Abstract:
:Objective: To review the mechanism of action, pharmacology, dosing, and complications of tranexamic acid (TXA) and consolidate current evidence for TXA in gynecologic surgery.Methods: A literature search of PubMed, Ovid (MEDLINE), Google Scholar, and Elsevier was performed, in addition to a targeted search of cited references involving TXA and gynecologic surgery. Preference was given to systematic reviews and randomized control trials (RCTs).Results: TXA reversibly binds to plasminogen, preventing clot degradation. RCTs on hysterectomy, myomectomy, cervical conisation, hysteroscopy, and surgery for cervical and ovarian cancer were identified, as were case reports on TXA use for ectopic pregnancy. During hysterectomy, TXA reduces blood loss (two RCTs, n = 432, mean difference -66.0 mL and 180 mL), blood transfusion (1 RCT, n = 100, 12% vs. 42%, p < .00001). For myomectomy, a systematic review and meta-analysis showed a statistically significant decrease in blood loss with TXA (two RCTs, mean difference -213.1 mL, 95% CI: -242.4 mL to -183.7 mL). Following cervical conisation, TXA decreased the risk of delayed hemorrhage (four RCTs, RR 0.23, 95% CI: 0.11-0.50). A single RCT for cervical and ovarian cancer surgery demonstrated a decrease mean blood loss of 120 mL-135 mL and 210 mL, respectively, and fewer blood transfusions for the latter (OR 0.44, upper 95% CI: 0.97, p = .02). Less robust data suggest a possible benefit from TXA during hysteroscopy and surgery for ectopic pregnancies. Most commonly, 1 g of intravenous TXA is given intraoperatively.Conclusion: TXA is a safe adjunct that can be considered in a variety of gynecologic surgeries to decrease blood loss and risk of blood transfusion.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Zakhari A,Sanders AP,Solnik MJdoi
10.1080/03007995.2019.1708533subject
Has Abstractpub_date
2020-03-01 00:00:00pages
513-520issue
3eissn
0300-7995issn
1473-4877journal_volume
36pub_type
杂志文章,评审abstract:BACKGROUND:Reducing low-density lipoprotein cholesterol (LDL-C) levels to National Cholesterol Expert Panel (NCEP) goal is recommended. However, sex-specific effects may influence benefit. METHODS AND RESULTS:In this post hoc analysis of the GREek Atorvastatin and Coronary heart disease (CHD) Evaluation [GREACE] study...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007990802069563
更新日期:2008-06-01 00:00:00
abstract:: Background & aims: Vitamin D deficiency is widespread worldwide. In this study, we aimed to evaluate the effect of a nano encapsulated form of vitamin D used for fortifying low-fat dairy products (milk and yogurt) on anthropometric indices, glycemic status, and lipid profi...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2021.1874324
更新日期:2021-01-12 00:00:00
abstract:OBJECTIVE:To analyse the significance of 'onset of effect' on clinical outcome in the treatment of depression and the contribution of individual Montgomery-Asberg Depression Rating Scale (MADRS) items to improvements in the MADRS total score. RESEARCH DESIGN AND METHOD:All five published placebo-controlled clinical st...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/030079906X148319
更新日期:2006-11-01 00:00:00
abstract::Venous thromboembolism (VTE) is a major cause of morbidity and mortality and is associated with substantial healthcare costs. Identification of patients at risk of developing VTE enables appropriate thromboprophylaxis to be implemented. Although no predisposing risk factors can be identified in many patients in whom V...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2015.1098599
更新日期:2015-12-01 00:00:00
abstract::Acetyl-L-carnitine (ALC) is a compound acting as an intracellular carrier of acetyl groups across inner mitochondrial membranes. It also appears to have neuroprotective properties and it has recently been shown to reduce attention deficits in patients with Alzheimer's disease (AD) after long-term treatment. We perform...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/030079903125001776
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:Data related to the cost effectiveness of surgical interventions and catheter ablation is sparse. This model-based analysis assessed the clinical and economic trade-offs involved in using catheter ablation or the Cox maze procedure in treating patients with atrial fibrillation. METHODS:A deterministic model...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2018.1546681
更新日期:2019-06-01 00:00:00
abstract::A randomized study was performed on 24 patients with ankylosing spondylitis to compare the efficacy and tolerability of 20 mg tenoxicam daily with 50 mg diclofenac twice daily. There were 6 withdrawals from the group taking tenoxicam and 4 from the diclofenac group. Depression in 1 patient taking tenoxicam was the onl...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007999009112691
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Tumor hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expression are important factors influencing treatment response and selection in patients with metastatic breast cancer (mBC). Using the LifeLink Oncology Analyzer Database, we classified mBC patients by combined HR and HER2 st...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2012.694364
更新日期:2012-07-01 00:00:00
abstract::Objective To assess the efficacy of a mixed intervention, educational, and reminder calendar of the intake, as a strategy to improve therapeutic adherence with dabigatran in patients with non-valvular atrial fibrillation (NVAF). Methods This was a prospective, longitudinal, multi-center study, carried out in 110 speci...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1080/03007995.2018.1435519
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To develop a patient-completed screening tool to help differentiate nociceptive and neuropathic pain. RESEARCH DESIGN AND METHODS:A multicenter study was performed for item reduction (initial 89-item questionnaire) and model building. Patients (N = 586) with non-headache chronic pain completed the questionna...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/030079906X115702
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of epoetin theta and epoetin beta in anaemic patients with chronic kidney disease, undergoing haemodialysis and previously on stable maintenance therapy with epoetin beta. METHODS:In this multicentre, randomised, controlled, double-blind study 270 haemodialysis patients wer...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2010.511084
更新日期:2010-10-01 00:00:00
abstract::Stress urinary incontinence (SUI) is the involuntary loss of urine associated with physical activities such as running, jumping, or lifting, or with sneezing and coughing. For many patients it can be a very bothersome symptom, causing social isolation, loss of self-esteem, and increased expenses. Although there is cur...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079903125002126
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To systematically identify and assess current quality measures for anticoagulation in atrial fibrillation (AF), venous thromboembolism (VTE) treatment and surgical VTE prophylaxis. RESEARCH DESIGN AND METHODS:Fifteen quality measure websites were searched as were bibliographic databases (January 2000-Februar...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1200020
更新日期:2016-10-01 00:00:00
abstract::This commentary critically evaluates the limitations of genetic risk predictions in multifactorial disease, with specific reference to age-related macular degeneration (AMD). AMD is a common blinding disease with 33 million people worldwide experiencing vision impairment. Although gene polymorphism combinations infer ...
journal_title:Current medical research and opinion
pub_type: 社论
doi:10.1185/03007995.2011.603301
更新日期:2011-09-01 00:00:00
abstract::A trial to compare the therapeutic potential of 1200 mg. azapropazone daily with 3.9 g. aspirin daily was carried out in 108 out-patients with rheumatoid arthritis over a 14-day period. Analysis of results from the 85 patients with completed assessment data (49 on azapropazone; 36 on aspirin) showed that azapropazone ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007997609109281
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:A recent retrospective meta-analysis of cardiovascular events from long-term studies with acarbose in type 2 diabetes showed that treatment was associated with a significant reduction in the risk of cardiovascular events, supporting the hypothesis that postprandial hyperglycemia is a risk factor for cardiovas...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079906X115531
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:These studies evaluated the safety and efficacy of enteric-coated budesonide for the induction and maintenance of remission of mild-to-moderate Crohn's disease (CD) in children. METHODS:The consecutive, multicenter, open-label, non-comparative studies enrolled patients aged 6-17 years. In the induction study...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1080/03007995.2017.1313213
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Allergic rhinitis (AR) can have substantial negative impact on children. Most notably, it can impede learning during the school-age years. Other consequences include adverse behavioral and psychosocial effects, poor quality of life, and potential impact on serious comorbidities, such as asthma. CONSENSUS PA...
journal_title:Current medical research and opinion
pub_type: 共识发展会议,杂志文章,评审
doi:10.1185/030079904x13266
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Tenofovir disoproxil fumarate (TDF)-based regimens have been associated with impaired kidney function and loss of bone mineral density among patients living with HIV (PLWH). We assess the association between TDF exposure and the odds of chronic kidney disease (CKD) and osteoporotic fracture in HIV patients. ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1816538
更新日期:2020-10-01 00:00:00
abstract::Amlodipine, a dihydropyrimidine calcium antagonist, is effective in the treatment of patients with mild to moderate hypertension at doses of 5-10 mg daily. The aim of the study reported here was to determine whether an early increase in dosage of amlodipine provided an advantage in terms of antihypertensive effect. Th...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/03007999909115172
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy and safety of ciprofloxacin 0.3%/dexamethasone 0.1% (CIP/DEX) otic suspension with that of neomycin 0.35%/polymyxin B 10,000 IU/mL/hydrocortisone 1.0% (N/P/H) otic suspension in patients with acute otitis externa (AOE). STUDY DESIGN:Randomized, observer-masked, parallel-group, multic...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/030079902125004312
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Stroke is a major cause of disability. Certain experimental studies have suggested that a combination of almitrine + raubasine (Duxil) increases the supply of oxygen to cerebral tissues and may be beneficial in post-stroke rehabilitation. This multicentre clinical study was carried out in orde...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/030079904125003080
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:Parenteral sodium ferric gluconate in complex (Ferrlecit [branded SFG]) is used to treat patients with iron deficiency anemia undergoing chronic hemodialysis and receiving supplemental epoetin. This comparative pharmacokinetic study (GeneraMedix, Inc., Study 17909) evaluates whether the recently approved gene...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007995.2011.597738
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:The efficacy of antihistamines in perennial allergic rhinitis in children has been evaluated in studies using active comparators, whereas placebo-controlled studies are very few. A randomized, multicenter, double-blind, parallel-group clinical study was carried out to evaluate the dose-response relationship a...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2010.485413
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To estimate the proportion of patients with moderate to severe chronic kidney disease (CKD) whose initial dipeptidyl-peptidase-4 inhibitor (DPP4-i) dosage was concordant with prescribing information (label) recommendations in the United States. METHODS:Adult patients with type 2 diabetes mellitus (T2DM) who ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1416346
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Alternaria alternata (AA) sensitisation is a common cause of respiratory allergies such as rhinitis and asthma. So far there are no controlled double-blind trials evaluating the efficacy and safety of specific sublingual immunotherapy (SLIT) in AA allergies. OBJECTIVE:To evaluate the efficacy of SLIT treatm...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007995.2010.532201
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:Many insulin-treated patients with type 2 diabetes (T2D) do not reach hemoglobin A1c (HbA1c) < 7%, but have clinically relevant HbA1c reductions. Using an integrated database (IDB) of 53 insulin lispro clinical trials and a real-world evidence (RWE) database of T2D patients initiating insulin therapy, an exp...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1396968
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Inadequate removal of extracellular volume markedly increases blood pressure and contributes to high morbidity and mortality in hemodialysis patients. Advances in fluid management are needed to improve clinical outcomes. The aim of this quality improvement project was to examine the advantages of using a hem...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1047746
更新日期:2015-01-01 00:00:00
abstract::Elevated serum cholesterol level is a key risk factor for cardiovascular morbidity and mortality. Cerivastatin is a highly effective lipid-lowering agent currently licensed at doses of 0.1, 0.2, 0.3 and 0.4 mg. This was a multicentre, randomised, double-blind, parallel-group study comparing the efficacy and safety of ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/03007999909114095
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:The objectives were to estimate the prevalence of self-treated hypoglycaemia in patients using basal insulin analogues; identify demographic, treatment related and behavioural risk factors; and describe patient and physician responses to these events. RESEARCH DESIGN AND METHODS:The GAPP2 (Global Attitude o...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1185/03007995.2012.743457
更新日期:2012-12-01 00:00:00