Search results for "intervention"

Dental management in patients with hemostasis alteration

2011

Haemostasis is a mechanism that, through different interdependent biologic processes, has the purpose of ensuring the integrity and permeability of the circulatory system. Hemostasis term means prevention the loss of blood. Interventions or treatments in the oral cavity, in particular those with a possibility of bleeding, represent a risk for patients with disorders of hemostasis. Prevention is the key to avoid bleeding complications after oral surgical procedures and therefore it is essential a detailed medical history of the patient. The appropriate diagnosis and treatment in patients with disorders of hemostasis, depends directly in the understanding of hemostasis standard mechanisms. Em…

Management of Antiaggregated and Anticoagulated Patients Scheduled for Thoracic Surgery: Recommendations for Venous Thromboprophylaxis

2017

The management of patients under the effect of antiplatelet or anticoagulant agents is a common challenge in thoracic surgery. Their temporary interruption or continuation needs a balanced assessment between the risk of thrombosis (interruption) and bleeding (continuation). Moreover, most patients must receive an anticoagulant for thromboprophylaxis (mainly a low-molecular-weight heparin). So, it is important to have in mind all surgical and anaesthetic implications of these drugs to take the optimal decision in each case.

Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes

2016

While treatment of patients with attention-deficit hyperactivity disorder (ADHD) is based on a multimodal approach that combines medication with specific psychological interventions, pharmacotherapy alone is generally considered an essential and cost-effective element. This paper aims to comprehensively and critically review factors involved in prescribing and medication use in individuals diagnosed with ADHD, focusing on the difficulties facing patients with ADHD seeking treatment, as well as the safety and tolerability aspects of ADHD pharmacotherapies, with particular attention on the cardiovascular adverse events and the potential risk of misuse or diversion of ADHD medications. A comp…

Impact of admission hyperglycemia on one-year mortality in non-diabetic patients admitted for rescue PCI

2013

0197: Angiographically visible distal embolization is not linked with culprit lesion but with clinical characteristics

2016

Despite the recent improvements in percutaneous coronary intervention (PCI), angiographically visible distal embolization (AVDE) complicates 6 to 18% of ST elevation myocardial infarction (STEMI) treated with PCI, and is associated with poor clinical outcomes. Culprit lesion characteristics have been proved to be the main predictive factor of AVDE. But data regarding clinical characteristics predicting AVDE are lacking. We aimed to identify predictors of AVDE complicating PCI in STEMI management. 769 consecutive patients admitted for STEMI who underwent PCI were included. Clinical, angiographic and therapeutics characteristics were assessed for each patien. AVDE was defined as an abrupt ves…

Drug-Eluting Stent for Left Main Coronary Artery Disease

2012

Objectives The aim of this study was to compare, in a large all-comers registry, major adverse cardiac and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in unprotected left main coronary artery (ULMCA) stenosis. Background Percutaneous coronary intervention with DES implantation in ULMCA has been shown to be a feasible and safe approach at midterm clinical follow-up. Methods All consecutive patients with ULMCA stenosis treated by PCI with DES versus CABG were analyzed in this multinational registry. A propensity score analysis was performed to adjust for baseline dif…

Preparando el escenario para dejar de fumar en el paciente con Trastorno Bipolar: intervención breve en la práctica clínica

2018

Tobacco consumption is the main preventable factor of mortality in smokers with bipolar disorder (BD), and any possible solutions are often blocked by prejudices over desire, and the possibilities and risks for these patients in giving up tobacco consumption. Adults with BD were recruited at 8 Mental Health Centres. Smokers were evaluated before and after a brief intervention based on the 3 A’s and classified into a ‘Stage of Change’ (SOC) and their ‘Readiness to Change’ (RTC). A multiple linear regression was used to analyze the progression in their RTC and the independent effect of different variables (pharmacological treatment, history of psychotic symptoms, current anxiety symptoms, wil…

Highlights and essentials from the first "experts-live" course of the EuroCTO club

2010

Chronic total occlusions (CTOs) are frequently encountered during diagnostic coronary catheterisation. However, there is still confusion regarding the indication for percutaneous coronary intervention (PCI) in this lesion subset, mainly because it is cumbersome and the prognostic impact of revascularisation in these patients remains unclear. Many studies have now shown the long term clinical benefits after CTO PCI1-3; still, with procedural complexity, high radiation exposure to both the patient and the operator, high costs and lower procedural success rates, most patients with CTO are managed medically or referred for bypass graft surgery – regardless of the severity of symptoms and extent…

Computing Methods for Composite Clinical Endpoints in Unprotected Left Main Coronary Artery Revascularization

2016

Abstract Objectives The study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease. Background TTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance. Methods The TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 interna…

Platelet glycoprotein IIb/IIIa blockers during percutaneous coronary intervention and as the initial medical treatment of non-ST segment elevation ac…

2010

BACKGROUND During percutaneous coronary intervention (PCI), and in non-ST segment elevation acute coronary syndromes (NSTEACS), the risk of acute vessel occlusion by thrombosis is high. Glycoprotein IIb/IIIa blockers strongly inhibit platelet aggregation and may prevent mortality and myocardial infarction. This is an update of a Cochrane review first published in 2001, and previously updated in 2007 and 2010. OBJECTIVES To assess the efficacy and safety effects of glycoprotein IIb/IIIa blockers when administered during PCI, and as initial medical treatment in patients with NSTEACS. SEARCH METHODS We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL) on The …