scholarly journals STUDY OF RIVAROXABAN FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS AFTER LOWER EXTREMITY FRACTURES IN RUSSIAN CLINICAL PRACTICE

2018 ◽  
pp. 47-51
Author(s):  
M. V. Belov
Keyword(s):  
Lower Extremity ◽  
Dabigatran Etexilate ◽  
Clinical Manifestations ◽  
Bleeding Risk ◽  
Recurrent Dislocation ◽  
Main Group ◽  
Control Group ◽  
Thromboembolism Prophylaxis ◽  
Vein Thrombosis ◽  
Femur Fractures

Thepurposeof the study was to evaluate the efficacy and safety of rivaroxaban in patients after surgical treatment for the lower extremity fractures.Patients and methods. Retrospective multicenter study included 663 patients with femur fractures, 43 patients with complications after total hip arthroplasty (periprosthetic femur fractures, recurrent dislocation) and 10 patients with shinbone fractures. The majority (81.99%) of patients were elderly or senile. In postoperative period all patients received a standard prophylactic dose of anticoagulants. Out of them 75 (main group) – rivaroxaban (10 mg/day), 241 (control group) – other drugs (enoxaparin – 40 mg/day and dabigatran etexilate 150 or 220 mg/day). The efficacy of prophylaxis was assessed by clinical picture and Doppler ultrasound scans.Results.Average bed day made up 9.28. During hospitalization no cases of PE were recorded. In the main and control groups the rate of deep vein thrombosis with clinical manifestations made up 1.89 and 3.31%, respectively. No cases of fatal bleeding occurred. Signs of continuous bleeding in the area of surgical intervention (soaking dressings or recurring wound hematomas) in the main group was recorded rarely (3.15%) than in the control one (8.29%).Conclusion.Reduction of VTE rate with no increase in bleeding risk indicates the feasibility of rivaroxaban use for postoperative PE prophylaxis in patients with lower extremity fractures.

scholarly journals Study of rivaroxaban for venous thromboembolism prophylaxis after lower extremity fractures in Russian clinical practice

2018 ◽  
Vol 25 (1) ◽  
pp. 47-51
Author(s):  
Mikhail V. Belov
Keyword(s):  
Lower Extremity ◽  
Dabigatran Etexilate ◽  
Clinical Manifestations ◽  
Bleeding Risk ◽  
Recurrent Dislocation ◽  
Main Group ◽  
Control Group ◽  
Thromboembolism Prophylaxis ◽  
Vein Thrombosis ◽  
Femur Fractures

The purpose of the study was to evaluate the efficacy and safety of rivaroxaban in patients after surgical treatment for the lower extremity fractures. Patients and methods. Retrospective multicenter study included 663 patients with femur fractures, 43 patients with complications after total hip arthroplasty (periprosthetic femur fractures, recurrent dislocation) and 10 patients with shinbone fractures. The majority (81.99%) of patients were elderly or senile. In postoperative period all patients received a standard prophylactic dose of anticoagulants. Out of them 75 (main group) - rivaroxaban (10 mg/day), 241 (control group) - other drugs (enoxaparin - 40 mg/day and dabigatran etexilate 150 or 220 mg/day). The efficacy of prophylaxis was assessed by clinical picture and Doppler ultrasound scans. Results. Average bed day made up 9.28. During hospitalization no cases of PE were recorded. In the main and control groups the rate of deep vein thrombosis with clinical manifestations made up 1.89 and 3.31%, respectively. No cases of fatal bleeding occurred. Signs of continuous bleeding in the area of surgical intervention (soaking dressings or recurring wound hematomas) in the main group was recorded rarely (3.15%) than in the control one (8.29%). Conclusion. Reduction of VTE rate with no increase in bleeding risk indicates the feasibility of rivaroxaban use for postoperative PE prophylaxis in patients with lower extremity fractures.

scholarly journals Prevention of Thromboembolic Complications afterSurgical Treatment for Lower Extremity BoneFractures: Experience in Rivaroxaban Use in ClinicalPractice

2016 ◽  
Vol 23 (2) ◽  
pp. 57-61
Author(s):  
O. A Kaplunov ◽  
S. N Biryukov ◽  
E. Yu Nekrasov
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Comparative Evaluation ◽  
Bone Fractures ◽  
Main Group ◽  
Control Group ◽  
Thromboembolic Complications ◽  
Vein Thrombosis ◽  
Fixation Devices ◽  
Deep Vein

Comparative evaluation of rivaroxaban (main group, n=37) and enoxaparin (control group, n=29) safety in thromboprophylaxis at closed lower extremity bone fractures treatment was performed. All patients were operated on at terms from 8 to 12 day after injury using external fixation devices. The volume of intra- and perioperative blood loss in the groups did not differ significantly ( p >0.05). The rate of symptomatic thromboembolic complications, i.e. calf deep vein thrombosis confirmed by clinical data, was significantly lower in patients from the main group (2.7%) as compared to the control group (6.8%; p

scholarly journals Prevention of Venous Thromboembolic Complications in Wounded with Gunshot Femur Fractures

2015 ◽  
Vol 22 (3) ◽  
pp. 60-65
Author(s):  
V. F Zubritskyi ◽  
A. P Koltovich ◽  
K. N Nikolaev ◽  
S. I Kapustin ◽  
S. N Dvortsevoy ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Main Group ◽  
Control Group ◽  
Care Provision ◽  
Thromboembolic Complications ◽  
Vein Thrombosis ◽  
Femur Fractures ◽  
Venous Thromboembolic ◽  
Specialized Care ◽  
Deep Vein

Analysis of different measures for the prevention of venous thromboembolic complications (VTEC) in 128 wounded with gunshot femur fractures was performed. Patients from control group (58) received pharmacologic prevention only at the step of specialized medical care provision. In the main group (70) combined VTEC prevention was provided at both the step of expert and specialized care. Rate of lower extremity deep vein thrombosis (LEDVT) made up 27.1% in the main group and 55.2% (p

scholarly journals Clinical evaluation of the effectiveness of treatment of the hand-foot syndrome – skin toxicity of antitumor target therapy with multi-kinase inhibitors

2018 ◽  
Vol 12 (3) ◽  
pp. 140-149 ◽  
Author(s):  
Evgeniya A. Shatokhina ◽  
Larisa S. Kruglova ◽  
Oleg A. Shukhov
Keyword(s):  
Lipoic Acid ◽  
Kinase Inhibitors ◽  
Clinical Manifestations ◽  
Main Group ◽  
Betamethasone Dipropionate ◽  
Control Group ◽  
Positive Trend ◽  
Alpha Lipoic Acid ◽  
Significant Difference ◽  
Hand Foot Syndrome

Background. The effective treatment of the hand-foot syndrome is a necessary component of the complex treatment of patients receiving antitumor therapy with multikinase inhibitors. Aims. The assessment of a new effective method for the treatment of palm-plantar syndrome in patients receiving multi-kinase inhibitors. Materials and methods. There are 27 patients received antitumor treatment with multi-kinase inhibitors and had clinical manifestations of the hand-foot syndrome (HFS) for observation. The main group (14 patients) used a combination of an alpha-lipoic acid at a dose of 600 mg per day per os and an ointment containing 0.005% calcipotriol and 0.05% betamethasone dipropionate 2 times a day. The control group, included 13 patients, used a combination with a cream containing 10% urea and ointment containing 0.05% betamethasone dipropionate. Results. After a week of treatment, the regression of the skin process was observed in both groups, but it was more evident in the main group: significant differences in severity of erythema, paresthesia, pain and burning sensation, the Dermatological Life Quality Index (DLQI) were observed at this stage of therapy (p < 0.05). After 2 weeks of therapy: a more positive trend in the main group in terms of erythema, paresthesia and burning, but the most significant difference is DLQI – 17.4 in the main group and 22.8 in the control group (p < 0.0001). At the end of the 3rd week of therapy: differences with the main characteristics of erythema, desquamation, paresthesia (p < 0.0008), pain (p < 0.0001), DLQI (p < 0.0001). At the end point of the study (after 4 weeks of therapy), significant differences were found in reducing the symptoms and the main parameters for evaluating the effectiveness of DLQI in patients of the main group with a reliability of p < 0.0001. The high correlation of DLQI was found with erythema, pain, burning, paresthesia and desquamation. Conclusions. The treatment of the hand-foot plantar syndrome combined using alpha-lipoic acid inside and topical therapy in the form of an ointment containing calcipotriol and betamethasone dipropionate, can be recommended for patients receiving targeted therapy with multi-kinaseinhibitors.

scholarly journals FEATURES OF CLINICAL MANIFESTATIONS, CELLULAR AND HUMORAL IMMUNITY OF NEWBORNS WITH INTRAUTERINE MIXED INFECTIONS

2020 ◽  
pp. 427-433
Author(s):  
M.A. YUSUPOVA ◽  
◽  
K.I. ISMOILOV ◽  
Keyword(s):  
Humoral Immunity ◽  
Phagocytic Activity ◽  
Clinical Manifestations ◽  
Main Group ◽  
Phagocytic Index ◽  
Control Group ◽  
Mixed Infections ◽  
Secondary Immunodeficiency ◽  
Group I ◽  
Cellular And Humoral Immunity

Objective: To study the features of clinical manifestations, cellular and humoral immunity of newborns with intrauterine mixed infections (IUMI). Methods: A comprehensive survey of 45 infants with IUMI was carried out. Depending on the classification of IUMI they were divided into 3 main groups: group I – 24 patients (53%) with the viral-bacterial association, group II – 12 patients (27%) with the viral-viral association, and group III – 9 patients (20%) with the viral-parasitic association. The control group consisted of 10 newborns born from uninfected, somatically healthy mothers. Diagnosis of IUMI was based on the detection of specific antibodies of the IgA, IgG and IgM classes, as well as phagocytic activity and phagocytic index of leukocytes. In addition, general clinical, biochemical, bacteriological and instrumental research methods have been conducted. Results: The blood serum IgA and IgM indices in patients of the main group were significantly higher, and the mean IgG values were lower compared to the control group. Analysis of cellular immunity parameters in the main group showed a decrease in the number of mature T-lymphocytes (CD3), B-lymphocytes (CD20), the number of T-helpers and cells that produce IL-2 in the peripheral blood, compared with the control group. In the main group, there was also an increase in the number of apoptosis cells (CD95), cells with high cytotoxic activity (CD25, CD71) and the percentage of natural killer cells (CD16). A decrease in the phagocytic activity and phagocytic index of neutrophils was recorded, which indicates the insufficiency of the nonspecific component of immunity. Conclusions: In newborns, various changes were found both on the part of specific and nonspecific components of immunity. This indicates the development of secondary immunodeficiency in this category of patients and makes it necessary to add to the main treatment of immune corrective therapy. Keywords: Congenital infections, mixed intrauterine infections, TORCH syndrome, opportunistic infections, secondary immunodeficiency.

scholarly journals A comparison of aspirin against rivaroxaban for venous thromboembolism prophylaxis after hip or knee arthroplasty: A meta-analysis

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901989602
Author(s):  
Joshua Xu ◽  
Aran Kanagaratnam ◽  
Jacob Y Cao ◽  
Gurpreet S Chaggar ◽  
Warwick Bruce
Keyword(s):  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Cost Effective ◽  
Bleeding Risk ◽  
Wound Complications ◽  
Significant Heterogeneity ◽  
Thromboembolism Prophylaxis ◽  
Vein Thrombosis ◽  
Deep Vein

Purpose: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients are at an elevated risk of post-operative venous thromboembolism (VTE). Newer thromboprophylactic agents such as rivaroxaban are increasingly used and effective in preventing thromboembolic events but may worsen bleeding risk. Recent studies have suggested that the more cost-effective aspirin may also be effective in preventing VTE. This systematic review and meta-analysis aimed to compare the efficacy of aspirin against rivaroxaban for the prevention of VTE following TKA and THA. Methods: Electronic searches were performed using five databases from their date of inception to August 2018. Relevant studies were identified, with data extracted and meta-analyzed from the studies. Results: Five studies were included, which consisted of 2257 in the aspirin group and 2337 in the rivaroxaban group. There were no differences between aspirin and rivaroxaban for either VTE ( p = 0.48) or its components deep vein thrombosis ( p = 0.44) and pulmonary embolism ( p = 0.98). Also, there were no differences between groups for either major bleeding ( p = 0.17), any bleeding ( p = 0.62), readmissions ( p = 0.37) or wound complications ( p = 0.17). Conclusion: Aspirin was not significantly different to rivaroxaban for prevention of VTE or adverse events after TKA or THA. However, this study was limited by the significant heterogeneity of the included studies. More large randomized studies are needed to add to this body of evidence.

Contrast enhancement patterns of hepatocellular carcinoma with portal vein thrombosis

2019 ◽  
pp. 68-75
Author(s):  
E. V. Rozengauz ◽  
A. G. Karakhanova ◽  
D. V. Nesterov
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Contrast Enhancement ◽  
Portal Vein Thrombosis ◽  
Diagnostic Errors ◽  
Main Group ◽  
Arterial Phase ◽  
Control Group ◽  
Portal Thrombosis ◽  
Vein Thrombosis

Purpose. To study contrast enhancement patterns of hepatocellular carcinoma (HCC) in cases with portal thrombosis and without it.Materials and methods. 61 consecutive patients with HCC were included in the study and divided into two groups: 41 patient with portal vein thrombosis (main group) and 20 patients without thrombosis (control group). Each patient underwent a abdominal CE MDCT for the analysis of the lesion contrast enhancement.Results. The 1st – “classic” – contrast enhancement pattern with a peak at arterial phase was observed in 2 (5%) patients with HCC complicated by portal thrombosis and in 10 (50%) patients without thrombosis (p < 0.01). The 2nd – “hypervascular” pattern with a peak shifted in 60–120s after contrast agent administration and no wash out was observed in 14 (34%) patients in the main group and in 10 (50%) patients in the control group (p = 0.4). The 3rd pattern – inhomogeneous contrast enhancement of liver parenchyma in the territory of thrombosed vein without visible tumor was discovered in 17 (41%) cases (p < 0.01). The 4th pattern – peripheral enhancement in arterial and portal phase with insignificant central enhancement in delayed phase was visualized in 8 cases (20%, p = 0.072).Conclusion. Portal thrombosis, which complicates the course of HCC, significantly changes the patterns of tumor’s contrast enhancement. This should be taken into account when image analysis to avoid diagnostic errors.

Results of the inclusion of osteopathic correction in the complex therapy of patients with chronic gastritis

2021 ◽  
pp. 80-89
Author(s):  
R. T. Fazlyakhmetov ◽  
R. R. Safiullin ◽  
A. V. Ustinov
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Chronic Gastritis ◽  
Eradication Therapy ◽  
Clinical Manifestations ◽  
Integrated Approach ◽  
Main Group ◽  
Control Group ◽  
Study Results ◽  
Complex Therapy

Introduction. Many key questions regarding the etiology, pathogenesis, clinical manifestations and treatment of chronic gastritis remain open. So, despite the success of chronic gastritis pharmacotherapy, much attention is paid to non-drug methods of therapy, in particular, osteopathy. However, evidences of the osteopathic methods effectiveness for the chronic gastritis treatment, obtained by objective instrumental methods, are insufficiently presented in the modern literature.The goal of research — to study the results of osteopathic correction inclusion in the complex therapy of patients with chronic gastritis.Materials and methods. The study involved 50 patients with chronic gastritis, divided by simple randomization into a control group (25 people) and a main group (25 people). The participants in the control group received standard eradication therapy according to a three-component scheme. The participants of the main group additionally received osteopathic correction. In both groups, at the beginning and at the end of the study, there were performed fibroesophagogastroduodenoscopy with targeted biopsy to assess the gastric mucosa state, Helicobacter pylori identification, and intragastric pH-metry to assess gastric juice acidity.Results. According to the study results, a statistically significant (p<0,05) decrease in edema and hyperemia of gastric mucosa was found in the control and main groups. There was a statistically significant (p<0,001) decrease in gastric aciditywith osteopathic accompaniment, compared with unaccompanied drug treatment. In both groups, there was a statistically significant (p<0,05) decrease in the incidence of Helicobacter pylori carriage. Conclusion. Based on the obtained results, it can be assumed that an integrated approach using osteopathic correction in the treatment of chronic gastritis may be more effective than the standard course of treatment.

Hepatoprotective therapy with low molecular weight sugar drug for pregnant women with liver dysfunction amid early toxicosis and hepatotoxicity

2021 ◽  
Vol 20 (2) ◽  
pp. 19-28
Author(s):  
E.V. Mozgovaya ◽  
◽  
M.A. Kryshnya ◽  
E.V. Shelaeva ◽  
S.V. Nagorneva ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pregnant Women ◽  
Bile Acids ◽  
Alanine Aminotransferase ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
Low Molecular Weight ◽  
Sugar Solution ◽  
Drug Induced

Objective. To assess the efficacy and safety of low molecular weight sugar solution as a hepatoprotector in the first trimester of pregnancy in patients with liver functional disorders against the background of early toxicosis and / or hepatotoxicity. Patients and methods. The study included 70 patients: the main group (n = 30) – pregnant women with functional hepatopathies who received therapy with drug Heptrong; the control group (n = 30) – pregnant women who received standard treatment, of which 15 patients had hepatotoxicity (essential phospholipid therapy) and 15 patients with early toxicosis (intravenous saline fluid therapy, Cerucal), as well as 10 pregnant women with early toxicosis who were treated without drugs (the placebo group). Results. Pregnant women with early toxicosis noted a decrease in its clinical manifestations against the use of the drug Heptrong after 2.3 ± 0.8 days from the onset of therapy; by the end of therapy, all patients had no vomiting, and nausea stopped in 80%, which was not observed in comparison groups. The normalization of alanine aminotransferase (≤40 U/L) occurred in 80% of pregnant women in the main group (p < 0.01) and in 66% (p < 0.01) when treating with essential phospholipids. The normalization of alanine aminotransferase (≤40 U/L) occurred in 90% (p < 0.01) and 33.3% (p = 0.03), respectively. A significant decrease in the level of bile acids (from 8.49 ± 2.1 μmol/L to 2.74 ± 1.1 μmol/L; p < 0.05) and improvement in the indicators of the antioxidant system – an increase in total antiradical activity (from 804.0.0 ± 10.5 μmol/L to 839.0 ± 11.0 μmol/L; p < 0.05) and a decrease in the level of conjugated dienes (from 3.77 ± 0.2 μmol/L to 3.26 ± ± 0.1 μmol/L; p < 0.05) – were observed only in the main group. A number of other indicators of the “liver panel” tended to improve only in the main group. Conclusion. Heptrong is an effective hepatoprotective drug, which considerably improves the state of pregnant women during early toxicosis and helps to reduce liver transaminases and bile acids in pregnant women with hepatotoxicity. Due to the antiinflammatory and pronounced antioxidant effect, which is not observed in standard pharmacological treatment, Heptrong can be used to prevent late obstetric complications. Key words: Heptrong, drug-induced hepatopathies, “liver panel” indicators, early toxicosis

scholarly journals Venous Thromboembolism Prophylaxis in Critically Ill Patients

2015 ◽  
Vol 41 (01) ◽  
pp. 068-074 ◽  
Author(s):  
Kochawan Boonyawat ◽  
Mark Crowther
Keyword(s):  
Venous Thromboembolism ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Preventive Measure ◽  
Venous Catheter ◽  
Bleeding Risk ◽  
Contributing Factors ◽  
Thromboembolism Prophylaxis ◽  
Vte Prophylaxis ◽  
Vein Thrombosis

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is recognized as a common complication in critically ill patients. Risk factors including critical illness, mechanical ventilation, sedative medications, and central venous catheter insertion are major contributing factors to the high risk of VTE. Because of their impaired cardiopulmonary reserve, PE arising from thrombosis in the deep veins of the calf that propagates proximally is poorly tolerated by critically ill patients. Pharmacologic prophylaxis with unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) has been shown to decrease the incidence of VTE in medical, surgical, and critically ill patients. As a result, over the past decades, VTE prophylaxis had become a standard of preventive measure in the intensive care unit (ICU). In clinical practice, the rate of VTE prophylaxis varies and may be inadequate in some centers. A perception of a high bleeding risk in critically ill patients is a major concern for most physicians that may lead to inadequate prophylaxis.

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