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Fondaparinux

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https://www.readbyqxmd.com/read/29324514/anticoagulant-bridge-comparison-in-mechanical-circulatory-support-patients
#1
Richard H Cosgrove, Robyn L Basken, Richard G Smith, Chiu-Hsieh Hsu, Toshinobu Kazui, Brandon K Martinez, Richard W Burt, Eric S Crawford, Scott D Lick, Zain Khalpey
Maintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29314514/non-immediate-heparin-and-heparinoid-cutaneous-allergic-reactions-a-role-for-fondaparinux
#2
Elina Tan, Grace Thompson, Charlotta Ekstrom, Michaela Lucas
Non-immediate allergic cutaneous reactions to heparins have been increasingly reported, typically manifesting as large, eczematous plaques at sites of subcutaneous injection. Patients may demonstrate cross-reactivity between unfractionated heparin, low molecular weight heparin and semi-synthetic heparinoids, making finding an alternative difficult. Fondaparinux has been identified as a useful alternative in such patients; here we present the first two documented cases in Australia and a literature review.
January 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29279638/prophylaxis-and-incidence-of-symptomatic-deep-vein-thrombosis-in-indian-patients-with-sepsis-detect-deep-vein-thrombosis-registry
#3
Nagarajan Ramakrishnan, Detect-Dvt Investigators
Purpose: To assess thromboprophylaxis rate and incidence of symptomatic deep vein thrombosis (DVT) in Indian patients with acute sepsis. Materials and Methods: Adult patients with sepsis, within 48 h of sepsis onset/hospital admission were included. DVT was assessed using Doppler ultrasonography if clinical signs were present. Data were collected at inclusion, discharge, and 30 ± 7 days (if discharged before 30 days). Results: The study included 278 patients (men: 69...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29274443/gynecologic-bleeding-complications-in-post-menarchal-adolescent-females-on-anti-thrombotic-medications
#4
Heather Soni, Jennifer Kurkowski, Danielle Guffey, Jennifer E Dietrich, Lakshmi V Srivaths
INTRODUCTION: The prevalence, clinical features and management of gynecologic bleeding complications and health care provider awareness of these in post-menarchal adolescents on anti-thrombotic medications has rarely been addressed in the literature. We sought to review our experience in a pediatric tertiary care center addressing these issues. MATERIALS AND METHODS: A retrospective chart review was conducted with Institutional Review Board approval from 2004-2014, on eligible post-menarchal adolescents on antithrombotic medications...
December 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29247268/-anticoagulation-strategies-in-patients-with-deep-vein-thrombosis-and-pulmonary-artery-embolisms
#5
P W Radke, M Möckel
Deep vein thrombosis and pulmonary artery embolisms share pathophysiological features and are therefore collectively referred to as venous thromboembolisms (VTE). While the incidence of VTE has been increasing for years as a result of demographic changes and improved diagnostics, the morbidity and mortality are decreasing. This is particularly due to more sensitive diagnostics, improvements in risk stratification and more effective anticoagulation strategies. The aim of effective anticoagulation therapy is the avoidance of early events up to death and prevention of recurrent events...
December 15, 2017: Herz
https://www.readbyqxmd.com/read/29222259/controversies-in-venous-thromboembolism-to-treat-or-not-to-treat-superficial-vein-thrombosis
#6
REVIEW
Jan Beyer-Westendorf
The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29199766/pentasaccharides-for-the-treatment-of-deep-vein-thrombosis
#7
REVIEW
Gustavo Ms Brandao, Daniela R Junqueira, Hamilton A Rollo, Marcone L Sobreira
BACKGROUND: Standard treatment of deep vein thrombosis (DVT) is based on antithrombotic therapy, initially with parenteral administration of unfractionated heparin or low molecular weight heparins (LMWH) for five to seven days, then subsequent long-term therapy with oral vitamin K antagonists (e.g. warfarin). Pentasaccharides are novel anticoagulants that may be favourable over standard therapy due to their predictable effect, no need for frequent monitoring or re-dosing, and few known drug interactions...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29184861/efficacy-and-safety-of-venous-thromboembolism-prophylaxis-with-fondaparinux-in-women-at-risk-after-cesarean-section
#8
Ryuji Kawaguchi, Shoji Haruta, Hiroshi Kobayashi
Objectives: Cesarean section is associated with an increased risk for venous thromboembolism (VTE). The safety and efficacy of primary prophylaxis of fondaparinux, a synthetic sulfated pentasaccharide heparin analog, in women at risk after cesarean section is uncertain. Methods: This was a retrospective study of 295 cases of pregnant women presenting to a tertiary referral center of Nara, Japan, to evaluate the usefulness of thromboprophylaxis with fondaparinux after cesarean delivery between 2011 and 2012...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29169471/fondaparinux-for-treatment-of-heparin-induced-thrombocytopenia-too-good-to-be-true
#9
EDITORIAL
Theodore E Warkentin
No abstract text is available yet for this article.
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29169470/use-of-fondaparinux-off-label-or-approved-anticoagulants-for-management-of-heparin-induced-thrombocytopenia
#10
MULTICENTER STUDY
Marc Schindewolf, Julia Steindl, Jan Beyer-Westendorf, Sebastian Schellong, Pascal Maria Dohmen, Johannes Brachmann, Katharina Madlener, Bernd Pötzsch, Robert Klamroth, Johannes Hankowitz, Norbert Banik, Sonja Eberle, Markus Michael Müller, Stefan Kropff, Edelgard Lindhoff-Last
BACKGROUND: Life-threatening heparin-induced thrombocytopenia (HIT) is treated with the alternative nonheparin anticoagulants argatroban, lepirudin, or danaparoid. Frequently, the pentasaccharide fondaparinux is used off-label. OBJECTIVES: The authors sought to investigate the safety and efficacy of the different anticoagulants for treating HIT. METHODS: In a national, multicenter registry study, hospitalized patients who were diagnosed with HIT, an at least intermediate clinical HIT-risk (4Ts score ≥4 points), and received treatment with ≥1 dose of the aforementioned anticoagulants were included...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29102971/delayed-onset-heparin-induced-skin-necrosis-a-rare-complication-of-perioperative-heparin-therapy
#11
Weh Kiat Gan
An uncommon case of delayed-onset dalteparin-induced skin necrosis in an 83-year-old Caucasian female patient associated with heparin-induced thrombocytopaenia (HIT) presenting on day 30 following dalteparin therapy is reported. Investigations revealed mild thrombocytopaenia with normal protein C, protein S, coagulation screen and positive test for heparin-platelet factor-4 antibody. Clinical diagnosis of heparin-induced skin necrosis with HIT was made. Dalteparin injection was discontinued promptly and substituted with fondaparinux therapy...
November 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29097174/medical-management-of-acute-superficial-vein-thrombosis-of-the-saphenous-vein
#12
REVIEW
Sherry D Scovell, Emel A Ergul, Mark F Conrad
OBJECTIVE: Acute superficial vein thrombosis (SVT) of the axial veins, such as the great saphenous vein (GSV), is a common clinical condition that carries with it significant risk of propagation of thrombus, recurrence, and, most concerning, subsequent venous thromboembolism (VTE). Conservative therapy with nonsteroidal anti-inflammatory medication and heat does not prevent extension of thrombus or protect against recurrent or future VTE in patients with extensive SVT (thrombotic segment of at least 5 cm in length)...
October 30, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29072911/the-design-of-small-molecule-active-site-inhibitors-of-the-s1a-family-proteases-as-procoagulant-and-anticoagulant-drugs
#13
Peter M Fischer
Vitamin K antagonists (VKA) have long been the default drugs for anticoagulant management in venous thrombosis. While efficacious, they are difficult to use due to interpatient dose-response variability and the risks of bleeding. The approval of fondaparinux, a heparin-derived factor Xa (fXa) inhibitor, provided validation for the development of direct oral anticoagulants (DOAC), and currently such inhibitors of thrombin and fXa are in clinical use. These agents can be used without regular coagulation monitoring but the inherent risk of bleeding complications associated with blocking the common coagulation pathway remains...
October 26, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29057391/agent-specific-effects-of-anticoagulant-induced-alopecia
#14
Angela C Weyand, Jordan A Shavit
Alopecia has been observed with many anticoagulants although the mechanism is unclear. A 20 year old female with recurrent DVTs developed alopecia with multiple anticoagulants, including heparin derivatives and the new oral anticoagulants. This resolved with discontinuation of the agents. The patient was ultimately able to be anticoagulated with fondaparinux long term without any alopecia. This case addresses the key clinical question of management and recognition of anticoagulant induced alopecia. This side effect can result from almost any of the available agents and is quickly reversible, underlining the importance of tailoring treatment to the individual and their experiences...
July 2017: Research and Practice in Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29049216/fondaparinux-is-effective-for-acute-portal-vein-thrombosis-in-decompensated-cirrhotic-patients
#15
REVIEW
Zhi-Hao Zhang, Jing-Wen Zhang, Ping He, Yan Zhou, Chang-Yu Sun
Portal vein thrombosis (PVT) is a rare but serious complication in the decompensated stage of cirrhosis, and recurrent upper gastrointestinal bleeding and refractory ascites can occur in such patients. In decompensated cirrhotic patients, the application of conventional anticoagulant therapy is limited due to severe coagulation disorders, thrombocytopenia, and history of gastrointestinal bleeding.In this study, we sought to investigate the effect of fondaparinux on acute PVT in decompensated cirrhotic patients...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29043538/venous-thromboembolism-prophylaxis-in-medically-ill-patients-a-mixed-treatment-comparison-meta-analysis
#16
REVIEW
Majed S Al Yami, Matthew A Silva, Jennifer L Donovan, Abir O Kanaan
The American College of Chest Physicians guidelines recommend unfractionated heparin (UFH), low molecular weight heparins (LMWHs) or fondaparinux for prevention of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in medically-ill patients. Direct oral anticoagulants (DOACs) have been evaluated relative to enoxaparin for VTE prophylaxis though head-to-head comparisons of these agents are lacking. Therefore, we conducted a mixed treatment comparisons meta-analysis to evaluate the safety and efficacy of established treatments and DOACs for VTE prophylaxis in medically-ill patients...
October 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29037351/rivaroxaban-versus-fondaparinux-for-thromboprophylaxis-after-endovenous-laser-ablation
#17
Hong H Keo, Frederic Baumann, Nicolas Diehm, Christian Regli, Daniel Staub
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) and deep venous thrombosis (DVT) are well-known complications after superficial endovenous thermoablation. We investigated the efficacy of rivaroxaban in preventing EHIT and DVT after endovenous laser ablation (EVLA). METHODS: We retrospectively analyzed a consecutive series of patients presenting with truncal varicosis class C2 to C6 undergoing EVLA. After EVLA, all patients received oral rivaroxaban (10 mg) or subcutaneous fondaparinux (2...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29034033/novel-anticoagulant-therapy-of-venous-thromboembolism-current-status-and-future-directions
#18
REVIEW
Mashio Nakamura, Norikazu Yamada, Masaaki Ito
The first-line treatment of venous thromboembolisms (VTE) is anticoagulant therapy, and unfractionated heparin and warfarin are used in Japan. However, as both drugs require dosage adjustments that are difficult, VTE recurrences occur relatively frequently, and hemorrhagic complications are extremely common. The parenteral factor Xa inhibitor fondaparinux and the direct oral anticoagulants (DOACs) edoxaban, rivaroxaban, and apixaban have recently become available as treatments for VTE in Japan. These novel anticoagulants have more stable effects than traditional therapies and are thus considered safer and more effective than the traditional agents...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29032302/synthetic-heparin-and-heparan-sulfate-probes-in-defining-biological-functions
#19
REVIEW
Ching-Ting Tsai, Medel Manuel L Zulueta, Shang-Cheng Hung
Heparin and heparan sulfate are glycosaminoglycans that modulate numerous biological processes. The desire to capture the structural diversity responsible for their functions provides notable issues during synthesis, including site-selective sulfonation, stereoselective glycosylation and the sheer number of probable targets at hand. With current advances in synthetic approaches, carbohydrate chemists generate these complex targets by chemical and enzymatic methods. Fondaparinux and a number of polysaccharides have been synthesized to probe anticoagulation and other biological functions...
October 2017: Current Opinion in Chemical Biology
https://www.readbyqxmd.com/read/28974915/a-case-of-upper-left-extremity-deep-vein-thrombosis-with-right-side-middle-lobe-syndrome
#20
Sathish Babu, Tom Devasia, Yeshwanth Rao Karkal, Ashwini Mohapatra
Upper extremity deep vein thrombosis is an extremely important clinical entity with potential for considerable morbidity and mortality. A 64-year-old woman was brought to the emergency department with complaints of left upper limb and neck swelling for 4 days. Ultrasonography of the neck showed thrombosis of the left internal jugular and other surrounding veins associated with local lymphadenopathy. Computed tomography (CT) of the neck also showed a hypodense 0.6 cm × 0.8 cm × 1.2 cm lesion in the right middle lobe bronchus, causing complete occlusion and collapse of the right middle lobe of the lung...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
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