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https://www.readbyqxmd.com/read/27923477/hydrophilic-interaction-chromatography-multiple-reaction-monitoring-mass-spectrometry-method-for-basic-building-block-analysis-of-low-molecular-weight-heparins-prepared-through-nitrous-acid-depolymerization
#1
Xiaojun Sun, Zhimou Guo, Mengqi Yu, Chao Lin, Anran Sheng, Zhiyu Wang, Robert J Linhardt, Lianli Chi
Low molecular weight heparins (LMWHs) are important anticoagulant drugs that are prepared through depolymerization of unfractionated heparin. Based on the types of processing reactions and the structures of the products, LMWHs can be divided into different classifications. Enoxaparin is prepared by benzyl esterification and alkaline depolymerization, while dalteparin and nadroparin are prepared through nitrous acid depolymerization followed by borohydride reduction. Compositional analysis of their basic building blocks is an effective way to provide structural information on heparin and LMWHs...
November 30, 2016: Journal of Chromatography. A
https://www.readbyqxmd.com/read/27919873/managing-transitions-from-oral-factor-xa-inhibitors-to-unfractionated-heparin-infusions
#2
Andrew C Faust, Dave Kanyer, Ann K Wittkowsky
PURPOSE: Published evidence regarding the effects of oral factor Xa inhibitors on anticoagulation monitoring tests is reviewed with a focus on monitoring concerns that can arise during transitions to i.v. heparin therapy. SUMMARY: Assays that measure inhibition of factor Xa activity (i.e., anti-Xa assays) are widely used in U.S. institutions to monitor i.v. heparin therapy and, in some cases, for monitoring other types of anticoagulation therapy. Clinicians have raised concerns that the use of anti-Xa assays to monitor heparin levels in hospitalized patients who must be transitioned from oral factor Xa inhibitor therapy to i...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27913481/anti-xa-monitoring-of-low-molecular-weight-heparin-in-adult-patients-with-cancer
#3
Lisa Baumann Kreuziger, Michael Streiff
A 68-year-old man developed a right femoral vein deep vein thrombosis and bilateral pulmonary embolism while receiving chemotherapy for stage IV prostate cancer. His creatinine at diagnosis is 1.4 mg/dL, with an estimated clearance of 63 mL/min. In patients with cancer, should low-molecular-weight heparin treatment be dosed according to weight, or adjusted using anti-Xa levels?
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27878507/the-scope-and-value-of-an-anticoagulation-stewardship-program-at-a-community-teaching-hospital
#4
Maura K Wychowski, Christina I Ruscio, Peter A Kouides, Ronald L Sham
To report the impact of an inpatient anticoagulation stewardship program at a community hospital to promote optimal anticoagulant use. The anticoagulation team (ACT) stewardship program consists of two clinical pharmacists and hematologists to provide oversight of anticoagulants, high cost reversal agents including prothrombin complex concentrate (PCC, Kcentra™), and heparin-induced thrombocytopenia (HIT) management. Intervention data and number of charts reviewed were collected. Average cost avoidance data was applied to ACT interventions to estimate cost savings...
November 22, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27872768/hip-replacement-surgery-in-14-year-old-girl-with-factor-v-deficiency-haemostatic-treatment-and-thromboprophylaxis
#5
María Eva Mingot-Castellano, Josefina Pérez-Núñez, Lourdes Baeza-Montañez
Factor V (FV) is a pivotal coagulation factor present in plasma and platelets. It plays an essential role in secondary haemostasis acting as a cofactor in the prothrombinase complex, catalysing the conversion of prothrombin to thrombin. There is little evidence on the management of mayor orthopaedic surgery in paediatric or adolescents subjects with this coagulopathy and almost no information about thromboprophylaxis in these situations. We report a case of a hip replacement in a 14-year-old girl with moderate FV deficiency (0...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27861383/living-donor-renal-transplantation-in-patients-with-antiphospholipid-syndrome-a-case-report
#6
Ji Yoon Choi, Joo Hee Jung, Sung Shin, Young Hoon Kim, Duck Jong Han
INTRODUCTION: Antiphospholipid syndrome (APS), autoantibodies directed against phospholipid-binding proteins are associated with cause vascular thrombosis. Patients with APS requiring renal transplantation are at risk of early graft loss due to arterial or venous thrombosis, or thrombotic microangiopathy (TMA). Here, we report 3 cases of successful renal transplantation in patients with APS. CLINICAL FINDINGS: A 53-year-old man with end-stage renal disease (ESRD) had experienced bilateral deep venous thrombosis (DVT) in the lower extremities 16 years ago and was administered warfarin...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858357/surface-plasmon-resonance-analysis-of-heparin-binding-angiogenic-growth-factors
#7
Marco Rusnati, Antonella Bugatti
Surface plasmon resonance (SPR) is an optical technique to evaluate biomolecular interactions. Briefly, SPR measures the capacity of two molecules to bind each other by detecting reflected light from a prism-gold film interface. One of the two putative interactants (called ligand) is chemically immobilized onto the gold film. When the sensor is exposed to a sample containing the second interactant (called analyte), its binding to the immobilized ligand causes a change of the refractive index of the material above the gold surface that is monitored as a real-time graph of the response units against time, producing a real-time graph called sensorgram...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27856667/protocolled-redefinition-of-the-therapeutic-range-for-unfractionated-heparin-lost-in-translation
#8
Karlien L M Coene, Fedde van der Graaf, Daan van de Kerkhof
BACKGROUND: Protocolled treatment with unfractionated heparin (UFH) is a subject of ongoing debate. Even though international guidelines prescribe calibration of the activated partial thromboplastin time (aPTT) to 0.3 to 0.7 U/mL anti-Xa activity to establish an UFH therapeutic range, evidence for this approach remains scarce. In this study, we evaluated different strategies to delineate the UFH therapeutic range and analyzed the effects on patient therapeutic classification. METHODS: In 109 patient samples, the aPTT was measured with 2 different reagents, both of which used mechanical clot detection...
November 16, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#9
Anthony Logaraj, Venessa H M Tsang, Shahrir Kabir, Julian C Y Ip
: Adrenal haemorrhage is a rare cause of adrenal crisis, which requires rapid diagnosis, prompt initiation of parenteral hydrocortisone and haemodynamic monitoring to avoid hypotensive crises. We herein describe a case of bilateral adrenal haemorrhage after hemicolectomy in a 93-year-old female with high-grade colonic adenocarcinoma. This patient's post-operative recovery was complicated by an acute hypotensive episode, hypoglycaemia and syncope, and subsequent computed tomography (CT) scan of the abdomen revealed bilateral adrenal haemorrhage...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27849857/215-evaluating-anti-xa-and-aptt-monitoring-of-heparin-in-patients-with-an-impella-device
#10
Nadine Musallam, Diana Altshuler, Tania Ahuja, Caitlin Aberle, John Papadopoulos
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#11
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27837164/evaluation-of-a-pharmacy-managed-heparin-protocol-for-extracorporeal-membrane-oxygenation-patients
#12
Kalliopi Fitousis, Robin Klasek, Phillip E Mason, Faisal Masud
INTRODUCTION: Unfractionated heparin is the preferred anticoagulant in extracorporeal membrane oxygenation (ECMO) patients. However, there is a lack of consensus on its titration and monitoring. The objective of this study was to describe the efficacy and safety of a pharmacy managed heparin protocol utilizing activated partial thromboplastin time (aPTT) in comparison to our standard physician-managed activated clotting time (ACT)-based anticoagulation in ECMO patients. METHODS: Patients administered a heparin drip while on ECMO were included in the study...
November 10, 2016: Perfusion
https://www.readbyqxmd.com/read/27836023/coagulation-factor-abnormalities-related-to-discordance-between-anti-factor-xa-and-activated-partial-thromboplastin-time-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#13
Sirtaz Adatya, Roy Sunny, Megan J Fitzpatrick, Monica Colvin, Thennapan Thennapan, Ranjit John, Nicole Dodge Zantek, Marc Pritzker, Peter Eckman, Nir Uriel
BACKGROUND: High levels of discordance between activated partial thromboplastin time (aPTT) and anti-factor Xa (anti-FXa) have been reported in patients with continuous-flow left ventricular assist devices (CF-LVADs). We sought to determine the biochemical basis for discordance by simultaneous measurement of coagulation factors with aPTT and anti-FXa. METHODS: Consecutive CF-LVAD patients admitted for intravenous unfractionated heparin (IV-UFH) therapy were studied...
November 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27820879/heparin-for-the-treatment-of-thrombosis-in-neonates
#14
REVIEW
Olga Romantsik, Matteo Bruschettini, Simona Zappettini, Luca Antonio Ramenghi, Maria Grazia Calevo
BACKGROUND: Among pediatric patients, newborns are at highest risk of developing thromboembolism. Neonatal thromboembolic (TE) events may consist of both venous and arterial thromboses and often iatrogenic complications (eg, central catheterization). Treatment guidelines for pediatric patients with TE events most often are extrapolated from the literature regarding adults. Options for the management of neonatal TE events include expectant management; nitroglycerin ointment; thrombolytic therapy or anticoagulant therapy, or a combination of the two; and surgery...
November 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27817998/-economic-consequences-of-biological-monitoring-and-medical-complications-of-injectable-anticoagulants-in-france
#15
P Paubel, M Cousin, C Amar, J Gourmelen, C Fabron, B Detournay
AIM: To assess the frequency of platelet monitoring and bleeding risks associated with the use of injectable anticoagulants in a real life setting and to estimate the associated costs. METHOD: An analysis of the 2013 data from a random sample of ≈600,000 patients registered in the French National Health Insurances reimbursement database was conducted to identify platelet counts performed during injectable anticoagulants exposure period and treatment interruptions due to heparin-induced thrombocytopenia or transfusion...
November 3, 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27803991/outcomes-of-surgery-for-lung-cancer-in-patients-with-atrial-fibrillation-as-a-preoperative-comorbidity-a-decade-of-experience-at-a-single-institution-in-japan
#16
Ryu Kanzaki, Toru Kimura, Tomohiro Kawamura, Soichiro Funaki, Yasushi Shintani, Masato Minami, Meinoshin Okumura
PURPOSE: To investigate the surgical outcomes of surgery for non-small cell lung cancer (NSCLC) in patients with atrial fibrillation (AF) as a preoperative comorbidity. METHODS: Among 805 patients who underwent surgery for NSCLC, 27 (3.4%) had a history of AF. We analyzed the perioperative and long-term outcomes of these 27 patients. RESULTS: Fourteen patients (52%) had chronic AF and 13 (48%) had paroxysmal AF; being high rates of a comorbid illness...
November 1, 2016: Surgery Today
https://www.readbyqxmd.com/read/27793877/cost-effectiveness-of-anticoagulants-for-the-management-of-suspected-heparin-induced-thrombocytopenia-in-the-us
#17
Ahmed Aljabri, Yvonne Huckleberry, Jason Karnes, Mahdi Gharaibeh, Hussam I Kutbi, Yuval Raz, Seongseok Yun, Ivo Abraham, Brian Erstad
Despite the availability of multiple non-heparin anticoagulants for the treatment of heparin-induced thrombocytopenia (HIT), little data is available comparing the cost-effectiveness of these agents. This analysis is particularly important considering differences in risks of adverse effects, routes of administration, requirements for phlebotomy and laboratory monitoring, and overall drug costs. We conducted a cost-effectiveness analysis of argatroban, bivalirudin, and fondaparinux for the treatment of suspected HIT from the institutional perspective...
October 28, 2016: Blood
https://www.readbyqxmd.com/read/27793619/patterns-in-the-management-of-acute-limb-ischemia-a-vess-survey
#18
Matthew R Smeds, Harleen K Sandhu, Samuel S Leake, Charles C Miller, Kristofer M Charlton-Ouw
BACKGROUND: Treatment strategies for acute limb ischemia (ALI) are abundant with few established guidelines. We sought to determine nationwide ALI treatment patterns in the modern era. METHODS: Anonymous electronic surveys examining the management of ALI involving native vessel and bypass occlusion were sent to all members of the Vascular and Endovascular Surgery Society (n = 738). Treatment options included catheter-directed lysis (CDL) or pharmacomechanical (PMT) thrombolysis and open surgery...
October 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27789605/reversal-of-anticoagulation-and-management-of-bleeding-in-patients-on-anticoagulants
#19
Prajwal Dhakal, Supratik Rayamajhi, Vivek Verma, Krishna Gundabolu, Vijaya R Bhatt
Bleeding is the most common complication of all anticoagulants. Any bleeding patient on an anticoagulant should be risk-stratified based on hemodynamic instability, source of bleeding, and degree of blood loss. Although minor bleed may be managed with discontinuation of anticoagulant, major bleed may require transfusion of blood products and use of specific antidote. The residual effects of each anticoagulant may be monitored with distinct coagulation assay. Intravenous or oral vitamin K can reverse the effect of warfarin within 24 to 48 hours and is indicated for any bleeding, international normalized ratio of >10 or 4...
October 26, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27761575/capillary-blood-samples-for-anti-xa-monitoring-of-heparin-in-paediatric-patients
#20
Sallyann Ridsdale, Victoria Martin, Jeanette H Payne
No abstract text is available yet for this article.
October 20, 2016: Thrombosis and Haemostasis
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