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https://www.readbyqxmd.com/read/27933144/a-project-to-improve-the-management-of-patients-on-warfarin-in-a-primary-care-setting-through-the-introduction-of-a-poc-analysis
#1
Thore Karlsson
When noticed that patients commonly misunderstood their warfarin prescriptions when they were given by telephone. We found that the average TIR (time in range) (the relative time period the patients PT-INR value was in the therapeutic range) for patients decreased, and we noticed that the numbers of incidents increased. We made several interventions over a period of close to three years (2010-2012) to improve the quality of care, increase patients' TIRs, and decrease incidents. The interventions included; taking extra care when speaking to patients about their warfarin prescriptions on the phone and using an express mail delivery system to make sure patients got their letters in time...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932130/acute-liver-failure-caused-by-primary-non-hodgkin-s-lymphoma-of-the-liver
#2
L Romacho López, F J León Díaz, B Sánchez Pérez, J A Pérez Daga, J L Fernández Aguilar, M C Montiel Casado, J M Aranda Narváez, M A Suárez Muñoz, J Santoyo Santoyo
INTRODUCTION: Acute liver failure (ALF) is a rare syndrome involving maximum liver dysfunction. This disease is characterized by a less than 26-week history of coagulopathy (INR ≥1.5) and hepatic encephalopathy and generally occurs in patients without any previously known disease. METHODS: We report the case of a healthy 25-year-old subject who presented with fulminant liver failure caused by a primary non-Hodgkin's lymphoma of the liver that required emergency liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931994/patient-knowledge-of-anticoagulant-treatment-does-not-correlate-with-treatment-quality
#3
M S Nybo, J Skov
OBJECTIVES: The objectives of this study were to investigate whether patient knowledge is a predictor of treatment stability in anticoagulant clinic patients and to evaluate the correlation between the patients' subjective assessment of own knowledge and their score on a validated knowledge assessment instrument. STUDY DESIGN: This is a prospective study where international normalized ratio (INR) stability was followed up 6 months after knowledge assessment. METHODS: We analyzed data of 42 consecutive patients new to vitamin-K antagonist (VKA) treatment and 64 experienced patients from an anticoagulant clinic offering patient education...
December 2016: Public Health
https://www.readbyqxmd.com/read/27927716/genome-wide-uniformity-of-human-open-pre-initiation-complexes
#4
William K M Lai, B Franklin Pugh
Transcription of protein-coding and noncoding DNA occurs pervasively throughout the mammalian genome. Their sites of initiation are generally inferred from transcript 5' ends and are thought to be either locally dispersed or focused. How these two modes of initiation relate is unclear. Here, we apply permanganate treatment and chromatin immunoprecipitation (PIP-seq) of initiation factors to identify the precise location of melted DNA separately associated with the preinitiation complex (PIC) and the adjacent paused complex (PC)...
November 10, 2016: Genome Research
https://www.readbyqxmd.com/read/27917793/high-dose-oral-furosemide-with-salt-ingestion-in-the-treatment-of-refractory-ascites-of-liver-cirrhosis
#5
Tolga Yakar, Mehmet Demir, Ozlem Dogan, Alper Parlakgumus, Birol Ozer, Ender Serin
PURPOSE: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA. METHODS: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n= 25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27917713/antiplatelets-and-antithrombotics-in-patients-with-liver-insufficiency-from-pathophysiology-to-clinical-practice
#6
Melanie Deutsch, John Koskinas
The liver represents the site of synthesis of most procoagulant and anticoagulant factors, fibrinolytic proteins and thrombopoetin while being also involved in the clearance of hemostatic and fibrinolyic proteins. Therefore in patients with liver insufficiency a great variety of disturbances can be documented resulting however in a new "rebalanced" hemostatic system with a labile equilibrium between thromboses or bleeding. Interestingly patients with liver insufficiency may present with arterial or venous thrombotic episodes requiring antiplatelet and/or antithrombotic therapy despite low platelet count or prolonged INR...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27914653/antithrombotic-therapy-after-bioprosthetic-aortic-valve-implantation-warfarin-versus-aspirin-a-randomized-controlled-trial
#7
Sulman Rafiq, Daniel Andreas Steinbrüchel, Nikolaj Bang Lilleør, Christian Holdflod Møller, Jens Teglgaard Lund, Jens Juel Thiis, Lars Køber, Peter Skov Olsen
BACKGROUND: The optimal medical strategy for prevention of thromboembolic events after surgical bioprosthetic aortic valve replacement (BAVR) is still debated. The objective of this study was to compare warfarin therapy (target INR of 2.0 to 3.0) with aspirin 150mg daily as antithrombotic therapy for the first three months after BAVR with or without concomitant coronary artery bypass grafting (CABG). The aim was to evaluate thromboembolic complications, major bleeding complications and death...
November 25, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27913535/reversing-vitamin-k-antagonists-making-the-old-new-again
#8
Sabine Eichinger
Vitamin K antagonists (VKAs) are commonly used for the prevention and treatment of thrombotic disorders. The response to VKAs is highly variable due to their specific interaction with the vitamin K cycle, and hence interference with hepatic synthesis of vitamin K-dependent coagulation factors. Monitoring the anticoagulant effect of VKAs by assessing the patient's international normalized ratio (INR) is essential because complications are closely related to the intensity of anticoagulation. Treatment with VKAs contains a substantial risk of bleeding with a high case fatality rate...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910036/evaluation-of-the-pharmacokinetic-interaction-between-venetoclax-a-selective-bcl-2-inhibitor-and-warfarin-in-healthy-volunteers
#9
Ahmed Hamed Salem, Beibei Hu, Kevin J Freise, Suresh K Agarwal, Dilraj S Sidhu, Shekman L Wong
BACKGROUND AND OBJECTIVE: Venetoclax is a selective, B-cell lymphoma-2 inhibitor that has demonstrated clinical efficacy in a variety of hematological malignancies. In vitro data indicated weak cytochrome P450 (CYP) 2C9 inhibition by venetoclax; however, it is not predicted to cause clinically relevant inhibition due to high plasma protein binding. A Phase 1 study was conducted in healthy volunteers to evaluate the effect of venetoclax on warfarin pharmacokinetics. METHODS: Subjects received a single oral dose of 5 mg warfarin on day 1 of both periods 1 and 2, separated by a 14 days washout...
December 2, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27909537/a-comparison-between-noacs-and-warfarin-on-time-to-elective-cardioversion
#10
REVIEW
Siva Krothapalli Md, Prashant D Bhave Md Fhrs
Cardioversion of atrial fibrillation is a procedure that has been commonly performed for over half a century. There is known to be an elevated risk of thromboembolism around the time of cardioversion, which has been shown to be drastically reduced with oral anticoagulation. The consistency of therapeutic anticoagulation in the weeks leading up to elective cardioversion is an important factor in the safety of the procedure. Until recently, the only option for oral anti-coagulation was Warfarin. The challenges of dosing Warfarin to achieve a therapeutic INR are well documented...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27905329/recombinant-interferon-alpha-2b-for-ocular-surface-squamous-neoplasia-an-efficient-and-cost-effective-treatment-modality-in-asian-indian-patients
#11
Swathi Kaliki, Swati Singh, Sadiya Iram, Dharani Tripuraneni
PURPOSE: The purpose was to study the efficacy of interferon alpha 2b (INF α2b) in the treatment of ocular surface squamous neoplasia (OSSN) and analyze its cost-effectiveness in India. STUDY DESIGN: This was a retrospective study of thirty patients with OSSN treated with topical INF α2b (1 MIU/cc) ± perilesional INF α2b (5 MIU/cc). RESULTS: The tumor involved cornea (n = 9, 30%), conjunctivo-limbal-corneal surface (n = 19, 63%), or bulbar conjunctiva (n = 2, 7%)...
October 2016: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/27904258/cost-analysis-of-a-disaster-facility-at-an-apex-tertiary-care-trauma-center-of-india
#12
Sheetal Singh, Shakti Gupta, Anoop Daga, Vijaydeep Siddharth, LaxmiTej Wundavalli
INTRODUCTION: For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27901310/topical-antimycotics-for-oral-candidiasis-in-warfarin-users
#13
Maja Hellfritzsch, Anton Pottegård, Andreas James Thestrup Pedersen, Alaa Burghle, Fatima Mouaanaki, Jesper Hallas, Erik Lerkevang Grove, Per Damkier
Treatment of oral candidiasis in warfarin users may be complicated by drug-drug interactions between warfarin and topically applied antimycotics. However, current knowledge of these putative drug-drug interactions is merely based on case series. We therefore performed a cohort cross-over study with the objective to evaluate the potential drug-drug interactions between warfarin and miconazole oral gel or nystatin oral solution. The cohort consisted of individuals using warfarin in the period of 1998-2012 (n≈7,400)...
November 30, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27894795/histological-parameters-and-alcohol-abstinence-determine-long-term-prognosis-in-patients-with-alcoholic-liver-disease
#14
Carolin Lackner, Walter Spindelboeck, Johannes Haybaeck, Philipp Douschan, Florian Rainer, Luigi Terracciano, Josef Haas, Andrea Berghold, Ramon Bataller, Rudolf E Stauber
BACKGROUND & AIMS: Few data exist on predictors of long-term prognosis in patients with alcoholic liver disease (ALD). Most studies have only assessed short-term prognosis in patients with advanced ALD. We aimed to assess the prognostic impact of clinical, biochemical and histological parameters on long-term prognosis in patients with early/compensated and decompensated ALD. METHODS: Consecutive patients (n=192) with biopsy-proven liver disease due to alcohol abuse were analyzed retrospectively...
November 25, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27891750/epidemiology-and-outcomes-of-primary-sclerosing-cholangitis-with-and-without-inflammatory-bowel-disease-in-an-australian-cohort
#15
Ken Liu, Ruoxi Wang, Viraj Kariyawasam, Mark Wells, Simone I Strasser, Geoff McCaughan, Crispin Corte, Rupert W Leong
BACKGROUND&AIMS: Epidemiological data on primary sclerosing cholangitis (PSC) outside the Northern hemisphere is limited. Similarly, the impact of inflammatory bowel disease (IBD) on PSC outcomes remains unclear. We aimed to study the epidemiology and outcomes of PSC patients with and without IBD in an Australian cohort. METHODS: We retrospectively studied PSC patients attending two tertiary referral hospitals over 20years. Diagnosis of PSC was made according to international guidelines by positive cholangiography and/or liver biopsy (for small duct PSC) with supporting clinical and laboratory evidence RESULTS: 208 PSC patients (61% male) were studied (2,271patient-years follow-up)...
November 28, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27890836/microcirculation-evaluated-by-intraoperative-fluorescence-angiography-after-tibial-bypass-surgery
#16
Ulrich Rother, Werner Lang, Raymund E Horch, Ingo Ludolph, Alexander Meyer, Susanne Regus
OBJECTIVE: Intact microperfusion of the foot in the critical ischemic limb remains a crucial condition for ulcer healing. Aim of this clinical study was to evaluate the immediate effect of tibial bypass surgery on the microcirculation by usage of fluorescence angiography. METHODS: Prospective analysis of 33 patients presenting with critical limb ischemia (Rutherford 4 to 6) undergoing tibial bypass surgery was performed. Macroperfusion was investigated by measurement of ankle-brachial index...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27888711/preoperative-monocyte-to-lymphocyte-ratio-in-peripheral-blood-predicts-stages-metastasis-and-histological-grades-in-patients-with-ovarian-cancer
#17
Jiangdong Xiang, Lina Zhou, Xing Li, Wei Bao, Taizhong Chen, Xiaowei Xi, Yinyan He, Xiaoping Wan
PURPOSE: The monocyte-to-lymphocyte ratio (MLR) has been shown to be associated with the prognosis of various solid tumors. This study sought to evaluate the important value of the MLR in ovarian cancer patients. METHODS: A total of 133 ovarian cancer patients and 43 normal controls were retrospectively reviewed. The patients' demographics were analyzed along with clinical and pathologic data. The counts of peripheral neutrophils, lymphocytes, monocytes, and platelets were collected and used to calculate the MLR, neutrophil-to-lymphocyte ratio (NLR)...
November 23, 2016: Translational Oncology
https://www.readbyqxmd.com/read/27887977/direct-and-indirect-cost-of-myasthenia-gravis-a-prospective-study-from-a-tertiary-care-teaching-hospital-in-india
#18
Kamlesh Kumar Sonkar, Sanjeev Kumar Bhoi, Deepanshu Dubey, Jayantee Kalita, Usha Kant Misra
Myasthenia gravis (MG) requires lifelong treatment. The cost of management MG is very high in developed countries but there is no information on the cost of management of MG in the developing countries. This study reports the direct and indirect cost and predictors of cost of MG in a tertiary care teaching hospital in India. In a prospective hospital based study, from a tertiary hospital in India 66 consecutive patient during 2014-2015 were included. The age of the patients ranged between 6 and 75years. The severity of MG was assessed by myasthenia gravis foundation association (MGFA) class (MGFA) I-V...
November 23, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27886686/preoperative-versus-postoperative-initiation-of-warfarin-therapy-in-patients-undergoing-total-hip-and-knee-arthroplasty
#19
REVIEW
Cara Cipriano, Nicholas Erdle, Kai Li, Brian Curtin
The optimal strategy for postoperative deep venous thrombosis prophylaxis remains controversial in hip and knee arthroplasty. Warfarin causes transient hypercoagulability; however, the optimal timing of treatment remains unclear. We evaluated the effects of preoperative versus postoperative warfarin therapy with a primary endpoint of perioperative change in hemoglobin. Warfarin was dosed according to a standard nomogram. No difference in perioperative hemoglobin change was observed. The preoperative group demonstrated higher INRs...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27886380/acceptability-and-preference-drivers-of-freshly-roasted-peanuts
#20
Shangci Wang, Koushik Adhikari, Yen-Con Hung
The objectives of this study were to determine and compare the sensory perceptions and aroma volatiles of 6 freshly roasted peanut samples and to explore the drivers of consumer acceptability. Normal-oleic Georgia 06G kernels (06G), high-oleic Georgia 13M kernels (13M), Georgia runner (mixed) in-shell (InR) & kernels (R), and Virginia (mixed) in-shell (InVA) & kernels (VA) were roasted to medium doneness for consumers, descriptive, and gas chromatography-mass spectroscopy (GC-MS) tests. For Virginia variety, InVA was preferred over VA...
November 25, 2016: Journal of Food Science
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