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https://www.readbyqxmd.com/read/29470561/safety-and-efficacy-of-cosmetic-augmentation-of-the-nasal-tip-and-nasal-dorsum-with-expanded-polytetrafluoroethylene-a-randomized-clinical-trial
#1
Yifei Gu, Wenxin Yu, Yunbo Jin, Hui Chen, Gang Ma, Shih-Jen Chang, Xiaoxi Lin
Importance: Expanded polytetrafluoroethylene (ePTFE) is a widely used alloplast, but studies of augmentation of the nasal tip and nasal dorsum with ePTFE are lacking. Objective: To investigate whether attaching the conchal cartilage as shield grafts at the distal end of the graft can prevent extrusion and whether the use of ePTFE in the nasal tip can achieve a stable aesthetic outcome. Design, Setting, and Participants: A randomized clinical trial was performed from April 1, 2006, to October 31, 2008...
February 22, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29469043/viscoelastic-testing-in-liver-disease
#2
Jessica P E Davis, Patrick G Northup, Stephen H Caldwell, Nicolas M Intagliata
Long thought to be hypocoagulable, new evidence suggests cirrhosis patients have "rebalanced" coagulation in the setting of decreased synthesis of both pro- and anti-coagulant factors. Traditional testing like PT/INR reflects only the decreased synthesis of pro-coagulant factors and thus does not correspond to bleeding or clotting risk in this population. In this review, we discuss the use of viscoelastic testing (VET), an assay of global hemostasis in cirrhosis patients. We describe the technique and interpretation of commercially available VET and assess the application of VET in both transplant and non-transplant cirrhosis populations...
March 1, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29468979/potentiation-of-warfarin-associated-with-salsalate-therapy-resulting-in-bleeding
#3
Joseph P Rindone, Chadwick K Mellen
BACKGROUND: Salsalate may offer many advantages over other non-steroidal anti-inflammatory agents in patients taking warfarin, however a drug-drug interaction may occur which has not been reported in the medical literature or by the manufacturer of salsalate. OBJECTIVE: To report a case of warfarin potentiation associated with salsalate treatment, which resulted in bleeding. METHODS: Clinical review of the course of a patient, who was stable on warfarin when salsalate therapy was added for chronic pain...
February 19, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29468795/suboptimal-use-of-pharmacological-venous-thromboembolism-prophylaxis-in-cirrhotic-patients
#4
Linda S Yang, Sumaya Alukaidey, Katherine Croucher, Damian Dowling
BACKGROUND: Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both pro-coagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. AIM: We aim to assess the rate of pharmacological prophylaxis for VTE among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld...
February 21, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29466222/-randomized-comparison-of-two-approaches-to-initial-warfarin-dosing-time-in-therapeutic-range-of-international-normalized-ratio-during-hospitalization
#5
I G Gordeev, O V Averkov, L N Mishchenko, N N Levchuk, V I Vechorko
AIM: To perform a randomized, open-label comparison of average time in therapeutic range (TTR) of international normalized ratio (INR) using two approaches to initial warfarin dosing during hospitalization: the standard method and the one using individual patient characteristics (clinical algorithm - the studied approach). MATERIALS AND METHODS: We randomly assigned 60 patients with different indications for vitamin K antagonist therapy to the studied approach (n=31, intervention group) or to the standard method (n=29, control group)...
September 2017: Kardiologiia
https://www.readbyqxmd.com/read/29464418/annual-costs-attributed-to-atrial-fibrillation-management-cross-sectional-study-of-primary-healthcare-electronic-records
#6
Marc Casajuana, Maria Giner-Soriano, Albert Roso-Llorach, Cristina Vedia, Concepció Violan, Rosa Morros
Atrial fibrillation (AF) is the most common chronic arrhythmia, with increasing healthcare and economic burden and a prevalence which increases with progressive ageing. This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug therapy...
February 20, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29463153/suspected-adverse-drug-reaction-reports-with-oral-anticoagulants-in-portugal-a-pharmacovigilance-study
#7
Daniel Caldeira, Raquel Rodrigues, Daisy Abreu, Ana Marta Anes, Mário M Rosa, Joaquim J Ferreira
OBJECTIVE: In this pharmacovigilance study, we aimed to determine the incidence of spontaneously reported suspected adverse drug reactions (ADRs) related to oral anticoagulants: non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban, rivaroxaban) and vitamin K antagonists (VKA) Research design and methods: In this retrospective observational study, we extracted all the individual case safety reports related to oral anticoagulants recorded in the Portuguese Pharmacovigilance Database (January 2010 to April 2015)...
February 20, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29462165/thromboelastometry-profile-in-critically-ill-patients-a-single-center-retrospective-observational-study
#8
Tomaz Crochemore, Thiago Domingos Corrêa, Marcus D Lance, Cristina Solomon, Ary Serpa Neto, João Carlos de Campos Guerra, Priscila Scolmeister Lellis, Livia Muller Bernz, Natalia Nunes, Cassio Massashi Mancio, Ana Paula Hitomi Yokoyama, Eliézer Silva
BACKGROUND: Transfusion therapy is associated with increased morbidity, mortality and costs. Conventional coagulation tests (CCT) are weak bleeding predictors, poorly reflecting coagulation in vivo. Thromboelastometry (ROTEM) provides early identification of coagulation disorders and can guide transfusion therapy by goals, reducing blood components transfusion. OBJECTIVE: The aim of this study is to describe coagulation profile of critically ill patients using ROTEM and evaluate the association between CCT and thromboelastometry...
2018: PloS One
https://www.readbyqxmd.com/read/29462053/vitamin-k-antagonists-and-emergencies
#9
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29461279/individualized-antithrombotic-therapy-in-heartware-hvad-recipients
#10
Erik N Sorensen, Hannah J Voorhees, Lynn M Dees, Si M Pham, Zachary N Kon, Bartley P Griffith, Erika D Feller
There are no evidence-based guidelines for antithrombotic therapy in left ventricular assist device patients. We evaluated the efficacy of a multi-agent, test-guided protocol, which remained consistent throughout our use of the Heartware HVAD. Thrombelastography and PFA-100 guide antiplatelet titration. Goals are normal kaolin thrombelastography maximum amplitude and prolonged PFA-100. We analyzed incidence and rates of nonprocedural bleeding, stroke, and pump thrombosis for all 81 primary Heartware left ventricular assist devices implanted since 2011...
February 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29459455/pearls-oy-sters-delayed-progression-of-isolated-cortical-vein-thrombosis-despite-therapeutic-inr
#11
Paul Gadient, Dimitri Archer, Negar Asdaghi
No abstract text is available yet for this article.
February 20, 2018: Neurology
https://www.readbyqxmd.com/read/29458277/inductive-effect-of-a-ritonavir-containing-hepatitis-c-treatment-regimen-on-warfarin-in-a-patient-a-case-report
#12
Audrey C Rosene, Jaymee L Gaspar
The warfarin management strategy for a mechanical mitral valve patient initiated on a ritonavir-based hepatitis C treatment regimen is described. A 62-year-old male with a past medical history of hepatitis C genotype 1a and stable warfarin dose history was initiated on a concomitant Viekira Pak® (VP) regimen containing ritonavir. Prior to initiation of the VP for hepatitis C treatment, the patient was stable on a warfarin dose of 40 mg/wk for 5 months. During treatment with VP, the patient experienced a markedly decreased international normalized ratio (INR) and warfarin requirements ultimately increased 125% from baseline (90 mg/wk)...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29456138/the-inr-akt-torc1-growth-promoting-signaling-negatively-regulates-jak-stat-activity-and-migratory-cell-fate-during-morphogenesis
#13
Di Kang, Dou Wang, Jianbing Xu, Chao Quan, Xuan Guo, Heng Wang, Jun Luo, Zhongzhou Yang, Shuai Chen, Jiong Chen
Cell growth and cell differentiation are two distinct yet coupled developmental processes, but how they are coordinated is not well understood. During Drosophila oogenesis, we found that the growth-promoting InR/Akt/TOR pathway was involved in suppressing the fate determination of the migratory border cells. The InR/Akt/TOR pathway signals through TOR and Raptor, components of TORC1, to downregulate the JAK/STAT pathway, which is necessary and sufficient for border cell fate determination. TORC1 promotes the protein stability of SOCS36E, the conserved negative regulator of JAK/STAT signaling, through physical interaction, suggesting that TORC1 acts as a key regulator coordinating both cell growth and cell differentiation...
February 9, 2018: Developmental Cell
https://www.readbyqxmd.com/read/29454558/clinical-characteristics-and-management-of-patients-with-atrial-fibrillation-treated-with-direct-oral-anticoagulants-according-to-blood-pressure-control
#14
M de la Figuera, S Cinza, I Egocheaga, N Marín, M A Prieto
OBJECTIVE: To determine the clinical characteristics and management of hypertensive patients with nonvalvular atrial fibrillation (AF) treated with direct oral anticoagulants (DOACs) according to blood pressure (BP) control. METHODS: For this purpose, data from two observational, cross-sectional and multicenter studies were combined. In both studies, patients on chronic treatment with anticoagulants and that were on current treatment with DOACs at least for 3 months were included...
February 14, 2018: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#15
Burr Fong, Daniel Novak, Michael Dalley, Gregory Alfred
BACKGROUND: Deep vein thrombosis (DVT) is a common disease that is diagnosed in approximately 1 in 1000 adults annually. Extensive DVT can lead to life- or limb-threatening diagnoses such as phlegmasia cerulea dolens (PCD), phlegmasia alba dolens, and venous gangrene. PCD, also known as massive iliofemoral venous thrombosis, is rare, and a severe complication of DVT. CASE REPORT: We report a case of a 94-year-old bedridden woman with past medical history of dementia, hypertension, pulmonary embolism, DVT, and atrial fibrillation...
February 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29448930/a-prediction-study-of-warfarin-individual-stable-dose-after-mechanical-heart-valve-replacement-adaptive-neural-fuzzy-inference-system-prediction
#16
Huan Tao, Qian Li, Qin Zhou, Jie Chen, Bo Fu, Jing Wang, Wenzhe Qin, Jianglong Hou, Jin Chen, Li Dong
BACKGROUND: It's difficult but urgent to achieve the individualized rational medication of the warfarin, we aim to predict the individualized warfarin stable dose though the artificial intelligent Adaptive neural-fuzzy inference system (ANFIS). METHODS: Our retrospective analysis based on a clinical database, involving 21,863 patients from 15 Chinese provinces who receive oral warfarin after the heart valve replacement. They were allocated into four groups: the external validation group (A group), the internal validation group (B group), training group (C group) and stratified training group (D group)...
February 15, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29447781/prediction-of-long-term-net-clinical-outcomes-using-the-timi-af-score-comparison-with-cha-2-ds-2-vasc-and-has-bled
#17
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
The TIMI-AF score was described to predict net clinical outcomes (NCOs) in atrial fibrillation (AF) patients receiving warfarin. However, this score derived from the ENGAGE AF-TIMI 48 trial, and no external validation exists in real world clinical practice. We tested the long-term predictive performance of the TIMI-AF score in comparison with CHA 2 DS 2 -VASc and HAS-BLED in a 'real-world' cohort of anticoagulated AF patients. METHODS: We included 1156 consecutive AF patients stable on vitamin K antagonist (INR 2...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#18
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440949/the-prevalence-of-long-term-oral-anticoagulation-therapy-in-a-cardiology-center-in-bucharest-romania
#19
Adelina-Mihaela Sorescu, Tudor Enache, Suzana Guberna
Background and aims: Few studies discuss the prevalence of oral anticoagulation therapy (OAT) in clinical practice, despite their increasing use worldwide. In America, studies established that 20% to 80% of the patients with indication benefit from OAT. In Romania, there is no data regarding the utilization of oral anticoagulants. Thus, this study aims to determine the trends of OAT. Methods: We designed a cross-sectional study of the patients admitted to the Cardiology Department of the "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, from the 1st of November 2016 until the 31st of January 2017...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29440623/bleeding-complications-related-to-right-heart-catheterization-in-the-setting-of-elevated-inr
#20
Jared Betz, Kelly Jia, Scott Lilly, Konstantinos Marmagkiolis, Ernest L Mazzaferri, Konstantinos Dean Boudoulas
OBJECTIVES: Right heart catheterization (RHC) provides cardiovascular hemodynamic information in a variety of clinical settings. RHC performed in the setting of coagulopathy may have the potential to increase bleeding complications; however, data currently are limited. This study was undertaken to determine bleeding complications during RHC with an elevated international normalized ratio (INR) value. METHODS: A total of 312 patients who underwent RHC were retrospectively studied...
February 15, 2018: Journal of Invasive Cardiology
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