Pulmonary thromboembolism is a very common cardiovascular disease, with a high mortality rate. Despite the clear guidelines, this disease still represents a great challenge both in diagnosis and treatment. The heterogeneous clinical picture, often without pathognomonic signs and symptoms, represents a huge differential diagnostic problem even for experienced doctors. The decisions surrounding this therapeutic regimen also represent a major dilemma in the group of patients who are hemodynamically stable at initial presentation and have signs of right ventricular (RV) dysfunction proven by echocardiography and positive biomarker values (pulmonary embolism of intermediate-high risk). Studies have shown conflicting results about the benefit of using fibrinolytic therapy in this group of patients until hemodynamic decompensation, due to the risk of major bleeding. The latest recommendations give preference to new oral anticoagulants (NOACs) compared to vitamin K antagonists (VKA), except for certain categories of patients (patients with antiphospholipid syndrome, mechanical valves, pregnancy). When using oral anticoagulant therapy, special attention should be paid to drug-drug interactions, which can lead to many complications, even to the death of the patient. Special population groups such as pregnant women, obese patients, patients with antiphospholipid syndrome and the incidence of cancer represent a great therapeutic challenge in the application of anticoagulant therapy. In these patients, not only must the effectiveness of the drugs be taken into account, but great attention must be paid to their safety and possible side effects, which is why a multidisciplinary approach is emphasized in order to provide the best therapeutic option.
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http://dx.doi.org/10.3390/ph15091146 | DOI Listing |
Hinyokika Kiyo
November 2024
The Department of Urology, Nara Medical University.
A 28-year-old man was diagnosed with chlamydial urethritis by his previous doctor and was prescribed minocycline (MINO). The result of a urinary chlamydia polymerase chain reaction (PCR) test later confirmed to be negative. However, the patient visited our hospital because of persistent miction pain.
View Article and Find Full Text PDFAnn Biomed Eng
December 2024
Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.
Vacuum-assisted delivery (VAD) uses a vacuum cup on the fetal scalp to apply traction during uterine contractions, assisting complicated vaginal deliveries. Despite its widespread use, VAD presents a higher risk of neonatal morbidity compared to natural vaginal delivery and biomechanical evidence for safe VAD traction forces is still limited. The aim of this study is to develop and assess the feasibility of an experimental VAD testing setup, and investigate the impact of traction forces on fetal brain deformation.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Neurosurgery, Neuromedicine Center, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
Background: Full-endoscopic microvascular decompression (fE-MVD) is an emerging treatment option for trigeminal neuralgia (TN). However, the risk factors associated with postoperative recurrence of TN after fE-MVD procedure remain controversial. The aim of the present study was to summarize the surgical technique of fE-MVD for the treatment of TN and to develop a predictive model for recurrence at 1 year postoperatively based on independent risk factors.
View Article and Find Full Text PDFLangenbecks Arch Surg
December 2024
Department of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Objective: Splenectomy is regularly performed in total and distal pancreatectomy due to technical reasons, lymph node dissection and radicality of the operation. However, the spleen serves as an important organ for competent immune function, and its removal is associated with an increased incidence of cancer and a worse outcome in some cancer entities (Haematologica 99:392-398, 2014; Dis Colon Rectum 51:213-217, 2008; Dis Esophagus 21:334-339, 2008). The impact of splenectomy in pancreatic cancer is not fully resolved (J Am Coll Surg 188:516-521, 1999; J Surg Oncol 119:784-793, 2019).
View Article and Find Full Text PDFSkeletal Radiol
December 2024
Department of Orthopedic Surgery, Akita Hospital, 2-6-12 Takara, Chiryu City, Aichi, 472-0056, Japan.
Objective: To determine which parameters, including femur morphology, proximal femur bone mineral density, or patient characteristics, are associated with bisphosphonate-related atypical femur fractures (AFFs) and to investigate the relationships between AFF location and these parameters.
Materials And Methods: Sixteen females with a history of bisphosphonate use who presented with AFFs and 38 females without AFFs, even those with long-term bisphosphonate use of > 5 years, were compared. Patient characteristics; physique, gait ability, and history of pain and medication, were recorded.
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