Active substances: Doxycycline
Photosensitivity reactions ranged from itching and burning sensations without any change in skin colour in seven patients, to mild erythema of sun-exposed face and extremities in nine patients.
Of the 16 patients with photosensitivity reactions, 13 did not adhere to the recommendation to avoid sun exposure completely. One patient was deliberately exposed to the sun while sunbathing, but other 12 patients were exposed only during unavoidable daily activities, such as going to work, which did not exceed one hour per day for an individual patient.
None of the patients had any sequelae of photosensitivity at the 2-month visit or later. Patients with photosensitivity did not differ from those without photosensitivity according to age median 43.
The clinical symptoms of photosensitivity ranged from itching and burning sensations to mild erythema of sun-exposed face and extremities.
A particular strength of our study is that we had data on a large number of patients with the same clinical entity who were treated at a single medical centre and given the same instructions, thus avoiding potential confounders when comparing data from different centres not using uniform approaches.
Comparison of the number patients and controls with new or increased symptoms since erythema migrans at 6 months. Brief Summary Background: While doxycycline is a standard antibiotic for treatment of erythema migrans in Europe as well as in the USA, the effectiveness of cefuroxime axetil in the treatment of adult patients with erythema migrans has been assessed only in the USA where the causative agent of Lyme disease is Borrelia burgdorferi, but not in Europe where the main etiologic agents are B.
Patients with LVADs require antiplatelet and anticoagulant therapy, which predisposes them to bleeding complications. Bleeding that occurs in the first 14 days after the implantation is mostly related to surgery.
Causes of later bleeding include the development of arteriovenous malformations, hepatic dysfunction from post-implant right ventricular failure and acquired von Willebrand syndrome.
Determining the potential causes and risk factors for bleeding is essential to improve overall outcomes as well as the quality of life of LVAD recipients. Gastrointestinal GI bleeding occurs at a median of 33 days from surgery range: 1 to 530 days, with the greatest risk within the first post-operative month.
It is the most common cause of 30-day readmission.
A recent, small, retrospective study proved video capsule endoscopy VCE to be a safe and feasible option in clarifying an obscure GI bleeding. However, it was performed, on average.
Recent studies found that all patients developed the typical laboratory findings of an AvWS after LVAD implantation, but not all of them had bleeding complications. Another important site of bleeding is bleeding into the central nervous system.
Central nervous system bleeds occur relatively late. In a pooled analysis of 734 patients, a significantly higher incidence of haemorrhagic stroke was found in patients treated with the HeartWare in comparison to the HeartMate II.
Proportionally, more patients on aspirin 325 mg had a haemorrhagic intracranial event in comparison with those on aspirin 81 mg plus dipyridamole or aspirin 81 mg.
High-dose aspirin in HeartMate II patients treated concomitantly with warfarin was associated with an increased hazard of bleeding but did not reduce thrombotic events. An important reason for early hospital readmission, post-implant discharge, is anaemia of an undetermined source of bleeding AUS that results in any red blood cell transfusion.
Capturing these data is extremely important, given the risks of red cell transfusion.
Efforts to reduce the bleeding rate are imperative and urgently needed. Strategies for lowering the incidence and severity of bleeding complications include: lowering the international normalised ratio INR goals, reducing the use of antiplatelet agents, and altering pump speed to allow pulsatile flow.
Penetration of doxycycline into cerebrospinal fluid in patients treated for suspected Lyme neuroborreliosis.