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https://www.readbyqxmd.com/read/28429248/time-in-therapeutic-range-as-a-marker-for-thrombotic-and-bleeding-outcomes-in-fontan-patients
#1
Jenna M Faircloth, Kristin M Miner, Tarek Alsaied, Nicole Nelson, Julie Ciambarella, Tomoyuki Mizuno, Joseph S Palumbo, Alexander A Vinks, Gruschen R Veldtman
Fontan patients managed with warfarin are at risk not only for thrombotic events, but also for bleeding episodes as a consequence of anticoagulation treatment. The aim of this study was to determine whether time spent in patient specified therapeutic range (TTR), when managed in a cardiology-based pharmacist managed anticoagulation clinic (PMAC), is a useful target metric for monitoring, as well as improving outcomes. A single center retrospective review was conducted evaluating TTR of all Fontan patients (n = 45) on warfarin managed in our outpatient cardiology pharmacist managed anticoagulation clinic (PMAC) during a 19 month time frame...
April 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28427335/cholesterol-esterification-in-plasma-as-a-biomarker-for-liver-function-and-prediction-of-mortality
#2
Thorsten Kaiser, Benedict Kinny-Köster, Michael Bartels, Thomas Berg, Markus Scholz, Cornelius Engelmann, Daniel Seehofer, Susen Becker, Uta Ceglarek, Joachim Thiery
BACKGROUND: Advanced stages of liver cirrhosis lead to a dramatically increased mortality. For valid identification of these patients suitable biomarkers are essential. The most important biomarkers for liver function are bilirubin and prothrombin time expressed as International Normalized Ratio (INR). However, the influence of several anticoagulants on the prothrombin time limits its diagnostic value. Aim of this study was the evaluation of cholesterol esterification (CE) fraction (esterified cholesterol vs...
April 20, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28426737/incidence-and-predictors-of-excessive-warfarin-anticoagulation-in-patients-with-atrial-fibrillation-the-ewa-study
#3
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Melina Issakoff, K E Juhani Airaksinen
Vitamin K antagonist warfarin is widely used in clinical practice and excessive anticoagulation is a well-known complication of this therapy. Little is known about permanent and temporary predictors for severe overanticoagulation. The aim of this study was to investigate the occurrence and predicting factors for episodes with very high (≥9) international normalized ratio (INR) values in warfarin treated patients with atrial fibrillation (AF). Excessive Warfarin Anticoagulation (EWA) study screened all patients (n = 13618) in the Turku University Hospital region with an INR ≥2 between years 2003-2015...
2017: PloS One
https://www.readbyqxmd.com/read/28425027/10-year-results-of-on-x-bileaflet-mechanical-heart-valve-in-the-aortic-position-low-target-inr-regimen-in-japanese
#4
Hideki Teshima, Masahiko Ikebuchi, Yosuke Miyamoto, Ryuta Tai, Toshikazu Sano, Yusuke Kinugasa, Hiroyuki Irie
OBJECTIVES: This study was designed to establish clinical outcomes after aortic valve replacement (AVR) with On-X bileaflet mechanical heart valve. METHODS: Between 2006 and 2014, AVR was performed to 686 patients. Of them, 78 patients using On-X valve were enrolled. The mean age was 65 ± 11 years (ranged 33-85); 65% were men; and 81% were in sinus rhythm preoperatively. Calcific or degenerative tricuspid aortic valve was present in 73%. Concomitant procedures included coronary artery bypass grafting (22%), Bentall (8%), mitral valve procedure (3%) and other (9%)...
April 19, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28423431/-treatment-and-secondary-prevention-of-venous-thromboembolism-change-in-oral-anticoagulation
#5
Thomas-Maria Helms, Dietrich Gulba, Ingo Ahrens, Andreas Schäfer, Johannes Hankowitz, Peter Kuhlencordt, Hans-Peter Lipp, Sigrid Nikol, Hanno Riess, Tom Stargardt, Peter Bramlage
With the recent approval of the fourth direct non vitamin K dependent oral anticoagulant (NOAC) edoxaban the range of available NOACs for the treatment of venous thromboembolism (VTE) has expanded. Shortly thereafter, two updated guidelines for the prevention and treatment of VTE have been published. In these NOACs are listed as equal anticoagulants to low-molecular weight heparin (LMWH), or fondaparinux (FDX), and VKA for the initial or maintenance treatment of VTE. All NOACs are approved for the maintenance therapy after VTE and two NOACs (rivaroxaban and apixaban) for the initial treatment in addition in an increased dose...
April 19, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28422425/negativization-of-viremia-prior-to-liver-transplant-reduces-early-allograft-dysfunction-in-hepatitis-c-recipients
#6
Silvia Martini, Francesco Tandoi, Lodovico Terzi di Bergamo, Silvia Strona, Bruna Lavezzo, Marco Sacco, Francesca Maione, Federica Gonella, Paolo Strignano, Dominic Dell Olio, Mauro Salizzoni, Giorgio Maria Saracco, Renato Romagnoli
Although early allograft dysfunction (EAD) negatively impacts on survival from the first months following liver transplantation (LT), direct-acting antivirals (DAAs) have revolutionized HCV therapy. We investigated the EAD definition best predicting 90-day graft loss and identified EAD risk factors in HCV positive recipients. From 11-2002 to 06-2016, 603 HCV-positive patients (hepatocellular carcinoma 53.4%) underwent a first LT with HCV-negative donors. Median recipient MELD score 15, median donor age 63 years...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28417267/preemptive-warfarin-dose-reduction-after-initiation-of-sulfamethoxazole-trimethoprim-or-metronidazole
#7
Anna Powers, Erin B Loesch, Anthony Weiland, Nicole Fioravanti, David Lucius
To evaluate the utility of a preemptive warfarin dose reduction at the time of initiation of either sulfamethoxazole-trimethoprim or metronidazole, a retrospective chart review of patients who received an outpatient prescription for warfarin and either sulfamethoxazole-trimethoprim and/or metronidazole from July 1, 2011 to July 1, 2015 was conducted. Clinical outcomes compared Veterans who had a warfarin dose reduction and those who did not within 120 h (5 days) of antibiotic initiation. The primary outcome compared the pre-and post-antibiotic International Normalized Ratio (INR) of patients in the intervention group (warfarin dose reduction) with those in the control group (no intervention)...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28416974/major-determinants-for-the-selecting-antithrombotic-therapies-in-patients-with-nonvalvular-atrial-fibrillation-in-japan-japaf-study
#8
Koichi Kusakawa, Kouji H Harada, Tatsuo Kagimura, Akio Koizumi
BACKGROUND: Oral anticoagulants (OACs) can help prevent stroke in patients with nonvalvular atrial fibrillation (NVAF). The aim of this study was to characterize the use of OACs other than direct thrombin inhibitors (DTIs) for NVAF. METHODS: Patients with NVAF taking antithrombotics other than DTIs were enrolled in this cross-sectional study. Patient demographics and medication history were collected, and the patients were classified as taking antiplatelet monotherapy (AP), anticoagulant monotherapy (AC), or combination therapy (AP+AC)...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#9
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414664/gonococcal-endocarditis-the-gift-that-stops-giving-an-uncommon-presentation-of-a-common-disease
#10
G Olayemi, M Oferczak, A Elagizi, I El-Abbassi, M Eschete, J Crowe
INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413854/use-of-a-pocket-compression-device-for-the-prevention-and-treatment-of-pocket-hematoma-after-pacemaker-and-defibrillator-implantation-stop-hematoma-i
#11
Mohit K Turagam, Darbhamulla V Nagarajan, Krzysztof Bartus, Akash Makkar, Vijay Swarup
BACKGROUND: Pocket hematoma is a recognized complication after placement of cardiac implantable electronic devices and is associated with increased device infection, length of hospitalization, and morbidity especially with uninterrupted antiplatelet agents and anticoagulants. We assessed the use of a post-surgical vest to decrease the incidence of pocket hematoma in patients undergoing device implantation with uninterrupted antiplatelet and anticoagulants. METHODS: In this observational study, a vest was used by 20 consecutive patients who were compared to 20 age-, gender-, procedure-matched patients who received standard care...
April 17, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28412319/genetic-and-non-genetic-factors-affecting-the-quality-of-anticoagulation-control-and-vascular-events-in-atrial-fibrillation
#12
Yun Kyung Park, Mi Ji Lee, Jae Ha Kim, Jin Soo Lee, Rae Woong Park, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, June Soo Kim, Soo-Youn Lee, Oh Young Bang
BACKGROUND: Warfarin has a narrow therapeutic window. We hypothesized that genetic factors related to warfarin metabolism (CYP2C9) and activity (VKORC1) would show stronger associations than modifiable factors with the quality of anticoagulation control and risks for thromboembolism and hemorrhage. METHODS: In this retrospective cohort analysis, clinical and genetic data were collected from 380 patients with atrial fibrillation (AF) who were followed for an average observation period of 4 years...
April 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28409489/cost-of-trauma-care-in-secondary-and-tertiary-care-public-sector-hospitals-in-north-india
#13
Ankur Sangwan, Shankar Prinja, Sameer Aggarwal, Jagnoor Jagnoor, Pankaj Bahuguna, Rebecca Ivers
BACKGROUND: Several initiatives to provide trauma care, including ambulance services, creation of a network of trauma hospitals and insurance schemes for cashless treatment, are currently being implemented in India. However, lack of information on the cost of trauma care is an impediment to the evidence-based planning for such initiatives. In this study, we aim to bridge this gap in evidence by estimating the unit cost of an outpatient consultation, inpatient bed-day of hospitalization, surgical procedure and diagnostics for providing trauma care through secondary- and tertiary-level hospitals in India...
April 13, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28408835/predictors-of-common-femoral-artery-access-site-complications-in-patients-on-oral-anticoagulants-and-undergoing-a-coronary-procedure
#14
Nicolas W Shammas, Gail A Shammas, Susan Jones-Miller, Mileah Rose Gumpert, Miranda Jade Gumpert, Christine Harb, Majid Z Chammas, W John Shammas, Rommy A Khalafallah, Amy Barzgari, Bassel Bou Dargham, Ghassan E Daher, Rayan Jo Rachwan, Andrew N Shammas
BACKGROUND: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure. METHODS: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28405671/predictors-of-oral-cavity-bleeding-and-clinical-outcome-after-dental-procedures-in-patients-on-vitamin-k-antagonists-a-cohort-study
#15
Joseph S Biedermann, Willem M H Rademacher, Hendrika C A M Hazendonk, Denise E van Diermen, Frank W G Leebeek, Frederik Rozema, Marieke J H A Kruip
Patients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1-3 elements) and extensive high-risk (e. g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and high-risk dental procedures in patients on VKA...
April 13, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28404094/development-and-validation-of-a-dynamic-outcome-prediction-model-for-paracetamol-induced-acute-liver-failure-a-cohort-study
#16
William Bernal, Yanzhong Wang, James Maggs, Christopher Willars, Elizabeth Sizer, Georg Auzinger, Nicholas Murphy, Damian Harding, Ahmed Elsharkawy, Kenneth Simpson, Fin Stolze Larsen, Nigel Heaton, John O'Grady, Roger Williams, Julia Wendon
BACKGROUND: Early, accurate prediction of survival is central to management of patients with paracetamol-induced acute liver failure to identify those needing emergency liver transplantation. Current prognostic tools are confounded by recent improvements in outcome independent of emergency liver transplantation, and constrained by static binary outcome prediction. We aimed to develop a simple prognostic tool to reflect current outcomes and generate a dynamic updated estimation of risk of death...
November 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28401863/real-life-experience-with-a-new-anticoagulation-regimen-for-patients-undergoing-left-sided-ablation-procedures
#17
Charles Dussault, Santiago Rivera, Mariano Badra-Verdu, Felix Ayala-Paredes, Jean-François Roux
BACKGROUND: Current guidelines for anticoagulation during left-sided procedures recommend the administration of unfractionated heparin (UFH) with an initial bolus of 50-100 U/kg, followed by continuous infusion to maintain an activated clotting time (ACT) ≥ 300 s. Our objective was to compare the effectiveness of this standard regimen (100 U/kg bolus) to a more aggressive approach (200 U/kg bolus). METHODS: We collected data on a series of consecutive patients undergoing left sided ablation procedures...
November 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/28401802/the-impact-of-gene-polymorphisms-on-anticoagulation-control-with-warfarin
#18
Hai He Jiang, Jia Liu, Yi Chen Wang, Hui Ming Ye, Xi Li, Ya Xing Zhou, Wei Zhang, Lian Sheng Wang
Differences in warfarin maintenance dosages based on the presence of polymorphisms in VKORC1, CYP2C9, CYP4F2, and ORM1 can be determined through dosage adjustment according to routine guidelines. Little is known about whether routine therapy could provide consensus anticoagulation control for patients with different genotypes. This study was carried out to compare anticoagulant control in patients with different genotypes. Six hundred seventy patients using warfarin according to Chinese guidelines were enrolled...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28399872/dose-dependent-artificial-prolongation-of-prothrombin-time-by-interaction-between-daptomycin-and-test-reagents-in-patients-receiving-warfarin-a-prospective-in-vivo-clinical-study
#19
Makoto Saito, Shuji Hatakeyama, Hideki Hashimoto, Takumitsu Suzuki, Daisuke Jubishi, Makoto Kaneko, Yukio Kume, Takehito Yamamoto, Hiroshi Suzuki, Hiroshi Yotsuyanagi
BACKGROUND: Daptomycin has been reported to cause artificial prolongation of prothrombin time (PT) by interacting with some test reagents of PT. This prolongation was particularly prominent with high concentrations of daptomycin in vitro. However, whether this prolongation is important in clinical settings and the optimal timing to assess PT remain unclear. METHODS: A prospective clinical study was conducted with patients who received daptomycin for confirmed or suspected drug-resistant, gram-positive bacterial infection at a university hospital in Japan...
April 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28398977/effect-of-international-normalized-ratio-monitoring-at-home-versus-the-clinic-on-monitoring-adherence-in-adults-taking-oral-anticoagulant-medications-a-systematic-review-protocol
#20
Lynndi M Price, Elizabeth Hinton
The objective of this review is to compare International Normalized Ratio (INR) monitoring adherence in two different settings: the outpatient INR clinic and the patient's home or residence. The review seeks to identify non-adherence trends in both settings to help providers determine which setting is best for patients on warfarin to improve INR monitoring adherence. Improved INR monitoring adherence correlates with maintaining routine INR testing.Specifically, the review question is what is the effect of home point-of-care INR monitoring compared to clinic monitoring on INR monitoring adherence in adults taking oral anticoagulant medications?...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
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