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Restarting antithrombotic drugs after gastrointestinal haemorrhage in people with atrial fibrillation

Thromboembolic stroke due to atrial fibrillation has a high case fatality and is more disabling than stroke from other causes.1 The optimal antithrombotic strategy in atrial fibrillation is with anticoagulation,2 and although antiplatelet treatment is no longer recommended3 evidence suggests it is still used in practice.4 All antithrombotic treatments increase the risk of major bleeding (defined as requiring hospital treatment), with gastrointestinal and intracranial haemorrhage being the commonest.5 As the incidence of atrial fibrillation is increasing,6 with a major bleeding risk of 5% per year during treatment,5 there will be more and more patients with atrial fibrillation in the future with antithrombotic associated bleeding.  
feeds.bmj.com
almost 5 years ago
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0

Restarting antithrombotic drugs after gastrointestinal haemorrhage in people with atrial fibrillation

Thromboembolic stroke due to atrial fibrillation has a high case fatality and is more disabling than stroke from other causes.1 The optimal antithrombotic strategy in atrial fibrillation is with anticoagulation,2 and although antiplatelet treatment is no longer recommended3 evidence suggests it is still used in practice.4 All antithrombotic treatments increase the risk of major bleeding (defined as requiring hospital treatment), with gastrointestinal and intracranial haemorrhage being the commonest.5 As the incidence of atrial fibrillation is increasing,6 with a major bleeding risk of 5% per year during treatment,5 there will be more and more patients with atrial fibrillation in the future with antithrombotic associated bleeding.  
feeds.bmj.com
almost 5 years ago
Preview
0
0

Restarting antithrombotic drugs after gastrointestinal haemorrhage in people with atrial fibrillation

Thromboembolic stroke due to atrial fibrillation has a high case fatality and is more disabling than stroke from other causes.1 The optimal antithrombotic strategy in atrial fibrillation is with anticoagulation,2 and although antiplatelet treatment is no longer recommended3 evidence suggests it is still used in practice.4 All antithrombotic treatments increase the risk of major bleeding (defined as requiring hospital treatment), with gastrointestinal and intracranial haemorrhage being the commonest.5 As the incidence of atrial fibrillation is increasing,6 with a major bleeding risk of 5% per year during treatment,5 there will be more and more patients with atrial fibrillation in the future with antithrombotic associated bleeding.  
feeds.bmj.com
almost 5 years ago
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Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study

Study question What are the risks of all cause mortality, thromboembolism, major bleeding, and recurrent gastrointestinal bleeding associated with restarting antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation?  
feeds.bmj.com
almost 5 years ago
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Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study

Study question What are the risks of all cause mortality, thromboembolism, major bleeding, and recurrent gastrointestinal bleeding associated with restarting antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation?  
feeds.bmj.com
almost 5 years ago
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6

Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study

Study question What are the risks of all cause mortality, thromboembolism, major bleeding, and recurrent gastrointestinal bleeding associated with restarting antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation?  
feeds.bmj.com
almost 5 years ago
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Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study

Study question What are the risks of all cause mortality, thromboembolism, major bleeding, and recurrent gastrointestinal bleeding associated with restarting antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation?  
feeds.bmj.com
almost 5 years ago
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Blood Transfusion, Bleeding, Anemia, and Survival in AMI

How does transfusion impact outcomes for patients with acute myocardial infarction?  
medscape.com
almost 5 years ago
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Surgery versus observation for people with abdominal injury | Cochrane

Injury to the abdomen is common and can be blunt from road traffic crashes or falls, or penetrating from gun shots or stabbing. These injuries are usually associated with injury to the abdominal organs such as the liver, spleen, kidneys, intestine and its covering, and big blood vessels. Massive bleeding or leakage of abdominal content into the abdominal cavity can occur, which may threaten a person's life. Examination of the patient by the doctor (physical examination), though the most accurate method of assessing people, is insufficient to determine the extent of damage. On the other hand, a person should not have a surgical procedure unless it is necessary. There are reports that injuries can be missed even when surgery is carried out.  
cochrane.org
almost 5 years ago
Ps 151113 hemophilia a 800x600
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FDA Approves Adynovate for Hemophilia A

The therapeutic reduced bleeding episodes and controlled them once they started.  
medscape.com
almost 5 years ago
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Use of nitroglycerin to deliver a retained placenta | Cochrane

Failure to deliver the placenta after a vaginal birth is an uncommon event that can be associated with significant bleeding and even death if left untreated. The retained placenta may be detached from the uterine wall but is trapped so that it is not expelled through the cervix or non-detached as the placenta fails to separate because of placental inhibition of uterine contractions. Conventional management involves spinal or general anaesthesia to enable introducing a hand inside the uterus to manually remove the placenta, which carries risks of infection and from the anaesthetic, and also requires special facilities. The use of uterine relaxing drugs (tocolytics), either alone or with other drugs to stimulate contractions of the uterus (uterotonics), may bring on the delivery of the placenta and avoid the need for this invasive procedure. This review included three trials that randomly assigned 175 women with the placenta remaining undelivered more than 15 minutes after delivery to either a placebo or the tocolytic nitroglycerin. Both groups received oxytocin to stimulate contractions of the uterus. Combined administration of nitroglycerin and oxytocin did not reduce the need for manual removal of placenta, blood loss, nor the incidence of severe postpartum haemorrhage. Nitroglycerin administration did not cause headache but resulted in a mild drop in blood pressure and a related increase in heart rate. Two out of the three trials had low risk of bias but this result needs confirmation in larger trials with adequate sample sizes to verify the role of nitroglycerin and other tocolytic drugs in managing different subtypes of retained placenta. The trials in this review did not specify the type of retained placenta. We have included an explanation of some of the scientific terms that are used in this review in a glossary (see Appendix 1).  
cochrane.org
almost 5 years ago
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Antidote reverses anticoagulant effects of factor Xa inhibitors in minutes, studies show

Bleeding is a potential complication with factor Xa inhibitors, but two studies reported in the New England Journal of Medicine have shown that the anticoagulant activity of apixaban and rivaroxaban was reversed within minutes by andexanet, an agent designed to block the anticoagulant effects of these inhibitors.1  
feeds.bmj.com
almost 5 years ago
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Antidote reverses anticoagulant effects of factor Xa inhibitors in minutes, studies show

Bleeding is a potential complication with factor Xa inhibitors, but two studies reported in the New England Journal of Medicine have shown that the anticoagulant activity of apixaban and rivaroxaban was reversed within minutes by andexanet, an agent designed to block the anticoagulant effects of these inhibitors.1  
feeds.bmj.com
almost 5 years ago
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Antidote reverses anticoagulant effects of factor Xa inhibitors in minutes, studies show

Bleeding is a potential complication with factor Xa inhibitors, but two studies reported in the New England Journal of Medicine have shown that the anticoagulant activity of apixaban and rivaroxaban was reversed within minutes by andexanet, an agent designed to block the anticoagulant effects of these inhibitors.1  
feeds.bmj.com
almost 5 years ago
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Proton-Pump Inhibitors May Boost Death Risk in Inpatients

Drugs commonly used in hospitals to prevent gastrointestinal bleeding can increase the risk for serious infections including pneumonia and C difficile, a modeling study has showed.  
medscape.com
almost 5 years ago
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Post-surgery anti-heartburn med use increases risk of death

Prescribing patients PPIs in the hospital to decrease the risk of gastrointestinal bleeding may increase their chance of life-threatening infections.  
medicalnewstoday.com
almost 5 years ago
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Bleeding Complications in Cholecystectomy

Are bleeding complications more common in laparoscopic cholecystectomy or open cholecystectomy?  
medscape.com
almost 5 years ago
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Reversal of Anticoagulation in a True Emergency - emdocs

A critically important, comprehensive review on the reversal of anticoagulation therapy in the setting of acute, life threatening hemorrhage  
emdocs.net
almost 5 years ago
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Emergency Management of Bleeding With NOACs: Do We Need a Reversal Agent? CME

Non-vitamin K antagonist oral anticoagulants (NOACs) are gradually replacing current vitamin K antagonists in a variety of clinical settings. Reversal agents of the vitamin K antagonists are available, but little is known about reversal agents for NOACs. The goal of this activity is to provide an update on the current NOACs being used by clinicians and the recently developed NOAC reversal agents and lab assays that can be used to measure their effects in emergency bleeding situations.  
medscape.org
almost 5 years ago