MedWorm: Bleeding

PPIs May Help Reduce Hospitalizations for Gastroduodenal Bleeding in Patients Treated With Clopidogrel

Medscape Today Headlines — Sat, 20 Mar 2010 16:08:13 +0100

Concurrent use of proton pump inhibitors in patients with serious coronary heart disease treated with clopidogrel was associated with fewer hospitalizations for gastroduodenal bleeding. Medscape Medical News (Source: Medscape Today Headlines)

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Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: Compared to a conservative strategy for UA/NSTEMI, an invasive strategy is associated with reduced rates of refractory angina and rehospitalization in the shorter term and myocardial infarction in the longer term. However, the invasive strategy is associated with a doubled risk of procedure-related heart attack and increased risk of bleeding and procedural biomarker leaks. Available data suggest that an invasive strategy may be particularly useful in those at high risk for recurrent events. PMID: 20238333 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: We found no convincing evidence to support the use of emergency sclerotherapy for variceal bleeding in cirrhosis as the first, single treatment when compared with vasoactive drugs. Vasoactive drugs may be safe and effective whenever endoscopic therapy is not promptly available and seems to be associated with less adverse events than emergency sclerotherapy. Other meta-analyses and guidelines advocate that combined vasoactive drugs and endoscopic therapy is superior to either intervention alone. PMID: 20238318 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Liver transplantation for polycystic liver and massive hepatomegaly.

World Journal of Gastroenterology : WJG — Sat, 20 Mar 2010 04:48:05 +0100

Authors: Gruttadauria S, di Francesco F, Gridelli B Liver tumor and other benign liver diseases such as polycystic liver disease can cause massive hepatomegaly and may represent an indication for liver transplantation (LT) in some instances. In this setting, LT can be extremely difficult and challenging due to its decreased mobility and access to vascular supply. Benefit from either a right or a left partial liver resection during the transplant procedure has been advocated to safely accomplish the hepatectomy of the native liver. Although we believe that partial hepatectomy adds some risk to intra-operative bleeding, we alternatively advise a different approach. We have a successful experience with LT in 6 massive hepatomegaly patients due to giant liver lesions. All the transplant pr...

Generalized peeling skin syndrome: Case report and review of the literature.

Dermatol Online J — Sat, 20 Mar 2010 01:42:03 +0100

We report a case of generalized PSS and provide a literature review. A 34-year-old woman reported a lifelong history of generalized and painless peeling of the skin that worsened in summer. Her parents were third degree cousins. Her twin sister and her two cousins presented with the same condition. Physical examination showed widespread superficial sheets of variable size that could be easily removed without bleeding or pain. No underlying erythema was noted. Otherwise, the patient was in good health. Histological findings showed an epidermal cleavage within the stratum corneum. The generalized form of PSS is classified into 3 types, A, B, and C, according to the classification system of Traupe and Mevorah. We have tried to classify the cases of generalized PSS already reported in the lite...

Spectrum of F8 gene mutations in haemophilia A patients from a region of Italy: identification of 23 new mutations

Haemophilia — Sat, 20 Mar 2010 00:00:00 +0100

Summary. Haemophilia A (HA) is an X-linked recessive bleeding disorder caused by a lack or decrease of coagulation factor VIII activity. The molecular diagnosis of HA is challenging and a variety of different mutations have been identified throughout the F8 gene. Our aim was to detect the causative mutation in 266 HA patients from Emilia-Romagna region (Italy) and in all suspected carriers. Molecular analysis of F8 in 201 HA patients (152 index cases) was performed with a combination of several indirect and direct molecular approaches, such as long distance polymerase chain reaction, multiplex ligation-dependent probe amplification, denaturing high performance liquid chromatography and direct sequencing. The analysis revealed 78 different mutations, 23 of which were novel, not having been ...

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Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Massons Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding

Karger Publishers — Fri, 19 Mar 2010 23:00:00 +0100

Case Rep Gastroenterol 2010;4:124132 (DOI:10.1159/000294148) (Source: Karger Publishers)

Center Treats Children With Bleeding Disorders

UK College of Medicine News — Fri, 19 Mar 2010 16:41:45 +0100

Nathan Hollon, age 9, does his own injections. Twice a week, he mixes up medications to treat hemophilia, puts on a tourniquet and finds a vein. (Source: UK College of Medicine News)

Abnormal Uterine Bleeding

Medscape Ob/Gyn & Women's Health Headlines — Fri, 19 Mar 2010 15:59:52 +0100

A handy informational sheet to share with your patients, which covers symptoms, causes, and treatment of abnormal uterine bleeding. Journal of Midwifery & Women's Health (Source: Medscape Ob/Gyn & Women's Health Headlines)

Postoperative management following sphincter pharyngoplasty

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: Upper airway obstruction requiring overnight observation following SP is uncommon. In otherwise healthy patients, performing SP in an outpatient setting, given appropriate recovery room evaluation for airway concerns, oral intake, and pain control, should be considered. (Source: Otolaryngology - Head and Neck Surgery)

Today's Opinions And Editorials

Health News from Medical News Today — Fri, 19 Mar 2010 11:00:00 +0100

Stop The Bleeding In California Los Angeles Times If California ever needed the federal government to enact a universal plan of its own, that time is now (Harold Meyerson, 3/18).Access, Access, Access The New York Times In short, great health care is often less about breakthrough technologies than it is about access. And for all the disagreements about President Obama's health care proposal, let's focus on this: it unquestionably would increase access, while its defeat would diminish access (Nicholas Kristof, 3/17)... (Source: Health News from Medical News Today)

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Study Details Machinery Of Immune Protection Against Inflammatory Diseases Like Colitis

Health News from Medical News Today — Fri, 19 Mar 2010 08:00:00 +0100

Scientists report a protein made by a gene already associated with a handful of human inflammatory immune diseases plays a pivotal role in protecting the intestinal tract from colitis. St. Jude Children's Research Hospital investigators led the research, which points to possible new strategies for combating colitis. Colitis is a chronic inflammatory disease associated with colon damage, resulting in abdominal pain, bleeding and other symptoms. The work also expands the link between the Nlrp3 protein and Crohn's disease, said Thirumala-Devi Kanneganti, Ph.D., assistant member of the St... (Source: Health News from Medical News Today)

State-of-the-art of non-hormonal methods of contraception: III. Intrauterine devices.

The European Journal of Contraception and Reproductive Health Care — Fri, 19 Mar 2010 02:10:20 +0100

Authors: Sivin I, Batár I Since the 1959 revival of the IUD, non-hormonal devices have become the most widely used of all reversible contraceptives. Pregnancy rates of copper-releasing IUDs in current use range from approximately 0.5 to 1.5 per hundred continuing users in the first year, with somewhat lower annual pregnancy rates thereafter. Evidence-based research has been systematically conducted and translated into guidelines for eligibility criteria and problem management. Recent device research, beyond the T, Multiload and frameless devices has centred on improved designs such as U ,Y and Slimline shapes, or enhanced copper release, the latter through electrochemical effects or nanotechnology applications. Other IUD research foci concern devices that decrease bleeding and pai...

PLATO: Ticagrelor lowers total and CV mortality vs clopidogrel in CABG patients

MedWire News - Cardiology — Fri, 19 Mar 2010 00:00:00 +0100

Ticagrelor was associated with significantly lower total and cardiovascular mortality when compared with clopidogrel in acute coronary syndrome patients undergoing coronary artery bypass graft surgery, without any difference in the risk of bleeding related to surgery, latest PLATO subanalysis findings show. (Source: MedWire News - Cardiology)

Awake tracheal intubation using the Sensascope™ in 13 patients with an anticipated difficult airway

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

We present the use of the SensaScope[trade], an S-shaped rigid fibreoptic scope with a flexible distal end, in a series of 13 patients at high risk of, or known to have, a difficult intubation. Patients received conscious sedation with midazolam or fentanyl combined with a remifentanil infusion and topical lidocaine to the oral mucosa and to the trachea via a trans-cricoid injection. Spontaneous ventilation was maintained until confirmation of tracheal intubation. In all cases, tracheal intubation was achieved using the SensaScope. The median (IQR [range]) insertion time (measured from the time the facemask was taken away from the face until an end-expiratory CO2 reading was visible on the monitor) was 58 s (38[ndash]111 [28[ndash]300]s). In nine of the 13 cases, advancement of the SensaSc...

Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length

Clinical Oral Implants Research — Fri, 19 Mar 2010 00:00:00 +0100

To monitor longitudinally the development of implant stability of SLA Straumann® tissue-level implants using resonance frequency analysis (RFA) and to determine the influence of instrument positioning, bone structure and implant length on the assessment of RFA. Thirty-two healthy adult patients received either 8 mm, [empty]4.1 mm Straumann® Standard Plus tissue-level implants (n=16: Group A) or 10 mm, [empty]4.1 mm Straumann® Standard Plus tissue-level implants (n=16: Group B). During healing, RFA was performed on Weeks 0,1, 2, 3, 4, 5, 6, 8 and 12. The implants were restored after 10 weeks (impression taking) and 12 weeks. In addition, probing depth, presence of plaque and bleeding on probing were assessed. Implant stability quotient (ISQ) values of Groups A and B were compared using u...

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Preliminary Evidence of a High Risk of Bleeding on Aspirin plus Clopidogrel in Aspirin-Naïve Patients in the Acute Phase after TIA or Minor Ischaemic Stroke

Cerebrovascular Diseases — Thu, 18 Mar 2010 23:00:00 +0100

Cerebrovasc Dis 2010;29:460467 (DOI:10.1159/000297961) (Source: Cerebrovascular Diseases)

Extrusion of embolization coils through the carotid artery in a radiated neck

Auris, Nasus, Larynx — Thu, 18 Mar 2010 14:19:50 +0100

We present and discuss a unique case of coil extrusion through the carotid artery into the pharyngeal soft tissue in the setting of soft tissue radionecrosis (STRN). A 55-year-old man with previous chemoradiation therapy presented with massive transoral hemorrhage. Control of the bleeding was accomplished by coil embolization of the right carotid artery system. The patient subsequently developed spiking fevers, and an exploration of the neck revealed coil extrusion through the common carotid artery and into the neck and pharynx. Although the incidence of coil extrusion in the head and neck is remarkably low, this complication must be considered in the heavily radiated neck and a high index of suspicion should be maintained in the setting of radionecrosis and signs and symptoms of systemic ...

Review: Factor XI Deficiency: Review and Management in Pregnant Women

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:35 +0100

Factor XI deficiency is a rare disease found predominantly in Ashkenazi Jews. There is a poor correlation between factor XI level and bleeding in patients with factor XI deficiency. Individuals with severe factor XI deficiency are usually at risk of excessive bleeding after surgery and injury, particularly when trauma involves tissues rich in fibrinolytic activity. Women with partial or severe deficiency are at risk of excessive uterine bleeding during labor. The unpredictable nature of factor XI deficiency complicates management during pregnancy and delivery. This review gives an overview of the management of pregnant women with factor XI deficiency. (Source: Clinical and Applied Thrombosis/Hemostasis)

Effective Hemostasis During Minor Surgery in a Case of Hereditary Combined Deficiency of Vitamin K-dependent Clotting Factors

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:35 +0100

Combined deficiency of the vitamin K-dependent clotting factors (VKCFD) is a rare bleeding disorder involving defective gamma-carboxylation of coagulation factors II , VII, IX and X as well as natural anticoagulants protein C and protein S. The disease is characterized by a cluster of different, often life threatening, bleeding symptoms occurring both spontaneously and in a surgical setting. In the present paper we describe two different treatment modalities to be used both in a programmed surgical procedure and in an emergency scenario. As this disease is a natural model that resembles oral anticoagulation, our experience discloses a possible rationale in the use of recombinant activated FVII for warfarin reversal. (Source: Clinical and Applied Thrombosis/Hemostasis)

Antiplatelet Therapy Prasugrel: A Novel Platelet ADP P2Y12 Receptor Antagonist

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:34 +0100

Novel adenosine diphosphate (ADP) P2Y12 antagonists, including prasugrel, ticagrelor, cangrelor and elinogrel, are in various phases of clinical development. These ADP P2Y12 antagonists have advantages over clopidogrel ranging from faster onset to greater and less variable inhibition of platelet function. Novel ADP P2Y12 antagonists are under investigation to determine whether their use can result in improved antiplatelet activity, faster onset of action, and/or greater antithrombotic effects than clopidogrel, without an unacceptable increase in hemorrhagic or other side effects. Prasugrel (CS-747; LY-640315), a novel third-generation oral thienopyridine, is a specific, irreversible antagonist of the platelet ADP P2Y12 receptor. Preclinical and early phase clinical studies have shown prasu...

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Evaluation of periodontal status in subjects with hyperlipidemia.

J Contemp Dent Pract — Thu, 18 Mar 2010 05:00:03 +0100

CONCLUSIONS: The results of our study showed that female patients with hyperlipidemia had higher values of periodontal parameters compared to control individuals. However, in the future studies with larger sample sizes in mixed gender populations are needed to determine the association between hyperlipidemia and periodontal disease. CLINICAL SIGNIFICANCE: The results of our study showed that female patients with hyperlipidemia might manifest clinically higher values of periodontal parameters compared to nonlipdemic individuals. However, due to the small sample size of this study the exact association between hyperlipidemia and periodontal disease is still uncertain. Care has to be taken with a hyperlipidemia patients and advice can be given to them for periodic periodontal checkup. PMI...

A Robust Current Pattern for the Detection of Intraventricular Hemorrhage in Neonates Using Electrical Impedance Tomography.

Annals of Biomedical Engineering — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Tang T, Oh S, Sadleir RJ We compared two 16-electrode electrical impedance tomography (EIT) current patterns on their ability to reconstruct and quantify small amounts of bleeding inside a neonatal human head using both simulated and phantom data. The current patterns used were an adjacent injection RING pattern (with electrodes located equidistantly on the equator of a sphere) and an EEG current pattern based on the 10-20 EEG electrode layout. Structures mimicking electrically important structures in the infant skull were included in a spherical numerical forward model and their effects on reconstructions were determined. The EEG pattern was found to be a better topology to localize and quantify anomalies within lateral ventricular regions. The RING electrode pattern could no...

A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey.

Chest — Thu, 18 Mar 2010 00:00:00 +0100

CONCLUSIONS: This simple, novel bleeding risk score (acronym HAS-BLED) provides a practical tool to assess the individual bleeding risk of 'real world' AF patients, potentially supporting clinical decision-making regarding antithrombotic therapy in AF patients. PMID: 20299623 [PubMed - as supplied by publisher] (Source: Chest)

AIM: New study refutes FDA's contraindication for Plavix and PPIs

Cardiovascular Business News — Wed, 17 Mar 2010 22:20:29 +0100

Heart patients who took proton-pump inhibitors (PPIs) along with clopidogrel were half as likely to be hospitalized for upper digestive tract bleeding than those who used clopidogrel alone. In addition, the PPIs did not inhibit clopidogrel’s therapeutic effect, according to a study published in the March 16 issue of the Annals of Internal Medicine. (Source: Cardiovascular Business News)

Moms post-birth bleeding tied to early radiation

Reuters: Health — Wed, 17 Mar 2010 18:55:58 +0100

NEW YORK (Reuters Health) - Women who had radiation to the abdomen in childhood to treat cancer may experience excessive bleeding after giving birth, new study findings suggest. (Source: Reuters: Health)

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Moms Post-Birth Bleeding Tied to Early Radiation

MedlinePlus Health News — Wed, 17 Mar 2010 17:55:58 +0100

Women who had radiation to the abdomen in childhood to treat cancer may experience excessive bleeding after giving birth, new study findings suggest.Source: Reuters Health Related MedlinePlus Pages: Cancer in Children, Childbirth, Radiation Therapy (Source: MedlinePlus Health News)

Contraindicated Antithrombotics May Be of Use in Dialysis Patients Undergoing PCI

Medscape Today Headlines — Wed, 17 Mar 2010 17:00:17 +0100

Certain drugs that confer an increased risk of bleeding are contraindicated in dialysis patients undergoing PCI. Dr. Lynda Szczech comments on a study that puts this prohibition into new perspective. Medscape Nephrology (Source: Medscape Today Headlines)

Ultrasonography: A novel approach to central venous cannulation

Indian Journal of Critical Care Medicine — Wed, 17 Mar 2010 16:11:54 +0100

Conclusion: USG-guided CVC is thus easier, quicker, and safer than landmark approach. (Source: Indian Journal of Critical Care Medicine)

ACC: 'Imperfect Evidence' Offered on Dual Antiplatelet Therapy

MedPage Today Cardiovascular — Wed, 17 Mar 2010 13:43:01 +0100

ATLANTA (MedPage Today) -- What is the ideal duration for dual antiplatelet therapy following treatment with a drug-eluting stent? That question -- a vexing one for cardiologists who try to balance the risks of stent thrombosis and bleeding -- is the subject of this InFocus™ report. (Source: MedPage Today Cardiovascular)

Journal Scan: Duration of Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents (N Engl J Med 2010;Mar 15:[Epub ahead of print].)

Cardiosource — Wed, 17 Mar 2010 09:58:43 +0100

In two trials, the investigators randomly assigned a total of 2,701 patients who had received DES and had been free of major adverse cardiac or cerebrovascular events and major bleeding for a period of at least 12 months to receive clopidogrel plus aspirin or aspirin alone. The primary endpoint was . . . (Source: Cardiosource)

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Patients Who Take a Proton-Pump Inhibitor Are Less Likely To Be Hospitalized for Bleeding Ulcers

MedlinePlus Health News — Wed, 17 Mar 2010 05:14:29 +0100

Source: Agency for Healthcare Research and Quality Related MedlinePlus Page: Peptic Ulcer (Source: MedlinePlus Health News)

Conference report: Genetic screening may reduce warfarin hospitalisations

NeLM - News — Wed, 17 Mar 2010 00:00:00 +0100

Source: Reuters Health Area: News According to the results of a study presented at the American College of Cardiology scientific meeting, use of genetic screening may help to reduce hospitalisations related to warfarin. The study was conducted by researchers from the Mayo Clinic in conjunction with Medco, which administers prescription drug benefits for employers and health plans in the US. Medco found that about 1 million of the 60 million people on its rolls were taking warfarin in 2007, and that around 22% of them were being hospitalised within six months of starting the drug. The study included 896 patients taking warfarin who were screened for the genes CYP2C9 and VKORC1 and 2,688 who did not undergo such screening. According to the Reuters rep...

EXPLORE-Xa: Betrixaban bleeding outcomes comparable to warfarin in dose-finding trial

MedWire News - Thrombosis — Tue, 16 Mar 2010 17:19:54 +0100

The investigational anticoagulant betrixaban has a comparable safety profile to that of warfarin in patients with non-valvular atrial fibrillation or flutter, according to the results of EXPLORE-Xa trial. (Source: MedWire News - Thrombosis)

EXPLORE-Xa: Betrixaban bleeding outcomes comparable to warfarin in dose-finding trial

MedWire News - Stroke — Tue, 16 Mar 2010 15:52:51 +0100

DNA Test May Cut Hospitalizations Caused by Blood Thinner

MedlinePlus Health News — Tue, 16 Mar 2010 13:00:00 +0100

Determining sensitivity can prevent bleeding, clotting problems, study shows Source: HealthDay Related MedlinePlus Pages: Blood Thinners, Genetic Testing (Source: MedlinePlus Health News)

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Betrixaban had dose-dependent effect on major, non-major bleeding

HemOncToday.com — Tue, 16 Mar 2010 11:14:00 +0100

(Source: HemOncToday.com)

Inappropriate Use of Antithrombotics in Patients Undergoing Percutaneous Coronary Intervention

Medscape Today Headlines — Tue, 16 Mar 2010 11:04:24 +0100

An "alarmingly high" number of dialysis patients receive an inappropriate antithrombotic during percutaneous coronary intervention, increasing their risk of bleeding. Journal Watch (Source: Medscape Today Headlines)

Embolization of Acute Nonvariceal Upper Gastrointestinal Hemorrhage Resistant to Endoscopic Treatment: Results and Predictors of Recurrent Bleeding

CardioVascular and Interventional Radiology — Tue, 16 Mar 2010 08:49:07 +0100

Abstract Acute nonvariceal upper gastrointestinal (UGI) hemorrhage is a frequent complication associated with significant morbidity and mortality. The most common cause of UGI bleeding is peptic ulcer disease, but the differential diagnosis is diverse and includes tumors; ischemia; gastritis; arteriovenous malformations, such as Dieulafoy lesions; Mallory-Weiss tears; trauma; and iatrogenic causes. Aggressive treatment with early endoscopic hemostasis is essential for a favorable outcome. However, severe bleeding despite conservative medical treatment or endoscopic intervention occurs in 5–10% of patients, requiring surgery or transcatheter arterial embolization. Surgical intervention is usually an expeditious and gratifying endeavor, but it can be associated with high o...

Proton-Pump Inhibitor Plus Clopidogrel Is Less Likely To Cause Bleeding Ulcers

Health News from Medical News Today — Tue, 16 Mar 2010 08:00:00 +0100

Heart patients who took a stomach acid-suppressing proton-pump inhibitor along with clopidogrel a drug that prevents blood clots were only half as likely to be hospitalized for upper digestive tract bleeding than those who used clopidogrel alone, according to a new study supported by HHS' Agency for Healthcare Research and Quality and the National Heart, Lung, and Blood Institute at the National Institutes of Health. The study also suggested that combining the drugs did not increase the risk of serious heart problems... (Source: Health News from Medical News Today)

Proton-Pump Inhibitor Plus Clopidogrel Is Less Likely To Cause Bleeding Ulcers

GastroIntestinal News From Medical News Today — Tue, 16 Mar 2010 08:00:00 +0100

Heart patients who took a stomach acid-suppressing proton-pump inhibitor along with clopidogrel a drug that prevents blood clots were only half as likely to be hospitalized for upper digestive tract bleeding than those who used clopidogrel alone, according to a new study supported by HHS' Agency for Healthcare Research and Quality and the National Heart, Lung, and Blood Instit... (Source: GastroIntestinal News From Medical News Today)

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Extended use of dual antiplatet therapy after stent implantation questioned

MedWire News - Cardiology — Tue, 16 Mar 2010 00:00:00 +0100

Extending the duration of dual antiplatelet therapy for more than 12 months after receipt of drug-eluting stents in patients with no prior bleeding does not appear to be more effective than aspirin monotherapy for reducing the rate of myocardial infarction or cardiovascular death, researchers report. (Source: MedWire News - Cardiology)

Oral antiplatelet agents - are they safe in breastfeeding?

NeLM - Medicines Q & A — Tue, 16 Mar 2010 00:00:00 +0100

Source: Trent Medicines Information Service Area: Evidence > Medicines Q & A Limited data and pharmacokinetics indicate that low dose aspirin and dipyridamole pass into breast milk in small amounts, although there is not enough information to accurately establish the milk:plasma ratio. There is no information regarding excretion of clopidogrel into breast milk but the pharmacokinetics of the drug would suggest that the amount would be very small. There have been no adverse reports described in infants exposed to low dose aspirin, clopidogrel or dipyridamole via breast milk, however, they should be used with caution in breastfeeding mothers. Infant monitoring of adverse effects described with therapeutic doses should be undertaken especially signs of bruising and bleeding, which ...

Psychosocial correlates of physical activity in adolescents with haemophilia

Haemophilia — Tue, 16 Mar 2010 00:00:00 +0100

Summary. Boys with haemophilia are now encouraged to exercise and take part in physical activities, but actual measures of time spent in active participation is lacking. The aim of this study was to obtain an objective measure of daily physical activity in boys with haemophilia as compared with healthy controls. The study also aimed to ascertain the social and cognitive factors associated with exercise in this population. Seventeen patients (aged 11[ndash]18 years) with haemophilia were studied and compared with 44 healthy controls (aged 10[ndash]16.5 years). Physical activity was measured by accelerometry. Psychosocial correlates were assessed using validated questionnaires. Measured physical activity levels in subjects with haemophilia were slightly higher than for the control group. Bot...

Clinical efficacy and safety of the factor VIII/von Willebrand factor concentrate BIOSTATE® in patients with von Willebrand's disease: a prospective multi-centre study

Haemophilia — Tue, 16 Mar 2010 00:00:00 +0100

This study also provides important insights into dosing regimens with BIOSTATE and the role of monitoring therapy with FVIII:C and VWF:RCo. (Source: Haemophilia)

Sports venues target of new sperm donor campaign

OnMedica Latest News — Tue, 16 Mar 2010 00:00:00 +0100

Sports fans and players asked to help infertile couples conceiveRelated items from OnMedicaSteep rise in Down's syndrome pregnanciesWide variation in treatment of heavy bleeding, audit showsUrgent review needed of women who use independent midwives Black women suffer more pregnancy complications than whitesBinge drinkers risk premature babies (Source: OnMedica Latest News)

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Extended use of dual antiplatet therapy after stent implantation questioned

MedWire News - Thrombosis — Tue, 16 Mar 2010 00:00:00 +0100

Concurrent PPI and clopidogrel: fewer GI bleed hospitalisations, little effect on cardiovascular outcomes?

NeLM - News — Tue, 16 Mar 2010 00:00:00 +0100

Source: Ann Intern Med Area: News Concurrent use of proton-pump inhibitor (PPI) and clopidogrel decreases the risk of hospitalisation for gastro-duodenal bleeding, and does not significantly increase the risk of adverse cardiovascular events, according to a cohort study published in the Annals of Internal Medicine. Clopidogrel increases the risk of gastro-duodenal bleeding, hence prophylaxis with PPI has been suggested in patients at increased risk from such bleeds. The overall benefits of this approach have been questioned by studies suggesting that PPI may reduce the cardiovascular benefits of clopidogrel by reducing its metabolic activation, however the evidence so far is conflicting. The authors of this retrospective cohort study used data from US healthcare databases to ex...

Do hospitalists affect clinical outcomes and efficiency for patients with acute upper gastrointestinal hemorrhage (UGIH)?

Journal of Hospital Medicine — Tue, 16 Mar 2010 00:00:00 +0100

Care by hospitalists has been associated with improved/similar clinical outcomes and efficiency. However, less is known about their effect on conditions dependent upon specialists for procedures/treatment plans. Our objective was to compare care for upper gastrointestinal hemorrhage (UGIH) patients attended by academic hospitalists and nonhospitalists.The study included 450 UGIH patients admitted to general medical services of 6 teaching hospitals. Outcomes included in-hospital mortality and complications (ie, recurrent bleeding, intensive care unit [ICU] transfer, decompensation, transfusion, reendoscopy, 30-day readmission). Efficiency was measured by hospital costs and length of stay (LOS).Of 450 patients, 40% (177) were cared for by hospitalists with no differences between groups by en...

Upper versus lower gastrointestinal bleeding: A direct comparison of clinical presentation, outcomes, and resource utilization

Journal of Hospital Medicine — Tue, 16 Mar 2010 00:00:00 +0100

To compare prevalence, clinical outcomes, and resource utilization between subjects with lower gastrointestinal bleeding (LGIB) and upper gastrointestinal bleeding (UGIB).Using administrative data, patient surveys, and chart abstraction, comparisons between subjects admitted with LGIB and UGIB were made by employing bivariate and multivariate statistics.A total of 367 subjects were identified, LGIB = 187 and UGIB = 180. Subjects with UGIB compared to LGIB had greater admission hemodynamic instability including tachycardia and orthostasis but clinical outcomes were similar. In multivariate analyses, no significant differences were observed for in-hospital mortality transfer to the intensive care unit (ICU) or 30-day readmission rate. Resource utilization was similar in UGIB and LGIB, includ...

Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study.

Annals of Internal Medicine — Tue, 16 Mar 2010 00:00:00 +0100

Conclusion: In patients with serious coronary heart disease treated with clopidogrel, concurrent PPI use was associated with reduced incidence of hospitalizations for gastroduodenal bleeding. The corresponding point estimate for serious cardiovascular disease was not increased; however, the 95% CI included a clinically important increased risk. Primary Funding Source: Agency for Healthcare Research and Quality and National Heart, Lung, and Blood Institute. PMID: 20231564 [PubMed - in process] (Source: Annals of Internal Medicine)

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Recombinant Factor VIIa to Manage Major Bleeding from Newer Parenteral Anticoagulants (April).

The Annals of Pharmacotherapy — Tue, 16 Mar 2010 00:00:00 +0100

CONCLUSIONS: rFVIIa may be considered to manage major refractory bleeding from newer parenteral anticoagulant agents when the benefit is thought to outweigh the thrombotic risk. PMID: 20233918 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Atraumatic convexal subarachnoid hemorrhage: Clinical presentation, imaging patterns, and etiologies

Neurology — Mon, 15 Mar 2010 20:00:56 +0100

Conclusion: Convexal subarachnoid hemorrhage is an important subtype of nonaneurysmal subarachnoid bleeding with diverse etiologies, though a reversible vasoconstriction syndrome appears to be a common cause in patients 60 years or younger whereas amyloid angiopathy is frequent in patients over 60. These observations require confirmation in future studies. (Source: Neurology)

Identification of Unknown Primary Tumors in Patients With Neuroendocrine Liver Metastases [Original Article]

Archives of Surgery — Mon, 15 Mar 2010 19:50:50 +0100

Conclusion For patients with NET liver metastases and unknown primary tumor, surgical exploration effectively identifies and resects occult primary tumors that are often located in the small intestine. Primary tumors are usually small and multifocal, so careful palpation of the small intestine is essential. Before patients are considered for surgery, a multidisciplinary team assessment and evaluation consisting of computed tomography, somatostatin receptor scintigraphy, and upper and lower endoscopy should be done. (Source: Archives of Surgery)

Portola Pharmaceuticals and Merck Announce that Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence of Bleeding Compared to Warfarin in Patients with Atrial Fibrillation

Drugs.com - Clinical Trials — Mon, 15 Mar 2010 19:18:54 +0100

ATLANTA--(BUSINESS WIRE)--Mar 15, 2010 - Portola Pharmaceuticals and Merck today announced the results of EXPLORE-Xa, a Phase 2 exploratory, dose finding study of betrixaban, an investigational oral direct Factor Xa inhibitor. Results showed that a... (Source: Drugs.com - Clinical Trials)

Portola, Merck anticoagulant shows strong response

bizjournals.com Health Care:Biotechnology headlines — Mon, 15 Mar 2010 18:20:06 +0100

Once-a-day dosing of an experimental drug under development by Portola Pharmaceuticals and drug giant Merck helped stop bleeding in some patients with heart problems. (MRK) (Source: bizjournals.com Health Care:Biotechnology headlines)

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A reduction in bleeding in acute coronary syndromes? Let's not rain on the parade!

European Heart Journal — Mon, 15 Mar 2010 16:45:22 +0100

(Source: European Heart Journal)

Has the frequency of bleeding changed over time for patients presenting with an acute coronary syndrome? The Global Registry of Acute Coronary Events

European Heart Journal — Mon, 15 Mar 2010 16:45:22 +0100

Conclusion Despite increasing use of more intensive therapies, there was a decline in the rate of major bleeding associated with changes in clinical practice. However, individual hospital characteristics remain an important determinant of the frequency of major bleeding. (Source: European Heart Journal)

Endometrial hyperplasia: a clinician's review

Obstetrics, Gynaecology and Reproductive Medicine — Mon, 15 Mar 2010 15:07:39 +0100

Abstract: Endometrial hyperplasia is considered present when the ratio of glandular to stromal tissue of the endometrium is greater than 1:1. Further differentiation is made into simple or complex hyperplasia with or without the presence of cytological atypia. Such changes are caused by excess or unopposed oestrogenic stimulation. Clinically endometrial hyperplasia is often asymptomatic but can present as abnormal uterine bleeding. Many cases are detected incidentally or following abnormal vaginal bleeding by an increase in the normal endometrial thickness on transvaginal ultrasonography (TVS). An endometrial biopsy can be obtained using a pipelle or at hysteroscopy, and examination of this allows a histological diagnosis. Cytological atypia mandates active intervention as its presence cor...

Portola Pharmaceuticals And Merck Announce That Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence Of Bleeding Compared To Warfarin In Patients With Atrial Fibrillation

Pharmaceutical Online News — Mon, 15 Mar 2010 12:00:00 +0100

Portola Pharmaceuticals and Merck today announced the results of EXPLORE-Xa, a Phase 2 exploratory, dose finding study of betrixaban, an investigational oral direct Factor Xa inhibitor. Results showed that a once-daily dose of oral betrixaban, given to patients with non-valvular atrial fibrillation or atrial flutter and at least one risk factor for stroke, reduced the incidence of major and clinically relevant non-major (CRNM) bleeds* compared to dose-adjusted warfarin. The data were presented during a (Source: Pharmaceutical Online News)

Prevalence of subclinical vitamin K deficiency in Thai newborns: relationship to maternal phylloquinone intakes and delivery risk

Archives of Disease in Childhood - Fetal and Neonatal Edition — Mon, 15 Mar 2010 11:33:26 +0100

Conclusions Functional, clinically relevant, vitamin K insufficiency was more common in ‘high-risk’ than ‘normal-risk’ newborns. Vitamin K insufficiency in mothers was linked to lower dietary K1 intakes during pregnancy. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

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New Biomedical Engineering Tools To Control Blood Loss

Health News from Medical News Today — Mon, 15 Mar 2010 09:00:00 +0100

Carnegie Mellon University's Matt Oberdier is developing a new hydrosurgery system to help physicians better manage excessive bleeding during surgery. Oberdier, a Ph.D. candidate in biomedical engineering at Carnegie Mellon, said his system will be designed to help surgeons readily clear excess blood and control bleeding during critical stages involving brain operations. "We are creating a device that will house a clear, hermetically sealed dome through which instruments may be passed, and a special pump to apply fluid pressure and monitor the flow to the surgical area,'' said Oberdier... (Source: Health News from Medical News Today)

New Biomedical Engineering Tools To Control Blood Loss

Medical Devices News From Medical News Today — Mon, 15 Mar 2010 09:00:00 +0100

Portola Pharmaceuticals and Merck Announce that Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence of Bleeding Compared to Warfarin in Patients with Atrial Fibrillation

Merck.com - Research & Development News — Mon, 15 Mar 2010 00:00:00 +0100

(Source: Merck.com - Research & Development News)

Correlation of transient elastography with APRI and FIB-4 in a cohort of patients with congenital bleeding disorders and HCV or HIV/HCV coinfection

Haemophilia — Mon, 15 Mar 2010 00:00:00 +0100

Summary. Patients with inherited bleeding disorders frequently suffer from chronic hepatitis C virus (HCV) mono- or human immunodeficiency virus (HIV)/HCV coinfection. Non-invasive markers for liver fibrosis are warranted for these patients. We tested a large cohort of haemophilic patients with HCV mono- or HIV/HCV coinfection for correlation of transient elastography (TE) with two simple surrogate markers of liver fibrosis and for differences in fibrosis stages according to these markers. We prospectively enrolled HCV-positive patients with congenital bleeding disorders with or without HIV coinfection. Liver function tests and platelet counts were determined and TE was performed. Aspartate aminotransferase-to-platelet ratio index (APRI) and a simple index called FIB-4 were calculated and ...

Single-port transvesical enucleation of the prostate: a clinical report of 34 cases

BJU International — Mon, 15 Mar 2010 00:00:00 +0100

Study Type [ndash] Therapy (case series)Level of Evidence 4 To present our experience with single-port transvesical enucleation of the prostate (STEP) in 34 patients with large-volume benign prostatic hyperplasia (BPH). We performed STEP in 34 patients with large volume (>60 g) BPH (mean age 69 years, body mass index 26 kg/m2, and American Society of Anesthesiology class 2). The mean prostate volume estimated by transrectal ultrasonography was 102.5 mL and the mean baseline prostate-specific antigen level was 6.7 ng/mL. A novel single-port device was inserted percutaneously into the bladder through a 2[ndash]3 cm incision in the suprapubic skin crease. After establishing pneumovesicum, the prostate adenoma was enucleated transvesically using standard laparoscopic instruments, and the adeno...

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Endoscopic management of recurrent epistaxis: the experience of two metropolitan hospitals in Italy.

Acta Oto-Laryngologica — Mon, 15 Mar 2010 00:00:00 +0100

Conclusion. Endoscopic cauterization of the sphenopalatine artery and anterior ethmoid artery is a first-line standard of care in managing intractable epistaxis, after the failure of previous packing. Epistaxis occurs in 12% of the population. Treatment is often based on nasal packing that could be poorly effective in the treatment of severe posterior epistaxis. Objective. To evaluate the effectiveness of the endoscopic approach for posterior epistaxis. Methods. We report the experience of endoscopic cauterization in two metropolitan hospitals in Italy: 48 patients with at least one nasal packing in the 3 weeks before hospital admission. They underwent endoscopic cauterization of the sphenopalatine artery or of the anterior ethmoid artery. Results. The patients' mean age was 58.7 years; th...

Post-tonsillectomy haemorrhage-Do coagulation tests and coagulopathy history have predictive value?

Acta Otorrinolaringologica Espanola — Mon, 15 Mar 2010 00:00:00 +0100

CONCLUSIONS: In healthy adults, coagulation tests results are irrelevant for the course of tonsillectomy and postoperative bleeding event. Personal medical history is important in predicting PTH. PMID: 20236621 [PubMed - as supplied by publisher] (Source: Acta Otorrinolaringologica Espanola)

Embolization in Trauma: Principles and Techniques

Seminars in Interventional Radiology — Sun, 14 Mar 2010 15:18:21 +0100

Semin intervent Radiol 2010; 27: 014-028DOI: 10.1055/s-0030-1247885ABSTRACTTrauma continues to be the leading cause of death in the young population. Uncontrolled bleeding is a major factor in early mortality after trauma, contributing to 30 to 40% of trauma-related deaths. Transcatheter embolization techniques play a significant role in the comprehensive modern treatment of traumatic vascular injuries to solid organs and extremities. The purpose of this article is to review current principles and techniques in the use of embolization for the treatment of traumatic arterial injuries of solid organs and extremities.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Interventional Radiology)

Risk factors to predict outcome in critically ill cancer patients receiving chemotherapy in the intensive care unit

Supportive Care in Cancer — Sun, 14 Mar 2010 12:25:52 +0100

Conclusions Chemotherapy in the ICU for critically ill cancer patients can be considered even when infection or organ failure is present. However, the severity of organ failure, including respiratory failure requiring mechanical ventilation, was associated with an increased mortality after chemotherapy during an ICU stay. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00520-010-0841-xAuthors Jae-Uk Song, Sungkyunkwan University School of Medicine Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center 50 Irwon-dong, Gangnam-gu Seoul 135-710 South KoreaGee Young Suh, Sungkyunkwan University School of Medicine Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center 50 ...

Platelet function testing: auditing local practice and broader implications.

Sun, 14 Mar 2010 01:44:03 +0100

CONCLUSIONS: This audit of local practice indicates that the process of platelet count adjustment using autologous PPP provides adverse outcomes related to identification of platelet dysfunction. Accordingly, we recommend that all laboratories validate this practice if used at their facility. For PFA-100 testing, local validation of the normal reference range is required according to local conditions and collection practice. Otherwise, laboratories may inappropriately identify platelet function disorders when these may not exist. PMID: 20218091 [PubMed - in process] (Source: Clinical Laboratory Science : Journal of the American Society for Medical Technology)

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Trauma of pancreas: predictor's factors of morbidity and mortality related to trauma index

Arquivos de Gastroenterologia — Sat, 13 Mar 2010 14:23:58 +0100

CONCLUSIONS: Higher morbidity and mortality was related with complex injuries of the pancreas (grade IV and V), but morbidity and mortality in the group of injuries grade I and II are not minimal in patients with changed values of revised trauma score and high values of injury severity score and abdominal trauma index. Systolic blood pressure lower 90 mm Hg, changed values of revised trauma score index, values of injury severity score higher 15 and values of abdominal trauma index higher 25 are predictive factors of morbidity. Changed values of revised trauma score, values of injury severity score or abdominal trauma index higher 25, systolic blood pressure are predictive factors of mortality in patients with pancreatic trauma. Low values of TRISS are predictive of higher morbidity and mor...

Colonic carcinoid tumors: a clinicopathologic study of 23 patients from a single institution

Arquivos de Gastroenterologia — Sat, 13 Mar 2010 14:23:58 +0100

CONCLUSIONS: Carcinoid tumors of the colon are frequently right-sided and may be clinically occult until an advanced stage is reached. Based on the relatively poor survival rates reported, it is recommended that, in addition to standard surgical resection, vigorous surveillance for metastatic disease must be performed, particularly during the first 2 years after surgery. In addition, these patients require evaluation of the entire gastrointestinal tract for evidence of coexisting malignancy, along with an extended period of follow-up, because tumor recurrences after 5 years are not uncommon.CONTEXTO: Carcinóides cólicos, excluindo aqueles que se originam no apêndice cecal, são extremamente raros. Devido a esta raridade, as características e comportamento desta neoplasia permanecem ind...

Adverse effects of drugs on small intestine and colon

Best Practice & Research. Clinical Gastroenterology — Sat, 13 Mar 2010 14:21:57 +0100

The small and large intestine are one of the most common sites for the adverse action of drugs, accounting for 20–40% of all drug side effects. The most important factor in the diagnosis of drug-induced intestinal side effect is awareness. The mechanisms of damage are invariably complex, but may be due to topical effects, a known pharmacologic action of the drug on motility (for instance cholinergic/anti-cholinergic effect) and/or secretion, immune suppression and in the case of cytotoxic drug treatment a combination of many actions. The diagnosis of damage may be simple and widely recognised (NSAID-induced enteropathy resulting in bleeding, protein loss and rarely perforation and diaphragm disease), or at other times ignored (tricyclic antidepressants increasing constipation) or life th...

Gastrointestinal and liver adverse effects of drugs used for treating IBD

Best Practice & Research. Clinical Gastroenterology — Sat, 13 Mar 2010 14:21:57 +0100

Drugs used for treating inflammatory bowel disease are known to have a number of gastrointestinal and liver adverse effects. 5-ASA products are relatively safe and have few adverse events. In contrast sulfasalazine has side effects in 11–40% of treated patients including fatigue, nausea, abdominal pain and diarrhoea. Glucocorticoids can induce or propagate peptic ulcers and upper GI bleeding especially in combination with NSAIDs. Thioguanins may have severe gastrointestinal side effects including gastrointestinal complaints (in up to 12%), hepatotoxicity (up to 4%) and pancreatitis (1%). Nodular regenerative hyperplasia (NRH) is an important potential side effect of thiopurine therapy especially in men with Crohn's disease after ileocecal resection. NRH may ultimately lead to portal hype...

Management of bleeding from pseudoaneurysms following pancreaticoduodenectomy.

World Journal of Gastroenterology : WJG — Fri, 12 Mar 2010 17:04:42 +0100

CONCLUSION: Bleeding pseudoaneurysms are among the most serious and fatal complications following pancreaticoduodenectomy. Diagnostic angiography has been preferred over endoscopy and is rapidly becoming the standard therapeutic treatment for bleeding pseudoaneurysms. PMID: 20222168 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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Specific endoscopic features of ulcerative colitis complicated by cytomegalovirus infection.

World Journal of Gastroenterology : WJG — Fri, 12 Mar 2010 17:04:38 +0100

CONCLUSION: Specific colonoscopic findings in patients with UC complicated by CMV infection were identified. These findings may facilitate the early diagnosis of CMV infection in UC patients. PMID: 20222169 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

Concurrent amoebic and histoplasma colitis: A rare cause of massive lower gastrointestinal bleeding.

World Journal of Gastroenterology : WJG — Fri, 12 Mar 2010 17:04:06 +0100

Authors: Koh PS, Roslani AC, Vimal KV, Shariman M, Umasangar R, Lewellyn R Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later, the patient developed massive lower gastrointestinal bleeding with hemorrhagic shock. Emergency total colectomy with end-ileostomy was performed. However, he deteriorated and died on the second postoperative...

Clinicopathological Features of Colon Polyps from African-Americans

Digestive Diseases and Sciences — Fri, 12 Mar 2010 06:50:07 +0100

Conclusion There was a ratio of 8:1 for neoplastic to hyperplastic polyps in our study, which is more than what has been reported in Caucasians (7:1). Our data shows a shift in polyps from the left side to the right side of the colon in recent years. This data is consistent with the lack of a reduction in the incidence of colon cancer in African-Americans. Screening is thus very important in AA to reduce the incidence of colon cancer. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-010-1133-5Authors Mehdi Nouraie, Howard University College of Medicine Department of Medicine and Cancer Center 2041 Georgia Avenue, N.W. Washington DC 20060 USAFatemeh Hosseinkhah, Howard University College of Medicine Department of Medicine and Cancer Center 204...

Carnegie Mellon researchers seek to control blood loss

EurekAlert! - Medicine and Health — Fri, 12 Mar 2010 05:00:00 +0100

(Carnegie Mellon University) Carnegie Mellon University's Matt Obedier is developing a new hydrosurgery system to help physicians better manage excessive bleeding during surgery. (Source: EurekAlert! - Medicine and Health)

Fewer platelets could be used for some cancer and bone-marrow transplantation patients

ScienceDaily Headlines — Fri, 12 Mar 2010 04:00:00 +0100

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Gallbladder ulcer erosion into the cystic artery: a rare cause of upper gastro-intestinal bleeding: a case report

World Journal of Emergency Surgery — Fri, 12 Mar 2010 00:00:00 +0100

Intra luminal gallbladder bleeding is a rare cause of hemobilia that results in upper gastro-intestinal bleeding. In this case report we present a patient who presented with melena and eventually was diagnosed as bleeding from an ulcer in the gallbladder which was induced by gallstones and eroded into the cystic artery. Surgery revealed perforation of gallbladder which was the result of a pressure sore induced by a second gallstone. (Source: World Journal of Emergency Surgery)

Dr Chris Kingswood : Kidney monitoring workshop, 2009 TSA AGM

Tuberous Sclerosis Association — Thu, 11 Mar 2010 17:27:22 +0100

In his kidney monitoring workshop at the AGM in November last year, Dr Chris Kingswood (Consultant Nephrologist and Voluntary Head of Research TSA) was asked the following questions: Q: My child is 6 and has had a kidney ultrasound at 1 year and 4 years, both of which were clear. Does he need one final scan? A: He should have repeat scans up to his mid 30s. The kidney retains its growth potential until mid-adult life so there is a continuing risk. However if nothing is found, these can be done less frequently. Perhaps every 3 years until mid teens and then 5-yearly (But these are “best guesses”). Q: Can AMLs start growing at any age? A: Yes, they can, but AMLs tend to stop growing by the age of 35 as this is when the kidney itself stops growing. The important thing to know ab...

Deletion of the p110{beta} isoform of phosphoinositide 3-kinase in platelets reveals its central role in Akt activation and thrombus formation in vitro and in vivo

Blood — Thu, 11 Mar 2010 17:02:03 +0100

During platelet activation, phosphoinositide 3-kinases (PI3Ks) produce lipid second messengers participating in the regulation of functional responses. Here, we generated a megakaryocyte-restricted p110β null mouse model and demonstrated a critical role of PI3Kβ in platelet activation via an immunoreceptor tyrosine-based activation motif, the glyco-protein VI-Fc receptor -chain complex, and its contribution in response to G-protein–coupled receptors. Interestingly, the production of phosphatidylinositol 3,4,5-trisphosphate and the activation of protein kinase B/Akt were strongly inhibited in p110β null platelets stimulated either via immunoreceptor tyrosine-based activation motif or G-protein–coupled receptors. Functional studies showed an important delay in fibr...

Prolonged activity of factor IX as a monomeric Fc fusion protein

Blood — Thu, 11 Mar 2010 17:02:03 +0100

Treatment of hemophilia B requires frequent infusions of factor IX (FIX) to prophylax against bleeding episodes. Hemophilia B management would benefit from a FIX protein with an extended half-life. A recombinant fusion protein (rFIXFc) containing a single FIX molecule attached to the Fc region of immunoglobulin G was administered intravenously and found to have an extended half-life, compared with recombinant FIX (rFIX) in normal mice, rats, monkeys, and FIX-deficient mice and dogs. Recombinant FIXFc protein concentration was determined in all species, and rFIXFc activity was measured in FIX-deficient animals. The half-life of rFIXFc was approximately 3- to 4-fold longer than that of rFIX in all species. In contrast, in mice in which the neonatal Fc receptor (FcRn) was deleted, the half-li...

Hemophilia A and Spinal Epidural Hematoma in Children

Neuropediatrics — Thu, 11 Mar 2010 15:13:53 +0100

In conclusion, rare hematomas should be considered and searched for in children with bleeding disorders and not well understood complaints. Early diagnosis is important for the neurological outcome.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents | Abstract | Full text (Source: Neuropediatrics)

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Blue rubber bleb nevus syndrome: Prominent oral findings

Indian Journal of Dermatology, Venereology and Leprology — Thu, 11 Mar 2010 14:10:55 +0100

We report a unique presentation of this syndrome in a 25-year-old male patient with prominent oral findings. This is a sporadic case, started during early childhood, progressively increasing in number and size. Oral vascular lesions were part of gastrointestinal involvement. Associated cardiac abnormalities were also observed. An early diagnosis of this syndrome is required as it gets complicated with bleeding, anemia and other systemic complications. (Source: Indian Journal of Dermatology, Venereology and Leprology)

Warfarin users appear more likely to develop brain bleeding following stroke treatment

ScienceDaily Headlines — Thu, 11 Mar 2010 13:00:00 +0100

Patients already taking warfarin who develop an acute stroke appear more likely to experience a brain hemorrhage following treatment with an intravenous clot-dissolving medication, even if their blood clotting function appears normal, according to a new study. (Source: ScienceDaily Headlines)

Fewer Platelets Could Be Used For Some Cancer And Bone-Marrow Transplantation Patients, Helping Alleviate Shortages

Cancer / Oncology News From Medical News Today — Thu, 11 Mar 2010 10:00:00 +0100

Fewer Platelets Could Be Used For Some Cancer And Bone-Marrow Transplantation Patients, Helping Alleviate Shortages

Health News from Medical News Today — Thu, 11 Mar 2010 10:00:00 +0100

Physicians may be able to safely lower the platelet dosage in transfusions for cancer and bone-marrow transplant patients without risking increased bleeding, according to new research involving UT Southwestern Medical Center and 28 other medical institutions. Reducing platelet transfusions, and lowering the threshold on when to administer transfusions could help address frequent shortages in platelet supplies, said Dr. Victor Aquino, associate professor of pediatrics and an author of the study appearing in The New England Journal of Medicine... (Source: Health News from Medical News Today)

Surgical treatment of primary tracheobronchial malignant tumors

The Chinese-German Journal of Clinical Oncology — Thu, 11 Mar 2010 04:14:43 +0100

Conclusion Surgical resection is the most effective treatment for primary tracheobronchial malignant tumors. The selection of operation modes should be individualized according to patients’ condition. Both complete resection and safety should be taken into consideration simultaneously. Content Type Journal ArticleDOI 10.1007/s10330-009-0182-8Authors Hailong Wang, Guilin Medical College Department of Cardiothoracic Surgery, Affiliated Hospital Guilin 541001 ChinaZhenzong Du, Guilin Medical College Department of Cardiothoracic Surgery, Affiliated Hospital Guilin 541001 ChinaHua Ren, Peking Union Medical College Department of Cardiothoracic Surgery, Peking Union Medical College Hospital Beijing 100730 ChinaChaoji Zhang, Peking Union Medical College Department of Card...

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Preoperative coronary risk assessment with dual-source CT in patients undergoing noncoronary cardiac surgery

La Radiologia Medica — Thu, 11 Mar 2010 02:48:46 +0100

Conclusions Coronary evaluation with DSCT is able to rule out the presence of coronary disease in patients scheduled for cardiac surgery, without the need for coronary angiography confirmation. Patients with significant stenosis or nondiagnostic image quality should be referred for coronary angiography. Content Type Journal ArticleCategory Cardiac Radiology/CardioradiologiaDOI 10.1007/s11547-010-0543-yAuthors V. Buffa, Ospedale San Camillo-Forlanini Dipartimento di Radiologia Cardiovascolare Roma ItalyC.N. De Cecco, Ospedale San Camillo-Forlanini Dipartimento di Radiologia Cardiovascolare Roma ItalyL. Cossu, Ospedale San Camillo-Forlanini Dipartimento di Cardiochirurgia Roma ItalyS. Fedeli, Ospedale San Camillo-Forlanini Dipartimento di Radiologia Cardiovascolare Ro...

Pulmonary effects of red blood cell transfusion in critically ill, non-bleeding patients

Transfusion Medicine — Thu, 11 Mar 2010 00:00:00 +0100

The aim of the study is to evaluate the effects of red blood cell (RBC) transfusions on pulmonary parameters in critically ill, non-bleeding patients. Retrospective chart analysis was performed on critically ill patients without overt bleeding in the intensive care unit (ICU) of a university hospital. In 83 patients in a 5-month period, who had received at least 1 RBC unit and stayed at least 24 h in the ICU, 199 transfusions of median 2 RBCs per transfusion (n = 504) were studied. Pulmonary parameters were retrieved during the period between 24 h before the start of transfusion and 24[ndash]48 h after transfusion. Outcome was assessed. The PaO2/FIO2 dose-dependently decreased from 250 ± 105 at baseline to 240 ± 102 mmHg at 24 h after RBC transfusion (P = 0·003), irrespective of acute l...

Fine needle aspiration cytology of infantile haemangioendothelioma of the liver: a report of two cases

Cytopathology — Thu, 11 Mar 2010 00:00:00 +0100

Conclusion: Radiological diagnosis of IHL is possible in a majority of cases, but sometimes features may overlap with hepatoblastoma and fine needle aspiration may be performed inadvertently. Characteristic kinked nuclei and intermixed normal liver tissue might suggest IHL in the differential diagnosis of a spindle cell vasoformative tumour. (Source: Cytopathology)

Phase 2 study of carboplatin, docetaxel, and bevacizumab as frontline treatment for advanced nonsmall-cell lung cancer

Cancer — Thu, 11 Mar 2010 00:00:00 +0100

Bevacizumab has recently been demonstrated to prolong overall survival when added to carboplatin and paclitaxel for chemotherapy-naïve patients with nonsquamous nonsmall-cell lung cancer (NSCLC). However, the effects of combining bevacizumab with other standard, front-line, platinum-based doublets have not been extensively explored. We designed this single treatment arm, phase 2 trial to determine whether the combination of carboplatin, docetaxel, and bevacizumab is tolerable and prolongs progression-free survival of chemotherapy-naïve patients with advanced, nonsquamous NSCLC.Forty patients were treated with up to 6 cycles of carboplatin (AUC 6), docetaxel (75 mg/m2), and bevacizumab (15 mg/kg) on Day 1 every 21 days. Patients with an objective response or stable disease received mainte...

A United Kingdom Haemophilia Centre Doctors' Organization guideline approved by the British Committee for Standards in Haematology: guideline on the use of prophylactic factor VIII concentrate in children and adults with severe haemophilia A

British Journal of Haematology — Thu, 11 Mar 2010 00:00:00 +0100

Consensus-based guidelines supported by the literature are presented on the role of prophylactic administration of factor VIII concentrate in children and adults with severe haemophilia A. The timing of initiation of prophylaxis, the choice of prophylactic regimen, monitoring, management of breakthrough bleeding and education of the patient and family are discussed. (Source: British Journal of Haematology)

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Limitations of internal iliac artery ligation for the reduction of intraoperative hemorrhage during cesarean hysterectomy in cases of placenta previa accreta

Journal of Obstetrics and Gynaecology Research — Thu, 11 Mar 2010 00:00:00 +0100

Conclusion: In cases of placenta previa accreta, ligation of the internal iliac artery did not significantly contribute to hemostasis during cesarean hysterectomy. (Source: Journal of Obstetrics and Gynaecology Research)

Fewer platelets could be used for some cancer and bone-marrow transplantation patients, helping alleviate shortages

UT Southwestern Medical Center News — Thu, 11 Mar 2010 00:00:00 +0100

Malignant melanoma presenting as obstructive jaundice secondary to metastasis to the ampulla of vater.

JOP — Wed, 10 Mar 2010 20:50:03 +0100

CONCLUSION: Multidisciplinary management of patients with metastatic melanoma is essential. PMID: 20208330 [PubMed - in process] (Source: JOP)

Pharmacogenetics of oral anticoagulant therapy.

Current Pharmaceutical Design — Wed, 10 Mar 2010 18:24:02 +0100

Authors: Schalekamp T, de Boer A The identification of the genes encoding CYP2C9, the principal metabolizing enzyme of the coumarins, and VKORC1, the molecular target for coumarins, has strongly stimulated the research on pharmacogenetics of vitamin K antagonists, also designated as coumarins. From 1999 to 2004 a number of observational studies firmly established associations between being carrier of the CYP2C9*2 and especially the CYP2C9*3 allele and reduced coumarin dose requirements and increased risks of overanticoagulation and even major bleeding compared to CYP2C9 wild type patients. The identification of the VKORC1 gene in 2004 gave rise to more observational studies, which mostly indicated a larger contribution of variants of these gene to the interindividual variability in dos...

Fixed-dose enoxaparin thromboprophylaxis feasible for morbidly obese

MedWire News - Thrombosis — Wed, 10 Mar 2010 17:27:11 +0100

US researchers say that enoxaparin administered at a 0.5-mg/kg dose may be effective at preventing thrombosis in morbidly obese patients without increasing the risk for bleeding. (Source: MedWire News - Thrombosis)

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Endoscopic Treatment for Lower Gastrointestinal Bleeding

Clinics in Colon and Rectal Surgery — Wed, 10 Mar 2010 17:13:26 +0100

Clinics in Colon and Rectal Surgery 2010; 23: 031-036DOI: 10.1055/s-0030-1247855ABSTRACTLower gastrointestinal bleeding is common and can result from several colonic causes including diverticulosis, arteriovenous malformations, ischemia, inflammatory bowel disease, infectious colitis, neoplasm, postpolypectomy, and anastomotic and radiation proctitis. Following resuscitation and evaluation, colonoscopy can be used for diagnosis and treatment. Most physicians prescribe a bowel preparation for their patients. Therapeutic options include injection, coagulation (monopolar or bipolar cautery, argon plasma coagulator), and mechanical (clips, bands, detachable loops) devices.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Clinics in Col...

Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma

Pediatric Radiology — Wed, 10 Mar 2010 16:11:34 +0100

Conclusion The presence of a linear skull fracture is an independent risk factor for intracranial hemorrhage. However, all the intracranial hemorrhages associated with the skull fractures were small and did not require any neurosurgical interventions. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00247-010-1555-4Authors David B. Erlichman, Jacobi Medical Center Department of Pediatric Radiology, Albert Einstein College of Medicine 1935 Eastchester Rd., #5A Bronx NY 10461 USAEinat Blumfield, Jacobi Medical Center Department of Pediatric Radiology, Albert Einstein College of Medicine 1935 Eastchester Rd., #5A Bronx NY 10461 USASwapnil Rajpathak, Albert Einstein College of Medicine Department of Epidemiology and Population Health Bronx NY USAAmanda W...

NK/T cell non-Hodgkin lymphoma in a HIV-positive patient

Journal of Hematopathology — Wed, 10 Mar 2010 16:08:50 +0100

Abstract NK/T lymphomas have rarely been reported in HIV/AIDS patients. Here we report a case of a 37-year-old woman, with AIDS and a recent diagnosis of Kaposi sarcoma in a mesenteric lymph node, who presented with extra-ocular nerve palsies and gastrointestinal bleeding. A small intestine resection specimen revealed an extra-nodal NK/T cell lymphoma, nasal type. The unique presentation of this rare and aggressive lymphoma in the setting of AIDS and Kaposi sarcoma underscores the importance of maintaining a broad differential diagnosis when evaluating a malignant neoplasm from a HIV-positive patient. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s12308-010-0057-5Authors Nicole C. Panarelli, Weill Cornell Medical College Department of Pathology and Labor...

Laparoscopic partial nephrectomy for large renal masses: results of a European survey

World Journal of Urology — Wed, 10 Mar 2010 15:57:15 +0100

Conclusions This survey confirms that LPN for tumours 4–7 cm in size is feasible in experienced hands. WIT and overall complication rate remain questionable points. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00345-010-0518-6Authors Francesco Porpiglia, University of Turin Division of Urology, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital Regione Gonzole 10, 10043 Orbassano Turin ItalyCristian Fiori, University of Turin Division of Urology, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital Regione Gonzole 10, 10043 Orbassano Turin ItalyThierry Piechaud, St-Augustin Urology Clinic Bordeaux FranceRichard Gaston, St-Augustin Urology Clinic Bordeaux FranceGiorgio Guazzoni, Vita-Salute Univ...

Contrast-enhanced ultrasonography revealed active thoracic bleeding

Journal of Medical Ultrasonics — Wed, 10 Mar 2010 15:46:09 +0100

Abstract A 61-year-old woman with a hepatocellular carcinoma located in the subphrenic region was treated by radiofrequency ablation (RFA) under artificial pleural effusion. During RFA, B-mode ultrasonography showed a swirling high echoic lesion in the artificial pleural effusion. A real-time scan performed using contrast-enhanced ultrasonography (CEUS) revealed a jet-like extravasation of contrast medium and pooling of microbubbles in the pleural cavity, which were confirmed by angiography. CEUS successfully identified the site of bleeding and can be regarded an effective tool for detecting active bleeding in an emergency. Content Type Journal ArticleCategory Ultrasound Image of the MonthDOI 10.1007/s10396-010-0257-8Authors Takaaki Sugihara, Tottori University School...

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Mortality and morbidity following a major bleed in a registry population with acute ST elevation myocardial infarction

Journal of Thrombosis and Thrombolysis — Wed, 10 Mar 2010 15:34:53 +0100

We examined the relationship between bleeding and outcome in 1,389 consecutive patients with ST-elevation myocardial infarction (STEMI) presenting to a tertiary center between May 1, 2003 and July 10, 2007. We recorded bleeding, length of stay and death during the first 30 days after hospitalization. Major bleeding occurred in 10.9% (152/1389, 95% confidence interval [CI] 9.3–12.6%). In hospital mortality was significantly higher in patients with major bleeding compared to those without major bleeding (19.7 vs. 8.2%, odds ratio [OR] 2.8, 95% CI 1.8–4.3) and was evident in the subgroups of patients with a low TIMI STEMI risk score (7.9 vs. 1.8%, OR 4.6, 95% CI 1.2–17.0) and medium risk score (11.7 vs. 6.3%, OR 2.0, 95% CI 0.6–6.2) but not those with a high TIMI STEMI risk...

Impact of the Red River Catastrophic Flood on Women Giving Birth in North Dakota, 1994–2000

Maternal and Child Health Journal — Wed, 10 Mar 2010 15:34:30 +0100

Abstract To document changes in birth rates, birth outcomes, and pregnancy risk factors among women giving birth after the 1997 Red River flood in North Dakota. We analyzed detailed county-level birth files pre-disaster (1994–1996) and post-disaster (1997–2000) in North Dakota. Crude birth rates and adjusted fertility rates were calculated. The demographic and pregnancy risk factors were described among women delivering singleton births. Logistic regression was conducted to examine associations between the disaster and low birth weight (<2,500 g), preterm birth (<37 weeks), and small for gestational age infants adjusting for confounders. The crude birth rate and direct-adjusted fertility rate decreased significantly after the disaster in North Dakota. T...

Dots are not clots: the over-diagnosis and over-treatment of PE

Emergency Radiology — Wed, 10 Mar 2010 15:25:35 +0100

Abstract The purpose of this work is to question the conventional theory that all pulmonary emboli (PE) are abnormal, and to test the hypothesis that small peripheral PE are a function of life. Most radiologists report any filling defect, independent of size, as clinically significant PE when detected in the pulmonary arteries. We sought to reinforce the theory that small dots in the pulmonary arteries are not clinically significant clots in the conventional setting. The necessity for anticoagulation should be balanced against the risk of bleeding. This retrospective HIPAA-compliant study was approved by the institutional review board; informed consent was not required. All patients diagnosed with PE by 16-slice or 64-slice multidetector computed tomography (CT) over a 6-m...

Fetal genotyping for platelets antigens: a precise tool for alloimmune thrombocytopenia: case report and literature review

Archives of Gynecology and Obstetrics — Wed, 10 Mar 2010 15:21:14 +0100

Conclusion Fetal alloimmune thrombocytopenia is a potentially lethal condition, but early detection and prevention lead to successful outcome in most cases. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s00404-010-1415-3Authors Marcelo Luís Nomura, Universidade Estadual de Campinas (Unicamp), Cidade Universitária Hematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM) Rua Alexander Fleming, 101 CEP 13084-881 Campinas SP BrazilEgle Couto, Universidade Estadual de Campinas (Unicamp), Cidade Universitária Hematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM) Rua Alexander Fleming, 101 CEP 13084-881 Campinas SP BrazilBeatriz Moraes Martinelli, Universidade Estadual de Campi...

Questionnaire survey of hospitals in Saitama Prefecture regarding the shortage of 99mTc-labeled radiopharmaceuticals and 99Mo/99mTc generators

Annals of Nuclear Medicine — Wed, 10 Mar 2010 13:20:40 +0100

Conclusions The results of this survey suggested the several procedures to resolve the issues related to the shortage. The staffs at all institutions except one gave the impression that their nuclear medicine ordering systems had been greatly affected by the shortage of supply. This adverse circumstance, however, may provide a good opportunity to educate the public about nuclear medicine studies that use 99mTc and SPECT, with which citizen are now unfamiliar. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s12149-010-0347-0Authors Shigeru Kosuda, National Defense Medical College Department of Radiology 3-2 Namiki Tokorozawa Saitama 359-8513 JapanHiroko Tomita, National Defense Medical College Department of Radiology 3-2 Namiki Tokorozawa Saitama...

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Fewer platelets could be used for some cancer and bone-marrow transplantation patients

EurekAlert! - Medicine and Health — Wed, 10 Mar 2010 05:00:00 +0100

(UT Southwestern Medical Center) Physicians may be able to safely lower the platelet dosage in transfusions for cancer and bone-marrow transplant patients without risking increased bleeding, according to new research involving UT Southwestern Medical Center and 28 other medical institutions. (Source: EurekAlert! - Medicine and Health)

Effects of pentoxifylline on coagulation profile and disseminated intravascular coagulation incidence in Egyptian septic neonates

Journal of Clinical Pharmacy and Therapeutics — Wed, 10 Mar 2010 00:00:00 +0100

Conclusion: Pentoxifylline protects against sepsis-induced microcirculatory derangement in neonates. It significantly lowered the incidence of bleeding and MODS and shortened the length of hospital stay. (Source: Journal of Clinical Pharmacy and Therapeutics)

The Glasgow Blatchford scoring system enables accurate risk stratification of patients with upper gastrointestinal haemorrhage

International Journal of Clinical Practice — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions: The GBS accurately identifies low risk patients who could be managed safely as outpatients. (Source: International Journal of Clinical Practice)

Increased Incidence of Gastrointestinal Bleeding Following Implantation of the HeartMate II LVAD

Journal of Cardiac Surgery — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions: Although definitive source identification remains elusive, we believe that the majority of bleeding arises in the small bowel, possibly due to angiodysplasias, similar to the pathophysiology encountered in patients with aortic stenosis and GI bleeding. As we move toward wider use of the HMII and other axial continuous-flow devices in both bridge-to-transplant patients and for destination therapy, more studies will be necessary to understand the mechanisms of this obscure GI bleeding and develop treatment strategies to minimize its development. (J Card Surg ****;**:**-**) (Source: Journal of Cardiac Surgery)

3-Pronged Treatment Improves Outcomes in Neonatal Post-Bleeding Ventricular Dilatation

Medscape Pediatrics Headlines — Tue, 09 Mar 2010 18:34:13 +0100

A treatment called DRIFT (DRainage, Irrigation, and Fibrinolytic Therapy) may improve developmental outcomes and survival in preterm infants with posthemorrhagic cerebral ventricular dilatation, new research suggests. Reuters Health Information (Source: Medscape Pediatrics Headlines)

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Care for baby brain bleeds

NHS News Feed — Tue, 09 Mar 2010 17:17:00 +0100

Conclusion This small study suggests that, compared to standard care, DRIFT reduces the risk of the combined outcome of death or severe disability in premature infants with enlargement of the ventricles in the brain due to bleeding. There are a number of points to note: The study was relatively small, with 39 children in the DRIFT group and 38 in the standard care group. The trial was also stopped early due to safety concerns. The researchers note that these factors mean the results should therefore be interpreted cautiously. While larger studies are preferable, the severity of the condition, its relatively uncommon nature and the difficulties associated with carrying out trials in infants mean that larger studies may not be feasible. There were some differences between the groups...

Primary aorto-enteric fistula: A rare complication of abdominal aortic aneurysm

Journal of Postgraduate Medicine — Tue, 09 Mar 2010 16:15:37 +0100

Thomson V S, Gopinath K G, Joseph E, Joseph GJournal of Postgraduate Medicine 2009 55(4):267-269A 70-year-old lady presented with recurrent gastrointestinal bleeding and septicemia caused by multiple enteric pathogens. She was diagnosed to have primary aorto-enteric fistula (PAEF) complicating abdominal aortic aneurysm. Endovascular aneurysm repair was carried out that arrested gastrointestinal bleeding, but despite prolonged antibiotic therapy the patient died a month later of probable sepsis. PAEF refers to abnormal communication between the aorta and the intestine resulting from disease at either site; this rare condition should be suspected in patients with abdominal aortic aneurysm who present with unexplained life-threatening gastrointestinal bleeding. Computerized tomography is the ...

Spontaneous rupture of adrenal haemangioma mimicking abdominal aortic aneurysm rupture

Articles of Archives of Medical Science - TERMEDIA publishing house — Tue, 09 Mar 2010 16:14:37 +0100

Serious bleeding from a ruptured adrenal mass limits preoperative diagnostics and can necessitate urgent laparotomy to control blood loss. A 45-year old man underwent an emergency laparotomy due to severe retroperitoneal haemorrhage causing hypovolaemia. Detailed retroperitoneal dissection after splenectomy and clamping of the abdominal aorta revealed bleeding from a ruptured haemangioma of the left adrenal gland. Following a left adrenalectomy, the patient returned to a stable haemodynamic state. Adrenal haemangiomas are rare, but may cause spontaneous life-threatening haemorrhage. (Source: Articles of Archives of Medical Science - TERMEDIA publishing house)

Haemophilia in the developing countries: the Iranian experience

Articles of Archives of Medical Science - TERMEDIA publishing house — Tue, 09 Mar 2010 16:12:04 +0100

Conclusions: A national formulary based on facilities of the country should be considered and followed by collaboration among the Ministry Of Health, universities and non-governmental organizations. (Source: Articles of Archives of Medical Science - TERMEDIA publishing house)

Hematuria: An uncommon presentation of Glanzmann's thrombasthenia-Lessons learnt

Indian Journal of Urology — Tue, 09 Mar 2010 16:12:01 +0100

Krishnamoorthy Sriram, Kumar Santosh, Kekre NitinIndian Journal of Urology 2010 26(1):115-117A 55-year-old man with Glanzmann's thrombasthenia had recurrent episodes of gross painless hematuria for the past 30 years. His last episode of hematuria occurred a month ago, associated with pain in the right loin and was diagnosed to have a right mid-ureteric calculus. Under adequate platelet cover, he underwent right ureteroscopy. Postoperatively, he had persistent significant hematuria that did not improve despite repeated platelet transfusions. Factor VIIa was also transfused, without much benefit. A ureteroscopy was done, which identified bleeding from within the renal pelvis. CT angiogram confirmed the rupture of an artery supplying the interpole segment of the right kidney. Bleeding ...

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The coagulopathy of chronic liver disease: Is there a causal relationship with bleeding? Yes.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:37:07 +0100

Authors: Basili S, Raparelli V, Violi F Variceal hemorrhage is a major cause of death in patients with cirrhosis. Much still could be performed in clinical practice to reduce the risk for bleeding in cirrhotic patients and accurate predictive rules should be provided for early recognition of high-risk patients. Liver cirrhosis patients present a complex hemostatic dysfunction with prolongation of bleeding time, chronic coagulation activation, and secondary hyperfibrinolysis. Therefore, liver failure determines an acquired coagulopathy that has been considered to be one potential underlying mechanism of bleeding. Endotoxemia may play a pivotal role in activating clotting system in portal and systemic circulation and it could represent a common mechanism accounting for portal vein thromb...

The coagulopathy of chronic liver disease: Is there a causal relationship with bleeding? No.

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:37:04 +0100

Authors: Tripodi A PMID: 20206872 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

Do diet and activity restrictions influence recovery after adenoidectomy and partial tonsillectomy?

International Journal of Pediatric Otorhinolaryngology — Tue, 09 Mar 2010 14:30:50 +0100

Abstract: Objective: To determine if restrictions of postoperative diet concerning hard food and hot drinks as well as excessive physical exertion influence recovery during 14 days after T&A surgery.Methods: 800 patients aged 3–13 years (median 6) underwent curette adenoidectomy with or without scissors tonsillotomy. 413 adenoidectomies and 387 adenotonsillotomies were performed. Caregivers of the children completed a questionnaire reporting their child's postoperative activity, diet, pain level, peak and duration, episodes of nausea and fever, medication and caregivers’ satisfaction scores. The children were enrolled to food and effort restricted (FER), food non-restricted (FnR), effort non-restricted (EnR), and food and effort non-restricted (FEnR) groups at the end of follow-up.Resu...

Propranolol therapy for infantile haemangiomas: Review of the literature

International Journal of Pediatric Otorhinolaryngology — Tue, 09 Mar 2010 14:30:48 +0100

Conclusion: There is the obtain that propranolol will detach steroids in the therapy for infantile haemangiomas. (Source: International Journal of Pediatric Otorhinolaryngology)

Warfarin Users Appear More Likely To Develop Brain Bleeding Following Stroke Treatment

Drugs.com - Clinical Trials — Tue, 09 Mar 2010 14:15:30 +0100

CHICAGO, March 8, 2010-Patients already taking warfarin who develop an acute stroke appear more likely to experience a brain hemorrhage following treatment with an intravenous clot-dissolving medication, even if their blood clotting function... (Source: Drugs.com - Clinical Trials)

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Bleeding Alert Sounded for Stroke Drugs

MedicineNet Cholesterol General — Tue, 09 Mar 2010 07:00:00 +0100

Title: Bleeding Alert Sounded for Stroke DrugsCategory: Health NewsCreated: 3/8/2010 4:10:00 PMLast Editorial Review: 3/9/2010 (Source: MedicineNet Cholesterol General)

Bleeding Alert Sounded for Stroke Drugs

MedicineNet Heart General — Tue, 09 Mar 2010 07:00:00 +0100

Title: Bleeding Alert Sounded for Stroke DrugsCategory: Health NewsCreated: 3/8/2010 4:10:00 PMLast Editorial Review: 3/9/2010 (Source: MedicineNet Heart General)

TPA raised intracerebral bleeding risk in stroke patients on warfarin

MD Consult: News: Top Stories — Tue, 09 Mar 2010 00:00:00 +0100

Read the full story on MD Consult: TPA raised intracerebral bleeding risk in stroke patients on warfarin (Source: MD Consult: News: Top Stories)

Letter by Al-Ruzzeh and Navia Regarding Article, "Safety and Efficacy of Recombinant Activated Factor VII: A Randomized Placebo-Controlled Trial in the Setting of Bleeding After Cardiac Surgery".

Circulation — Tue, 09 Mar 2010 00:00:00 +0100

Authors: Al-Ruzzeh S, Navia JL PMID: 20212289 [PubMed - in process] (Source: Circulation)

Amount of Bone Loss in Relation to Time around the Final Menstrual Period and Follicle-Stimulating Hormone Staging of the Transmenopause.

The Journal of Clinical Endocrinology and Metabolism — Tue, 09 Mar 2010 00:00:00 +0100

Conclusions: Spine and FN bone loss accelerates in FSH stage 3. Bone loss also began to accelerate 2 yr before the FMP with the greatest loss occurring in the 2 yr after the FMP. Bone loss rates in both spine and FN BMD were greater in nonobese women than obese women. PMID: 20215399 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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Effect of erythropoietin on hepcidin expression in hemojuvelin-mutant mice.

Blood Cells, Molecules & Diseases — Tue, 09 Mar 2010 00:00:00 +0100

Authors: Krijt J, Jonášová A, Neuwirtová R, Nečas E Transcription of the hepcidin (Hamp) gene is controlled by iron stores and the rate of erythropoiesis. Functional hierarchy between these two stimuli has not yet been completely established. It is also not known whether the erythropoiesis-related downregulation of Hamp expression utilises the bone morphogenetic protein/hemojuvelin (Bmp/Hjv) pathway. Hemojuvelin-mutant (Hjv-/-) mice treated with erythropoietin (EPO) at 50IU/mouse/day for three days displayed marked decrease in Hamp mRNA, demonstrating that hemojuvelin is not an indispensable component in EPO-induced Hamp gene downregulation. Irradiation of Hjv-/- mice prevented the EPO-induced decrease of Hamp mRNA, highlighting the role of erythropoiesis in ...

Heparins from porcine and bovine intestinal mucosa: Are they similar drugs?

Thrombosis and Haemostasis — Tue, 09 Mar 2010 00:00:00 +0100

Authors: Aquino RS, Pereira MS, Vairo BC, Cinelli LP, Santos GR, Fonseca RJ, Mourao PA Increasing reports of bleeding and peri- or post-operative blood dyscrasias in Brazil were possibly associated with the use of heparin from bovine instead of porcine intestine. These two pharmaceutical grade heparins were analysed for potential differences. NMR analyses confirmed that porcine heparin is composed of mainly trisulfated disaccharides -->4-alpha-IdoA2S-1-->4-alpha-GlcNS6S-1-->. Heparin from bovine intestine is also composed of highly 2-sulfated alpha-iduronic acid residues, but the sulfation of the alpha-glucosamine units vary significantly: ~50% are 6- and N -disulfated, as in porcine heparin, while ~36% are 6-desulfated and ~14% N -acetylated. These heparins differ significant...

Novel integrin-dependent platelet malfunction in siblings with leukocyte adhesion deficiency-III (LAD-III) caused by a point mutation in FERMT3.

Thrombosis and Haemostasis — Tue, 09 Mar 2010 00:00:00 +0100

We report on a novel integrin-dependent platelet dysfunction in two brothers with LAD-III syndrome caused by a homozygous mutation 1717C>T in the FERMT3 gene leading to a premature stop codon R573X in the focal adhesion protein kindlin-3. Stimulation of patients platelets with all used agonists resulted in a severely decreased binding of soluble fibrinogen indicating a defect in inside-out activation of the integrin aIIbb3 (GPIIb/IIIa). Patients platelets did not respond to the a2b1-integrin agonist aggretin-A at all. Our data on granula secretion indicate for the first time that the thrombin receptor PAR-4 but not PAR-1 may be important in integrin-triggered granule secretion in response to thrombin. In contrast, collagen mediated platelet granule secretion was not affected in LAD-III-...

The direct thrombin inhibitors (argatroban, bivalirudin and lepirudin) and the indirect Xa-inhibitor (danaparoid) increase fibrin network porosity and thus facilitate fibrinolysis.

Thrombosis and Haemostasis — Tue, 09 Mar 2010 00:00:00 +0100

Authors: He S, Blombäck M, Bark N, Johnsson H, Wallén NH The present study aimed to assess whether the fibrin network structure is modified by the direct thrombin-inhibitors lepirudin, argatroban or bivalirudin and by the indirect Xa-inhibitor danaparoid. Using an in vitro assay that imitates the physiological process of coagulation from thrombin generation to fibrin formation, we examined a normal plasma pool spiked with one of the inhibitors. At concentrations considered to be the plasma levels observed during therapy, almost no influence was detected for lepirudin despite clear-cut effects on "clotting time". However, argatroban, bivalirudin and danaparoid increased the fibrin gel permeability (Ks) to a similar extent. At concentrations higher than the "therapeutic" levels...

Thrombolysis for pulmonary embolism: Past, present and future.

Thrombosis and Haemostasis — Tue, 09 Mar 2010 00:00:00 +0100

Authors: Lankeit M, Konstantinides S Patients with high-risk pulmonary embolism (PE), i.e. those with shock or hypotension at presentation, are at high risk of in-hospital death, particularly during the first hours after admission. A meta-analysis of trials which included haemodynamically compromised patients indicated that thrombolytic treatment significantly reduces the rate of in-hospital death or PE recurrence. Therefore, thrombolysis should be administered to patients with high-risk PE unless there are absolute contraindications to its use. Uncontrolled data further suggest that thrombolysis may be a safe and effective alternative to surgery in patients with PE and free-floating thrombi in the right heart. On the other hand, normotensive patients generally have a favourable short-...

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Treatment options for advanced endometrial carcinoma.

Gynecologic Oncology — Tue, 09 Mar 2010 00:00:00 +0100

CONCLUSIONS: Clinical trials are planned to further explore how to best incorporate novel agents into the current treatment algorithm with the aim to improve the options in both first- and second-line treatments for women with endometrial adenocarcinomas. PMID: 20223510 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

I Love You, But You're Impossible

Psychology Today Relationships Center — Mon, 08 Mar 2010 21:39:06 +0100

One of the great paradoxes of life is that conflict occurs most frequently between people who love each other: Husbands and wives, parents and children, siblings and siblings. It is in these relationships that we are most likely to find people fighting. I am going to focus here on marriage, spending a little time on why couples fight, and then making a few suggestions as to how they might avoid having these fights escalate into all-out marital warfare. I'm not going to show this to my wife, because she'll probably criticize what I've written, since she doesn't really appreciate me, even after all I've done for her! Anyhow, why do husbands and wives fig...

Bleeding Alert Sounded for Stroke Drugs

MedlinePlus Health News — Mon, 08 Mar 2010 21:00:00 +0100

Medication combination raises risk 10-fold, small study finds Source: HealthDay Related MedlinePlus Pages: Blood Thinners, Drug Safety, Stroke (Source: MedlinePlus Health News)

Most local banks’ earnings still bleeding red

bizjournals.com Health Care:Health Insurance headlines — Mon, 08 Mar 2010 05:00:00 +0100

Eight of 11 community banks and one thrift based in Shelby County lost a combined $28.1 million in 2009 as they struggled with deteriorating loan portfolios and set aside more cash for future losses. (Source: bizjournals.com Health Care:Health Insurance headlines)

A prospective evaluation of the prevalence of symptomatic von Willebrand disease (VWD) in a pediatric primary care population

Pediatric Blood and Cancer — Mon, 08 Mar 2010 00:00:00 +0100

The prevalence of von Willebrand disease (VWD) is reported as [sim]1%; however, these estimates were not based on individuals with significant symptoms. Four thousand five hundred ninety-two unselected parents/children were asked: "Does your child have a problem with bleeding/bruising?"; 223 (5%) answered yes, 41 of whom were administered the validated Pediatric Bleeding Questionnaire and had VWF testing. Five were diagnosed with VWD (three type 1, one type 2A, one type 2B). The prevalence of bleeding/bruising in a general pediatric population is 5%; the prevalence of symptomatic VWD at the level of pediatric primary care is at least 1 in 1,000. Pediatr Blood Cancer. © 2010 Wiley-Liss, Inc. (Source: Pediatric Blood and Cancer)

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Ambulatory pediatric otolaryngologic procedures in the United States: Characteristics and perioperative safety

The Laryngoscope — Mon, 08 Mar 2010 00:00:00 +0100

Determine the prevalence and safety of pediatric ambulatory otolaryngologic procedures in the United States.Historical cohort study.All cases of pediatric otolaryngologic surgery were extracted from the National Survey of Ambulatory Surgery 2006 release. The population was characterized according to age, sex, and individual procedures performed. Rates of immediate perioperative complications were determined for arrest, malignant hyperthermia, hemorrhage, blood transfusion, and postoperative nausea/vomiting. Discharge status and unexpected medical return visits were tabulated. Complication rates for patients younger than 3 years were compared to the remaining cohort.An estimated 1,410,546 ± 246,009 (± standard error) children underwent one or more pediatric otolaryngologic procedures in 2...

Neonatal arterial iliac thrombosis in type-I protein C deficiency: a case report

Italian Journal of Pediatrics — Mon, 08 Mar 2010 00:00:00 +0100

A male infant born by caesarean section at 38 weeks of gestational age (B.W. 4055g; Apgar 9-10), in the first two hours of life his right leg became hypovascularizated.Normal values of leukocities, red cells, haematocrit, hemoglobin, platelets. C-Reactive Protein negative. Electrolytes and coagulation tests were normal. Normal vitamin K coagulation proteins levels. Serological tests for TORCH (IgM) and Parvovirus (IgG and IgM) were negative.Sonography showed a reduced blood flow in the iliac artery and reported a 1 cm long vessel thrombosis.From 8 hours of life we administred an intravenous infusion of unfractionated heparin (UFH) 75 UI/Kg for the first 10 minutes then 28 UI/Kg/h.On the 2nd day tests were performed to assess absence of inhibiting-clot factors. The dosage of homocysteine, p...

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement

NeLM - News — Mon, 08 Mar 2010 00:00:00 +0100

Source: Lancet Area: News According to the results of the ADVANCE-2 study, the orally active factor Xa inhibitor apixaban is more effective than subcutaneous enoxaparin in the prevention of venous thromboembolism (VTE) following elective total knee replacement (TKR), without increasing the bleeding risk. ADVANCE-2 is the second of three phase III studies evaluating the efficacy and safety of apixaban for prevention VTE after elective total knee or hip replacement. In ADVANCE-1, researchers compared apixaban 2.5 mg twice daily with post-operative enoxaparin 30mg twice daily. Although the rates of VTE with apixaban and enoxaparin were clinically similar (9.0% versus 8.8% respectively) and reduced bleeding was reported with apixaban, the statistical criteria for ...

[Laparoscopic resection of a mesenteric cyst.]

Orvosi Hetilap — Mon, 08 Mar 2010 00:00:00 +0100

We present a case of a 32-year-old female patient with a jejunal mesenteric cyst, treated by laparoscopic resection. Postoperative period was uneventful, and after an early discharge the patient's recovery was free of symptoms. Histopathological examination revealed a benign cyst. We conclude that laparoscopic resection of abdominal cysts with unknown origin is a safe operation and can be recommended. PMID: 20211806 [PubMed - in process] (Source: Orvosi Hetilap)

Contraindications for Anticoagulation in Older Patients with Atrial Fibrillation; A Narrative Review.

Current Drug Safety — Sun, 07 Mar 2010 00:00:00 +0100

Conclusion: The decision to prescribe OAC in older patients with AF remains a challenging task since bleeding risk is difficult to estimate reliably. Stratification schemes may be helpful. PMID: 20210731 [PubMed - as supplied by publisher] (Source: Current Drug Safety)

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[Psychogenic Purpura with Hematuria and Sexual Pain Disorder: A Case Report.]

Turkish Journal of Psychiatry — Sat, 06 Mar 2010 17:14:03 +0100

We report a psychogenic purpura case that presented with hematuria in addition to skin lesions. Based on the psychiatric evaluation she was diagnosed with major depressive disorder, generalized anxiety disorder, and obsessive-compulsive disorder. Additionally, sexual pain disorder accompanied these disorders. With the help of antidepressant and supportive psychotherapy, the patient's ecchymosis and bleeding disappeared. During 8 months of follow-up the symptoms did not return. Vaginismus has not been reported in patients with psychogenic purpura. The presence of vaginismus, which is seen more frequently in eastern cultures and is thought to be related to sociocultural determinants, suggests that some cultural factors may be common to both psychogenic purpura and vaginismus. The aim of this...

Apixaban superior to LMWH for VTE prevention after TKA

MedWire News - Thrombosis — Sat, 06 Mar 2010 15:43:59 +0100

Results from ADVANCE-2 show that the oral active factor Xa inhibitor apixaban offers greater protection from venous thromboembolism following total knee arthroplasty than low molecular weight heparin, without increasing the risk for bleeding. (Source: MedWire News - Thrombosis)

Genetic Cause Discovered For Rare Bleeding Disorder

Health News from Medical News Today — Sat, 06 Mar 2010 08:00:00 +0100

For some Canadians, any cut such as from dental work or surgery can cause days or more of bleeding. Although they are not hemophiliacs, for some an ordinary bruise can balloon into the size of an orange. For others, knees, elbows and ankles are crippled when bleeding seeps into joints. In very serious cases, hundreds of blood transfusions are required for recovery. Now a team led by McMaster University hematologist Dr. Catherine Hayward has discovered the genetic cause of Quebec Platelet Disorder (QPD)... (Source: Health News from Medical News Today)

Genetic Cause Discovered For Rare Bleeding Disorder

Genetics News From Medical News Today — Sat, 06 Mar 2010 08:00:00 +0100

MedWorm: Bleeding

PPIs May Help Reduce Hospitalizations for Gastroduodenal Bleeding in Patients Treated With Clopidogrel

Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era.

Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients.

Liver transplantation for polycystic liver and massive hepatomegaly.

Generalized peeling skin syndrome: Case report and review of the literature.

Spectrum of F8 gene mutations in haemophilia A patients from a region of Italy: identification of 23 new mutations

Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Massons Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding

Center Treats Children With Bleeding Disorders

Abnormal Uterine Bleeding

Postoperative management following sphincter pharyngoplasty

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Study Details Machinery Of Immune Protection Against Inflammatory Diseases Like Colitis

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Extrusion of embolization coils through the carotid artery in a radiated neck

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Antiplatelet Therapy Prasugrel: A Novel Platelet ADP P2Y12 Receptor Antagonist

Evaluation of periodontal status in subjects with hyperlipidemia.

A Robust Current Pattern for the Detection of Intraventricular Hemorrhage in Neonates Using Electrical Impedance Tomography.

A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey.

AIM: New study refutes FDA's contraindication for Plavix and PPIs

Moms post-birth bleeding tied to early radiation

Moms Post-Birth Bleeding Tied to Early Radiation

Contraindicated Antithrombotics May Be of Use in Dialysis Patients Undergoing PCI

Ultrasonography: A novel approach to central venous cannulation

ACC: 'Imperfect Evidence' Offered on Dual Antiplatelet Therapy

Journal Scan: Duration of Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents (N Engl J Med 2010;Mar 15:[Epub ahead of print].)

Patients Who Take a Proton-Pump Inhibitor Are Less Likely To Be Hospitalized for Bleeding Ulcers

Conference report: Genetic screening may reduce warfarin hospitalisations

EXPLORE-Xa: Betrixaban bleeding outcomes comparable to warfarin in dose-finding trial

EXPLORE-Xa: Betrixaban bleeding outcomes comparable to warfarin in dose-finding trial

DNA Test May Cut Hospitalizations Caused by Blood Thinner

Betrixaban had dose-dependent effect on major, non-major bleeding

Inappropriate Use of Antithrombotics in Patients Undergoing Percutaneous Coronary Intervention

Embolization of Acute Nonvariceal Upper Gastrointestinal Hemorrhage Resistant to Endoscopic Treatment: Results and Predictors of Recurrent Bleeding

Proton-Pump Inhibitor Plus Clopidogrel Is Less Likely To Cause Bleeding Ulcers

Proton-Pump Inhibitor Plus Clopidogrel Is Less Likely To Cause Bleeding Ulcers

Extended use of dual antiplatet therapy after stent implantation questioned

Oral antiplatelet agents - are they safe in breastfeeding?

Psychosocial correlates of physical activity in adolescents with haemophilia

Clinical efficacy and safety of the factor VIII/von Willebrand factor concentrate BIOSTATE® in patients with von Willebrand's disease: a prospective multi-centre study

Sports venues target of new sperm donor campaign

Extended use of dual antiplatet therapy after stent implantation questioned

Concurrent PPI and clopidogrel: fewer GI bleed hospitalisations, little effect on cardiovascular outcomes?

Do hospitalists affect clinical outcomes and efficiency for patients with acute upper gastrointestinal hemorrhage (UGIH)?

Upper versus lower gastrointestinal bleeding: A direct comparison of clinical presentation, outcomes, and resource utilization

Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study.

Recombinant Factor VIIa to Manage Major Bleeding from Newer Parenteral Anticoagulants (April).

Atraumatic convexal subarachnoid hemorrhage: Clinical presentation, imaging patterns, and etiologies

Identification of Unknown Primary Tumors in Patients With Neuroendocrine Liver Metastases [Original Article]

Portola Pharmaceuticals and Merck Announce that Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence of Bleeding Compared to Warfarin in Patients with Atrial Fibrillation

Portola, Merck anticoagulant shows strong response

A reduction in bleeding in acute coronary syndromes? Let's not rain on the parade!

Has the frequency of bleeding changed over time for patients presenting with an acute coronary syndrome? The Global Registry of Acute Coronary Events

Endometrial hyperplasia: a clinician's review

Portola Pharmaceuticals And Merck Announce That Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence Of Bleeding Compared To Warfarin In Patients With Atrial Fibrillation

Prevalence of subclinical vitamin K deficiency in Thai newborns: relationship to maternal phylloquinone intakes and delivery risk

New Biomedical Engineering Tools To Control Blood Loss

New Biomedical Engineering Tools To Control Blood Loss

Portola Pharmaceuticals and Merck Announce that Phase 2 Study Showed Investigational Factor Xa Inhibitor, Betrixaban, Reduced Incidence of Bleeding Compared to Warfarin in Patients with Atrial Fibrillation

Correlation of transient elastography with APRI and FIB-4 in a cohort of patients with congenital bleeding disorders and HCV or HIV/HCV coinfection

Single-port transvesical enucleation of the prostate: a clinical report of 34 cases

Endoscopic management of recurrent epistaxis: the experience of two metropolitan hospitals in Italy.

Post-tonsillectomy haemorrhage-Do coagulation tests and coagulopathy history have predictive value?

Embolization in Trauma: Principles and Techniques

Risk factors to predict outcome in critically ill cancer patients receiving chemotherapy in the intensive care unit

Platelet function testing: auditing local practice and broader implications.

Trauma of pancreas: predictor's factors of morbidity and mortality related to trauma index

Colonic carcinoid tumors: a clinicopathologic study of 23 patients from a single institution

Adverse effects of drugs on small intestine and colon

Gastrointestinal and liver adverse effects of drugs used for treating IBD

Management of bleeding from pseudoaneurysms following pancreaticoduodenectomy.

Specific endoscopic features of ulcerative colitis complicated by cytomegalovirus infection.

Concurrent amoebic and histoplasma colitis: A rare cause of massive lower gastrointestinal bleeding.

Clinicopathological Features of Colon Polyps from African-Americans

Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Massons Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding