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International Normalized Ratio

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https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#1
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/28724836/prothrombin-complex-concentrate-for-vitamin-k-antagonist-associated-intracranial-hemorrhage%C3%A3-global-evidence-and-the-japanese-perspective
#2
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/28724442/impact-of-obesity-on-the-response-to-tumor-necrosis-factor-inhibitors-in-axial-spondyloarthritis
#3
Raphael Micheroli, Monika Hebeisen, Lukas M Wildi, Pascale Exer, Giorgio Tamborrini, Jürg Bernhard, Burkhard Möller, Pascal Zufferey, Michael J Nissen, Almut Scherer, Adrian Ciurea
BACKGROUND: Few studies have investigated the impact of obesity on the response to tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA). The aim of our study was to investigate the impact of different body mass index (BMI) categories on TNFi response in a large cohort of patients with axSpA. METHODS: Patients with axSpA within the Swiss Clinical Quality Management (SCQM) program were included in the current study if they fulfilled the Assessment in Spondyloarthritis International Society (ASAS) criteria for axSpA, started a first TNFi after recruitment, and had available BMI data as well as a baseline and follow-up visit at 1 year (±6 months)...
July 19, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28722092/-predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-vascular-occlusive-diseases
#4
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/28721346/prediction-of-survival-following-percutaneous-biliary-drainage-for-malignant-biliary-obstruction
#5
Wa'el Tuqan, Ayoub Innabi, Alia Alawneh, Fadi Abu Farsakh, Maan Al-Khatib
BACKGROUND AND OBJECTIVES: Percutaneous transhepatic biliary drain is an intervention used to relieve malignant biliary obstruction. This study aims to explore survival after biliary drain insertion, predictive factors of survival and effectiveness to reduce total bilirubin level. METHODS: We conducted a retrospective analysis of 72 patients who had malignant biliary obstruction and received biliary drain during the time period between March 2005 and February 2015...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28718527/evaluation-of-intralesional-injection-of-hyaluronic-acid-compared-with-verapamil-in-peyronie-s-disease-preliminary-results-from-a-prospective-double-blinded-randomized-study
#6
V Favilla, G I Russo, A Zucchi, G Siracusa, S Privitera, S Cimino, M Madonia, T Cai, G Cavallini, G Liguori, G D'Achille, M Silvani, G Franco, P Verze, A Palmieri, B Torrisi, V Mirone, G Morgia
Several intralesional therapeutic protocols have been proposed for the treatment of Peyronie's disease. Among all, hyaluronic acid (HA) and verapamil have been differently tested. We aimed to evaluate the efficacy of intralesional verapamil (ILVI) compared with intralesional HA in patients with early onset of Peyronie's disease (PD). This is a multi-centre prospective double-arm, randomized, double-blinded study comparing ILVI vs. intralesional HA after 12-weeks. Sexually active men, older than 18 years and affected by the acute phase of PD were eligible for this study...
July 2017: Andrology
https://www.readbyqxmd.com/read/28718296/real-life-management-of-venous-thromboembolism-with-rivaroxaban-results-from-experience-vte-an-italian-epidemiological-survey
#7
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
#8
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/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#9
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28709756/postoperative-outcomes-associated-with-neuraxial-vs-general-anesthesia-following-bilateral-total-knee-arthroplasty
#10
Jeffrey B Walker, Patrick L Nguyen, Ulrich H Schmidt, Rodney A Gabriel
BACKGROUND: There is sparse evidence on the benefit of neuraxial (NA) vs general anesthesia (GA) as the primary anesthetic in postoperative outcomes following bilateral total knee arthroplasty. We sought to elucidate differences in outcomes in this surgical population using a national database. METHODS: We used data from the National Surgical Quality Improvement Program from 2007 to 2013 and compared rates of various postoperative outcomes in propensity-matched cohorts (NA vs GA)...
June 23, 2017: Journal of Arthroplasty
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
#11
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
#12
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/28708531/relationships-among-early-postpartum-luteal-activity-parity-and-insemination-outcomes-based-on-in-line-milk-progesterone-profiles-in-canadian-holstein-cows
#13
Tony C Bruinjé, Marcos G Colazo, Mohanathas Gobikrushanth, Divakar J Ambrose
The objectives of this retrospective study were to use in-line milk progesterone (mP4) data to investigate relationships of (1) commencement of luteal activity (CLA), and (2) luteal phase (LP) length and frequency preceding first postpartum AI, with parity and AI outcomes in Canadian Holstein cows. Starting 21 ± 1 days postpartum (DPP), levels of mP4 were assessed every 2.2 ± 2.0 d through an automated in-line milk analysis system (Herd Navigator™, DeLaval International, Tumba, Sweden) until ∼55 d after first or second AI in 748 Holstein cows from two herds...
May 27, 2017: Theriogenology
https://www.readbyqxmd.com/read/28707694/trapping-desorption-and-direct-scattering-of-formaldehyde-at-au-111
#14
Bastian C Krüger, G Barratt Park, Sven Meyer, Roman J V Wagner, Alec M Wodtke, Tim Schäfer
Nonreactive surface scattering of atoms, molecules and clusters can be almost universally described by two mechanisms: trapping-desorption and direct-scattering. A hard cube model with an attractive square well provides a zeroth order description of the branching ratio between these two mechanisms as a function of the incidence energy. However, the trapping process is likely to be enhanced by excitation of internal degrees of freedom during the collision. In this molecular beam surface scattering study, we characterize formaldehyde/Au(111) scattering using angle resolved time-of-flight techniques...
July 14, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28707652/thermal-ablation-in-the-management-of-adrenal-metastasis-originating-from-non-small-cell-lung-cancer-a-5-year-single-center-experience
#15
Evanthia I Botsa, Ioanna L Thanou, Aspasia T Papatheodoropoulou, Loukas I Thanos
BACKGROUND: Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients. However, not all patients can undergo surgery; thus, minimally invasive ablation procedures such as radiofrequency ablation (RFA) and microwave ablation (MWA) have gained acceptance as alternative treatment methods. This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography (CT)-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer (NSCLC)...
July 13, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28704393/whole-exome-sequence-based-association-analyses-of-plasma-amyloid-%C3%AE-in-african-and-european-americans-the-atherosclerosis-risk-in-communities-neurocognitive-study
#16
Jeannette Simino, Zhiying Wang, Jan Bressler, Vincent Chouraki, Qiong Yang, Steven G Younkin, Sudha Seshadri, Myriam Fornage, Eric Boerwinkle, Thomas H Mosley
OBJECTIVE: We performed single-variant and gene-based association analyses of plasma amyloid-β (aβ) concentrations using whole exome sequence from 1,414 African and European Americans. Our goal was to identify genes that influence plasma aβ42 concentrations and aβ42:aβ40 ratios in late middle age (mean = 59 years), old age (mean = 77 years), or change over time (mean = 18 years). METHODS: Plasma aβ measures were linearly regressed onto age, gender, APOE ε4 carrier status, and time elapsed between visits (fold-changes only) separately by race...
2017: PloS One
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/28701443/critical-elevation-of-international-normalized-ratio-in-an-elderly-woman-using-a-natural-health-product
#18
Kevin Pottie, Kamila Premji, Sitelle Léonie Cheskey
No abstract text is available yet for this article.
July 2017: Canadian Family Physician Médecin de Famille Canadien
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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