Articles related to BLEEDING DISORDERS

Uterine fibroids are a common cause of heavy menstrual bleeding and pain. Combination therapy with once-daily oral gonadotropin-releasing hormone-receptor antagonist relugolix plus estradiol and norethindrone acetate in a 12-week course resulted in a significant reduction in bleeding in more than 70% of those in the therapy arms versus less than 20% for the placebo groups.

The timing of re-initiation of antithrombotic therapy needs to be individualized based on the severity of the bleed, among other factors. This article reviews the issue and offers tools and guidelines for determining if and when to restart antiplatelet and oral anticoagulant therapy.

Working from the hypothesis that stomach ulcer bleeds in people on long-term low-dose aspirin therapy was secondary to H. pylori infection, this team gave antibiotic treatment to aspirin takers who test positive for the bacteria, and followed them for up to 7 years. Protection started rapidly and persisted, while diminishing somewhat, over the period of observation.

A 75-y-o man is found to have an INR of 8.5 on routine monitoring. There is no evidence of bleeding, and he is otherwise well. He is instructed to stop warfarin. His hemoglobin comes back normal. What is the best next step in managing him: intervention or observation?

What is the best strategy for preventing stroke in patients with non-valvular AF: anticoagulants or left atrial appendage occlusion (LAAO)? The answer depends on the individual patient’s combination of stroke and bleeding risks. In this study, combined risks favored LAAO for higher bleeding risk, but that benefit became less certain at higher stroke risks.

This BMJ editorial examines whether approaches better equipped to compare rates of menstrual variation in vaccinated versus unvaccinated populations are needed, based on the reports of changes to periods and unexpected vaginal bleeding after vaccination. The US has taken the first step, earmarking $1.67M from the National Institutes of Health to encourage research.