Current perspectives in antithrombotic therapy

2001 ◽  
Vol 21 (03) ◽  
pp. 82-96 ◽  
Author(s):  
D. Hoppensteadt ◽  
O. Iqbal ◽  
R. L. Bick ◽  
J. Fareed
Keyword(s):  
Blood Coagulation ◽  
Antithrombotic Therapy ◽  
Thrombotic Event ◽  
The United States ◽  
Vascular Thrombosis ◽  
Common Cause ◽  
Coagulation Protein ◽  
Coronary Events ◽  
Platelet Defects

SummaryThrombotic disorders are the most common cause of death in the United States. About two million individuals die each year from an arterial or venous thrombosis or related disorders. About 80% to 90% of all cases of thrombosis can now be defined with respect to cause. Of these, over 50% occur in patients who harbor a congenital or acquired blood coagulation protein or platelet defect which caused the thrombotic event. It is obviously of major importance to define those individuals harboring such a defect as this allows: 1) appropriate antithrombotic therapy to decrease risks of recurrence; 2) determination of the length of time the patient must remain on therapy for secondary prevention; and 3) allow for testing of family members of those harboring a blood coagulation protein or platelet defect which is hereditary (about 50% of all coagulation and platelet defects mentioned above). Aside from mortality, significant additional morbidity occurs from both arterial or venous thrombotic events, including, but not limited to paralysis (non-fatal thrombotic stroke), cardiac disability (repeated coronary events), loss of vision (retinal vascular thrombosis), fetal waste syndrome (placental vascular thrombosis), stasis ulcers and other manifestations of post-phlebitic syndrome, etc.

State-by-State Use of AMA Guides

2019 ◽  
Vol 24 (5) ◽  
pp. 3-7, 16
Keyword(s):  
Expert Testimony ◽  
Narrow Range ◽  
The United States ◽  
Workers Compensation ◽  
Federal Employees ◽  
Permanent Disability ◽  
Sixth Edition ◽  
History Of ◽  
Canadian Provinces

Abstract This article presents a history of the origins and development of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), from the publication of an article titled “A Guide to the Evaluation of Permanent Impairment of the Extremities and Back” (1958) until a compendium of thirteen guides was published in book form in 1971. The most recent, sixth edition, appeared in 2008. Over time, the AMA Guides has been widely used by US states for workers’ compensation and also by the Federal Employees Compensation Act, the Longshore and Harbor Workers’ Compensation Act, as well as by Canadian provinces and other jurisdictions around the world. In the United States, almost twenty states have developed some form of their own impairment rating system, but some have a narrow range and scope and advise evaluators to consult the AMA Guides for a final determination of permanent disability. An evaluator's impairment evaluation report should clearly document the rater's review of prior medical and treatment records, clinical evaluation, analysis of the findings, and a discussion of how the final impairment rating was calculated. The resulting report is the rating physician's expert testimony to help adjudicate the claim. A table shows the edition of the AMA Guides used in each state and the enabling statute/code, with comments.

Leveraging Technology in Detection of Alzheimer’s Disease: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Clemens Kruse ◽  
Britney Larson ◽  
Reagan Wilkinson ◽  
Roger Samson ◽  
Taylor Castillo
Keyword(s):  
Magnetic Resonance Imaging ◽  
United States ◽  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
The United States ◽  
Diagnostic Process ◽  
Resonance Imaging ◽  
Common Cause ◽  
Key Terms

BACKGROUND Incidence of AD continues to increase, making it the most common cause of dementia and the sixth-leading cause of death in the United States. 2018 numbers are expected to double by 2030. OBJECTIVE We examined the benefits of utilizing technology to identify and detect Alzheimer’s disease in the diagnostic process. METHODS We searched PubMed and CINAHL using key terms and filters to identify 30 articles for review. We analyzed these articles and reported them in accordance with the PRISMA guidelines. RESULTS We identified 11 technologies used in the detection of Alzheimer’s disease: 66% of which used some form of MIR. Functional, structural, and 7T magnetic resonance imaging were all used with structural being the most prevalent. CONCLUSIONS MRI is the best form of current technology being used in the detection of Alzheimer’s disease. MRI is a noninvasive approach that provides highly accurate results in the diagnostic process of Alzheimer’s disease.

scholarly journals Complications of drowning: A case report

2019 ◽  
Vol 59 (5) ◽  
pp. 284-8
Author(s):  
Felicia Anita Wijaya ◽  
I Gde Doddy Kurnia Indrawan
Keyword(s):  
United States ◽  
Case Report ◽  
Brain Damage ◽  
The United States ◽  
Accidental Death ◽  
Common Cause ◽  
Death By Drowning

Unintentional drowning is the sixth most common cause of accidental death, accounting for 4,086 deaths (1.4 per 100,000) in the United States in 2007.1 In children, drowning is the second leading cause of injury-related death, and those aged 1–3 years have the highest rate of drowning.2 More than 1,400 pediatric drownings were reported in the United States in 2008.3 Many drowning deaths are due to lack of supervision in the bathtub, unprotected access to a pool, or lack of swimming skills.3 For every death by drowning, six children are hospitalized for drowning, and up to 10% of survivors experience severe brain damage.2

Performance Testing of Coal Fired Power Plants

2007 ◽  
Author(s):  
Shane E. Powers ◽  
William C. Wood
Keyword(s):  
Power Plant ◽  
Power Plants ◽  
Performance Test ◽  
Model Development ◽  
Performance Testing ◽  
The United States ◽  
Plant Performance ◽  
Cycle Performance ◽  
Test Program

With the renewed interest in the construction of coal-fired power plants in the United States, there has also been an increased interest in the methodology used to calculate/determine the overall performance of a coal fired power plant. This methodology is detailed in the ASME PTC 46 (1996) Code, which provides an excellent framework for determining the power output and heat rate of coal fired power plants. Unfortunately, the power industry has been slow to adopt this methodology, in part because of the lack of some details in the Code regarding the planning needed to design a performance test program for the determination of coal fired power plant performance. This paper will expand on the ASME PTC 46 (1996) Code by discussing key concepts that need to be addressed when planning an overall plant performance test of a coal fired power plant. The most difficult aspect of calculating coal fired power plant performance is integrating the calculation of boiler performance with the calculation of turbine cycle performance and other balance of plant aspects. If proper planning of the performance test is not performed, the integration of boiler and turbine data will result in a test result that does not accurately reflect the true performance of the overall plant. This planning must start very early in the development of the test program, and be implemented in all stages of the test program design. This paper will address the necessary planning of the test program, including: • Determination of Actual Plant Performance. • Selection of a Test Goal. • Development of the Basic Correction Algorithm. • Designing a Plant Model. • Development of Correction Curves. • Operation of the Power Plant during the Test. All nomenclature in this paper utilizes the ASME PTC 46 definitions for the calculation and correction of plant performance.

IMPROVEMENT OF THE CAMERAL CHECKS PROCESS IN RUSSIA BASED ON FOREIGN EXPERIENCE

2020 ◽  
Author(s):  
Darya Sergeevna Kareva ◽  
◽  
Sevinj Mahmud kyzy Ismailova ◽  
Elena Evgenievna Dozhdva ◽  
◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Foreign Experience ◽  
Correct Determination

The article substantiates the need to reform cameral tax control in Russia based on the experience of the United States. The necessity of introducing into the procedure of cameral control the mechanism of requesting all documents confirming the correct determination of tax obligations is determined. The aim of improving the process of desk audits of control is that the new procedure for conducting audits will reduce the likelihood of tax violations.

Abstract P252: Discharge Antithrombotic Therapy for Ischemic Stroke Patients With Prior Aspirin Failure

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ying Xian ◽  
Haolin Xu ◽  
Deepak L Bhatt ◽  
Gregg C Fonarow ◽  
Eric E Smith ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Prevention ◽  
Antithrombotic Therapy ◽  
Recurrent Stroke ◽  
Oral Anticoagulants ◽  
The United States ◽  
Future Research ◽  
Large Artery ◽  
Secondary Stroke Prevention ◽  
Stroke Registry

Introduction: Aspirin is one of the most commonly used medications for cardiovascular disease and stroke prevention. Many older patients who present with a first or recurrent stroke are already on aspirin monotherapy, yet little evidence is available to guide antithrombotic strategies for these patients. Method: Using data from the American Heart Association Get With The Guidelines-Stroke Registry, we described discharge antithrombotic treatment pattern among Medicare beneficiaries without atrial fibrillation who were discharged alive for acute ischemic stroke from 1734 hospitals in the United States between October 2012 and December 2017. Results: Of 261,634 ischemic stroke survivors, 100,016 (38.2%) were on prior aspirin monotherapy (median age 78 years; 53% women; 79.4% initial stroke and 20.6% recurrent stroke). The most common discharge antithrombotics (Figure) were 81 mg aspirin monotherapy (20.9%), 325 mg aspirin monotherapy (18.2%), clopidogrel monotherapy (17.8%), and dual antiplatelet therapy (DAPT) of 81 mg aspirin and clopidogrel (17.1%). Combined, aspirin monotherapy, clopidogrel monotherapy, and DAPT accounted for 86.8% of discharge antithrombotics. The rest of 13.2% were discharged on either aspirin/dipyridamole, warfarin or non-vitamin K antagonist oral anticoagulants with or without antiplatelet, or no antithrombotics at all. Among patients with documented stroke etiology (TOAST criteria), 81 mg aspirin monotherapy (21.2-24.0%) was the most commonly prescribed antithrombotic for secondary stroke prevention. The only exception was those with large-artery atherosclerosis, in which, 25.3% received DAPT of 81 mg aspirin and clopidogrel at discharge. Conclusion: Substantial variations exist in discharge antithrombotic therapy for secondary stroke prevention in ischemic stroke with prior aspirin failure. Future research is needed to identify best management strategies to care for this complex but common clinical scenario.

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