Safety and efficacy of awake intubation with McGrath® videolaryngoscope (VLS) in patients with predicted difficult airways: a case series

Background: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults and children. Initial treatment with heparin followed by wafarin is the mainstay of treatment. Only insufficient experience is available for direct oral anticoagulants (DOACs). Aims: The study aims to demonstrate the efficacy and safety of DOACs such as (Rivaroxaban and Dabigatran) in patients with objectively confirmed CVT. Methods: Data of 46 cases of CVT collected using a standardized case report form. Inclusion criteria were patients diagnosed with CVT, confirmed by CT or MRI imaging. Results: The total number of patients was 46 (9 males and 37 females). The mean age of the patients was 35.2± 5 years. The most common clinical manifestations among our patients were headache followed by seizure. 52% of cases were unprovoked, while 48% were provoked by pregnancy and oral contraceptive pills. Superior sagittal sinus (55%) and transverse sinus (44.9%) were the most common sites. Involvement of more than three venous sinuses was 34.8%. Thrombophilic abnormality was detected in 21.7% of patients. Initiation of anticoagulation (AC) was mostly low molecular weight heparin (LMWH) (80%), followed by unfractionated heparin (UFH) (17.7%) and fondaparinex (2%). Maintenance AC with Rivaroxaban after heparin (LMWH/UFH) was in 63% of our patients, the rest were switched from Warfarin to Rivaroxaban (34.8%), and one was treated by Dabigatran (2%). CVT recurrence was observed in one patient. Major bleeding (according to ISTH criteria) was not reported in our case series. Conclusions: DOACs demonstrated good safety and efficacy profile and can potentially replace warfarin in CVT patients. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Abstract No. 390 Feasibility, safety, and efficacy of in-line balloon occlusion assisted delivery of ethylene-vinyl alcohol copolymer (Onyx) for peripheral arterial applications: a multicenter case series

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2019.12.451 ◽

2020 ◽

Vol 31 (3) ◽

pp. S176

Author(s):

Z. Berman ◽

A. Fischman ◽

L. Young ◽

S. Flanagan ◽

M. Katz ◽

...

Keyword(s):

Vinyl Alcohol ◽

Case Series ◽

Balloon Occlusion ◽

Safety And Efficacy ◽

Ethylene Vinyl Alcohol ◽

Ethylene Vinyl Alcohol Copolymer ◽

Assisted Delivery ◽

Peripheral Arterial

Download Full-text

Safety and Efficacy of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Neoplasms: A Case Series

ACG Case Reports Journal ◽

10.14309/crj.2015.36 ◽

2015 ◽

Vol 2 (1) ◽

pp. 146-149 ◽

Cited By ~ 6

Author(s):

Naoki Ishii ◽

Hitoshi Akiyama ◽

Koyu Suzuki ◽

Yoshiyuki Fujita

Keyword(s):

Endoscopic Submucosal Dissection ◽

Case Series ◽

Duodenal Neoplasms ◽

Safety And Efficacy ◽

Submucosal Dissection

Download Full-text

Safety and Efficacy of the Tracheobronchial Bonastent: A Single-Center Case Series

Respiration ◽

10.1159/000506815 ◽

2020 ◽

Vol 99 (4) ◽

pp. 353-359 ◽

Cited By ~ 1

Author(s):

Van Kim Holden ◽

Daniel Ospina-Delgado ◽

Alex Chee ◽

Mihir S. Parikh ◽

Megan M. Carreiro ◽

...

Keyword(s):

Case Series ◽

Single Center ◽

Safety And Efficacy

Download Full-text

Safety and efficacy of ambulatory management of secondary spontaneous pneumothorax: a case series

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2018-000373 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000373 ◽

Cited By ~ 2

Author(s):

Fasih Khan ◽

Yusuf Vali ◽

Muhammad Naeem ◽

Raja Reddy

Keyword(s):

Cost Saving ◽

Spontaneous Pneumothorax ◽

Case Series ◽

Optimal Management ◽

Outpatient Management ◽

Safety And Efficacy ◽

Secondary Spontaneous Pneumothorax ◽

Drainage Time ◽

Comparator Group ◽

The Mean

IntroductionThe optimal management of pneumothorax remains undefined. There is a growing consensus that patients with spontaneous pneumothorax can be considered for ambulatory management with the use of a one-way valve. Despite this, there is little data on the outcomes of outpatient management of secondary spontaneous pneumothorax (SSP).MethodsAt our institution, selected patients with primary and secondary spontaneous pneumothorax who meet the predefined local criteria are managed on an ambulatory pathway. We prospectively evaluated our practice over a 3-year period and explore outcomes of patients with SSP using primary spontaneous pneumothorax (PSP) as a comparator group.Results163 consecutive patients presenting to our hospital between September 2014 and July 2017 were evaluated using a predefined protocol. 111 (49 SSP and 62 PSP) were deemed suitable for outpatient management. Resolution on day 5 was similar between the two groups (65% in the SSP vs 79% in the PSP group; p=0.108). The mean drainage time was 5.84 days in SSP compared with 5.69 days in PSP, representing a difference of 0.15 days (95% CI −2.47 to 2.16; p=0.897). Complications such as infection and drain blockage/falling-out were scarce, with comparable pain and satisfaction scores across both groups. There were no deaths during this period. An estimated £86 796 ($113 920) was saved over the study period, equating to £1118.80 ($1550) per patient.DiscussionThis study suggests that outpatient management of selected patients with SSP may be effective, safe and cost-saving.

Download Full-text

Off-Label High-Dose Secukinumab for the Treatment of Moderate-to-Severe Psoriasis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475419843118 ◽

2019 ◽

Vol 23 (4) ◽

pp. 391-393 ◽

Cited By ~ 3

Author(s):

Michelle Phung ◽

Arvin Ighani ◽

Jorge R Georgakopoulos ◽

Ron Vender ◽

Lyne Giroux ◽

...

Keyword(s):

Clinical Practice ◽

Dose Escalation ◽

Case Series ◽

Severe Psoriasis ◽

Adult Patients ◽

High Dose ◽

Physician Global Assessment ◽

Upper Respiratory Tract ◽

Safety And Efficacy ◽

Off Label

Background: Secukinumab is an anti-IL-17A monoclonal antibody approved for the treatment of moderate-to-severe psoriasis in adult patients. Despite its favourable safety and efficacy profile in clinical trials, some patients in clinical practice fail to respond adequately to the approved maintenance regimen of 300 mg subcutaneous monthly. Some clinicians manage these patients by using off-label high-dose secukinumab regimens, which include shortening the dosing interval to 300 mg every 2 or 3 weeks instead of monthly, or increasing the monthly dose to 450 mg. Objective: This study aims to investigate the safety and efficacy of high-dose secukinumab regimens for the treatment of psoriasis to inform real-world clinical practice. Methods: We performed a retrospective chart review at 5 dermatology clinics for adult patients diagnosed with moderate-to-severe psoriasis treated with an off-label high-dose secukinumab regimen. Efficacy was measured using the Psoriasis Area and Severity Index or a Physician Global Assessment score of 0 or 1 after dose escalation. Adverse events were recorded to assess safety outcomes. Results: Twenty-five patients were included in this case series, and 14 of them achieved efficacy from dose escalation with secukinumab based on our study endpoints. There was 1 case of the common cold and 1 upper respiratory tract infection reported after dose escalation. Conclusion: Our study provides evidence that dose escalation with secukinumab results in clinical benefit and is well tolerated among patients with moderate-to-severe psoriasis who failed to respond adequately to the approved regimen. This work necessitates larger studies to fully characterize the efficacy and long-term safety profile of secukinumab dose escalation.

Download Full-text