ABSTRACT
AIMS: Perioperative management of anticoagulation in patients referred for pacemaker or cardiac defibrillator implantation isn't consensual. Our objective was to evaluate, in a large cohort, hemorrhagic complications in patients having implantation or replacement of a cardiac pacemaker or defibrillator, and to assess perioperative anticoagulation effect on hemorrhagic risk. METHODS AND RESULTS: A cohort of 461 consecutive patients having implantation or replacement of a cardiac pacemaker or defibrillator has been analyzed. Thirty patients (6,5%) had oral anticoagulants (OAC) switched to heparin/low-molecular-weight heparin, while 76 (16,5%) had their oral anticoagulation disrupted habitually for 48 hours. A total of six over 30 (20%) and two over 76 (2.6%) patients in the bridge and OAC, respectively experienced a pocket hematoma (bridge vs. OAC, p<0.05), while ten over 355 (2.8%) had a pocket hematoma in the control group (bridge vs. control p=0.006). Duration of the hospital stay was longer in the bridge group in comparison with OAC and control groups (9 vs. 7 vs. 6 days, respectively, p=0.006). CONCLUSION: Oral anticoagulation bridging with heparin or low-molecular-weight heparin is associated with a higher risk of pocket hematoma and a longer duration of hospitalization, in comparison with a strategy allowing a temporary disruption of OAC adapted to the thromboembolic risk.
Subject(s)
Anticoagulants/adverse effects , Defibrillators, Implantable , Hematoma/chemically induced , Hemorrhage/epidemiology , Pacemaker, Artificial , Adult , Aged , Aged, 80 and over , Clinical Protocols , Hospitals, Community , Humans , Middle Aged , Perioperative Care , Retrospective Studies , Risk FactorsABSTRACT
6 cases of hypersensitivity to Tixocortol pivalate and 3 to Amcinonide are reported. The 9 female patients all presented with features of contact dermatitis.
Subject(s)
Dermatitis, Contact/etiology , Facial Dermatoses/chemically induced , Hydrocortisone/analogs & derivatives , Triamcinolone/analogs & derivatives , Administration, Topical , Adult , Aged , Chemical Phenomena , Chemistry , Female , Humans , Hydrocortisone/administration & dosage , Hydrocortisone/adverse effects , Middle Aged , Triamcinolone/administration & dosage , Triamcinolone/adverse effectsABSTRACT
Observations concerning contact dermatitis to derivatives of isothiazolin-3-one are reported. A systematic review of the literature of previously published cases is reported. A verified contact dermatitis to benzisothiazolin-3-one of a laborer in a rubber factory is discussed. Another case of occupational dermatitis concerns an allergy to a commercial product, containing 2-n-octyl-4-isothiazolin-3-one as a preservative and utilized by shoe factory workers. Additionally, cases of an allergy to cosmetic preparations, containing a mixture of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one, are elaborated.
