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https://www.readbyqxmd.com/read/28734130/right-lobe-living-donors-ages-55-and-older-in-liver-transplantation
#1
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver...
July 22, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28730779/a-comparative-study-on-postoperative-mortality-prediction-of-sfli-scoring-system-and-child-pugh-classification-in-patients-with-hepatocellular-carcinoma
#2
Jun Zheng, Rong-Chun Xing, Wei-Hong Zheng, Wei Liu, Ru-Cheng Yao, Xiao-Song Li, Jian-Ping Du, Lin Li
PURPOSE: In our previous study, we have established the clinical significance of the SFLI (scoring formula of liver injury), the purpose of this study was to compare the SFLI system and the Child-Pugh grading system in the prediction of postoperative mortality in patients with hepatocellular carcinoma (HCC). METHODS: 114 patients with HCC who underwent surgical treatment were enrolled. According to the requirement of the indicators for the Child-Pugh classification, various indices (including albumin [ALB], total bilirubin [TBIL], prothrombin time [PT], ascites, and hepatic encephalopathy) were considered in these patients before surgery, and then Child-Pugh grading was performed...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28727814/low-pcsk9-levels-are-correlated-with-mortality-in-patients-with-end-stage-liver-disease
#3
Valentin Schlegel, Theresa Treuner-Kaueroff, Daniel Seehofer, Thomas Berg, Susen Becker, Uta Ceglarek, Joachim Thiery, Thorsten Kaiser
INTRODUCTION: Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a key role in the cholesterol metabolism and is synthesized by the liver. It interacts with the LDL-receptor to promote its degradation. The model of end-stage liver disease (MELD) score is a well-established tool to estimate the risk of mortality in patients with end-stage chronic liver disease. The study aims to assess the associations between PCSK9, hypocholesterinemia, liver synthesis, cholestasis, MELD score and mortality in patients with end-stage liver disease...
2017: PloS One
https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#4
Abimbola Adike, Mohanad Al-Qaisi, Noemi J Baffy, Heidi Kosiorek, Rahul Pannala, Bashar Aqel, Douglas O Faigel, M Edwyn Harrison
BACKGROUND: Cirrhosis is often accompanied by an elevated international normalized ratio (INR) due to a decrease in pro-coagulant factors. An elevated INR in cirrhosis is often interpreted as an increased risk of bleeding. There are a paucity of data in the literature on the use of INR to predict risk of gastrointestinal bleeding (GIB) following endoscopic retrograde cholangiopancreatography (ERCP) in patients with cirrhosis. The aims of the study were to determine if there is a correlation between INR and GIB following ERCP in patients with cirrhosis, and to determine if there is a difference in frequency of post-ERCP complications in patients with and without cirrhosis...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725042/global-deregulation-of-ginseng-products-may-be-a-safety-hazard-to-warfarin-takers-solid-evidence-of-ginseng-warfarin-interaction
#5
Haiyan Dong, Ji Ma, Tao Li, Yingying Xiao, Ning Zheng, Jian Liu, Yu Gao, Jingwei Shao, Lee Jia
Recent global deregulation of ginseng as the table food raises our concern about the possible ginseng-warfarin interaction that could be life-threatening to patients who take warfarin for preventing fatal strokes and thromboembolism while using ginseng products for bioenergy recovery. Here we show that quality-control ginsenosides, extracted from ginseng and containing its major active ingredients, produce dose- and time-dependent antagonism in rats against warfarin's anti-coagulation assessed by INR and rat thrombosis model...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724836/prothrombin-complex-concentrate-for-vitamin-k-antagonist-associated-intracranial-hemorrhage%C3%A3-global-evidence-and-the-japanese-perspective
#6
Masahiro Yasaka, Andres Brainsky, Kazunori Toyoda
Patients receiving vitamin K antagonists (VKAs) are at increased risk of bleeding. Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality in this population, and is a particular concern among Japanese clinicians, given reports of an elevated risk of this bleeding type in patients of Asian ethnicity. Patients with VKA-associated ICH require rapid international normalized ratio (INR) reversal, and treatment guidelines suggest the use of prothrombin complex concentrates (PCCs) or plasma for this purpose...
July 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28722795/influence-of-renal-function-on-anticoagulation-control-in-patients-with-non-valvular-atrial-fibrillation-taking-vitamin-k-antagonists
#7
José M Lobos-Bejarano, Angel Castellanos Rodríguez, Vivencio Barrios, Carlos Escobar, José Polo-García, José Carlos Del Castillo-Rodríguez, Diego Vargas-Ortega, Adriana Lopez-Pineda, Luis Prieto-Valiente, Gregory Y H Lip
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD...
July 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28722092/-predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-vascular-occlusive-diseases
#8
Dafang Liu, Yingjiang Ye, Qiwei Xie, Mujun Yin, Xiaodong Yang, Bin Liang, Shan Wang
OBJECTIVE: To explore the predictive factors of intestinal necrosis in acute mesenteric vascular occlusive diseases and its significance for the timing of exploratory laparotomy. METHODS: This retrospective study enrolled 63 patients diagnosed as acute mesenteric vascular occlusive diseases at Peking University People's Hospital between July 1995 and June 2015. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721958/cost-analysis-of-a-simulation-based-training-for-health-workforce-in-india
#9
Gursimer Jeet, Shankar Prinja, Arun Kumar Aggarwal
BACKGROUND: Training of health-care workforce including doctors, staff nurses, and Auxiliary Nurse Midwives using simulation techniques for skill enhancement have been used in a variety of clinical settings to improve the quality of training. India adopted the skills laboratories model for capacity building of health workers in maternal and child health in Bihar state. OBJECTIVE: Current economic evaluation was performed with the objective of assessing the financial and economic cost of implementing skills laboratories...
April 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28721954/out-of-pocket-health-expenditure-and-sources-of-financing-for-delivery-postpartum-and-neonatal-health-in-urban-slums-of-bhubaneswar-odisha-india
#10
Kirti Sundar Sahu, Bhavna Bharati
BACKGROUND: Out-of-pocket expenditure (OOPE) is an obstacle in the path of getting universal health coverage in India. OBJECTIVE: This study aimed to explore the OOPE, sources of funding, and experience of catastrophic expenditure (CE) for healthcare related to delivery, postpartum, and neonatal morbidity. METHODS: A community-based, cross-sectional survey was conducted among a sample of 240 recently delivered women from the slums of Bhubaneswar, Odisha...
April 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28718296/real-life-management-of-venous-thromboembolism-with-rivaroxaban-results-from-experience-vte-an-italian-epidemiological-survey
#11
Davide Imberti, Giovanni Barillari
Two large randomized controlled trials examined the efficacy and safety of rivaroxaban for the treatment of venous thromboembolism (VTE). The aim of this epidemiological study was to analyze a cohort of Italian patients affected by VTE who were treated with rivaroxaban in clinical practice. The data were collected by physicians using an online electronic questionnaire. The study was performed during a 6-month period from January to June 2014. We analyzed the clinical characteristics, risk factors for VTE, comorbidities, diagnostic techniques, and treatments in the whole population and in the subgroups with deep vein thrombosis (DVT) only, pulmonary embolism (PE) only, and DVT+PE...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28717074/effect-of-thrombomodulin-alfa-on-disseminated-intravascular-coagulation-in-patients-with-lung-cancer
#12
Kentaro Nakano, Kumiya Sugiyama, Hideyuki Satoh, Hajime Arifuku, Takayoshi Fujimatsu, Naruo Yoshida, Hiroyoshi Watanabe, Shingo Tokita, Tomoshige Wakayama, Masamitsu Tatewaki, Ryosuke Souma, Hiroyuki Masuda, Kenya Koyama, Hirokuni Hirata, Yasutsugu Fukushima
Objective The mortality rate due to disseminated intravascular coagulation (DIC) is higher in patients with lung cancer than in those without. We examined the effect of treatment with thrombomodulin alfa (TM-α) for DIC in lung cancer patients. Methods Subjects were 57 patients with DIC (43 men, 14 women; mean age, 71.7 years), comprising 31 with lung cancer and 26 without. DIC patients with or without lung cancer did not differ significantly in their background characteristics. Results No significant difference was noted in the mortality rate between patients with lung cancer (61...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28711678/linezolid-in-liver-failure-exploring-the-value-of-the-maximal-liver-function-capacity-limax-test-in-a-pharmacokinetic-pilot-study
#13
Sebastian G Wicha, Otto R Frey, Anka C Roehr, Johann Pratschke, Martin Stockmann, Rawan Alraish, Tilo Wuensch, Magnus Kaffarnik
BACKGROUND: Patients in the intensive care unit frequently require antibiotic treatment. Liver impairment possesses substantial challenges for dose selection in these patients. The aim of the present pilot study was to assess the novel maximal liver function capacity (LiMAx test) in comparison to conventional liver function markers as covariates of drug clearance in liver failure using linezolid as model drug. METHODS: 28 patients with different degrees of liver failure were recruited and LiMAx test, plasma, dialysis and urine sampling was performed under linezolid steady-state therapy (600 mg BID)...
July 12, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28709650/anticoagulation-control-in-warfarin-treated-patients-undergoing-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-enoxaparin-warfarin-in-patients-undergoing-cardioversion-of-atrial-fibrillation-trial
#14
Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette
In the Edoxaban Versus Enoxaparin-Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin-warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open blinded end-point trial, we analyzed patients randomized to enoxaparin-warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; and impact on primary end points (composite of stroke, systemic embolic event[SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant nonmajor bleeding)...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#15
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28705210/transcutaneous-electrical-stimulation-of-somatic-afferent-nerves-in-the-foot-relieved-symptoms-related-to-postoperative-bladder-spasms
#16
Chanjuan Zhang, Zhiying Xiao, Xiulin Zhang, Liqiang Guo, Wendong Sun, Changfeng Tai, Zhaoqun Jiang, Yuqiang Liu
BACKGROUND: Bladder spasm is a common side effect of urological surgery. Main treatment modalities include opioids or anticholinergic medication; however, bladder spasms still occur even after these interventions. Recent studies indicate that transcutaneous stimulation of the foot can result in 50% increase in bladder capacity in healthy adults, and inhibit bladder detrusor overactivity in spinal cord injured patients. In this study, we examined the effects of transcutaneous electrical stimulation of the foot on bladder spasms related symptoms...
July 13, 2017: BMC Urology
https://www.readbyqxmd.com/read/28704111/incomplete-dabigatran-reversal-with-idarucizumab
#17
Aaron P Steele, Jin A Lee, William E Dager
CONTEXT: With increasing use of direct oral anticoagulants (DOACs), urgent reversal of these agents becomes a growing concern. Idarucizumab is a humanized monoclonal antibody fragment that specifically binds to dabigatran with higher affinity than thrombin, rapidly neutralizing its anticoagulant effect without increased risk of thrombosis. CASE DETAILS: We describe two cases in which the recommended dose of idarucizumab was unsuccessful in completely reversing the anticoagulant effects of dabigatran...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28698808/vitamins-k1-and-k2-the-emerging-group-of-vitamins-required-for-human-health
#18
REVIEW
Gerry Kurt Schwalfenberg
OBJECTIVE: To review the evidence for the use of vitamin K supplementation in clinical conditions such as osteoporosis, vascular calcification, arthritis, cancer, renal calculi, diabetes, and warfarin therapy. QUALITY OF EVIDENCE: PubMed was searched for articles on vitamin K (K1 and K2) along with books and conference proceedings and health conditions listed above. Level I and II evidence supports the use of vitamins K1 and K2 in osteoporosis and Level II evidence supports vitamin K2 in prevention of coronary calcification and cardiovascular disease...
2017: Journal of Nutrition and Metabolism
https://www.readbyqxmd.com/read/28698538/warfarin-should-not-be-used-for-thromboprohylaxis-in-elective-major-orthopaedic-surgery-a-croatian-perspective
#19
Robert Kolundžić, Marijana Šimić Jovičić, Maja Ðinkić, Tadija Petrović, Tomislav Crnković, Vladimir Trkulja
Aim To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia. Methods A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). Results Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH)...
August 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/28695669/risk-estimation-for-biliary-tract-cancer-development-and-validation-of-a-prognostic-score
#20
Nora Schweitzer, Mareike Fischer, Martha M Kirstein, Sarah Berhane, Martina Kottas, Marianne Sinn, Maria A Gonzalez-Carmona, Zeynep Balta, Tobias J Weismüller, Christian P Strassburg, Tanja Reineke-Plaaß, Hüseyin Bektas, Michael P Manns, Philip Johnson, Arndt Weinmann, Arndt Vogel
BACKGROUND & AIMS: Biliary tract cancer is a rare tumor entity characterized by a poor prognosis. We aimed to identify prognostic factors and create a prognostic score to estimate survival. METHODS: Clinical data of the training set, consisting of 569 patients treated from 2000 to 2010 at Hannover Medical School, were analyzed. A prognostic model defining 3 prognostic risk groups was derived from Cox regression analyses. The score was applied and validated in an independent cohort of 557 patients from four different German centers...
July 11, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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