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Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures.

Clin Otolaryngol 2021 Sep 27. Epub 2021 Sep 27.

Charing Cross Airway Service, Department of Otolaryngology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, UK.

Objectives: In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit's complication rates.

Design: Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Read More

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September 2021

Direct oral anticoagulants decrease treatment failure for acute lower extremity deep venous thrombosis.

Vascular 2021 Sep 26:17085381211042231. Epub 2021 Sep 26.

Department of Surgery, Division of Vascular Surgery, 12244Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Objective: Optimal medical therapy for acute lower extremity deep venous thrombosis (DVT) remains an enigma. While clinical trials demonstrate non-inferiority with an oral anti-Xa inhibitor, or direct oral anticoagulant (DOAC), versus combined low-molecular weight heparin (LMWH) and oral vitamin K antagonist (VKA), the most effective regimen remains to be determined.

Methods: This study is a single-center retrospective cohort study from October 2014 to December 2015 of patients with a diagnosis of acute DVT and subsequent serial lower extremity venous duplex. Read More

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September 2021

Termination Based on Event Accrual in Per Protocol Versus Intention to Treat in the ROCKET AF Trial.

J Am Heart Assoc 2021 Sep 25:e022485. Epub 2021 Sep 25.

Duke Clinical Research Institute Duke University Durham NC.

Background In event-driven clinical trials, study termination is based on accrual of a target number of primary efficacy events. For noninferiority trials in which superiority is conditionally examined, the ideal cohort in which to track event accrual is unclear. We used data from the ROCKET AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) trial to determine the effect of primary efficacy-event tracking in the per-protocol cohort during the on-treatment period versus the intention-to-treat (ITT) cohort during the ITT period. Read More

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September 2021

Uninterrupted Direct Oral Anticoagulants Without a Change in Regimen for Catheter Ablation for Atrial Fibrillation Is an Acceptable Protocol.

Circ Rep 2021 Sep 30;3(9):481-487. Epub 2021 Jul 30.

Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo Tokyo Japan.

In patients undergoing catheter ablation (CA) for atrial fibrillation (AF), the use of uninterrupted direct oral anticoagulants (DOACs) is the current protocol. This study evaluated bleeding complications following the uninterrupted use of 4 DOACs in patients undergoing CA for AF without any change in the dosing regimen. Moreover, we assessed differences between once- and twice-daily DOAC dosing in patients undergoing CA for AF who continued on DOACs without any change in the dosing regimen. Read More

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September 2021

Automated Thrombin Generation Assay for Rivaroxaban, Apixaban, and Edoxaban Measurements.

Front Cardiovasc Med 2021 9;8:717939. Epub 2021 Sep 9.

Department of Clinical Chemistry, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.

The thrombin generation assay (TG) is a promising approach to measure the degree of anticoagulation in patients treated with direct oral anticoagulants (DOAC). A strong association with plasma drug concentrations would be a meaningful argument for the potential use to monitor DOAC. We aimed to study the correlation of TG with rivaroxaban, apixaban, and edoxaban drug concentrations in a large, prospective multicenter cross-sectional study. Read More

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September 2021

Impact of Age, Sex, and Renal Function on the Efficacy and Safety of Direct Oral Anticoagulants vs. Vitamin K Antagonists for the Treatment of Acute Venous Thromboembolism: A Meta-Analysis of 22,040 Patients.

Front Cardiovasc Med 2021 8;8:700740. Epub 2021 Sep 8.

Cardiovascular Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

In this study, we conducted a meta-analysis to assess the impact of age, sex, and renal function on the efficacy and safety of direct oral anticoagulants (DOACs) vs. vitamin K antagonists (VKAs) for the treatment of acute venous thromboembolism (VTE). Electronic databases (accessed till June 2021) were systematically searched to investigate randomized clinical trials evaluating apixaban, dabigatran, edoxaban, and rivaroxaban vs. Read More

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September 2021

Acute Secondary Prevention of Ischemic Stroke: Overlooked No Longer.

Front Neurol 2021 10;12:701168. Epub 2021 Sep 10.

Department of Neurology, The University of Chicago, Chicago, IL, United States.

Recent studies of interventions initiated acutely following onset of minor ischemic stroke or transient ischemic attack (TIA) have disclosed early stroke recurrence rates that are substantially higher than long-term recurrence rates and that can be reduced by acute antiplatelet treatment interventions. These observations, bolstered by analysis based on kinetic modeling of the time course of recurrence following initial events, suggest that acute stroke patients experience an underlying vulnerable state that quickly transitions to a more stable state. Some evidence also supports the benefits of early treatment with direct-acting oral anticoagulants in cardioembolic stroke and of continuation or early initiation of statin therapy in atherosclerotic stroke. Read More

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September 2021

Direct intraoperative versus percutaneous computed tomographyguided celiac plexus neurolysis in non-resectable pancreatic cancer: A randomized, controlled, non-inferiority study.

Rev Esp Anestesiol Reanim 2021 Sep 23. Epub 2021 Sep 23.

Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egipto.

Background: Celiac plexus neurolysis (CPN) has been used to control pancreatic cancer (PC) pain, up to our knowledge, there is no study compared intraoperative CPN and computed tomography (CT)-guided techniques.

Objectives: To compare the effects of intraoperative and CT-guided CPN in unresectable PC on pain intensity and analgesic requirements.

Methods: A total of 90 patients were enrolled in this prospective, randomized, open label, controlled, non-inferiority study, 20 patients were excluded or lost to follow up. Read More

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September 2021

Utilization of diverse protein sources for the development of protein-based nanostructures as bioactive carrier systems: A review of recent research findings (2010-2021).

Crit Rev Food Sci Nutr 2021 Sep 27:1-19. Epub 2021 Sep 27.

Department of Food Science, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.

Consumer awareness of the relationship between health and nutrition has caused a substantial increase in the demand for nutraceuticals and functional foods containing bioactive compounds (BACs) with potential health benefits. However, the direct incorporation of many BACs into commercial food and beverage products is challenging because of their poor matrix compatibility, chemical instability, low bioavailability, or adverse impact on food quality. Advanced encapsulation technologies are therefore being employed to overcome these problems. Read More

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September 2021

Cardiac amyloidosis presenting with coronary artery embolization.

Rev Cardiovasc Med 2021 Sep;22(3):883-889

Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.

Amyloid light-chain (AL) amyloidosis is a multisystemic disease. Among its clinical manifestations, vein and arterial thromboembolic events are included. We report the unusual case of a 57-year-old female patient with AL amyloidosis presenting with an ST segment elevation myocardial infarction due to coronary artery embolization (CE). Read More

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September 2021

Management of antithrombotic therapy in patients with atrial fibrillation and acute coronary syndromes.

Rev Cardiovasc Med 2021 Sep;22(3):659-675

Cardiology Clinic, "St. Spiridon" County Emergency Hospital, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iaşi, Romania.

If atrial fibrillation (AF) and acute coronary syndrome (ACS) coexist, they should be treated with combined antithrombotic therapy. To reduce the risk of bleeding while maintaining the desired antithrombotic effect, choices should be made for each patient according to the balance between the bleeding and the thrombotic risk. There are many ways to select the type and dose of the oral anticoagulant (OAC) and P2Y12 inhibitors. Read More

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September 2021

Infrastructure, logistics and clinical practice management of acute trauma hemorrhage and coagulopathy: a survey across German trauma centers.

Eur J Trauma Emerg Surg 2021 Sep 26. Epub 2021 Sep 26.

Department of Medicine, Faculty of Health, Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany.

Purpose: Early detection and management of acute trauma hemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructure, logistics and clinical strategies may differ.

Methods: To assess local differences in infrastructure, logistics and clinical management of acute trauma hemorrhage and coagulopathy we have conducted a web-based survey amongst clinicians working in DGU-certified supraregional, regional and local trauma centers.

Results: 137/1875 respondents completed the questionnaire yielding a response rate of 7. Read More

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September 2021

The Language of Dreams: Application of Linguistics-Based Approaches for the Automated Analysis of Dream Experiences.

Clocks Sleep 2021 Sep 19;3(3):495-514. Epub 2021 Sep 19.

MoMiLab Research Unit, IMT School for Advanced Studies Lucca, 55100 Lucca, Italy.

The study of dreams represents a crucial intersection between philosophical, psychological, neuroscientific, and clinical interests. Importantly, one of the main sources of insight into dreaming activity are the (oral or written) reports provided by dreamers upon awakening from their sleep. Classically, two main types of information are commonly extracted from dream reports: structural and semantic, content-related information. Read More

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September 2021

Malondialdehyde, an Oxidative Stress Marker in Oral Squamous Cell Carcinoma-A Systematic Review and Meta-Analysis.

Curr Issues Mol Biol 2021 Aug 28;43(2):1019-1035. Epub 2021 Aug 28.

Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Objective: To qualitative and quantitatively review published literature assessing the oxidative stress marker malondialdehyde (MDA) in oral squamous cell carcinoma (OSCC).

Methodology: Pubmed (MeSH), Science Direct, Scopus, Web of Science, Willey Online Library, Cochrane, and Cross Reference were searched for studies assessing MDA levels in OSCC samples.

Results: From the 1008 articles identified, 849 were excluded based on title and abstract screening due to duplication and irrelevance to the topic of interest. Read More

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Diagnostic and Therapeutic Challenges of Cerebral Venous Thrombosis in SARS-CoV-2 Infection: A Case Report and Review of Literature.

Clin Pract 2021 Sep 7;11(3):598-606. Epub 2021 Sep 7.

School of Medicine, Caribbean Medical University, 4797 Willemstad, Curaçao.

Headache, a common prodromal symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, can also be a manifestation of cerebral venous thrombosis (CVT), secondary to COVID-19. CVT management continues to evolve, with direct oral anticoagulants (DOACs) emerging as an alternative to warfarin. A 44-year-old Asian female, with no past medical history, presented to the emergency room (ER) with complaints of nonproductive cough and left-sided headache. Read More

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September 2021

Argon Bioactivation of Implants Installed Simultaneously to Maxillary Sinus Lifting without Graft. An Experimental Study in Rabbits.

Dent J (Basel) 2021 Sep 6;9(9). Epub 2021 Sep 6.

Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil.

Background: The treatment of the surface of titanium implants with argon plasma improved its hydrophilicity and cell adhesion, resulting in higher bone apposition on implant and graft surfaces. The spontaneous perforation over time of the sinus mucosa after sinus augmentation has been documented in experimental studies at both implants and graft particles. The aim of the present study was to evaluate the influence of plasma argon treatment of the implant surface on bone apposition and on the rate of sinus mucosa perforations. Read More

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September 2021

From Activated Partial Thromboplastin Time to Antifactor Xa and Back AgainThe Evolution of Monitoring Unfractionated Heparin.

Am J Clin Pathol 2021 Sep 25. Epub 2021 Sep 25.

Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, USA.

Objectives: Monitoring is essential to safe anticoagulation prescribing and requires close collaboration among pathologists, clinicians, and pharmacists.

Methods: We describe our experience in the evolving strategy for laboratory testing of unfractionated heparin (UFH).

Results: An intrainstitutional investigation revealed significant discordance between activated partial thromboplastin time (aPTT) and antifactor Xa (anti-Xa) assays, prompting a transition from the former to the latter in 2013. Read More

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September 2021

Effect of oral health literacy on self-reported tooth loss: A multiple mediation analysis.

Community Dent Oral Epidemiol 2021 Sep 24. Epub 2021 Sep 24.

School of Public Health, The University of Adelaide, Adelaide, Australia.

Background: This study aims to investigate the mediating pathways of oral health literacy (OHL) and oral health-related behaviours on the relationship between education and self-reported tooth loss among Australian adults.

Methods: Data used for studying the effects of mediating pathways are from the National Dental Telephone Interview Survey 2013, a random sample survey of Australian adults aged 18+ years. To study the mediating effects, we use counterfactual-based analysis. Read More

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September 2021

Effect of remote ischemic preconditioning on fibrin formation and metabolism in patients undergoing hip fracture surgery: a randomized clinical trial.

Blood Coagul Fibrinolysis 2021 Sep 24. Epub 2021 Sep 24.

Centre for Surgical Science, Department of Surgery, Zealand University Hospital, Køge Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark and Department of Clinical Biochemistry, University Hospital of Southern Denmark Department of Clinical Biochemistry, Regional Hospital West Jutland, Holstebro, Denmark.

Remote ischemic preconditioning (RIPC) prior to surgery has recently been shown to reduce the risk of myocardial injury and myocardial infarction after hip fracture surgery. This study investigated whether RIPC initiated antithrombotic mechanisms in patients undergoing hip fracture surgery. This trial was a predefined sub-study of a multicentre randomized clinical trial. Read More

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September 2021

A Modified Procedure for Anterior Maxillary Osteotomy.

J Craniofac Surg 2021 Sep 24. Epub 2021 Sep 24.

Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.

Abstract: Anterior maxillary osteotomy is a traditional operation in the treatment of maxillary protrusion. Varies fields about operation have been changed or improved in those years to avoid different kinds of complications. In our study, the authors would present 1 kind of improved anterior maxillary osteotomy surgical method. Read More

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September 2021

Airway administration of OM-85, a bacterial lysate, blocks experimental asthma by targeting dendritic cells and the epithelium/IL-33/ILC2 axis.

J Allergy Clin Immunol 2021 Sep 21. Epub 2021 Sep 21.

Department of Cellular and Molecular Medicine, The University of Arizona, Tucson, AZ, 85721, USA; Asthma and Airway Disease Research Center, The University of Arizona, Tucson, AZ, 85721, USA; The BIO5 Institute, The University of Arizona, Tucson, AZ, 85721, USA; Arizona Center for the Biology of Complex Diseases, The University of Arizona.

Background: Microbial interventions against allergic asthma have robust epidemiologic underpinnings and the potential to recalibrate disease-inducing immune responses. Oral administration of OM-85, a standardized lysate of human airways bacteria, is widely used empirically to prevent respiratory infections and a clinical trial is testing its ability to prevent asthma in high-risk children. We previously showed that intra-nasal administration of microbial products from farm environments abrogates experimental allergic asthma. Read More

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September 2021

Efficacy and safety of PXL770, a direct AMP kinase activator, for the treatment of non-alcoholic fatty liver disease (STAMP-NAFLD): a randomised, double-blind, placebo-controlled, phase 2a study.

Lancet Gastroenterol Hepatol 2021 Sep 21. Epub 2021 Sep 21.

Institute for Cardiometabolism and Nutrition, Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, France.

Background: AMP kinase (AMPK) is an energy sensor implicated in regulation of lipid metabolism, inflammation, and insulin sensitivity. We aimed to assess efficacy and safety of PXL770, a novel direct AMPK activator, in patients with non-alcoholic fatty liver disease (NAFLD).

Methods: STAMP-NAFLD, a randomised, double-blind, placebo-controlled phase 2a study, was done across 15 US clinical sites. Read More

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September 2021

Adverse events in patients taking apixaban or rivaroxaban who have undergone bariatric surgery: a retrospective case series.

J Thromb Thrombolysis 2021 Sep 24. Epub 2021 Sep 24.

Division of Cardiovascular Medicine, Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, 24 Frank Lloyd Wright, Lobby A, Suite 3201, Ann Arbor, MI, 48105, USA.

Clinical trials comparing direct oral anticoagulants (DOAC) to warfarin excluded patients with a history of bariatric surgery. The anatomic changes from bariatric procedures have several effects on drug absorption which can have serious consequences for these patients. We sought to describe real-world use of DOACs among adults that had a history of bariatric surgery or underwent a bariatric surgery while receiving a DOAC. Read More

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September 2021

First-in-human study of milvexian, an oral, direct, small molecule factor XIa inhibitor.

Clin Transl Sci 2021 Sep 24. Epub 2021 Sep 24.

Bristol Myers Squibb, Princeton, New Jersey, USA.

Milvexian (BMS-986177/JNJ-70033093) is a small molecule, active-site inhibitor of factor XIa (FXIa) being developed to prevent and treat thrombotic events. The safety, tolerability, pharmacokinetics (PKs), and pharmacodynamics (PDs) of milvexian were assessed in a two-part, double-blind, placebo-controlled, sequential single ascending dose (SAD) and multiple ascending dose (MAD) study in healthy adults. Participants in SAD panels (6 panels of 8 participants; n = 48) were randomized (3:1) to receive milvexian (4, 20, 60, 200, 300, or 500 mg) or placebo. Read More

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September 2021

Direct Oral Anticoagulant Dose Selection: Challenging Cases.

J Thromb Haemost 2021 Sep 24. Epub 2021 Sep 24.

Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada.

Treatment with a vitamin K antagonist (VKA) such as warfarin requires dose adjustment according to the results of laboratory monitoring of the international normalized ratio (INR). Unlike VKAs, direct oral anticoagulants (DOACs) are given in fixed doses without routine laboratory monitoring, which simplifies treatment. Read More

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September 2021

Risk of major bleeding associated with concomitant use of anticancer drugs and direct oral anticoagulant in patients with cancer and atrial fibrillation.

J Thromb Thrombolysis 2021 Sep 23. Epub 2021 Sep 23.

Division of Cardiology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.

This study evaluated the risk of major bleeding associated with concomitant use of direct oral anticoagulant (DOAC) and anticancer drugs (ACDs), which share metabolic pathways, in patients with atrial fibrillation (AF) and cancer. We performed a retrospective cohort study using Taiwan's National Health Insurance database and included patients with AF and cancer who received DOAC prescriptions from 1 to 2012 to 31 December 2017. The incidence of major bleeding in person-quarters with concomitant use of DOAC and any of 15 ACDs with inhibitory or competitive effects of CYP3A4 or P-gp activity (docetaxel, vinorelbine, methotrexate, irinotecan, etoposide, doxorubicin, cyclophosphamide, imatinib, nilotinib, abiraterone, bicalutamide, tamoxifen, anastrozole, cyclosporine, tacrolimus) was compared with that in person-quarters with DOAC alone. Read More

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September 2021

The pharmacoeconomics of the state-of-the-art drug treatments for asthma: a systematic review.

Multidiscip Respir Med 2021 Jan 2;16(1):787. Epub 2021 Aug 2.

Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia IRCCS, Reggio Emilia.

Asthma is a chronic disease characterized by significant morbidities and mortality, with a large impact on socio-economic resources and a considerable burden on health-care systems. In the standard care of asthma, inhaled corticosteroids (ICS) associated with long-acting β-adrenoceptor agonists (LABA) are a reliable and often cost-effective choice, especially if based on the single inhaler therapy (SIT) strategy; however, in a subset of patients it is not possible to reach an adequate asthma control. In these cases, it is possible to resort to other pharmacologic options, including corticosteroids (OCS) or biologics. Read More

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January 2021

ARTS: A Large, International Trial of Thromboprophylaxis in Intra-abdominal, Gynecologic, and Urologic Surgery.

Eur Urol Focus 2021 Sep 21. Epub 2021 Sep 21.

Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland. Electronic address:

ARTS will be the first trial to compare anticoagulation with a direct oral anticoagulant (apixaban) versus no anticoagulation among patients undergoing intra-abdominal, gynecologic, or urologic surgery at sufficiently similar risk of deep vein thrombosis or pulmonary embolism and major bleeding. Read More

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September 2021

Treatment Impact on Patient-Reported Outcomes in Peripheral Neuropathic Pain: Comparing Single Intervention With Topical High-Concentration Capsaicin to Daily Oral Pregabalin.

Pain Physician 2021 Sep;24(6):453-463

Grünenthal GmbH, Aachen, Germany.

Background: Peripheral neuropathic pain (PNP) is a complex, subjective experience affecting both physical and psychological aspects of functioning. Assessing patient-reported outcomes (PROs) beyond pain relief is important and aligns with the recommendations of IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials). Moreover, PRO data are key to clinical decision-making when evaluating treatment options. Read More

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September 2021

In-hospital Bleeding Outcomes of Oral Anticoagulant and Dual Antiplatelet Therapy During Percutaneous Coronary Intervention: An Analysis From the Japanese Nationwide Registry.

J Cardiovasc Pharmacol 2021 Apr 1;78(2):221-227. Epub 2021 Apr 1.

Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan.

Abstract: The type of periprocedural antithrombotic regimen that is the safest and most effective in percutaneous coronary intervention (PCI) patients on oral anticoagulant (OAC) therapy has not been fully investigated. We aimed to retrospectively investigate the in-hospital bleeding outcomes of patients receiving OAC and antiplatelet therapies during PCI using Japanese nationwide multicenter registry data. A total of 26,938 patients who underwent PCI with OAC and antiplatelet therapies between 2016 and 2017 were included. Read More

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