Articles related to BLEEDING DISORDERS
When Should Antithrombotic Therapy Be Resumed After Gastrointestinal Bleeding?
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.
Gastroenterology November 29th 2022
A Major Clinical Trial Shows How to Reduce the Risk of Stomach Bleeding Occasionally Caused by Regular Aspirin Use
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.
Family Medicine/General Practice November 16th 2022
MKSAP Quiz: Elevated INR Found on Routine Monitoring
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?
Hematology October 6th 2022
Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation
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.
Cardiology August 23rd 2022
Menstrual Changes After COVID-19 Vaccination
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.
Internal Medicine September 28th 2021
A Bleeding Diathesis in a 65-Year-Old Woman with Newly Diagnosed Breast Cancer
After diagnosis during a partial mastectomy, this patient’s estimated blood loss was 58 mL, causing anemia and requiring a red blood cell transfusion along with ventriculoperitoneal drain placement. With a substantive bleeding history before the diagnosis, what would you do next with this patient? Work her up for von Willebrand disease? Do a complete blood count test to look at platelet count, a peripheral smear to look at the morphology of the platelets, and a coagulation profile? Offer genetic testing for fibrinogen disorders? What would your next steps be? Read the full case presentation and expert opinion to see how your peers responded.
Emergency Medicine August 3rd 2021