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anticoagulation im elderly

Emily Cerier, Bryan A Whitson, Ahmet Kilic
This case report describes an unusual case of spontaneous iliac intramuscular hematoma after a heart transplant secondary to valvular cardiomyopathy. A spontaneous retroperitoneal hematoma occurring after a heart transplant is rare, but can occur when the patient is on immunosuppressive medications. This could be secondary to the medications' ability to suppress the immune system and cause antiplatelet therapylike effects. Spontaneous retroperitoneal hematomas can cause significant patient morbidity, sometimes even causing immobility; however, a high index of suspicion with early recognition and immediate intervention can reduce the sequelae...
December 2017: Experimental and Clinical Transplantation
L Velicki, N Cemerlić-Adić, D Bogdanović, T Mrdanin
Rectus sheath haematoma, an uncommon complication related to subcutaneous administration of enoxaparin, has overall mortality of 4%. Possible mechanisms include unintended intramuscular injection of enoxaparin, and enhanced anticoagulant effect in the elderly and patients with increased bleeding risk. We describe the case of an 80 year-old female patient who was treated after a non-ST-elevated myocardial infarction, with enoxaparin, aspirin and clopidogrel. After a single dose of enoxaparin, the patient developed massive rectus sheath haematoma that was promptly diagnosed and was surgically managed...
March 2013: Acta Clinica Belgica
M Vardi, N O Ghanem-Zoubi, R Zidan, V Yurin, H Bitterman
BACKGROUND: Sepsis is prevalent in internal medicine (IM) departments. Elderly patients with sepsis and chronic medical conditions are at an increased risk for venous thromboemolism (VTE). The objective of this study was to assess the rate of VTE and the accuracy of the Padua Prediction Score (PPS) to predict VTE in patient with sepsis admitted to IM departments. METHODS: We prospectively collected data on septic patients admitted to IM departments in a community-based medical center...
March 2013: Journal of Thrombosis and Haemostasis: JTH
Hirotake Yo, Hirotsugu Ohashi, Fumiaki Inori, Yoshiaki Okajima, Yoshio Matsui, Kosuke Shintani
We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia. However, her elderly depression confused her chief complaint, and she was transferred to a psychiatric hospital. Two months after the onset of the symptoms, she was finally diagnosed with a pseudoaneurysm by contrast-enhanced CT and angiography...
2012: Case Reports in Orthopedics
Thomas Ross Clark, Stephanie Burns
PURPOSE: The case of a patient receiving long-term warfarin therapy who experienced elevated International Normalized Ratio (INR) values on two occasions after injections of ceftriaxone is reported. SUMMARY: An elderly woman (age, 67 years) with multiple comorbidities who had been receiving warfarin therapy for about 8 years was given an intramuscular injection of ceftriaxone 1 g for the treatment of a urinary tract infection. Four days later, her INR (which had recently ranged from 1...
September 1, 2011: American Journal of Health-system Pharmacy: AJHP
E Cogan
Complementary to their specific metabolic actions, several vitamins are given for new previously unsuspected properties. In addition to its role in calcium absorption, vitamin D has been proven to possess beneficial effects for some autoimmune diseases, several cancers and cardiovascular illnesses. It also increases muscle strength and prevents falls particularly in elderly people. Low dose oral vitamin K supplementation is a new indication for people with unstable coumarinic anticoagulant treatment. Oral vitamin 812 administration is an alternative to the classical parenteral intramuscular administration in pernicious anemia...
September 2008: Revue Médicale de Bruxelles
Gianna Fabbri, Marco Gorini, Aldo P Maggioni, A Di Lenarda et al.
In the last years the treatment of heart failure has radically changed due to the results of multicenter clinical trials. The antagonism of neurohormonal systems has proved to be the only strategy, which favorably modifies the prognosis of the patients with heart failure. Particularly, the effectiveness of angiotensin-converting enzyme (ACE)-inhibitors and beta-blockers has been proven in patients with heart failure and left ventricular dysfunction; more recently, angiotensin receptor blockers (ARBs) and aldosterone blockers have shown to improve the outcome in heart failure...
February 2007: Giornale Italiano di Cardiologia
J C Delafuente, J A Davis, J R Meuleman, R A Jones
STUDY OBJECTIVES: To determine if subcutaneous administration of influenza vaccine is as immunogenic as the intramuscular route, and to evaluate the frequency of local adverse events associated with both routes in elderly anticoagulated men. DESIGN: Single-blind, prospective study of consecutively enrolled subjects. SETTING: Ambulatory clinic at a university-affiliated Veterans Affairs medical center. PATIENTS: Twenty-six men age 60 years or older, receiving therapeutic dosages of warfarin...
May 1998: Pharmacotherapy
C Kluft, R M Bertina, F E Preston, R G Malia, S L Blamey, G D Lowe, C D Forbes
On both oral and intramuscular administration, the anabolic steroid stanozolol was found to increase protein C antigen concentrations in circulating blood. In fourteen healthy young volunteers (who received stanozolol orally, dose 10 mg/day) the average increase was 1.5-1.6 times the normal concentrations after 3-6 weeks' treatment and was accompanied by more moderate increases in the other vitamin K-dependent factors II, IX and X to 1.4, 1.4 and 1.2 times their normal concentration respectively. However, there was no change in factor VII...
February 1, 1984: Thrombosis Research
J J Grob, J L Mege, J Follana, R Legre, L Andrac, J J Bonerandi
A case of extensive skin necrosis following intramuscular injections of sisomycin is described. Eight cases of necrosis following subcutaneous injections of aminoside antibiotics have been reported in elderly females under anticoagulant theray, but the pathogenic mechanisms of these lesions have not been investigated. Defective fibrinolysis and abnormalities of oxidative metabolism of neutrophils were noted in our patient. Four major mechanisms are discussed: an Arthus reaction, a thrombotic process, a direct toxicity of aminosides for subcutaneous tissue, or a pyoderma-like neutrophilic reaction...
1990: Dermatologica
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