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https://www.readbyqxmd.com/read/28820550/is-fasting-for-ramadan-safe-in-patients-with-mechanical-cardiac-valves
#1
Ersin Yildirim, Ozlem Secen, Okkes Uku, Mehmet Nail Bilen, Makbule Kutlu Karadag
BACKGROUND: The study aim was to investigate the safety and effects of fasting during Ramadan on the International Normalized Ratio (INR) in patients with mechanical cardiac valves. METHODS: A total of 105 patients admitted to the authors' hospital between June and October 2015, who had history of prosthetic valve replacement, was investigated. The patients were allocated to two groups: those fasting during Ramadan (n = 42) and those not fasting (n = 63). All patients were examined by a cardiologist, and the clinical findings and complaints for the past three months were evaluated...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28817760/association-between-hypercoagulability-and-severe-obstructive-sleep-apnea
#2
Seung-No Hong, Hee-Chul Yun, Joon Hyuk Yoo, Seung Hoon Lee
Importance: Obstructive sleep apnea (OSA) is related to the increased risk of cardiovascular disease. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a link. Objective: To investigate the association between the severity of OSA and blood coagulability. Design, Setting, and Participants: A retrospective cohort study conducted at a tertiary care university hospital evaluated 146 patients with OSA from January 1, 2009, to July 31, 2015...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28816020/real-world-efficacy-and-safety-of-ombitasvir-paritaprevir-r-dasabuvir-ribavirin-in-genotype-1b-patients-with-hcv-liver-cirrhosis
#3
Carmen Monica Preda, Corneliu Petru Popescu, Cristian Baicus, Theodor Voiosu, Mircea Manuc, Corina Silvia Pop, Liana Gheorghe, Ioan Sporea, Anca Trifan, Marcel Tantau, Alina Tantau, Emanoil Ceausu, Doina Proca, Ileana Constantinescu, Simona Maria Ruta, Mircea Diculescu, Alexandru Oproiu
BACKGROUND: Direct antiviral agents (DAA) showed very good results in terms of efficacy and safety in clinical trials, but real life data are still needed in order to confirm this profile. MATERIAL AND METHODS: In Romania, through a nationwide government-funded programme in 2015-2016, approx.5800 patients with virus C liver cirrhosis received fully reimbursed DAA therapy with OBV/PTV/r+DSV+RBV for 12 weeks. We analysed a national prospective cohort enrolling the first 2070 patients, all with genotype 1b...
August 17, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28815459/a-roadmap-for-reducing-cardiac-device-infections-a-review-of-epidemiology-pathogenesis-and-actionable-risk-factors-to-guide-the-development-of-an-infection-prevention-program-for-the-electrophysiology-laboratory
#4
REVIEW
Westyn Branch-Elliman
PURPOSE OF REVIEW: Cardiovascular implantable electronic device (CIED) infections are highly morbid, common, and costly, and rates are increasing (Sohail et al. Arch Intern Med 171(20):1821-8 2011; Voigt et al. J Am Coll Cardiol 48(3):590-1 2006). Factors that contribute to the development of CIED infections include patient factors (comorbid conditions, self-care, microbiome), procedural details (repeat procedure, contamination during procedure, appropriate pre-procedural prep, and antimicrobial use), environmental and organizational factors (patient safety culture, facility barriers, such as lack of space to store essential supplies, quality of environmental cleaning), and microbial factors (type of organism, virulence of organism)...
August 16, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28815410/efficacy-and-safety-of-a-4-factor-prothrombin-complex-concentrate-for-rapid-vitamin-k-antagonist-reversal-in-japanese-patients-presenting-with-major-bleeding-or-requiring-urgent-surgical-or-invasive-procedures-a-prospective-open-label-single-arm-phase-3b-study
#5
Shigeki Kushimoto, Toshio Fukuoka, Akio Kimura, Kazunori Toyoda, Andres Brainsky, Amy Harman, Thomas Chung, Masahiro Yasaka
Rapid vitamin K antagonist (VKA) reversal is required in patients experiencing major bleeding or requiring urgent surgery. Four-factor prothrombin complex concentrate (4F-PCC; Beriplex(®)/Kcentra(®)) was shown in two large randomized controlled, international phase 3b trials to be an effective alternative to plasma for urgent VKA reversal. In the present prospective, open-label, single-arm phase 3b trial, we evaluate the efficacy and safety of 4F-PCC in Japanese patients. Eleven patients [international normalized ratio (INR) ≥2] requiring rapid VKA reversal owing to major bleeding (n = 6) or before urgent surgical/invasive procedures (n = 5) were administered 4F-PCC dosed based on INR and weight...
August 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28810918/tranexamic-acid-reduces-hidden-blood-loss-in-the-treatment-of-intertrochanteric-fractures-with-pfna-a-single-center-randomized-controlled-trial
#6
Jinlai Lei, Binfei Zhang, Yuxuan Cong, Yan Zhuang, Xing Wei, Yahui Fu, Wei Wei, Pengfei Wang, Shiming Wen, Hai Huang, Hu Wang, Shuang Han, Shuguang Liu, Kun Zhang
BACKGROUND: Hidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture. The objective of this study was to investigate whether tranexamic acid (TXA) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture. METHODS: A total of 77 patients with intertrochanteric fracture were enrolled in this randomized controlled study. Patients received either 200 mL (1 g) of TXA (n = 37) or normal-saline (NS) (n = 40) i...
August 15, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28809389/cost-effectiveness-analysis-of-telephone-based-support-for-the-management-of-pressure-ulcers-in-people-with-spinal-cord-injury-in-india-and-bangladesh
#7
M Arora, L A Harvey, J V Glinsky, H S Chhabra, M S Hossain, N Arumugam, P K Bedi, I D Cameron, A J Hayes
OBJECTIVE: To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers. STUDY DESIGN: Cost-effectiveness and cost-utility analysis of a randomised clinical trial. SETTING: Tertiary centre in India and Bangladesh. METHODS: An economic evaluation was conducted alongside a randomised clinical trial comparing 12 weeks of telephone-based support (intervention group) with usual care (control group)...
August 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28808886/assessment-of-pharmacokinetic-interactions-between-obeticholic-acid-and-caffeine-midazolam-warfarin-dextromethorphan-omeprazole-rosuvastatin-and-digoxin-in-phase-1-studies-in-healthy-subjects
#8
Jeffrey E Edwards, Lise Eliot, Andrew Parkinson, Sharon Karan, Leigh MacConell
INTRODUCTION: Obeticholic acid (OCA), a potent and selective farnesoid X receptor agonist, is indicated for the treatment of primary biliary cholangitis (PBC). We investigated the potential drug-drug interaction effect of OCA on metabolic CYP450 enzymes and drug transporters. METHODS: Five phase 1 single-center, open-label, fixed-sequence, inpatient studies were conducted in healthy adult subjects to evaluate the effect of oral daily doses of 10 or 25 mg OCA on single-dose plasma pharmacokinetics of specific probe substrates for enzymes CYP1A2 (caffeine, R-warfarin), CYP3A (midazolam, R-warfarin), CYP2C9 (S-warfarin), CYP2D6 (dextromethorphan), CYP2C19 (omeprazole), and drug transporters, BCRP/OATP1B1/OATP1B3 (rosuvastatin), and P-gp (digoxin)...
August 14, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28807252/role-of-hepatic-trisectionectomy-in-advanced-hepatocellular-carcinoma
#9
J S Tsang, K S H Chok, C M Lo
BACKGROUND: Advanced hepatocellular carcinoma (HCC) with underlying cirrhosis poses a major operative challenge. Patients have a dismal prognosis without curative resection. The role of hepatic trisectionectomy in these patients is not established. The aim of this study was to analyze and compare the perioperative outcome and prognosis of patients undergoing trisectionectomy with hepatic resection of a lesser extent. METHODS: From 2000 to 2014, 48 patients underwent hepatic trisectionectomy for HCC with background cirrhosis or chronic hepatitis (Group A)...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806200/quality-of-anticoagulation-control-and-hemorrhage-risk-among-african-american-and-european-american-warfarin-users
#10
Nita A Limdi, Todd M Brown, Aditi Shendre, Nianjun Liu, Charles E Hill, Timothy M Beasley
OBJECTIVE: We evaluated whether percent time in target range (PTTR), risk of over-anticoagulation [international normalized ratio (INR)>4], and risk of hemorrhage differ by race. As PTTR is a strong predictor of hemorrhage risk, we also determined the influence of PTTR on the risk of hemorrhage by race. PARTICIPANTS AND METHODS: Among 1326 warfarin users, PTTR was calculated as the percentage of interpolated INR values within the target range of 2.0-3.0. PTTR was also categorized as poor (PTTR<60%), good (60≤PTTR<70%), or excellent (PTTR≥70%) anticoagulation control...
August 11, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28804818/optimizing-the-verification-of-mean-normal-prothrombin-time-mnpt-and-international-sensitivity-index-isi-for-accurate-conversion-of-prothrombin-time-pt-to-international-normalized-ratio-inr
#11
Emmanuel J Favaloro
The Prothrombin Time (PT) assay is the most common test performed in hemostasis laboratories, most commonly as converted to an international normalized ratio (INR) to monitor anticoagulant therapy using vitamin K antagonists (VKAs) such as warfarin. Although the INR is meant to standardize PT values by taking into consideration reagent and instrument variability, substantial inter-laboratory variation in INRs still exists and suggests that this can be further improved. This paper describes the PT test, its conversion to an INR value, and methods to improve the accuracy of INRs by improving the determination of critical components to the INR, namely the mean normal prothrombin time (MNPT) and the international sensitive index (ISI)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#12
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#13
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
August 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28800176/catheter-ablation-of-left-atrial-arrhythmias-on-uninterrupted-oral-anticoagulation-with-vitamin-k-antagonists-how-is-the-relationship-between-international-normalized-ratio-activated-clotting-time-and-procedure-related-complications
#14
Marc Kottmaier, Felix Bourier, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Carsten Lennerz, Sarah Lengauer, Marielouise Kornmayer, Elena Rousseva, Stephanie Brooks, Amir Brkic, Christian Grebmer, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
BACKGROUND: Ablation of atrial fibrillation (AF) on uninterrupted phenprocoumon reduces periprocedural thromboembolic and bleeding complications. Heparin is administered intraprocedurally to achieve activated clotting times (ACT) of 300-400 seconds. We investigated the effect of international normalized ratio (INR) on ACT and intraprocedural heparin requirements. Moreover, safety of a target ACT of 250-300 seconds was investigated. METHODS AND RESULTS: We studied 949 patients referred for AF or left atrial tachycardia ablation...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischemic-stroke-and-non-valvular-atrial-fibrillation
#15
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Yohei Takayama, Kentaro Suzuki, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has a potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aims of the present study were to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF (NVAF)...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28795244/a-retrospective-study-on-the-risk-factors-for-bleeding-events-in-warfarin-therapy-focusing-on-renal-function
#16
Toshinori Hirai, Yukihiro Hamada, Yujiro Geka, Shiori Kuwana, Koji Hirai, Mai Ishibashi, Yutaka Fukaya, Toshimi Kimura
PURPOSE: The anticoagulant effect of warfarin used to treat stroke has been shown to vary with the concomitant use of medications and comorbidity. Concomitant use of antithrombotic drugs and underlying chronic kidney disease (CKD) represent risk factors for bleeding events. We conducted a comprehensive investigation of the background characteristics and concomitant use of drugs to identify the risk factors for warfarin-related bleeding, focusing on renal function. METHODS: The study population consisted of patients prescribed warfarin at the Tokyo Women's Medical University Hospital...
August 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28794530/retrospective-analysis-of-post-operative-coagulopathy-after-major-hepatic-resection-at-a-tertiary-care-centre-in-northern-india
#17
Shweta A Singh, P Vivekananthan, Ankur Sharma, Sandeep Sharma, Kishore Gs Bharathy
BACKGROUND AND AIMS: Hepatic resection is a major surgery associated with intraoperative massive fluid shifts, blood loss, haemodynamic instability and risk of development of post-hepatectomy liver failure. Hepatic resection predisposes the patient to coagulopathy as well as venous thrombosis. However, due to the development of deranged coagulation profile post-operatively, there is a dilemma in starting thromboprophylaxis. Our aim in this study was to determine the incidence of coagulopathy in patients undergoing major hepatectomy...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28791851/clinical-risk-factors-for-loss-of-stent-primary-patency-in-patients-with-chronic-legs-ischemia
#18
Klaudia Koza, Paweł Grzelązka, Adrianna Trofimiuk, Karol Suppan, Marcin Wasielewski, Joanna Wiśniewska, Jacek Budzyński
BACKGROUND: The outcome of endovascular therapy can be influenced by a number of factors, either demographic, biochemical, angiographic or procedural. Knowledge about these factors may help in the individualization of therapeutic methods, surveillance intensity, and should, ultimately, improve intervention efficacy. OBJECTIVES: The aim of this study was to estimate the effect of clinical and biochemical factors on the late outcome of lower limb artery stenting. MATERIAL AND METHODS: The medical documentation of 91 patients with at least a 1 year follow-up after the stenting of a lower limb artery was retrospectively evaluated...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28782153/n-acetylcysteine-and-prednisolone-treatment-improved-serum-biochemistries-in-suspected-flupirtine-cases-of-severe-idiosyncratic-liver-injury
#19
Jürgen Borlak, Florian van Bömmel, Thomas Berg
BACKGROUND & AIMS: The analgesic flupirtine has been linked to cases of severe idiosyncratic drug-induced liver injury (sFILI). We therefore examined whether N-acetylcysteine (NAC) and glucocorticoid therapy is effective in the management of sFILI. METHODS: In a retrospective cohort study efficacy of NAC-infusion and oral prednisolone treatments on liver-function-tests (LFTs) and clinical outcome of 21 sFILI cases was evaluated by comparing it to an external cohort of 30 sFILI cases not receiving the antidote...
August 7, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28776437/warfarin-monitoring-in-nursing-homes-assessed-by-case-histories-do-recommendations-and-electronic-alerts-affect-judgements
#20
Reyes Serrano Teruel, Geir Thue, Svein Ivar Fylkesnes, Sverre Sandberg, Ann Helen Kristoffersen
PURPOSE: Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. MATERIALS AND METHODS: In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes...
August 4, 2017: Scandinavian Journal of Primary Health Care
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