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https://www.readbyqxmd.com/read/29158366/therapeutic-anticoagulation-in-patients-with-primary-brain-tumors-or-secondary-brain-metastasis
#1
REVIEW
Richard J Lin, David L Green, Gunjan L Shah
Patients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagulation with low molecular weight heparin or direct oral anticoagulants, although thrombocytopenia (platelet count less than 50,000/μL) and other coagulopathies are relative contraindications...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29157916/the-effect-of-bariatric-surgery-on-direct-acting-oral-anticoagulant-drug-levels
#2
Amihai Rottenstreich, Aviv Barkai, Ariela Arad, Bruria Hirsh Raccah, Yosef Kalish
OBJECTIVE: To determine direct-acting oral anticoagulant (DOAC) blood levels in post-bariatric surgery (BS) patients treated with long-term anticoagulation therapy. METHODS: We identified from medical records patients who underwent BS during 2005-2016 and who were treated with DOACs. We offered testing DOAC blood levels to these patients and to age, sex, body mass index, and serum creatinine-matched individuals treated by DOACs who did not undergo BS. RESULTS: Overall, 36 individuals were enrolled, 18 post-BS patients and 18 control subjects...
November 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29153742/direct-oral-anticoagulants-for-japanese-atrial-fibrillation-in-the-elderly
#3
EDITORIAL
Yusuke Kondo, Keitaro Senoo, Yoshio Kobayashi
No abstract text is available yet for this article.
November 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29153212/-new-treatments-for-heart-failure
#4
Clément Venner, Olivier Huttin, Christine Selton-Suty, Yves Juillière
New direct oral anticoagulants are recommended as first-line therapy in case of atrial fibrillation within a heart failure. In the absence of atrial fibrillation, the role for new direct oral anticoagulants would have to be confirmed in the next years. Sacubitril/valsartan, angiotansin II receptor neprilysin inhibitor, presents with an efficacy superior to that of angiotensin converting enzyme inhibitors. It is now recommended in the treatment of heart failure as a third-line therapy. Modalities of prescription are strict, and safety is good...
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29149708/photodegradation-of-novel-oral-anticoagulants-under-sunlight-irradiation-in-aqueous-matrices
#5
Montaha Yassine, Laura Fuster, Marie-Hélène Dévier, Emmanuel Geneste, Patrick Pardon, Axelle Grélard, Erick Dufourc, Mohamad Al Iskandarani, Selim Aït-Aïssa, Jeanne Garric, Hélène Budzinski, Patrick Mazellier, Aurélien S Trivella
Kinetics of photodegradation of novel oral anticoagulants dabigatran, rivaroxaban, and apixaban were studied under simulated solar light irradiation in purified, mineral, and river waters. Dabigatran and rivaroxaban underwent direct photolysis with polychromatic quantum yields of 2.2 × 10(-4) and 4.4 × 10(-2), respectively. The direct photodegradation of apixaban was not observed after 19 h of irradiation. Kinetics of degradation of rivaroxaban was not impacted by the nature of the aqueous matrix while photosensitization from nitrate ions was observed for dabigatran and apixaban dissolved in a mineral water...
November 9, 2017: Chemosphere
https://www.readbyqxmd.com/read/29146668/percutaneous-left-atrial-appendage-closure-current-devices-and-clinical-outcomes
#6
REVIEW
Lluis Asmarats, Josep Rodés-Cabau
Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29141274/use-of-direct-oral-anticoagulants-in-the-first-year-after-market-entry-of-edoxaban-a-danish-nationwide-drug-utilization-study
#7
Anton Pottegård, Erik L Grove, Maja Hellfritzsch
OBJECTIVES: To describe the early uptake of edoxaban; the fourth direct oral anticoagulant (DOAC) to enter the market. METHODS: Using the Danish nationwide health registries, we identified new users of edoxaban (n = 609) from June 6 (day of marketing) through June 2017. For comparison, we also identified new users of dabigatran (n = 2211), rivaroxaban (n = 19 227), and apixaban (n = 14 736). Users were described regarding indication of use, previous anticoagulant experience, comorbidity, and co-medication...
November 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29137844/occult-gastrointestinal-disease-unmasked-by-direct-oral-anticoagulants-used-for-the-prevention-of-atrial-fibrillation
#8
Luis Colín, Manlio F Márquez
No abstract text is available yet for this article.
November 11, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29132510/indications-and-methods-of-anticoagulation-reversal
#9
REVIEW
Jeremy L Holzmacher, Babak Sarani
The use of anticoagulation in the prevention of strokes due to atrial fibrillation or the treatment of venous thromboembolic disease has been on the rise. With the advent and proliferation of direct oral anticoagulation medications, the management of anticoagulation reversal has become increasingly complex, especially when urgent or emergent reversal is required. This review details the commonly used parenteral and oral anticoagulants, the treatment strategies necessary for their reversal, and therapies still in development...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29131074/tranexamic-acid-failed-to-reverse-the-anticoagulant-effect-and-bleeding-by-an-oral-direct-factor-xa-inhibitor-edoxaban
#10
Yuko Honda, Taketoshi Furugohri, Yoshiyuki Morishima
BACKGROUND/AIMS: Agents to reverse the anticoagulant effect of edoxaban, an oral direct factor Xa inhibitor, would be desirable in emergency situations. The aim of this study is to determine the effect of tranexamic acid, an antifibrinolytic agent, on the anticoagulant activity and bleeding by edoxaban in rats. METHODS: A supratherapeutic dose of edoxaban (3 mg/kg) was intravenously administered to rats. Three minutes after dosing, tranexamic acid (100 mg/kg) was given intravenously...
November 3, 2017: Pharmacology
https://www.readbyqxmd.com/read/29127863/pharmacokinetics-of-dabigatran-etexilate-and-rivaroxaban-in-patients-with-short-bowel-syndrome-requiring-parenteral-nutrition-the-pder-pan-study
#11
Y Whitney Cheung, Stefano Barco, Ron A A Mathôt, Erik-Jan van den Dool, An K Stroobants, Mireille J Serlie, Saskia Middeldorp, Michiel Coppens
BACKGROUND AND AIMS: Patients on parenteral nutrition for short bowel syndrome (SBS) have a high risk of thrombotic complications and are often treated with parenteral anticoagulation. Direct oral anticoagulants are absorbed proximally in the digestive tract and may represent alternative regimens in selected SBS patients. In our pilot study, we provided pharmacokinetics parameters of dabigatran etexilate and rivaroxaban in this setting and compared peak (Cmax), trough (Ctrough) concentrations, and areas-under-the-concentration-time-curve (AUC0-t) to reference values retrieved from phase I-III studies...
November 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29126891/early-real-world-experience-with-direct-oral-anticoagulants-in-the-treatment-of-intermediate-high-risk-acute-pulmonary-embolism
#12
Sónia Martins Santos, Susana Cunha, Rui Baptista, Sílvia Monteiro, Pedro Monteiro, Francisco Gonçalves, Mariano Pêgo
INTRODUCTION: Intermediate-high risk pulmonary embolism (IHR-PE) has a poor prognosis, but is under-represented in trials of direct oral anticoagulants (DOACs) in venous thromboembolic disease (VTE). We aimed to assess whether the administration of DOACs was equivalent to the conventional (CONV) treatment of low-molecular weight heparin bridged with warfarin for treating IHR-PE. METHODS: We conducted a retrospective cohort study including 59 consecutive patients admitted with IHR-PE and followed for up to three months after discharge...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126301/coagulation-testing-in-the-core-laboratory
#13
William E Winter, Sherri D Flax, Neil S Harris
Primary hemostasis begins with endothelial injury. VWF, produced by endothelial cells, binds to platelets and links them to subendothelial collagen. Platelet-derived ADP and thromboxane activate non-adhered platelets via their GPIIb/IIIa receptors, allowing these platelets to participate in platelet aggregation. Secondary hemostasis is initiated with the binding of factor VII to extravascular tissue factor (TF). Factors II, VII, IX and X are vitamin K-dependent factors. The role of vitamin K is to assist in the addition of gamma carboxylate groups to glutamic acids in the "GLA" domains of these factors...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29125269/direct-oral-anticoagulants-use-in-elderly-patients-with-non-valvular-atrial-fibrillation-state-of-evidence
#14
Giulia Benedetti, Matteo Neccia, Luciano Agati
Non-valvular atrial fibrillation (NVAF) increases the risk of stroke by three- to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29122733/readmissions-in-anticoagulated-intracranial-hemorrhage-patients-a-retrospective-review
#15
Monica M DiFiori, Laura C Lamb, Lori L Calavan, Christopher H Comey, James M Feeney
OBJECTIVE: The objective of this study was to determine the effect of Direct Oral Anticoagulants (DOACs) when compared to warfarin, on the 30-day readmission rates in patients with traumatic intracranial hemorrhage (ICH). METHODS: We conducted a retrospective review of patients from our hospital's trauma database admitted from June 2011 to October 2015 to our Level II trauma center after sustaining a traumatic ICH while anticoagulated. Patients were stratified based on the anticoagulation drug (DOAC or warfarin) they were prescribed upon admission...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29120909/rivaroxaban-induced-hepatotoxicity-review-of-the-literature-and-report-of-new-cases
#16
Anna Licata, Fania Puccia, Vania Lombardo, Antonietta Serruto, Maria G Minissale, Ilaria Morreale, Lydia Giannitrapani, Maurizio Soresi, Giuseppe Montalto, Piero L Almasio
AIM/OBJECTIVE/BACKGROUND: Direct-acting oral anticoagulant drugs are marketed worldwide for the primary and secondary prevention and treatment of thromboembolic disorders. Rivaroxaban, an oral, direct factor Xa inhibitor, is one of the most used. Rivaroxaban-induced hepatotoxicity is unusual, although a number of adverse reports have recently been reported. Here, we report two new cases of rivaroxaban-induced hepatitis. METHODS: A systematic search of case reports on the MEDLINE database encompassing the years 2008-2016 was carried out...
November 8, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29119147/betrixaban-a-direct-oral-inhibitor-of-activated-factor-x-for-the-prophylaxis-of-venous-thromboembolism-in-patients-hospitalized-for-acute-medical-illness
#17
G Escolar, M Díaz-Ricart, E Arellano-Rodrigo
Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism, is a serious clinical and public health concern. Hospitalization is a major risk factor for developing VTE. Hospital-associated events account for more than 50% of all cases of VTE. Heparins have demonstrated to be efficacious in the prevention of VTE in medically ill patients. Despite the demonstrated efficacy and safety of the available direct oral anticoagulants in the prevention and treatment of different thromboembolic conditions, their net benefit in the prevention of VTE in hospitalized medically ill patients has not been fully confirmed...
August 2017: Drugs of Today
https://www.readbyqxmd.com/read/29117993/an-update-on-the-bleeding-risks-associated-with-doacs
#18
(no author information available yet)
The direct oral anticoagulants (DOACs), also referred to as novel (or non-vitamin K antagonist) oral anticoagulants (NOACs), represent a major development in anticoagulation therapy due to their rapid onset of action, predictable dose-response with fixed doses and limited interactions with food and drugs.(1,2) However, these agents have been in widespread clinical use for less than a decade and, compared with extensive experience with warfarin, there is uncertainty relating to optimal laboratory monitoring of anticoagulation, perioperative management and treatment of bleeding...
November 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29117605/-new-oral-anticoagulants-noac-in-stroke-treatment
#19
Clemens Küpper, Lars Kellert, Steffen Tiedt, Frank Arne Wollenweber
Since 2011, new oral anticoagulants (NOAC) can be prescribed for prevention of cardio-embolic ischemic strokes in addition to vitamin K antagonists. NOAC are indicated in patients with non-valvular atrial fibrillation. Although its use is a matter of debate in Germany, the neurological and cardiological societies recommend the use of NOAC over and above vitamin K antagonists due to a better benefit-to-risk ratio attributed to it, especially because of the lower risk of intracranial hemorrhage in NOAC use. A specific antidote is commercially available for the direct thrombin inhibitor dabigatran only...
November 8, 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29115714/deep-vein-thrombosis-in-pediatric-patients
#20
REVIEW
Julie Jaffray, Guy Young
Due to advances in caring for critically ill children and those with chronic diseases, rates of deep vein thrombosis (DVT) are increasing in children. Risk factors consist of central venous catheters, chronic medical conditions, thrombophilia, and various medications. Compression Doppler ultrasonography is the method most commonly used to diagnose DVT, and patients will usually present with pain and swelling of the affected limb. Anticoagulation via subcutaneous injection is the most common treatment regime for children with DVT, and the new, direct oral anticoagulants are currently under investigation...
November 8, 2017: Pediatric Blood & Cancer
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