Search results for "Contraindication"

Intravenous thrombolysis for suspected ischemic stroke with seizure at onset

2019

Objective Seizure at onset (SaO) has been considered a relative contraindication for intravenous thrombolysis (IVT) in patients with acute ischemic stroke, although this appraisal is not evidence based. Here, we investigated the prognostic significance of SaO in patients treated with IVT for suspected ischemic stroke. Methods In this multicenter, IVT-registry-based study we assessed the association between SaO and symptomatic intracranial hemorrhage (sICH, European Cooperative Acute Stroke Study II definition), 3-month mortality, and 3-month functional outcome on the modified Rankin Scale (mRS) using unadjusted and adjusted logistic regression, coarsened exact matching, and inverse probabil…

Indications for ECMO: we need to look at the patient first

2021

The use of esmolol in whole-body hyperthermia: Cardiovascular effects

1997

Whole-body hyperthermia (WBH) is a well-described investigational adjunct to systemic chemotherapy for the treatment of advanced malignancies. The hemodynamic consequences of this physiologic state may include tachycardia, which can produce acute myocardial ischemia in patients with coronary artery disease. Ischemic heart disease is currently considered a contraindication to WBH. We chose to investigate the consequences of using a new beta 1-adrenergic antagonist, esmolol, to attempt to control the tachycardia associated with WBH. After institutional approval and patient consent, nine consecutive patients with normal cardiac function presenting for WBH with carboplatin infusion were studied…

Agomelatine and Hepatotoxicity: Implications of Cumulated Data Derived from Spontaneous Reports of Adverse Drug Reactions

2013

Considering the antidepressant agomelatine (AGM) there is a discrepancy between the widespread knowledge of the potential of AGM to cause hepatotoxic adverse drug reactions (ADR) and the availability of corresponding published data. This impedes an adequate assessment of the hepatotoxicity profile of AGM. We conducted a query of the database of a German Medical Regulatory Body (BfArM) and analyzed spontaneous reports of hepatotoxic ADR. We identified n=58 cases of AGM-related hepatotoxic ADR. Most frequent ADR was asymptomatic increase of liver enzymes (79%); n=6 patients (10%) with AGM-related toxic hepatitis were reported. Characteristics of patients: female sex (69%), age > 50 years (mea…

CLINICAL ROLE OF GASLESS LAPAROSCOPIC ADRENALECTOMY

2009

BACKGROUND: Several studies have demonstrated that the pneumoperitoneum (PNP) may have several hemodynamic, metabolic, neurologic, and humoral effects; in a limited number of patients, these effects represent a contraindication to the use of the PNP in the presence of glaucoma, cardiovascular insufficiency, advanced chronic obstructive bronchitis, and neurologic disease. PATIENTS AND METHODS: Between May 2002 and July 2008, we performed 9 laparoscopic gasless adrenalectomies in 8 patients (5 male and 3 female): 4 left, 3 right, and 1 bilateral, treated in 2 different operations. Mean age was 54.8 years (range: 34 to 76 y). Preoperative diagnosis was Cushing in 5 cases, pheochromocytoma in 1…

Surgery during etanercept therapy in patients with rheumatoid arthritis: is it time to follow patient preferences?

2008

Tumor necrosis factor (TNF)-a inhibitors, such as etanercept and infliximab, improve symptoms and function in patients affected by rheumatoid arthritis (RA) [1, 2] and, therefore, are playing an increasing role in the management of this disease. However, interference with endogenous TNF-a signalling has been reported to alter both normal inflammatory responses in tissue healing and infection surveillance [2, 3]. To our knowledge, the rates of surgery in RA are decreasing. However, with the duration of antiTNF therapy, the number of patients under these agents having surgery will be increasing. These data raise the question of whether TNF-inhibitors can be safely used in RA patients who shou…

Intravitreal clindamycin and dexamethasone for zone 1 toxoplasmic retinochoroiditis at twenty-four months.

2009

Purpose To report the anatomic and functional outcomes of intravitreal clindamycin and dexamethasone for the treatment of zone 1 toxoplasmic retinochoroiditis (TRC). Patients had 1 or more of the following indications for local therapy: intolerance to oral medication, contraindication to oral medication because of pregnancy, lack of response despite oral antimicrobial treatment, or treatment with concomitant oral and local therapy to avoid or limit foveal or optic disc involvement. Design Noncomparative, retrospective, multicentric interventional case series. Participants We reviewed the medical records of 12 consecutive patients (eyes) with posterior pole (zone 1) TRC who were treated week…

Pulmonary balloon angioplasty of chronic thromboembolic pulmonary hypertension (CTEPH) in surgically inaccessible cases.

2003

Abstract The clinical course of patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) depends on the distribution pattern of the thromboembolic material. In patients with thromboembolic findings in the central pulmonary segments pulmonary thrombendarterectomy (PTE) has excellent results and acceptable operative risk. This paper presents two surgically inaccessible cases that were successfully treated with balloon pulmonary angioplasty. Balloon angioplasty improved parenchymal perfusion, increased cardiac index (Delta CI +19.2 % [Case 1], and +15.4 % [2]), reduced pulmonary vascular resistance during follow-up (Delta PVRI -25.0 % [1] and -15.9 % [2]), and is discussed…

Age-related satisfaction with complete dentures, desire for improvement and attitudes to implant treatment

1994

In the edentulous lower jaw implant stabilised dentures have proved clinically so successful that the indication for this treatment is now being discussed more often with geriatric patients. The aim of this study of edentate subjects was to determine the age-relation of the demand for denture improvement, the risks and feasibility of implant treatment. Sixty four complete denture wearers aged from 42 to 84 years took part in the study. A questionnaire was used to determine the subjective demand for denture improvement. For 33 subjects implants seemed possible. For these patients fear and scepticism concerning implant treatment were specified and quantified. Impaired general health was the m…

Safety of etanercept therapy in rheumatoid patients undergoing surgery: preliminary report

2009

This is a preliminary report on a case-series of rheumatoid patients that underwent various kinds of elective surgery but did not withdraw etanercept therapy in spite of physician advise. Elective surgery consisted of right knee surgical prosthesis, bilateral cataract, bilateral hallux valgus, right hip prosthesis, bladder stone by cystoscopy and left inguinal hernia. All the patients had a regular healing rate. During follow-up (6-12 months) no one of these patients were suffering from infective complications after surgery. According to same recent literature results, our data suggest that it is the time to value rheumatoid patient preferences through a correct information about cost-benef…