The treatment of acute ischemic stroke usually involves argatroban administration by continuous infusion for 2 d and by intravenous infusion twice a day for 5 d after that. However, the appropriate dose of argatroban to be administered is not clear. Therefore, no studies have been reported a comparison of intravenous and continuous argatroban infusion after day 3 for acute ischemic stroke patients. We aimed to identify the connection between differences in argatroban administration and worsening of symptoms after day 3 in ischemic stroke patients. We retrospectively evaluated the data of 107 ischemic stroke patients who received treatment with argatroban. The study endpoint was defined as the worsening of symptoms from days 3 to 7. Logistic regression analysis was used to determine the risk factors that were significantly associated with worsening of symptoms. Patients were administered argatroban, with rates of 72.0%, and 28.0% for continuous, and intravenous infusion, respectively. A total of 10 (9.3%) patients experienced worsening of symptoms. In the single logistic regression analysis, carotid stenosis [non-adjusted odds ratio (OR) 5.775, 95% confidence interval (CI) 1.486-22.442, p=0.011] was only significantly associated with worsening of symptoms. Worsening of symptoms was not related to either intravenous or continuous infusion group (16.7% vs. 6.5%, p=0.104). Bleeding was also not associated with either group (6.7% vs. 3.9%, p=0.618). We suggest that the differences in the mode of argatroban administration were not related to the worsening of symptoms in ischemic stroke patients. We also found that safety was equivalent regardless of the administration route.
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http://dx.doi.org/10.1248/yakushi.20-00090 | DOI Listing |
Rev Bras Ortop (Sao Paulo)
November 2024
Serviço de Ortopedia e Traumatologia, Hospital das Clínicas Samuel Libânio (HCSL), UNIVÁS, Pouso Alegre, MG, Brasil.
This paper described a case of talus osteonecrosis in a 13-year-old female with a diagnosis of T-type acute lymphocytic leukemia, who underwent chemotherapy and treatment with glucocorticoids, attended at the Orthopedics and Traumatology Sector of our institution. After approximately six months of treatment, the patient began to complain of sporadic pain in her left ankle with progressive worsening. Bone scintigraphy and magnetic resonance imaging of the ankles showed the presence of avascular osteonecrosis of the bilateral talar body.
View Article and Find Full Text PDFTher Adv Neurol Disord
December 2024
Department of Neurology, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, Augsburg 86156, Germany.
In seropositive myasthenia gravis (MG), complement inhibition has been shown to be an effective and a fast-acting therapeutic option. Myasthenic crisis (MC), usually preceded by impending MC, is a life-threatening complication requiring highly effective treatments with rapid onset of action. Currently used treatment options of MC are limited, consisting mainly of symptomatic and immune therapies, that is, intravenous immunoglobulins and plasma exchange/immunoadsorption.
View Article and Find Full Text PDFCureus
November 2024
Dermatology, The Oxford Medical College, Hospital, and Research Centre, Bangalore, IND.
Leprosy is a chronic, infectious, and debilitating disorder that primarily affects the skin and peripheral nerves. The disease course may be complicated by immune-mediated reactions during or after therapy, which may further worsen nerve damage. Type II lepra reaction (T2LR) is a painful inflammatory condition with systemic features, such as fever, tender erythematous nodules, arthritis, neuritis, orchitis, lymphadenitis, and iritis.
View Article and Find Full Text PDFOxf Med Case Reports
December 2024
Department of Cardiology, Pulmonology, Hypertension & Nephrolgy, Ehime University Graduate School of Medicine, Toon, Japan.
An 82-year-old woman with a history of myocardial infarction presented with worsening effort angina. Coronary angiography (CAG) revealed 75% stenosis in the proximal left anterior descending artery (LAD), with intravascular ultrasound (IVUS) identifying a severe calcified nodule near a previously implanted drug-eluting stent. The lesion was treated with intravascular lithotripsy (IVL) and a drug-coated balloon (DCB), avoiding left main crossover stenting.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of Liver and Small Bowel Health, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia.
Background: Liver transplantation (LTx) is vital in patients with end-stage liver disease, with metabolic dysfunction-associated steatotic liver disease being the most common indication. Primary sclerosing cholangitis (PSC) is an important indication. Portopulmonary hypertension, associated with portal hypertension, poses a significant perioperative risk, making pretransplant screening essential.
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