Most Read Articles
Rachel Soon, 6 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Jackey Suen, 08 Oct 2018

Adding pertuzumab to trastuzumab plus an aromatase inhibitor (AI) improves progression-free survival (PFS) in patients with HER2-positive metastatic or locally advanced breast cancer, the phase II PERTAIN study has shown.

05 Aug 2019
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure-lowering drugs, as reported in a recent study.
Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.

Periprocedural bridging in VTE patients tied to greater bleeding incidence

10 Jul 2019

Compared with vitamin K antagonist (VKA) without bridging, periprocedural bridging is associated with a higher risk of bleeding, with no significant difference in periprocedural venous thromboembolism (VTE) rates, results of a systematic review have shown.

This study sought to examine recurrent VTE and bleeding outcomes with and without bridging in patients with previous VTE due to the uncertain benefits and risks of periprocedural bridging in this population.

The investigators searched the PubMed and Embase databases from inception to 7 December 2017 for randomized and nonrandomized studies that included adults with previous VTE requiring VKA interruption to undergo an elective procedure and that reported VTE or bleeding outcomes. Quality of evidence was graded by consensus.

Twenty-eight cohort studies (20 single-arm cohorts) with a total of 6,915 procedures were analysed. In 27 studies reporting perioperative VTE outcomes, recurrent VTE with bridging had a pooled incidence of 0.7 percent (95 percent CI, 0.4–1.2 percent), while that in recurrent VTE without bridging was 0.5 percent (0.3–0.8 percent).

In 18 studies, major or nonmajor bleeding outcomes were reported. The corresponding pooled incidence of any bleeding for with and without bridging was 3.9 percent (2.0–7.4 percent) and 0.4 percent (0.1–1.7 percent). The pooled incidence for VTE in bridged patients at high thromboembolic risk was 0.8 percent (0.3–2.5 percent) and 7.5 percent (3.1–17.4 percent) for any bleeding.

Due to a high risk of bias among included studies, the quality of available evidence was very low.

“VKA are the most widely used anticoagulants, and bridging is commonly administered during periprocedural VKA interruption,” the investigators said.

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Most Read Articles
Rachel Soon, 6 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Jackey Suen, 08 Oct 2018

Adding pertuzumab to trastuzumab plus an aromatase inhibitor (AI) improves progression-free survival (PFS) in patients with HER2-positive metastatic or locally advanced breast cancer, the phase II PERTAIN study has shown.

05 Aug 2019
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure-lowering drugs, as reported in a recent study.
Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.