Articles tagged with Bleeding
A study ranked obstetrical residency programs based on maternal complication rates, finding that top-quintile programs had significantly lower complication rates compared to bottom-quintile programs. The rankings were consistent across individual types of complications, suggesting that these rates may reflect overall quality.
The HORIZONS-AMI trial showed that bivalirudin therapy significantly reduces major bleeding and cardiac death in patients with ST-segment myocardial infarction (STEMI) who have disease of the left anterior descending (LAD) artery. In high-risk STEMI patients, bivalirudin also provides the greatest mortality benefit.
A study published in the World Journal of Gastroenterology found that underlying malignancy, liver cirrhosis, and hematemesis are key predictors of rebleeding after negative angiographic findings. The research team analyzed 128 patients with acute non-variceal gastrointestinal bleeding who had negative initial angiography results.
The TRIANA trial found primary angioplasty superior to thrombolysis in treating acute myocardial infarction (AMI) in patients aged 75 or older. Primary angioplasty showed a significantly lower need for recurrent cardiac ischemia and comparable outcomes compared to thrombolysis.
Researchers found warfarin therapy reduces ischemic stroke risk but increases intracranial bleeding risk in patients with atrial fibrillation. Benefits of treatment are greatest for patients over 85 years old and those with multiple risk factors for stroke.
The PLATO study demonstrated that ticagrelor reduced cardiovascular events by 16% compared to clopidogrel, with no increase in major bleeding. The efficacy of ticagrelor was observed across all major acute coronary syndromes patient types, with a consistent benefit seen in secondary endpoints.
The HORIZONS-AMI study found that bivalirudin reduced clinical events and major bleeding in heart attack patients undergoing angioplasty. This is a significant finding with important clinical implications for the selection of treatment strategies for high-risk patients.
A phase II trial shows otamixaban, an intravenous blood clot inhibitor, reduces major coronary complications in high-risk ACS patients with lower bleeding rates compared to heparin. The study found intermediate doses of otamixaban offer a significant reduction in death and ischemic complications.
The RE-LY study found dabigatran to be more effective than warfarin in preventing stroke in patients with atrial fibrillation. The higher dose of dabigatran significantly reduces stroke risk by 34% compared to warfarin, while the lower dose has a similar effect but with less major bleeding.
A rare case of duodenal obstruction after successful embolization for duodenal diverticular hemorrhage was reported. The study highlights the importance of thorough observation of resolving hematomas and conservative treatment before surgery to relieve duodenal fibrotic encasement.
A recent study found carvedilol to be more effective in preventing variceal bleeding in cirrhotic patients compared to traditional treatment with variceal band ligation. The results showed that carvedilol reduced the risk of bleeding by 10% compared to VBL, while survival rates remained unchanged.
A study found that early endoscopy in elderly patients with peptic ulcer bleeding reduced hospital stay by two days and decreased the need for surgical intervention. The study analyzed Medicare claims data from 2004-2006, finding that early endoscopy was associated with increased efficiency of care.
Researchers have developed a new oral anti-clotting drug called Apixaban that is effective in preventing blood clots and reducing bleeding risk by half. The treatment was tested in a double-blind study of over 3,000 patients and proved to be a major step forward in preventing deadly blood clots after joint replacement surgery.
Data show ATryn safely prevents peri-operative and peri-partum acute deep vein thrombosis in patients with hereditary antithrombin deficiency. Dosing algorithms allow for normalization of antithrombin levels during high-risk situations, providing a safe treatment option.
Researchers found that acute treatment results in an average hospital stay of 8.3 days and a cost of nearly $21,000, while ischemic stroke had an average stay of 6.6 days and cost of $15,000.
A case of Meckel's diverticulum masked by intermittent recurrent subocclusive episodes is presented, highlighting the difficulty in diagnosing this condition due to overlapping symptoms. Laparoscopy proved to be a crucial diagnostic tool in establishing the final diagnosis and also therapeutic in nature.
The study found that oral rivaroxaban reduced the risk of death, heart attack, or stroke by 21% compared to placebo, with a lower risk of clinically significant bleeding. The medication inhibits factor Xa and has been shown effective in preventing venous thromboembolism.
Researchers at Harvard University have uncovered a fundamental feedback mechanism that regulates blood clotting, leading to new insights into bleeding disorders and potential treatments.
Women with heavy menstrual cycles may be at risk for undiagnosed bleeding disorders. The new guidelines emphasize recognizing symptoms beyond just heavy bleeding, such as family history and laboratory tests. Early diagnosis can prevent complications like bleeding to death during menstruation, childbirth, or surgical procedures.
Women with excessive menstrual bleeding may have underlying bleeding disorders. The consensus conference recommends hematologic evaluations to diagnose conditions like Von Willebrand Disease, which affects 74-92% of women with menorrhagia.
A study published in World Journal of Gastroenterology found that small colon polyps can be removed without interrupting anticoagulation therapy, resulting in an acceptable bleeding rate. The procedure was performed on 123 patients with lesions up to 1 cm in size.
Researchers analyzed primary care records of 5,477 colorectal cancer patients and 38,314 controls to quantify the exact risks posed by eight clinical features. The study found that rectal bleeding carries a high risk warranting investigation regardless of other symptoms.
A large and solitary congenital arterioportal fistula (APF) was diagnosed in a 73-year-old woman. Transcatheter closure using multiple coils was initially successful but resulted in two subsequent episodes of alimentary tract hemorrhage, suggesting that APFs with significant collateral circulation may be challenging to treat.
The World Federation of Hemophilia launches a video podcast on comprehensive care, emphasizing the need for multidisciplinary teams to provide accurate diagnosis, prompt treatment, and support for families. Comprehensive care is crucial in both developing and developed countries to improve patient outcomes and prevent complications.
Researchers created a new method to estimate bleeding risk for heart attack patients using eight basic medical facts. The CRUSADE bleeding score assigns points to each factor, ranging from very low to high risk of bleeding.
Cerebral microbleeds, small deposits of hemosiderin in the brain, are more common among older adults taking anti-clotting medications like aspirin. The study found an association between these medications and brain microbleeds, particularly among those taking higher doses.
Researchers at Uppsala University have identified the three genes that determine warfarin dosage: VKORC1, CYP2C9, and CYP4F2. This discovery will enable more precise treatment and reduce the risk of bleeding or blood clots.
A new study finds that X-ray-guided spinal tap procedures fail in about 60% of young infant cases and cause bleeding in 25% of infant cases. For patients over 80, the risk of bleeding doubles, but can be reduced by inserting the needle in the middle of the lower back.
Researchers found a new drug derived from magnolia trees to be effective in preventing blood clots without causing excessive bleeding. The Phase II study showed that the compound was generally well-tolerated and did not increase bleeding risk, even when taken with standard anti-clotting medications.
Minimally invasive treatments using embolization effectively control life-threatening bleeding in women after C-sections, reducing the need for blood transfusions and hospital stays. Interventional radiology also helps women with invasive placenta by stopping excessive bleeding and potentially eliminating the need for a hysterectomy.
A new study shows sonohysterography as an effective diagnostic tool for women with adenomyosis, improving detection rates and reducing errors in interpretation. The technique helps identify specific signs of the condition, such as 'myometrial cracks,' which were previously difficult to characterize on standard ultrasound.
Research published in Clinical Gastroenterology and Hepatology found that patients with upper GI bleeding admitted on weekends had a 22% higher mortality rate and were less likely to undergo early endoscopy. Patients with peptic ulcer-related UGIB also faced increased mortality, hospital charges, and length of stay.
A multicenter study led by Johns Hopkins shows that an experimental clot-busting treatment can increase survival rates and improve function in patients with intracranial hemorrhage, a lethal form of stroke. After six months, about 10% had no lingering disability and 40% were independently caring for themselves.
Patients with mild to severe kidney dysfunction require lower warfarin doses and closer monitoring due to increased bleeding risk. Warfarin dose is significantly affected by kidney function, even after accounting for genetics.
Researchers have reconstructed the chronology of Oetzi's injuries, finding evidence of a short-lived arrow wound and a blow to the back before his death. The study suggests that Oetzi endured at least two injuring events, which could indicate two separate attacks.
New analysis by University of Cincinnati researchers found that genetic testing to guide initial dosing of warfarin may not be worth the costs for typical patients. However, it could be beneficial for those at high risk of major bleeding. The study suggests that testing should be done in-house and at lower cost without delays.
Researchers capture images of bleeding inside heart muscle after heart attack using MRI scans, finding correlation between bleeding and extent of heart damage. Patients with larger heart attacks show more significant bleeding and poorer recovery chances.
Mayo Clinic researchers studied 816 women who underwent global endometrial ablation (GEA) to assess its effectiveness in reducing menstrual bleeding. They found that only 16% of patients required hysterectomy five years after the procedure, which is nearly half of what was previously reported.
A new study reveals that smokers with a family history of brain aneurysm are significantly more likely to suffer a stroke. The research found that current smokers were six times more likely to experience a stroke, and quitting smoking could reduce this risk by over half.
A study found that dexamethasone effectively reduces postoperative nausea and vomiting after tonsillectomies, but also increases the risk of bleeding in children. The largest dose was associated with a nearly 7 times higher risk of bleeding.
Researchers have found that preventive use of antithrombotic medication can reduce incidence of thromboembolic events in cancer patients. The PROTECHT Study shows a 47.2% reduction in risk, while also demonstrating safety with minimal major bleeding episodes.
The study presents a new combination therapy for previously untreated ITP, an investigational oral treatment for chronic ITP, and a low-dose platelet transfusion strategy. These approaches aim to minimize bleeding episodes in patients with platelet disorders.
A study published in the Academy of General Dentistry reveals that stopping antiplatelet medications before dental procedures increases the risk of permanent disability or death. Dentists can help patients by discussing treatment risks and benefits with their physicians.
Double-balloon enteroscopy is a cost-effective approach for patients with obscure gastrointestinal bleeding, offering reduced costs and complications compared to other diagnostic methods. The study suggests that an initial capsule-directed double-balloon enteroscopy may be preferred over other options due to its potential for fewer com...
A study published by researchers in Japan found that Double Balloon Endoscopy (DBE) was effective in diagnosing small intestinal lesions in patients with obscure GI bleeding, with a sensitivity of 92.7%. DBE also showed therapeutic benefits for most patients, and the technique was more sensitive than capsule endoscopy in certain cases.
Research suggests a shared metabolic pathway between vitamins E and K may cause interaction, diminishing vitamin K levels as vitamin E increases. The Women's Health Study found 24% fewer deaths from heart disease in women taking 600 IU vitamin E supplements.
Patients who receive written and verbal instructions on proper warfarin use are less likely to experience gastrointestinal and brain bleeding problems. Improved doctor-patient communication may also prevent a substantial number of injuries and resulting hospitalizations.
A multicenter study led by Johns Hopkins Children's Center found that hydrocortisone treatment in preemies has little to no benefit and may increase the risk of brain bleeding. Low cortisol levels in premature babies do not appear to be harmful, contrary to common belief.
A study of 87 stroke patients found that blacks had a 32% higher microbleed prevalence than whites, with more frequent and varied locations in the brain. Hypertension was also associated with microbleed frequency.
A study published in Neurology found that African-Americans are more likely to have cerebral microbleeds, which can increase the risk of having a stroke. Researchers discovered that African-Americans had 32% more microbleeds than Caucasians and were more likely to have them in certain areas of the brain.
A new study found that warfarin, commonly used to prevent blood clotting, increases the risk of brain hemorrhage and death if a hemorrhagic stroke occurs. The study showed that people taking warfarin with an INR above three had twice as much initial bleeding as those not on the drug.
Researchers successfully treated bleeding gastric varices using a novel sclerotherapy combining alpha-cyanoacrylate alkyl with aethoxysklerol, with no complications or re-bleeding observed in six months. The treatment was found to be an effective alternative for obliteration and eradication of gastric fundal varices.
Primary aortoenteric fistula (PAEF) is a rare but life-threatening condition that can cause massive gastrointestinal bleeding. PAEFs often present with a herald bleed prior to exsanguination, making early diagnosis challenging. The incidence of PAEF is likely higher than estimated, and prompt surgical intervention is crucial for survival.
A study published in World Journal of Gastroenterology found that severe comorbidity is the main factor affecting clinical outcome in very old patients with acute gastrointestinal bleeding. Older patients (over 80 years) experience similar severity and rebleeding rates as younger populations, but higher mortality rates.
Researchers used 3-D MRI to accurately detect bleeding in diseased carotid arteries, a condition that may lead to stroke. The technique identifies complicated plaques with surface ulcerations and blood clots, which are major causes of vascular events.
Researchers developed a simplified clinical score to predict active bleeding in UGIB patients. The study showed that early or delayed urgent endoscopy can be differentiated according to the score, allowing effective treatment of high-risk patients.
A Phase II study found trends suggesting apixaban reduces heart attack, stroke risk but increases bleeding among higher doses, warranting further study.
The APPRAISE-I trial found a non-statistically significant trend that patients taking apixaban with aspirin or clopidogrel had lower incidence of heart attack, stroke, and cardiovascular death, compared to those taking a placebo. However, bleeding complications were a concern, especially at higher doses.
The European Society of Cardiology recommends pre-hospital treatment with antiplatelet agents, such as aspirin and clopidogrel, to improve clinical outcomes in STEMI patients. Unfractionated heparin is also used during primary PCI in STEMI, while bivalirudin has been shown to reduce major bleeding and ischemic events.
The use of anticoagulants, antiplatelet agents, and thrombolytics in acute coronary syndromes (ACS) increases the risk of bleeding, which has emerged as a major contributor to poor outcomes. Careful selection of drugs and measures to prevent gastrointestinal bleeding can help mitigate this risk.