, inferior vena cava and superior mesenteric vein congestion, azygos vein failure (as a failed collateral pathway), electrocardiogram disturbances, and heart, lung, liver and kidney lesions. Read More

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September 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


Arq Bras Cir Dig 2021 15;34(2):e1586. Epub 2021 Oct 15.

Mackenzie Evangelical Faculty of Paraná, Curitiba, PR, Brazil.

Background: The treatment of 3rd degree burns represents a major medical challenge. Pinus vegetable cellulose is a biomaterial with characteristic similar to bacterial cellulose.

Aim: To evaluate the safety of cellulose membrane (Pinus sp) in the treatment of 3rd burns in rats and to compare its effectiveness with the bacterial membrane already on the market. Read More

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October 2021

Prothrombin complex concentrates in cardiac surgery: where are we?

Curr Opin Anaesthesiol 2021 Oct 19. Epub 2021 Oct 19.

Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Major bleeding in cardiac surgery is commonly encountered, and, until recently, most frequently managed with fresh frozen plasma (FFP). However, a Cochrane review found this practice to be associated with a significant increase in red blood cell (RBC) transfusions and costs. These findings have led to off-label uses of prothrombin complex concentrates (PCCs) in cardiac surgery. Read More

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October 2021

Minimally invasive aortic valve repair using geometric ring annuloplasty.

J Card Surg 2021 Oct 20. Epub 2021 Oct 20.

Department of Cardiac Surgery, Klinikum Nürnberg Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany.

Objectives: As aortic valve repair (AVr) for aortic insufficiency (AI) expands, minimally invasive (Mi) approaches are increasingly being applied. Cardiac surgical techniques can be more difficult through small incisions, and this report analyzes medium-term outcomes for MiAVr facilitated by geometric ring annuloplasty.

Methods: Since 2013, 58 patients were selected for AVr through upper sternotomy third-interspace incisions. Read More

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October 2021

Management of pre-, peri-, and post-menopausal abnormal uterine bleeding: When to perform endometrial sampling?

Int J Gynaecol Obstet 2021 Oct 20. Epub 2021 Oct 20.

Department of Obstetrics-Gynecology, University Hospital, University of Patras School of Medicine, Patras, Greece.

Abnormal uterine bleeding (AUB) is defined as abnormal volume, duration, or frequency of menstrual period and is a common symptom in women of all ages (premenopausal, perimenopausal, and postmenopausal). The acronym PALM-COEIN, introduced by the International Federation of Gynecology and Obstetrics (FIGO), facilitates the evaluation and differential diagnosis of AUB, mostly in premenopausal women with AUB. Endometrial evaluation (including ultrasound or hysteroscopic imaging and tissue sampling) for subtle pathology is proposed in patients who are at high risk for endometrial cancer and in patients at low risk who present with AUB and who present poor correspondence in medical treatment. Read More

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October 2021

Improving prediction of anticoagulant-related major bleeding in atrial fibrillation: The search for new biomarkers.

J Thromb Haemost 2021 Nov;19(11):2674-2676

TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

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November 2021

Management of major venous bleeding during minimally invasive pelvic surgery: A proposed protocol for "What should we do next?"

Int J Urol 2021 Oct 19. Epub 2021 Oct 19.

Department of Urology, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.

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October 2021

Subcutaneous Endoscopy in Plastic and Reconstructive Surgery.

Bharatendu Swain

Indian J Plast Surg 2021 Sep 16;54(3):297-301. Epub 2021 Sep 16.

Department of Plastic Surgery, Aakar Asha Hospital, Hyderabad, India.

Scar visibility is a major deterrent to patients seeking reconstructive surgery. Endoscopic surgery can address a wide range of problems, from minimizing or concealing scars to improving access and outcomes in certain situations. This case series includes a wide range of reconstructive surgery problems addressed by subcutaneous endoscopic surgery. Read More

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September 2021

Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma.

J Chest Surg 2021 Oct 20. Epub 2021 Oct 20.

Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.

Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival outcomes following surgical resection for esophageal carcinoma (EC). However, the factors predicting the amount of blood lost during thoracoscopic esophagectomy have yet to be sufficiently studied. We sought to identify risk factors for excessive blood loss during video-assisted thoracoscopic surgery (VATS) for EC. Read More

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October 2021

Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index: the EURopean study of older subjects with atrial fibrillation-EUROSAF.

Eur Geriatr Med 2018 Apr 27;9(2):149-154. Epub 2018 Feb 27.

Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genoa, 16128, Italy.

Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF PURPOSE: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with different treatments for AF (no treatment vs oral anticoagulants) and differences in the main outcomes, i. Read More

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Characteristics and outcome of Emergency Department intubation in geriatric patients.

Eur Geriatr Med 2018 Oct 27;9(5):623-629. Epub 2018 Jul 27.

Geriatric Department, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium.

Introduction: The number of elderly patients admitted to the Emergency Department (ED) continues to grow due to the natural aging of the population. Consequently, tracheal intubation will be increasingly used in the oldest old. The objective of this retrospective study is to evaluate the characteristics and outcome of patients of 75 years and older undergoing an endotracheal intubation in the ED. Read More

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October 2018

Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta-analysis.

Clin Cardiol 2021 Oct 19. Epub 2021 Oct 19.

Heart Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

Dual antiplatelet therapy (DAPT) was currently recommended for transcatheter aortic valve implantation (TAVI) postoperative management in clinical application. However, POPular-TAVI trial showed DAPT increased the incidence of adverse events compared to single antiplatelet therapy (SAPT). Herein, we performed a meta-analysis to investigate the effect of SAPT versus DAPT on the adverse events after TAVI. Read More

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October 2021

Left atrial appendage closure: a new strategy for cardioembolic events despite oral anticoagulation.

Panminerva Med 2021 Oct 19. Epub 2021 Oct 19.

Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy.

Background: Patients with non-valvular atrial fibrillation (nvAF) who experienced a cardioembolic (CE) event despite adequate oral anticoagulation (OAC) are at high risk of recurrence, and further prevention strategies are deemed necessary. The present study aimed to evaluate the safety and efficacy of off-label use of left atrial appendage closure (LAAC) in this subset of patients.

Methods And Results: Seventy-five consecutive patients with nvAF who experienced a CE event despite adequate OAC therapy were retrospectively enrolled from two Italian centers. Read More

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October 2021

Efficacy and Safety of Oral P2Y12 Inhibitors in Older Patients with Acute Coronary Syndrome: A Frequentist Network Meta-Analysis.

Drugs Aging 2021 Oct 19. Epub 2021 Oct 19.

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Background And Objective: Previous studies and meta-analyses have assessed optimal P2Y12 inhibitors following acute coronary syndrome in overall trial cohorts. However, there are insufficient data for the elderly cohort who are prone to high bleeding and ischemic events. We aimed to assess the optimal P2Y12 inhibitor therapy for older patients. Read More

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October 2021

Haemorrhagic ulcerative duodenitis in a patient with COVID-19 infection: clinical improvement following treatment with budesonide.

BMJ Open Gastroenterol 2021 Oct;8(1)

Department of Gastroenterology and Hepatology, Charité Universitätsmedizin Berlin, Berlin, Germany

We present a case of a male patient in his mid-30s with COVID-19-induced lung failure requiring extracorporeal membrane oxygenation, who needed an emergency oesophagogastroduodenoscopy due to major upper gastrointestinal bleeding. Endoscopy exposed severe ulcerative duodenitis with diffuse mucosal bleeding. While CT angiography did not show any signs of ischaemia, histopathology revealed duodenitis with substantial inflammatory cell infiltrates consisting of neutrophils and CD3 T lymphocytes with equal CD4/CD8 distribution. Read More

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October 2021

Impact of renin-angiotensin-aldosterone system inhibition on morbidity and mortality during long-term continuous-flow left ventricular assist device support: An IMACS report.

J Heart Lung Transplant 2021 Sep 9. Epub 2021 Sep 9.

Cardiovascular Division, Tufts Medical Center, Boston, Massachusetts.

Background: Inhibition of the renin angiotensin aldosterone system (RAAS) improves survival and reduces adverse cardiac events in heart failure with reduced ejection fraction, but the benefit is not well-defined following left ventricular assist device (LVAD).

Methods: We analyzed the ISHLT IMACS registry for adults with a primary, continuous-flow LVAD from January 2013 to September 2017 who were alive at postoperative month 3 without a major adverse event, and categorized patients according to treatment an angiotensin converting enzyme inhibitor (ACEI/ARB) or mineralocorticoid receptor antagonist (MRA). Propensity score matching was performed separately for ACEI/ARB vs none (n = 4,118 each) and MRA vs none (n = 3,892 each). Read More

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September 2021

A high-dose 24-hour tranexamic acid infusion for the treatment of significant gastrointestinal bleeding: HALT-IT RCT.

Health Technol Assess 2021 Oct;25(58):1-86

Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.

Background: Tranexamic acid reduces blood loss in surgery and the risk of death in trauma patients. Meta-analyses of small trials suggest that tranexamic acid decreases the number of deaths from gastrointestinal bleeding, but these meta-analyses are prone to selection bias.

Objective: The trial provides reliable evidence of the effect of tranexamic acid on mortality, rebleeding and complications in significant acute gastrointestinal bleeding. Read More

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October 2021

Anticoagulation in cancer-associated thromboembolism with thrombocytopenia: a prospective, multi-center cohort study.

Blood Adv 2021 Oct 18. Epub 2021 Oct 18.

Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.

Venous thromboembolism (VTE) with concurrent thrombocytopenia is frequently encountered in patients with cancer. Therapeutic anticoagulation in the setting of thrombocytopenia is associated with a high risk of hemorrhage. Retrospective analyses suggest the utility of modified-dose anticoagulation in this population. Read More

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October 2021

Growth differentiation factor-15 for prediction of bleeding in cancer patients.

J Thromb Haemost 2021 Oct 18. Epub 2021 Oct 18.

Department of Medicine, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Growth-differentiation factor-15 (GDF-15) is a strong predictor for bleeding in patients with atrial fibrillation, but there are no data on cardiovascular outcomes for this biomarker in cancer patients. Bleeding risk assessment is important in cancer patients when considering primary thromboprophylaxis since it is associated with an increased bleeding risk.

Objectives: To evaluate GDF-15 as predictor for bleeding events in cancer patients previously enrolled in the AVERT trial. Read More

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October 2021

Thromboembolic and bleeding risks in edoxaban patients with pacemaker and cardiac monitoring procedures: Outcomes of the Global EMIT program.

Pacing Clin Electrophysiol 2021 Oct 18. Epub 2021 Oct 18.

Polyclinic of Bari - Hospital, Department of Cardiology, Bari, Italy.

Introduction: Limited data were published on the management of direct oral anticoagulants in the insertion of pacemaker and cardiac monitoring devices. This study describes the management and outcomes of edoxaban, a direct oral factor Xa inhibitor, in patients undergoing pacemaker or monitoring device implantation in routine clinical practice.

Methods And Results: EMIT-AF/VTE collected data of patients from Europe, Korea, and Taiwan. Read More

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October 2021

Ticagrelor monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention: TWILIGHT-HBR.

Eur Heart J 2021 Oct 18. Epub 2021 Oct 18.

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.

Aims: Patients at high bleeding risk (HBR) represent a prevalent subgroup among those undergoing percutaneous coronary intervention (PCI). Early aspirin discontinuation after a short course of dual antiplatelet therapy (DAPT) has emerged as a bleeding avoidance strategy. The aim of this study was to assess the effects of ticagrelor monotherapy after 3-month DAPT in a contemporary HBR population. Read More

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October 2021