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Thromboembolic Disease in Pregnancy

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3801. Inferior vena cava filter Full Text available with Trip Pro

arrhythmia and often requires pacemakers to resolve condition. Heart Migration: Requires surgery to remove IVC from heart. Sudden Death: Caused by the filter migrating to an active region in the heart. Migration of Filter to Chest: Requires surgery. Perforation of filter strut into small-bowel: Requires surgery to repair perforation. Even though the cases above are the exception, and not the rule, most radiologists object to doing prophylactic filter insertions in patients who do not have thromboembolic (...) diseases. For the most part, whenever possible, interventional radiologists would rather start the patient on anticoagulants than use an IVC, even if requested or referred via a doctor. MRI [ ] While most IVC filters are made of non-ferromagnetic materials, there are a few types that are weakly ferromagnetic. Accordingly, IVC filters fall under the MRI Safe and MRI Conditional categories depending mostly on type of material used during construction. Rarely will one find an MRI Not Safe IVC filter

2012 Wikipedia

3802. Embolism

the origin of the embolus. An embolism in which the embolus is a piece of thrombus is called a thromboembolism. An embolism is usually a pathological event, i.e., accompanying or . Sometimes it is created intentionally for a reason, such as to or to kill a tumor by stopping its blood supply. Such therapy is called . Contents Classification [ ] There are different types of embolism, some of which are listed below. Embolism can be classified based on where it enters the circulation, either (...) . It is a major cause of , tissue death from blockage of the blood supply. An embolus lodging in the from either the or a will most likely be the cause of a due to . An arterial embolus might originate in the heart (from a thrombus in the , following or be a septic embolus resulting from ). Emboli of are frequently encountered in clinical practice. Thrombus formation within the atrium occurs mainly in patients with disease, and especially in those with (narrowing), with (AF). In the absence of AF, pure mitral

2012 Wikipedia

3803. Stroke

with the speech production disorders: and , , cognitive-communication impairments, and . Patients may have particular problems, such as , which can cause swallowed material to pass into the lungs and cause . The condition may improve with time, but in the interim, a may be inserted, enabling liquid food to be given directly into the stomach. If swallowing is still deemed unsafe, then a (PEG) tube is passed and this can remain indefinitely. Treatment of spasticity related to stroke often involves early (...) they are happy. Emotional lability occurs in about 20% of those who have had a stroke. Those with a right hemisphere stroke are more likely to have an empathy problems which can make communication harder. Cognitive deficits resulting from stroke include perceptual disorders, , , and problems with attention and memory. A stroke sufferer may be unaware of his or her own disabilities, a condition called . In a condition called , the affected person is unable to attend to anything on the side of space opposite

2012 Wikipedia

3804. Myocardial infarction

. : . . ^ O'Connor RE, Brady W, Brooks SC, Diercks D, Egan J, Ghaemmaghami C, Menon V, O'Neil BJ, Travers AH, Yannopoulos D (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation . 122 (18 Suppl 3): S787–817. : . . ^ GBD 2015 Disease Injury Incidence Prevalence Collaborators (October 2016). . Lancet . 388 (10053): 1545–1602. : . . . Coventry LL, Finn J, Bremner AP (2011). "Sex differences (...) and vascular disease: review of published results of the homocysteine-lowering trials". Journal of Inherited Metabolic Disease . 34 (1): 83–91. : . . Lonn E (September 2007). "Homocysteine in the prevention of ischemic heart disease, stroke and venous thromboembolism: therapeutic target or just another distraction?". Current Opinion in Hematology . 14 (5): 481–7. : . . Agewall S, Beltrame JF, Reynolds HR, Niessner A, Rosano G, Caforio AL, De Caterina R, Zimarino M, Roffi M, Kjeldsen K, Atar D, Kaski JC

2012 Wikipedia

3805. Bioidentical hormone replacement therapy Full Text available with Trip Pro

hormones have been described as a form of marketing; the chief medical editor of Endocrine Today called compounded BHT a "marketing concept" with no scientific backing, and the FDA warned that pharmacies use these terms to imply that the drugs are natural and have the same effects as endogenous hormones. Other claims include compounded BHT's ability to prevent or treat conditions such as heart disease, stroke, Alzheimer’s disease, endometrial and breast cancer; fewer side effects; and custom blending (...) and the United States). Custom-compounded BHT is a practice almost wholly restricted to the United States. Compounded BHT is a form of . It has been promoted as a for many diseases and for relieving the symptoms of , beyond the medical objective of reducing the risk of . There is little evidence to support these incremental claims; the hormones are expected to have the same risks and benefits of comparable approved drugs for which there is on extensive research and regulation. The exception is progesterone

2012 Wikipedia

3806. Oral contraceptive formulations

, Bayer) 75 µg (UK: Cerazette, Loestrin; RU: Cerazette, Organon; Lactinette, Richter Gedeon; SE: Gestrina) 500 µg (RU: Exluton, Organon) Contraindications [ ] Generally oral contraceptives should not be used in people who currently have the following conditions: Thrombophlebitis or thromboembolic disorders A past history of deep vein thrombophlebitis or thromboembolic disorders Cerebrovascular or coronary artery disease (current or history) Valvular heart disease with thrombogenic complications Severe (...) hypertension Diabetes with vascular involvement Headaches with focal neurological symptoms Major surgery with prolonged immobilization Known or suspected carcinoma of the breast or personal history of breast cancer Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia Undiagnosed abnormal genital bleeding Cholestatic jaundice of pregnancy or jaundice with prior pill use Hepatic adenomas or carcinomas, or active liver disease Known or suspected pregnancy Hypersensitivity

2012 Wikipedia

3807. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. (Abstract)

Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Robust evidence to direct management of pregnant women with mild hypertensive disease at term is scarce. We investigated whether induction of labour in women with a singleton pregnancy complicated by gestational hypertension or mild pre-eclampsia reduces severe maternal morbidity.We undertook a multicentre (...) was not possible. The primary outcome was a composite measure of poor maternal outcome--maternal mortality, maternal morbidity (eclampsia, HELLP syndrome, pulmonary oedema, thromboembolic disease, and placental abruption), progression to severe hypertension or proteinuria, and major post-partum haemorrhage (>1000 mL blood loss). Analysis was by intention to treat and treatment effect is presented as relative risk. This study is registered, number ISRCTN08132825.756 patients were allocated to receive induction

2009 Lancet Controlled trial quality: predicted high

3808. Statins: Are these cholesterol-lowering drugs right for you?

with a heart condition needs to use a statin. Guidelines from the U.S. Preventive Services Task Force, American College of Cardiology and American Heart Association outline four main groups of people who may be helped by statins: People without cardiovascular disease who have risk factors for the disease and a higher 10-year risk of a heart attack. This group includes people who have diabetes, high cholesterol, high blood pressure, or who smoke and whose 10-year risk of a heart attack is 7.5 percent (...) stabilize the lining of blood vessels. In the heart, healthier blood vessel linings would make plaques less likely to rupture, thereby reducing the chance of a heart attack. Researchers are also studying whether statin therapy could prevent venous thrombosis, which includes blood clots in the lungs (pulmonary embolism) or deep veins (deep vein thrombosis, or DVT). Weighing the risks and benefits of statins You should not take statins if you are pregnant or have some forms of advanced liver disease. When

2010 Mayo Decision Aids

3809. How safe is it to prescribe hrt in a perimenopausal lady with a previous history of PE?

-dependent cancer (e.g. endometrial cancer, current or past breast cancer). - Active or recent arterial thromboembolic disease (e.g. angina or myocardial infarction). - Venous thromboembolic disease, pulmonary embolism, or current pregnancy. - Severe active liver disease. - Undiagnosed breast mass. - Uninvestigated abnormal vaginal bleeding. It suggests seeking specialist advice for women who would like HRT but who have a contraindication. They also have a section on managing symptoms without HRT [3 (...) ], which might be of interest. The RCOG have a 2004 guideline ‘Hormone replacement therapy and venous thromboembolism’ [4] which discusses a number of scenarios, one of which is a personal history of VTE. This reports: “It is recommended that, in women with a previous VTE, with or without an underlying heritable thrombophilia, oral HRT should usually be avoided in view of he relatively high risk of recurrent VTE.” We recommend you read the guidance in full as it gives a number of other related

2009 TRIP Answers

3810. What evidence is available comparing the difference in risk between Yasmin, Dianette and the third generation pill marvelon containing desogestrel?

and the third generation pill marvelon containing desogestrel? The most recent secondary information we found discussing this issue was in a 2004 RCOG guideline on Venous thromboembolism and hormonal contraception (1). “Describing risk in relative terms may sound more alarming than in absolute terms. The risk of VTE in non-users is low (5 per 100000 woman years).This increases to 15 per 100000 woman years with COCs containing levonorgestrel or norethisterone and to 25 per 100000 woman years with COCs (...) containing desogestrel or gestodene.22 Thus, venous thromboembolism is uncommon in women of reproductive age and despite a five-fold increase in risk for women using gestodene- or desogestrel-containing COCs, the absolute risk remains small (Table 1). Table 1. Risk table for combined oral contraceptive (COC) users and risk of venous thromboembolism Relative risk Absolute risk per 100 000 woman-years Not using COC 5 in 100 000 COC containing levonorgestrel or norethisterone 3- fold increase 15 in 100 000

2009 TRIP Answers

3811. Treatment of adverse perinatal outcome in inherited thrombophilias: a clinical study. (Abstract)

the necessity and effectiveness of this treatment. Ninety-three patients with the history of recurrent pregnancy loss or thromboembolism were included in this study. Eighty milligram acetylsalicylic acid treatment was started just after the diagnosis for the patients with hereditary thrombophilia, continued throughout pregnancy and ceased 3 days before the delivery. Low molecular weight heparin (LMWH) was started for the patients with the unsuccessful in-vitro fertilization (IVF) history, just after (...) finishing the egg collection. For the other patients, LMWH was started after the positive result of the pregnancy test. Treatment was started for 67 (72%) of patients. Among the treated 67 patients, 38 had MTHFR C677T gene mutation, 25 had protein S deficiency, 19 had FV Leiden mutation, four had protein C deficiency, two had Prothrombin 20210A gene abnormality, two had antiphospholipid anticore syndrome and two had AT III deficiency. Fifty-seven (85.1%) of 67 patients under treatment had pregnancy

2010 Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis

3812. Factors associated with positive D-dimer results in patients evaluated for pulmonary embolism. Full Text available with Trip Pro

) age was 48 (+/-17) years. Overall, 1,903 (44%) D-dimers were positive. Model fit was adequate (c-statistic = 0.739, Hosmer and Lemeshow p-value = 0.13). Significant positive predictors of D-dimer positive included female sex; increasing age; black (vs. white) race; cocaine use; general, limb, or neurologic immobility; hemoptysis; hemodialysis; active malignancy; rheumatoid arthritis; lupus; sickle cell disease; prior venous thromboembolism (VTE; not under treatment); pregnancy and postpartum state

2010 Academic Emergency Medicine

3813. FMISO-PET in Brain Tumors and SCS Effect

and/or intrauterine device (IUD) or withdrawal over the course of the study. Serious co-existing or concurrent illness, including any of the following: uncontrolled or severe infection, heart, liver or kidney disease Lung thromboembolism. Another malignancy in the last 5 years other than basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix. Patients with life expectancy <3 months. Patients with any of the following: creatinine > 2 mg/dl, neutrophils <1.5 * 10^9/L, platelets <100 (...) of patients. Additionally, the potential correlation with pathological, imaging and clinical parameters will be analyzed. Condition or disease Intervention/treatment Phase Malignant Glioma Drug: 18F-FMISO Procedure: PET without SCS Device: SCS Procedure: PET without/with SCS Radiation: Radiotherapy Drug: Temozolomide Phase 2 Detailed Description: Tumour ischaemia-hypoxia decreases the efficacy of radio-chemotherapy. Polarographic probe (and some 18F-FMISO-PET) studies have demonstrated prognostic value

2010 Clinical Trials

3814. Trial of BMS-690514 in Non-Small Cell Lung Cancer Subjects Who Have Been Treated With Gefitinib or Erlotinib and Are Genotypically EGFR Mutation Positive or Who Have Had a Prior Response

/thromboembolic event (within last 6 months) History of hemoptysis greater than 10 mL/day within last 30 days Uncontrolled or significant cardiovascular disease History of uncontrolled diarrhea, Crohn's disease or ulcerative colitis Inability to swallow tablets, untreated malabsorption or GI surgery that results in inability to absorb protocol therapy Women unwilling to avoid pregnancy or use adequate contraception History of allergy or adverse drug reaction to gefitinib or erlotinib Contacts and Locations Go (...) with gefitinib or erlotinib and are genotypically EGFR mutation positive or who have had a prior a response. Condition or disease Intervention/treatment Phase Non-Small-Cell Lung Carcinoma Drug: BMS-690514 Phase 2 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 11 participants Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Phase 2 Trial of BMS-690514 in Non-Small Cell Lung

2010 Clinical Trials

3815. ULTrasound Accelerated ThrombolysIs of PulMonAry Embolism

. Condition or disease Intervention/treatment Phase Submassive Pulmonary Embolism Device: EkoSonic Endovascular System Drug: Unfractionated heparin Phase 3 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 59 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Outcomes Assessor) Primary Purpose: Treatment Official Title: Randomized, Controlled Study Comparing EKOS EkoSonic Ultrasound Accelerated (...) by at least 40 mm Hg for at least 15 min with signs of end organ hypoperfusion (cold extremities or low urinary output < 30 mL/h or mental confusion); or need for catecholamine administration to maintain adequate organ perfusion and a systolic blood pressure of > 90 mm Hg. Severe hypertension on repeated readings (systolic > 180 mmHg or diastolic > 105 mmHg). Pregnant, lactation or parturition within the previous 30 days (positive pregnancy test, women of childbearing age must be tested). Participating

2010 Clinical Trials

3816. Safety and Efficacy Study for Solid Tumor Patients Treated With Eltrombopag

of eltrombopag. Phase II will confirm that the chosen dose and schedule of eltrombopag from Phase I can deliver clinically meaningful benefit(s) to thrombocytopenic patients by improving platelet numbers. Condition or disease Intervention/treatment Phase Thrombocytopaenia Drug: Eltrombopag olamine Other: Placebo Phase 2 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 130 participants Allocation: Randomized Intervention Model: Parallel (...) outside the range(s) in the table due to Gilbert's syndrome or asymptomatic gall stones are not excluded. Women of childbearing potential must have a negative serum pregnancy test within 2 weeks prior to randomization and agree to use effective contraception, during the study and for 4 weeks following the last dose of investigational product. Men with a female partner of childbearing potential must have either had a prior vasectomy or agree to use effective contraception from 2 weeks prior

2010 Clinical Trials

3817. Neoadjuvant Therapy for Ovarian Cancer

): Jason D. Wright, Columbia University Study Details Study Description Go to Brief Summary: This study is to determine the feasibility of administering neoadjuvant carboplatin, paclitaxel, and bevacizumab without excessive dose modification or cycle delay in patients with epithelial ovarian cancer, primary peritoneal cancer or fallopian tube cancer. Condition or disease Intervention/treatment Phase Epithelial Ovarian Cancer Primary Peritoneal Cancer Fallopian Tube Cancer Drug: Carboplatin, paclitaxel (...) ) less than or equal to CTCAE Grade 1. Coagulation function: PT such that international normalized ratio (INR) is ≤ 1.5 (or an in-range INR, usually between 2 and 3, if a patient is on a stable dose of therapeutic warfarin for management of venous thrombosis including pulmonary thromboembolism) and a PTT < 1.2 times the upper limit of normal. Patients must have measurable disease. Patients may or may not have cancer-related symptoms. Baseline CA-125 must be ≥ 70 units/mL. Patients must have met all

2010 Clinical Trials

3818. [Trial of device that is not approved or cleared by the U.S. FDA]

adverse skin condition in the area of sensor placement (i.e. psoriasis, rash, staphylococcus infection) that is not resolved at the time of enrollment Subject is pregnant or plans to become pregnant during the course of the study Subject has a history of myocardial infarction, unstable angina, coronary artery bypass surgery, coronary artery stenting, transient ischemic attack, cerebrovascular accident, angina, congestive heart failure, ventricular rhythm disturbances or thromboembolic disease Subject (...) Sponsor: Medtronic Diabetes Information provided by (Responsible Party): Medtronic Diabetes Study Details Study Description Go to Brief Summary: The purpose of this study is to assess the efficacy of the Low Glucose Suspend (LGS) feature in reducing hypoglycemia with the MiniMed Paradigm® X54 System with hypoglycemic induction from exercise. The study will consist of a total of 50 subjects, age 16 through 60 years with Type 1 Diabetes Mellitus. Condition or disease Intervention/treatment Phase Type 1

2010 Clinical Trials

3819. Haemocomplettan® P During Elective Complex Cardiac Surgery

Study Description Go to Brief Summary: Fibrinogen concentrate is increasingly used in cardiac surgery to reverse coagulopathy. Whether its use reduces blood loss, transfusion and occurrence of clinical adverse events remains unknown. Condition or disease Intervention/treatment Phase Fibrinogen Deficiency in Complex Cardiac Surgery Drug: Haemocomplettan® P Drug: Human albumin (Placebo) Phase 2 Phase 3 Detailed Description: Fibrinogen concentrate is increasingly used in surgical patients suffering (...) Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Eighteen years of age or older. Undergoing elective complex cardiac surgery. Understood and willingly given written informed consent. Experience clinically relevant non-surgical microvascular bleeding following removal of cardiopulmonary bypass. Exclusion Criteria: Positive pregnancy test, pregnancy or lactation. Undergoing an emergency operation. Proof or suspicion of a congenital or acquired coagulation disorder

2010 Clinical Trials

3820. MGuard Stent in ST-elevation Myocardial Infarction

by: Federico II University Study Details Study Description Go to Brief Summary: The Investigators will test the hypothesis that MGuard net protective stent, the investigational device, would be superior to conventional revascularization strategy (i.e. bare-metal stenting plus manual thrombectomy), for STEMI patients undergoing urgent percutaneous coronary interventions. Condition or disease Intervention/treatment Phase ST-Elevation Myocardial Infarction Thrombus Stents Device: MGuard net protective (...) , the investigational device, is a bare-metal stent covered with a ultra-thin flexible polyethylene terephthalate (or Dacron) mesh sleeve, that is anchored to the external surface of the struts. This biocompatible fiber net (string diameter 10-22 μm) has minimal effects on the stents' trackability and deliverability. During stent deployment, the net stretches and slides over the expanding stent struts, trapping the thromboembolic debris underneath the fiber net and isolating the prothrombotic intima components from

2010 Clinical Trials

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