salicylates and Mitral-Valve-Stenosis

This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral stenosis.. Warfarin was more effective than aspirin in preventing stroke in these patients; combined therapy with low anticoagulant intensity was ineffective. Mitral stenosis patients were not investigated.. We performed a multicenter randomized trial in 1,209 patients at risk. The intermediate-risk group included patients with risk factors or age >60 years: 242 received the cyclooxygenase inhibitor triflusal, 237 received acenocumarol, and 235 received a combination of both. The high-risk group included patients with prior embolism or mitral stenosis: 259 received anticoagulants and 236 received the combined therapy. Median follow-up was 2.76 years. Primary outcome was a composite of vascular death and nonfatal stroke or systemic embolism.. Primary outcome was lower in the combined therapy than in the anticoagulant arm in both the intermediate- (hazard ratio [HR] 0.33 [95% confidence interval (CI)0.12 to 0.91]; p = 0.02) and the high-risk group (HR 0.51 [95% CI 0.27 to 0.96]; p = 0.03). Primary outcome plus severe bleeding was lower with combined therapy in the intermediate-risk group. Nonvalvular and mitral stenosis patients had similar embolic event rates during anticoagulant therapy.. The combined antiplatelet plus moderate-intensity anticoagulation therapy significantly decreased the vascular events compared with anticoagulation alone and proved to be safe in atrial fibrillation patients.

Topics: Acenocoumarol; Aged; Anticoagulants; Atrial Fibrillation; Cause of Death; Dose-Response Relationship, Drug; Drug Therapy, Combination; Embolism; Female; Follow-Up Studies; Hemorrhage; Humans; International Normalized Ratio; Intracranial Embolism; Male; Middle Aged; Mitral Valve Stenosis; Platelet Aggregation Inhibitors; Proportional Hazards Models; Salicylates; Survival Analysis; Treatment Outcome

Topics: Acenocoumarol; Aged; Anticoagulants; Aspirin; Atrial Fibrillation; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; International Normalized Ratio; Male; Middle Aged; Mitral Valve Stenosis; Platelet Aggregation Inhibitors; Randomized Controlled Trials as Topic; Salicylates; Warfarin

For many clinicians and parents "teething" remains a convenient diagnosis to explain all manner of local and systemic upset in the young child. Many therapies are on the market to help alleviate the symptoms of primary tooth eruption. In this article we highlight the problems of "teething" as a diagnosis by presenting a case where an initial misdiagnosis of teething compromised a patient's life. The same patient then suffered from topical analgesic misuse during the recovery period.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Choline; Diagnostic Errors; Drug Combinations; Echocardiography; Fatty Alcohols; Heart Septal Defects, Atrial; Humans; Infant; Male; Mefenamic Acid; Mitral Valve Stenosis; Mouth Diseases; Mouth Mucosa; Quaternary Ammonium Compounds; Salicylates; Tooth Eruption

Topics: Adult; Aged; Autoantibodies; Cardiac Surgical Procedures; Female; Fluorescent Antibody Technique; Glucocorticoids; Humans; Male; Middle Aged; Mitral Valve Stenosis; Myocardial Infarction; Myocardium; Myofibrils; Postoperative Complications; Postpericardiotomy Syndrome; Salicylates; Sarcolemma

Topics: Adolescent; Adrenal Cortex Hormones; Aortic Valve Stenosis; Cardiac Surgical Procedures; Child; Drug Therapy; Electrocardiography; Humans; Mitral Valve Stenosis; Penicillins; Pericarditis; Postoperative Complications; Rheumatic Fever; Rheumatic Heart Disease; Salicylates; Sulfonamides; Thoracic Surgery; Tricuspid Valve Stenosis

Topics: Cardiac Surgical Procedures; Gastrointestinal Hemorrhage; Hemorrhage; Mitral Valve Stenosis; Postoperative Complications; Salicylates; Thoracic Surgery; Toxicology

Topics: Adolescent; Aortic Valve; Aortic Valve Stenosis; Child; Follow-Up Studies; Heart Valve Diseases; Humans; Mitral Valve; Mitral Valve Stenosis; Myocarditis; Rheumatic Heart Disease; Salicylates

Topics: Humans; Mitral Valve Stenosis; Postpericardiotomy Syndrome; Salicylates