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[PMID]:29419381
[Ti] Título:How to estimate the effect of treatment duration on survival outcomes using observational data.
[So] Source:BMJ;360:k182, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência de Longa Duração/métodos
Análise de Sobrevida
Resultado do Tratamento
[Mh] Termos MeSH secundário: Anti-Inflamatórios não Esteroides/administração & dosagem
Anti-Inflamatórios não Esteroides/farmacologia
Aspirina/administração & dosagem
Aspirina/farmacologia
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k182


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[PMID]:29329092
[Au] Autor:Tian Z; Pang H; Zhang Q; Du S; Lu Y; Zhang L; Bai J; Li P; Li D; Zhao M; Chen X
[Ad] Endereço:School of Chinese Materia Medica, Beijing University of Chinese Medicine, 6#, WangjingZhonghuanNanlu, Chaoyang District, Beijing 100102, China; School of Pharmaceutical Science, Tsinghua University, Shuangqinglu, Beijing, China.
[Ti] Título:Effect of aspirin on the pharmacokinetics and absorption of panax notoginseng saponins.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1074-1075:25-33, 2018 Feb 01.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Panax notoginseng saponins, a traditional Chinese medicine extraction, and aspirin are both widely used to treat cerebral infarction in China. Good results in clinical practice have been achieved, when Panax notoginseng saponins was taken together with aspirin. METHODS: To investigate the interaction of the two drugs in vivo, the concentration of notoginsenoside R , ginsenoside Rg , Rb , Re and Rd. in blood were simultaneously measured by UPLC/MS/MS. Sample preparation was carried out by the protein precipitation technique with an internal standard saikosaponin A standard. The separation of six components was achieved by using an ACQUITY UPLC ®BEH C18 column (1.7µm 2.1×100mm) by gradient elution using water (containing 0.2% formic acid) and acetonitrile (containing 0.2% formic acid) as the mobile phase at a flow rate of 0.2mL/min. The pharmacokinetic parameters were determined using non-compartmental analysis. The transport of notoginsenoside R , ginsenoside Rg , Rb , Re and Rd. in MDCK -MDR1 cell monolayer was also used to verify the conclusion of pharmacokinetic drug-drug interaction and study the mechanism of drug interaction. RESULTS: The concentrations of the five components increased in a certain extent when the two drugs administered together in rats. The values of apparent permeability coefficients were significantly increased when the two drugs were used together. Aspirin and salicylic acid could destroy the tight junction protein and open the intercellular space to increase the absorption of Panax notoginseng saponins. CONCLUSION: Pharmacokinetic drug-drug interaction in vivo existed between Panax notoginseng saponins and aspirin. The drug-drug interaction mainly occurred in the process of absorption.
[Mh] Termos MeSH primário: Aspirina/farmacocinética
Medicamentos de Ervas Chinesas/farmacocinética
Panax notoginseng/química
Saponinas/sangue
Saponinas/farmacocinética
[Mh] Termos MeSH secundário: Animais
Aspirina/farmacologia
Membrana Celular/efeitos dos fármacos
Cães
Medicamentos de Ervas Chinesas/farmacologia
Interações Ervas-Drogas
Limite de Detecção
Modelos Lineares
Células Madin Darby de Rim Canino
Ratos
Ratos Sprague-Dawley
Reprodutibilidade dos Testes
Saponinas/química
Saponinas/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal); 0 (Saponins); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE


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[PMID]:28460643
[Au] Autor:Clarke CA; Canchola AJ; Moy LM; Neuhausen SL; Chung NT; Lacey JV; Bernstein L
[Ad] Endereço:Cancer Prevention Institute of California, 2201 Walnut Ave. Suite 300, Fremont, CA, 94538, USA.
[Ti] Título:Regular and low-dose aspirin, other non-steroidal anti-inflammatory medications and prospective risk of HER2-defined breast cancer: the California Teachers Study.
[So] Source:Breast Cancer Res;19(1):52, 2017 May 01.
[Is] ISSN:1465-542X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Regular users of aspirin may have reduced risk of breast cancer. Few studies have addressed whether risk reduction pertains to specific breast cancer subtypes defined jointly by hormone receptor (estrogen and progesterone receptor) and human epidermal growth factor receptor 2 (HER2) expression. This study assessed the prospective risk of breast cancer (overall and by subtype) according to use of aspirin and other non-steroidal anti-inflammatory medications (NSAIDs) in a cohort of female public school professionals in California. METHODS: In 1995 - 1996, participants in the California Teachers Study completed a baseline questionnaire on family history of cancer and other conditions, use of NSAIDs, menstrual and reproductive history, self-reported weight and height, living environment, diet, alcohol use, and physical activity. In 2005-2006, 57,164 participants provided some updated information, including use of NSAIDs and 1457 of these participants developed invasive breast cancer before January 2013. Multivariable Cox proportional hazards regression models provided hazard rate ratios (HRR) for the association between NSAID use and risk of invasive breast cancer as well as hormone receptor- and HER2-defined subtypes. RESULTS: Developing breast cancer was associated inversely with taking three or more tablets of low-dose aspirin per week (23% of participants). Among women reporting this exposure, the HRR was 0.84 (95% confidence interval (CI) 0.72-0.98) compared to those not taking NSAIDs and this was particularly evident in women with the hormone receptor-positive/HER2-negative subtype (HRR = 0.80, 95% CI 0.66-0.96). Use of three or more tablets of "other" NSAIDs was marginally associated with lower risk of breast cancer (HRR = 0.79, 95% CI 0.62-1.00). Other associations with NSAIDs were generally null. CONCLUSION: Our observation of reduced risk of breast cancer, among participants who took three or more tablets of low-dose aspirin weekly, is consistent with other reports looking at aspirin without differentiation by dose. This is the first report to suggest that the reduction in risk occurs for low-dose aspirin and not for regular-dose aspirin and only among women with the hormone receptor-positive/HER2-negative subtype. This preliminary study builds on previous knowledge and further supports the need for formal cancer chemoprevention studies of low-dose aspirin.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico
Aspirina/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Receptor ErbB-2/genética
[Mh] Termos MeSH secundário: Idoso
Neoplasias da Mama/epidemiologia
Neoplasias da Mama/patologia
California
Relação Dose-Resposta a Droga
Feminino
Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos
Seres Humanos
Meia-Idade
Modelos de Riscos Proporcionais
Receptores Estrogênicos/genética
Receptores de Progesterona/genética
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1186/s13058-017-0840-7


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:29466159
[Au] Autor:Anderson DR; Dunbar M; Murnaghan J; Kahn SR; Gross P; Forsythe M; Pelet S; Fisher W; Belzile E; Dolan S; Crowther M; Bohm E; MacDonald SJ; Gofton W; Kim P; Zukor D; Pleasance S; Andreou P; Doucette S; Theriault C; Abianui A; Carrier M; Kovacs MJ; Rodger MA; Coyle D; Wells PS; Vendittoli PA
[Ad] Endereço:From the Departments of Medicine (D.R.A.), Surgery (M.D.), and Community Health and Epidemiology (P.A.), Dalhousie University, and the Nova Scotia Health Authority (S. Pleasance, S. Doucette, C.T., A.A.), Halifax, the Department of Surgery, University of Toronto, Toronto (J.M.), the Departments of M
[Ti] Título:Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty.
[So] Source:N Engl J Med;378(8):699-707, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome). RESULTS: A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; P<0.001 for noninferiority and P=0.84 for superiority). Major bleeding complications occurred in 8 patients (0.47%) in the aspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43). CONCLUSIONS: Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .).
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Aspirina/uso terapêutico
Inibidores do Fator Xa/uso terapêutico
Inibidores da Agregação de Plaquetas/uso terapêutico
Complicações Pós-Operatórias/prevenção & controle
Rivaroxabana/uso terapêutico
Tromboembolia Venosa/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Aspirina/efeitos adversos
Método Duplo-Cego
Inibidores do Fator Xa/efeitos adversos
Hemorragia/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Inibidores da Agregação de Plaquetas/efeitos adversos
Fatores de Risco
Rivaroxabana/efeitos adversos
[Pt] Tipo de publicação:EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Factor Xa Inhibitors); 0 (Platelet Aggregation Inhibitors); 9NDF7JZ4M3 (Rivaroxaban); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1712746


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[PMID]:29441924
[Au] Autor:Zhou C; Guo X; Cui Q; Liu X; Su G; Zhang J
[Ti] Título:Sildenafil improves the function of endothelial cells in patients suffering from congenital heart disease with pulmonary hypertension.
[So] Source:Pharmazie;71(10):570-574, 2016 Oct 01.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Aim of this study was to investigate the potential effects of sildenafil on the function of endothelial cells from patients with congenital heart disease with pulmonary hypertension (CHDPH). Patients who are diagnosed as CHD with PH (n=30) or without PH (n=30), and 30 healthy persons (control) were enrolled in this study. The 30 CHDPH cases were separated into two groups, one was given aspirin while the other received aspirin and sildenafil. An ELISA assay was used to detect the biological indexes for endothelial cells. Furthermore, 24 male New Zealand white rabbits were used to construct the CHDPH model. The signal pathway-related protein expression was analyzed using RT-PCR and western blotting. Compared to that in healthy people, levels for flowmediated dilatation (FDM), NO, and adiponectin (APN) were significantly decreased while endothelin (ET-1) was significantly increased in CHD patients, while their levels were drastically changed in CHDPH patients (P<0.01). Besides, no significant differences for expression levels including FDM, APN, NO, and ET-1 was observed in CHDPH patients receiving aspirin. But the levels for FDM, APN, NO, and ET-1 were significantly changed in CHDPH patients after treatment with sildenafil for 3 months (P<0.01). The mRNA and protein levels for JNK1/2, MAPK, and NF-κB were significantly increased in CHDPH rabbits compared to the control (P<0.01), but their levels were significantly suppressed by the sildenafil application compared to the CHDPH group (P<0.01). Taken together, our study suggested that sildenafil may play a protective role on endothelial function via suppressing the JNK and NF-κB signal pathways in CHDPH patients.
[Mh] Termos MeSH primário: Células Endoteliais/efeitos dos fármacos
Cardiopatias Congênitas/tratamento farmacológico
Hipertensão Pulmonar/tratamento farmacológico
Citrato de Sildenafila/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Adiponectina/metabolismo
Animais
Aspirina/uso terapêutico
Endotelina-1/metabolismo
Ensaio de Imunoadsorção Enzimática
Voluntários Saudáveis
Cardiopatias Congênitas/fisiopatologia
Seres Humanos
Hipertensão Pulmonar/fisiopatologia
Masculino
NF-kappa B/efeitos dos fármacos
NF-kappa B/metabolismo
Óxido Nítrico/metabolismo
Inibidores da Agregação de Plaquetas/uso terapêutico
Coelhos
Transdução de Sinais/efeitos dos fármacos
Vasodilatação/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (ADIPOQ protein, human); 0 (Adiponectin); 0 (Endothelin-1); 0 (NF-kappa B); 0 (Platelet Aggregation Inhibitors); 0 (Vasodilator Agents); 31C4KY9ESH (Nitric Oxide); BW9B0ZE037 (Sildenafil Citrate); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6510


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[PMID]:29367530
[Au] Autor:Nariai R; Kobayashi T; Masuda H; Ono H; Imadome KI; Kubota M; Ito S; Ishiguro A
[Ad] Endereço:National Center for Child Health and Development, Department of Postgraduate Education and Training.
[Ti] Título:[Transient detection of lupus anticoagulant in acute phase of Kawasaki disease].
[So] Source:Nihon Rinsho Meneki Gakkai Kaishi;40(6):456-459, 2017.
[Is] ISSN:1349-7413
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:  In Kawasaki disease (KD), endothelial damage and an elevation in coagulant factors provoke thrombosis. Lupus anticoagulant (LA) is strongly associated with the risk of thrombosis in patients with antiphospholipid syndrome; however, there has been no report of positive LA in KD patients. A previously healthy, 2-year-old boy was admitted due to fever, bilateral conjunctivitis, redness of the lips, and unilateral cervical lymphadenopathy. Typical Kawasaki disease was diagnosed on day 5 of illness. Adenovirus antigens were detected in his stool. After the KD symptoms were successfully treated with intravenous immunoglobulin, his activated partial thromboplastin time (APTT) increased to 88 seconds at eight days of illness. The cross-mixing test showed an inhibition pattern, and the presence of LA was proved using diluted Russell's viper venom time. APPT elongation improved due to continued low dose aspirin therapy without thromboembolisms. The possibility of contamination by LA was low because six other patients treated with the same immunoglobulin lot showed no APTT elongation. We speculated that KD-related infections led to the presence of LA, which may have triggered the thrombosis. Further accumulation of data is warranted to elucidate the role of LA in KD patients.
[Mh] Termos MeSH primário: Reação de Fase Aguda/sangue
Reação de Fase Aguda/diagnóstico
Inibidor de Coagulação do Lúpus/sangue
Síndrome de Linfonodos Mucocutâneos/sangue
Síndrome de Linfonodos Mucocutâneos/diagnóstico
[Mh] Termos MeSH secundário: Reação de Fase Aguda/tratamento farmacológico
Aspirina/administração & dosagem
Pré-Escolar
Seres Humanos
Imunoglobulinas Intravenosas/administração & dosagem
Masculino
Síndrome de Linfonodos Mucocutâneos/complicações
Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico
Tempo de Tromboplastina Parcial
Trombose/etiologia
Trombose/prevenção & controle
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulins, Intravenous); 0 (Lupus Coagulation Inhibitor); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.2177/jsci.40.456


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[PMID]:27774838
[Au] Autor:Myles PS; Smith JA; Forbes A; Silbert B; Jayarajah M; Painter T; Cooper DJ; Marasco S; McNeil J; Bussières JS; McGuinness S; Byrne K; Chan MT; Landoni G; Wallace S; ATACAS Investigators of the ANZCA Clinical Trials Network
[Ad] Endereço:From the Alfred Hospital (P.S.M., D.J.C., S. Marasco, S.W.) and Monash University (P.S.M., J.A.S., A.F., D.J.C., S. Marasco, J.M., S.W.), Melbourne, VIC, St. Vincent's Hospital, Fitzroy, VIC (B.S.), and the Royal Adelaide Hospital, Adelaide, SA (T.P.) - all in Australia; South West Cardiac Centre, D
[Ti] Título:Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery.
[So] Source:N Engl J Med;376(2):136-148, 2017 01 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. METHODS: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here. The primary outcome was a composite of death and thrombotic complications (nonfatal myocardial infarction, stroke, pulmonary embolism, renal failure, or bowel infarction) within 30 days after surgery. RESULTS: Of the 4662 patients who were enrolled and provided consent, 4631 underwent surgery and had available outcomes data; 2311 were assigned to the tranexamic acid group and 2320 to the placebo group. A primary outcome event occurred in 386 patients (16.7%) in the tranexamic acid group and in 420 patients (18.1%) in the placebo group (relative risk, 0.92; 95% confidence interval, 0.81 to 1.05; P=0.22). The total number of units of blood products that were transfused during hospitalization was 4331 in the tranexamic acid group and 7994 in the placebo group (P<0.001). Major hemorrhage or cardiac tamponade leading to reoperation occurred in 1.4% of the patients in the tranexamic acid group and in 2.8% of the patients in the placebo group (P=0.001), and seizures occurred in 0.7% and 0.1%, respectively (P=0.002 by Fisher's exact test). CONCLUSIONS: Among patients undergoing coronary-artery surgery, tranexamic acid was associated with a lower risk of bleeding than was placebo, without a higher risk of death or thrombotic complications within 30 days after surgery. Tranexamic acid was associated with a higher risk of postoperative seizures. (Funded by the Australian National Health and Medical Research Council and others; ATACAS Australia New Zealand Clinical Trials Registry number, ACTRN12605000557639 .).
[Mh] Termos MeSH primário: Antifibrinolíticos/uso terapêutico
Ponte de Artéria Coronária
Hemorragia/prevenção & controle
Complicações Intraoperatórias/prevenção & controle
Ácido Tranexâmico/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antifibrinolíticos/efeitos adversos
Aspirina/uso terapêutico
Transfusão de Sangue/estatística & dados numéricos
Doença da Artéria Coronariana/mortalidade
Doença da Artéria Coronariana/cirurgia
Método Duplo-Cego
Feminino
Valvas Cardíacas/cirurgia
Hemorragia/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Inibidores da Agregação de Plaquetas/uso terapêutico
Complicações Pós-Operatórias/induzido quimicamente
Reoperação/estatística & dados numéricos
Convulsões/induzido quimicamente
Trombose/induzido quimicamente
Ácido Tranexâmico/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Platelet Aggregation Inhibitors); 6T84R30KC1 (Tranexamic Acid); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1606424


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[PMID]:29381951
[Au] Autor:Wong CK; Chan PH; Lam CC; Kwok OH; Lam YY; Siu CW
[Ad] Endereço:Cardiology Division, Department of Medicine, The University of Hong Kong.
[Ti] Título:WATCHMAN device-related thrombus successfully treated with apixaban: A case report.
[So] Source:Medicine (Baltimore);96(47):e8693, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. PATIENT CONCERNS: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He was prescribed dual anti-platelet therapy with aspirin and clopidogrel. DIAGNOSIS: Reassessment echocardiography 3 months later found device-related thrombus. INTERVENTIONS: The antithrombotic regimen was switched from dual antiplatelet therapy to apixaban. OUTCOMES: Reassessment echocardiography 3 months later revealed complete resolution of the device-related thrombus. Apixaban was stopped. He had dual antiplatelet therapy for 6 more months followed by life-long aspirin. There was no bleeding complication since implantation of Watchman device. LESSONS: We demonstrated successful treatment of device-related thrombus with a short course of apixaban with complete resolution of thrombus. Further randomized controlled trials are required to determine the choice and duration of drug therapy for device-related thrombus.
[Mh] Termos MeSH primário: Fibrilação Atrial/cirurgia
Inibidores do Fator Xa/uso terapêutico
Próteses e Implantes/efeitos adversos
Pirazóis/uso terapêutico
Piridonas/uso terapêutico
Trombose/tratamento farmacológico
Trombose/etiologia
[Mh] Termos MeSH secundário: Idoso
Anticoagulantes/administração & dosagem
Aspirina/administração & dosagem
Apêndice Atrial/cirurgia
Seres Humanos
Masculino
Trombose/prevenção & controle
Ticlopidina/administração & dosagem
Ticlopidina/análogos & derivados
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridones); 3Z9Y7UWC1J (apixaban); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008693


  9 / 40457 MEDLINE  
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[PMID]:28595197
[Au] Autor:Shan J; Lei H; Shi W; Sun X; Tang Y; Ren C
[Ad] Endereço:Department of Gastroenterology, The 3rd People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China.
[Ti] Título:High Serum Pepsinogen I and beta Helicobacter pylori Infection Are Risk Factors for Aspirin-Induced Gastroduodenal Injury.
[So] Source:Dig Dis;36(1):66-71, 2018.
[Is] ISSN:1421-9875
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Whether gastric hyperchlorhydria and Helicobacter pylori infection contribute to aspirin-induced gastroduodenal injury still lacks evidence. Because serum pepsinogens (PGs) and gastrin-17 (G17) can reflect gastric acid secretion, this study intended to elucidate whether serum PGs, serum G17, and H. pylori infection are associated with aspirin-induced gastrointestinal injury. SUMMARY: A total of 60 patients taking low-dose aspirin for more than 1 month were enrolled in this study. Serum PG I, PG II, and G17 were determined using ELISA. A 14C-urea breath test was used for the detection of an H. pylori infection. The modified Lanza score was used to evaluate the degree of gastroduodenal injury under endoscopy. The median serum PG I level was significantly higher in the intensive gastroduodenal injury (IGI) group compared to that in the mild gastroduodenal injury group (155.0 vs. 116.6 ng/mL, p = 0.006). The H. pylori infection rate was significantly higher in the IGI group (73 vs. 40%, p = 0.037). Receiver operator characteristic curves analysis revealed that the cutoff value of PG I was 123 ng/mL, with 80% sensitivity and 61.4% specificity. H. pylori infection combined with PG I at >123 ng/mL had an OR (95% CI) of 15.8 (2.4 ± 104.5) for the prediction of aspirin-induced gastroduodenal injury. Key Messages: Serum PG I and H. pylori infection could be used to identify potential high-risk aspirin-induced gastroduodenal injury patients.
[Mh] Termos MeSH primário: Aspirina/efeitos adversos
Duodeno/lesões
Infecções por Helicobacter/sangue
Infecções por Helicobacter/microbiologia
Helicobacter pylori/fisiologia
Pepsinogênio A/sangue
Estômago/lesões
[Mh] Termos MeSH secundário: Idoso
Área Sob a Curva
Duodeno/efeitos dos fármacos
Feminino
Gastrinas/sangue
Infecções por Helicobacter/complicações
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Curva ROC
Fatores de Risco
Estômago/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Gastrins); 60748-06-3 (gastrin 17); 9001-10-9 (Pepsinogen A); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1159/000477203


  10 / 40457 MEDLINE  
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[PMID]:28743241
[Au] Autor:Herath HMMTB; Pahalagamage SP; Withana D; Senanayake S
[Ad] Endereço:National Hospital, Colombo, Sri Lanka. tharukaherath11@gmail.com.
[Ti] Título:Complete ophthalmoplegia, complete ptosis and dilated pupil due to internal carotid artery dissection: as the first manifestation of Takayasu arteritis.
[So] Source:BMC Cardiovasc Disord;17(1):201, 2017 07 25.
[Is] ISSN:1471-2261
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion. Internal carotid artery dissection in Takayasu arteritis is very rare and complete ophthalmoplegia due to internal carotid artery dissection is also rare. This is the first case report of Takayasu arteritis presenting as complete ophthalmoplegia due to internal carotid artery dissection. CASE PRESENTATION: A 38-year-old Sri Lankan female presented with sudden onset severe headache, fixed dilated pupil, complete ptosis and ophthalmoplegia on the right side. On imaging, dissection and dilatation was evident in the right internal carotid artery from the origin up to the cavernous segment. She also had stenosis and aneurysmal dilatation of right subclavian artery. Takayasu arteritis was diagnosed subsequently. She was started on aspirin and high dose steroids. CONCLUSIONS: Internal carotid artery dissection within the cavernous sinus can lead to third, fourth and sixth nerve palsy due to compression, stretching and ischemia from occlusion of the nutritional arteries. This case report illustrates that internal carotid artery dissection should be a differential diagnosis in palsies of the third, fourth, or sixth cranial nerves, especially when associated with headache. In cases of internal carotid artery dissection, vasculitis such as Takayasu arteritis should also be considered.
[Mh] Termos MeSH primário: Aneurisma Dissecante/etiologia
Blefaroptose/etiologia
Doenças das Artérias Carótidas/etiologia
Artéria Carótida Interna
Aneurisma Intracraniano/etiologia
Oftalmoplegia/etiologia
Pupila
Arterite de Takayasu/complicações
[Mh] Termos MeSH secundário: Adulto
Aneurisma Dissecante/diagnóstico por imagem
Angiografia Digital
Aspirina/administração & dosagem
Blefaroptose/diagnóstico
Blefaroptose/fisiopatologia
Doenças das Artérias Carótidas/diagnóstico por imagem
Artéria Carótida Interna/diagnóstico por imagem
Angiografia Cerebral/métodos
Angiografia por Tomografia Computadorizada
Feminino
Seres Humanos
Aneurisma Intracraniano/diagnóstico por imagem
Imagem por Ressonância Magnética
Oftalmoplegia/diagnóstico
Oftalmoplegia/fisiopatologia
Esteroides/administração & dosagem
Arterite de Takayasu/diagnóstico
Arterite de Takayasu/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Steroids); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1186/s12872-017-0638-7



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