Internal and emergency medicine
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Splanchnic vein thrombosis (SVT) is a possible complication of acute pancreatitis (AP). There are no precise guidelines on the use of anticoagulant therapy (AT) in these patients. The aim of the study was to determine the safety and the efficacy of AT in AP-associated SVT. ⋯ No treated patient developed haemorrhagic complications after AT. No deaths were recorded, either in the group undergoing AT or in the one that was not. In conclusion, AT in AP-associated SVT appears to be safe and effective; yet prospective clinical trials are needed to confirm our results.
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Antithrombotic treatment in patients with atrial fibrillation undergoing percutaneous coronary intervention is still debated. We conducted a meta-analysis of recent randomized controlled trials to evaluate the benefit of different antithrombotic strategies. Data were analyzed between May and September 2019. ⋯ DAT was as effective and safer than TAT in patients with stable coronary artery disease, while a trend towards increased ischemic events was seen in ACS patients. DAT with a DOAC showed similar efficacy and less bleeding than TAT with a VKA. However, increased stent thrombosis with DAT may be present, and TAT should be considered in patients at high ischemic risk, such as ACS patients.
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Literature reviews can be directly used by clinicians and other health professionals to support many decision-making processes. This review aims to offer health professionals an essential practical guide to critically evaluate and properly understand results of review articles published in the scientific literature. ⋯ Key steps of this guide are: to consider the topic and the research question (a), to check the review type (b), to evaluate the methodology (with a keen focus on review guidelines, search strategy and study-selection process, evaluation of the quality and certainty of included evidence, and statistical analysis) (c), and to define the real impact of review results (d). This guide offers a description of essential and easy-to-apply key steps which can help health professionals to evaluate the reliability and implications of a literature review, and to select the latest high-quality scientific evidence to keep updated with.