Adding a proton-pump inhibitor to oral anticoagulation can defend against gastrointestinal bleeding, but with varying success, depending on which oral anticoagulant, especially in high-risk patients.Medscape Medical News

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Authors: Koo BN, Kwon MA, Kim SH, Kim JY, Moon YJ, Park SY, Lee EH, Chae MS, Choi SU, Choi JH, Hwang JY
Abstract
Considering the functional role of red blood cells (RBC) in maintaining a proper supply of oxygen to the tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component of safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Besides, excessi…

Abstract
BACKGROUND: Potent P2Y12 blockers are preferred in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). However, the risk of bleeding remains a major concern. We assessed the association of potent P2Y12 blockers with ischemic and bleeding outcomes in patients with NSTEMI.
METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 4927 patients with NSTEMI receiving drug-eluting stents (DES) were divided into potent P2Y12 blocker (ticagrelor or prasugrel, n=901) and clopidogrel (n=3180)…

Source: Journal of CardiologyCategory: Cardiology Authors: Tags: J Cardiol Source Type: research

ConclusionChlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy.Clinical relevanceWithin the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised….

We report laparoscopic reversible uterine arteries occlusion as hemostatic technique during laparoscopic enucleation by cornuostomy of an interstitial pregnancy at advanced gestational age (46 × 40 mm gestational sac). Preliminary identification of the uterine arteries and bilateral reversible occlusion by Hem-o-Lok clips allowed bleeding control during surgery. The laparoscopic procedure was performed without complications and with limited blood loss. The reported case reinforces the feasibility of this minimally invasive technique in interstitial pregnancy.
PMID: 30514139 [PubMed – as supplied by publisher]

This study evaluates the effect of intrauterine lidocaine on the patient’s pain score during endometrial biopsy by the Novak curette. We included patients aged 35 years or more who had abnormal uterine bleeding between December 2016 and March 2018. The study was conducted at Thammasat University Hospital, Pathum Thani, Thailand. 250 patients were randomly allocated to either receive intrauterine lidocaine (study group) or normal saline (control group). Assessment of pain severity was evaluated using a visual analogue scale (VAS) score at 6 time-points, namely, before performing the procedure, when grasping the cervix by th…

Source: Pain PhysicianCategory: Anesthesiology Authors: Tags: Pain Res Treat Source Type: research

Publication date: Available online 6 December 2018Source: Journal of OrthopaedicsAuthor(s): Scott Gleason, David Mehl, William Payne, Steve Parry, Amy Buros SteinAbstractAbsorbable hemostats such as microporous polysaccharide hemospheres (MPH) are used to manage hemostasis and prevent complications in total knee arthroplasty (TKA). We aimed to determine safety and effectiveness of MPH use in TKA. Records were reviewed for blood loss, hematomas, and infections. No differences existed regarding demographics, superficial infections (P = 0.933) or hematomas (P = 0.393). Positive correlation existed between hematoma and…

Conclusion: Better self-completion rates and shorter procedure times were noted for gastric ESD using the CC by nonexperts than for that using IT2, probably due to hemostatic efficacy.Digestion

Source: DigestionCategory: Gastroenterology Source Type: research

Publication date: Available online 6 December 2018Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): L.A Davies, E.M.S. Crawford, J.L. Jones, S.D. JonesAbstractIn the UK, patients who have bilateral sagittal split osteotomy (BSSO) have generally been thought to require inpatient admission and an overnight hospital stay. However, since the introduction of national standards on day case surgery in the UK in 2011, patients at the Royal Gwent Hospital, Newport, have been treated as day cases, and have been pleased with the results. The aim of this paper was to show that these procedures conform to current nati…

CONCLUSION: Incorporation of an early anal cancer detection programme into routine HIV clinical care for MSM living with HIV showed high patient acceptability, uncommon adverse outcomes and specialist referral patterns similar to other cancer screening programmes.
PMID: 30516346 [PubMed – in process]

In this study, we evaluated the efficacy of gastroprotective agents (GPAs) in reducing the risk of UGIB in patients receiving DOACs.
METHODS: We retrospectively reviewed the medical records of 2076 patients who received DOACs for the prevention or treatment of thromboembolic events between January 2008 and July 2016. A cumulative incidence analysis using the Kaplan-Meier method was performed to determine the rate of UGIB and its association with GPAs administration.
RESULTS: Of the 2076 patients, 360 received GPAs. Over the follow-up period (1160 person-years), one patient in the GPA group (0.7 per 100 person-years…



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