Oral anticoagulant re-initiation following intracerebral hemorrhage in non-valvular atrial fibrillation: Global survey of the practices of neurologists, neurosurgeons and thrombosis experts

<div><p>Background</p><p>While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials.</p><p>Aims/Hypothesis</p><p>To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH.</p><p>Methods</p><p>An online survey was distributed to members of the International Society for Thrombosis and Haemostasis, Canadian Stroke Consortium, NAVIGATE-ESUS trial investigators (Clinicatrials.gov identifier NCT02313909) and American Association of Neurological Surgeons. Demographic factors and 11 clinical scenarios were included.</p><p>Results</p><p>Two hundred twenty-eight participants from 38 countries completed the survey. Majority of participants were affiliated with academic centers, and >20% managed more than 15 OAC-associated ICH patients/year. Proportion of respondents suggesting OAC anticoagulant resumption varied from 30% (for cerebral amyloid angiopathy) to 98% (for traumatic ICH). Within this group, there was wide distribution in response for timing of resumption: 21.4% preferred to re-start OACs after 1–3 weeks of incident ICH, while 25.3% opted to start after 1–3 months. Neurosurgery respondents preferred earlier OAC resumption compared to stroke neurologists or thrombosis experts in 5 scenarios (p<0.05 by Kendall’s tau).</p><p>Conclusions</p><p>Wide variations in current practice exist among management of OAC-associated ICH, with decisions influenced by patient- and provider-related factors. As these variations likely reflect the lack of high quality evidence, randomized trials are direly needed in this population.</p></div

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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Desplazamiento y distanciamiento lingüístico en el teatro de Víctor Hugo Rascón Banda: La mujer que cayó del cielo

In the 1980s, Rita Quintero, a Tarahumara from northern Mexico, was detained in a mental hospital in Larned, Kansas for twelve years because of ignorance and maltreatment from Kansas state officials and health care workers. As a result of their inability and lack of effort to understand her culture, the doctors diagnosed Rita with schizophrenia and forced her to take psychiatric medications. Rita’s case eventually caught national and international attention, especially through the work of the Mexican playwright, Victor Hugo Rascón Banda (1948-2008) who produced the theater piece La mujer que cayó del cielo (2000) to detail the actual events that occurred in Rita’s life from the time that she was detained to her release in 1995. This essay discusses the power of documentary theater in giving a voice to immigrants like Rita, whose histories have been silenced by injustice and ethnocentrism in the United States. Rascón Banda incorporates dialogues between Spanish, English and Rarámuri (spoken by the Tarahumaras) to emphasize the lack of communication between Rita and her oppressors and the paralleled lack of understanding between the audience and the characters at certain points in the play. Thus, this analysis suggests that Rascón Banda plays with Brechtian theater’s de-familiarization element, characterization and the concept of translation to challenge the ethnocentrism in America and convey the effects of alienation experienced by migrants, provoking viewers to take action towards social change

A new genetic method to generate and isolate small, short-lived but highly potent dendritic cell-tumor cell hybrid vaccines

Fusion of tumor cells with antigen-presenting cells (APCs) has been proposed for the preparation of cancer vaccines. However, generation of these hybrids, using physical or chemical methods such as electrofusion or polyethylene glycol (PEG), has been difficult to standardize. Characterization of cell fusion has also been problematic because of difficulties in differentiating fusion from cell aggregation, leakage of cellular dyes and dendritic-cell (DC) phagocytosis of tumor material. In this report, we describe a new method to generate hybrid cell vaccines, based on gene transfer of a viral fusogenic membrane glycoprotein (FMG) into tumor cells, and incorporate a genetic method by which true hybrid formation can be unambiguously detected. We describe a new class of tumor cell?DC hybrid that can be rapidly isolated after cell fusion. These hybrids are highly potent in in vitro antigen presentation assays, target lymph nodes in vivo and are powerful immunogens against established metastatic disease