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International Normalized Ratio

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https://www.readbyqxmd.com/read/28079789/the-impact-of-irrigating-fluid-absorption-on-blood-coagulation-in-patients-undergoing-transurethral-resection-of-the-prostate-a-prospective-observational-study-using-rotational-thromboelastometry
#1
Hyun-Jung Shin, Hyo-Seok Na, Young-Tae Jeon, Hee-Pyoung Park, Sun-Woo Nam, Jung-Won Hwang
Although endoscopic transurethral resection of the prostate (TURP) is a well-established procedure as a treatment for benign prostatic hyperplasia, its complications remain a concern. Among these, coagulopathy may be caused by the absorption of irrigating fluid. This study aimed to evaluate such phenomenon using a rotational thromboelastometry (ROTEM).A total of 20 patients undergoing TURP participated in this study. A mixture of 2.7% sorbitol-0.54% mannitol solution and 1% ethanol was used as an irrigating fluid, and fluid absorption was measured via the ethanol concentration in expired breath...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079258/combined-effect-of-therapeutic-strategies-for-bleeding-injury-on-early-survival-transfusion-needs-and-correction-of-coagulopathy
#2
K Balvers, S van Dieren, K Baksaas-Aasen, C Gaarder, K Brohi, S Eaglestone, S Stanworth, P I Johansson, S R Ostrowski, J Stensballe, M Maegele, J C Goslings, N P Juffermans
BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. METHODS: A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate)...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28078470/appropriate-timing-to-start-and-optimal-response-evaluation-of-high-dose-corticosteroid-therapy-for-patients-with-acute-liver-failure
#3
Keisuke Kakisaka, Kojiro Kataoka, Yuji Suzuki, Hidekatsu Kuroda, Yasuhiro Takikawa
BACKGROUND: Corticosteroid therapy has been commonly administered to patients with acute liver injury (ALI)/acute liver failure (ALF) in Japan to prevent the development of hepatic encephalopathy, but the appropriate timing to start corticosteroid therapy has not been determined and optimal response evaluation of the therapy has not been conducted. We prospectively investigated the optimal timing to start therapy on the established severity indication: the Japan Hepatic Encephalopathy Prediction Model (JHEPM) and prothrombin time (PT)...
January 11, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28078111/percutaneous-biliary-drainage-catheter-insertion-in-patients-with-extensive-hepatic-metastatic-tumor-burden
#4
Eun L Langman, Paul V Suhocki, Herbert I Hurwitz, Michael A Morse, Rebecca A Burbridge, Tony P Smith, Charles Y Kim
BACKGROUND: Patients with metastatic disease of the liver can have hyperbilirubinemia due to a number of reasons, including biliary obstruction. The purpose of this study was to analyze patient outcomes after percutaneous biliary drainage (PBD) catheter insertion in patients with extensive hepatic metastatic tumor burden. METHODS: Out of 746 PBD insertions, 44 patients (24 males, 20 females, mean age 57.4 years, range, 34-80 years) had metastatic malignancy with a hepatic tumor burden of greater than 20% parenchymal volume based on pre-procedure computed tomography (CT) or magnetic resonance imaging (MRI)...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077330/dehydropachymic-acid-decreases-bafilomycin-a1-induced-%C3%AE-amyloid-accumulation-in-pc12-cells
#5
Mengyao Yu, Xiaoyan Xu, Nan Jiang, Wei Wei, Fang Li, Liming He, Xia Luo
ETHNOPHARMACOLOGICAL RELEVANCE: Fuling, the sclerotium of Poria cocos, was frequently used in traditional Chinese medicine (TCM) formulae for Alzheimer's disease (AD) intervention over the past 10 centuries. And its extracts exhibited significant effects in both cellular and animal models of AD in previous studies. However, its mechanisms on prevention and treatment of AD have not been well elucidated yet. AIM OF THE STUDY: To investigate the effect and corresponding mechanisms of dehydropachymic acid, which is one of the major triterpenes in Poria cocos, on the clearance of β-Amyloid accumulation in bafilomycin A1 induced PC12 cells...
January 7, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28072955/-clinical-analysis-of-12-patients-with-pediatric-antiphospholipid-syndrome-with-pulmonary-embolism
#6
J R Ma, H M Song, J Xiao, X Y Tang, Y Y He, M Wei
Objective: To identify the clinical and immunological characteristics of pediatric antiphospholipid syndrome (APS) patients with pulmonary embolism. Method: Among 47 pediatric APS patients from Peking Union Medical College Hospital during the year of 2000 to 2015, 12 patients were diagnosed of pulmonary embolism, who were investigated and compared with APS patients without pulmonary embolism. Result: Twelve patients (among whom 6 cases were primary and the other 6 were secondary APS)had pulmonary embolism and all of them were non-shock type, which was the first presenting manifestation in 6 of them...
January 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28070934/long-term-outcomes-after-mechanical-aortic-valve-replacement-with-aortic-root-enlargement-in-adolescents
#7
Zhiwei Xu, Qiuxia Shi, Ju Mei, Yan Tan
BACKGROUND: Deciding which prosthetic aortic valve to choose is difficult in adolescents who have not yet met their full growth potential. The aim of this study was to assess long-term outcomes following mechanical aortic valve replacement with aortic root enlargement in adolescents. METHODS: Between September 1997 and December 2006, 58 consecutive adolescents (49 male, 9 female, median age 15.5, range 13 to 17 years) underwent mechanical aortic valve replacement with aortic root enlargement...
January 10, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#8
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28063245/dosing-algorithms-for-vitamin-k-antagonists-across-vkorc1-and-cyp2c9-genotypes
#9
Ekaterina V Baranova, Talitha I Verhoef, Georgia Ragia, Saskia Le Cessie, Folkert W Asselbergs, Anthonius de Boer, Vangelis G Manolopoulos, Anke H Maitland-van der Zee
BACKGROUND: The multicenter, single-blind, randomized EU-PACT trial compared safety and efficacy of genotype-guided and non-genetic dosing algorithms for acenocoumarol and phenprocoumon in patients with atrial fibrillation or deep venous thrombosis. The trial showed no differences in the primary outcome between the two dosing strategies. OBJECTIVES: To explore possible reasons for the lack of differences between trial arms this secondary analysis of EU-PACT data evaluated the performance of both dosing algorithms across VKORC1-CYP2C9 genetic sub-groups...
January 7, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28062209/thromboelastogram-does-not-detect-pre-injury-anticoagulation-in-acute-trauma-patients
#10
Jawad T Ali, Mitchell J Daley, Nina Vadiei, Zachary Enright, Joseph Nguyen, Sadia Ali, Jayson D Aydelotte, Pedro G Teixeira, Thomas B Coopwood, Carlos Vr Brown
PURPOSE: Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC. METHODS: This retrospective chart review evaluated all trauma patients admitted to an urban, level one trauma center from February 2011 to September 2014 who received a TEG within the first 24h...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060142/the-importance-of-appendectomy-in-surgery-for-mucinous-adenocarcinoma-of-the-ovary
#11
Mikkel Rosendahl, Laura Amalie Haueberg Oester, Claus Kim Høgdall
OBJECTIVE: The aim of this study was to assess the importance of appendectomy during surgery for mucinous ovarian cancer. It can be difficult to distinguish between primary ovarian and primary appendiceal cancers clinically, histologically, and immunohistochemically. Removal of the appendix may facilitate differential diagnosis, improve staging, and possibly increase 5-year survival but may also be associated with increased postsurgical morbidity. In the largest population published to date, we analyze and discuss these matters...
January 4, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28058824/the-effect-of-amiodarone-on-warfarin-anticoagulation-a-register-based-nationwide-cohort-study-involving-the-swedish-population
#12
Johan Holm, Jonatan D Lindh, Marine L Andersson, Buster Mannheimer
BACKGROUND: Data indicate that the interaction between warfarin and amiodarone results in increased warfarin effect. There are several large, well-performed studies using genetic and clinical factors such as comedication to predict an adequate starting dose of warfarin. However, longitudinal data on the effect of introducing amiodarone in patients on an ongoing warfarin regime are more scarce. OBJECTIVES: An investigation of how initiation of amiodarone affects the anticoagulant effect and dosing of warfarin, using data from three nation-wide registries...
January 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28058699/international-coordinator-survey-results-on-the-outpatient-management-of-patients-with-the-heartware%C3%A2-ventricular-assist-system
#13
Thomas Schlöglhofer, Desiree Robson, Jayne Bancroft, Gro Sørensen, Friedrich Kaufmann, Leslie Sweet, Neil Wrightson
PURPOSE: While the HeartWare® Ventricular Assist System (HVAS) is a successful therapy for end-stage heart failure, outpatient management methods can vary significantly and require further investigation. METHODS: A survey to assess the long-term HVAS patient management and monitoring strategies was completed by 36 international heart centers that currently have over 1,450 patients on VAD support either at home or in the hospital. Multiple choice questions examined VAD program characteristics, anticoagulation management, driveline exit-site dressing and showering recommendations, blood pressure and pump parameter monitoring, and patient discharge protocols...
December 26, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#14
E Rafflenbeul, J Müller-Ehmsen
Atrial fibrillation and venous thromboembolisms are frequent cardiovascular diseases. Until a few years ago only vitamin K antagonists (VKA) were available for oral anticoagulation as primary and secondary prevention of thrombembolic events. Currently, the non-vitamin K dependent new oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban and edoxaban are approved for use. The approval studies, meta-analyses and data from registries provide evidence for the superiority of NOAC vs. VKA with respect to reduction of thrombembolisms and reduced bleeding complications; therefore, in the 2016 European Society of Cardiology (ESC) guidelines the use of NOAC is recommended as first line therapy for anticoagulation in atrial fibrillation (recommendation grade I/evidence level A)...
January 5, 2017: Der Internist
https://www.readbyqxmd.com/read/28057952/direct-thrombin-inhibitor-resistance-and-possible-mechanisms
#15
Maria Cardinale, Michael Ha, Michael H Liu, David P Reardon
Objective: To report 3 cases in which doses of bivalirudin higher than commonly used in clinical practice were required in order to achieve therapeutic anticoagulation as monitored by the activated partial thromboplastin time (aPTT). Case Summary: The medical records of 3 patients who required large doses of bivalirudin to remain therapeutic were thoroughly reviewed. In all 3 patients, bivalirudin was initiated at a rate appropriate for the patients' renal function and titrated using a nurse-driven protocol with recommended dose adjustments based on aPTT...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28057806/12-15-lipoxygenase-inhibition-or-knockout-reduces-warfarin-associated-hemorrhagic-transformation-after-experimental-stroke
#16
Yu Liu, Yi Zheng, Hulya Karatas, Xiaoying Wang, Christian Foerch, Eng H Lo, Klaus van Leyen
BACKGROUND AND PURPOSE: For stroke prevention, patients with atrial fibrillation typically receive oral anticoagulation. The commonly used anticoagulant warfarin increases the risk of hemorrhagic transformation (HT) when a stroke occurs; tissue-type plasminogen activator treatment is therefore restricted in these patients. This study was designed to test the hypothesis that 12/15-lipoxygenase (12/15-LOX) inhibition would reduce HT in warfarin-treated mice subjected to experimental stroke...
January 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28056701/rivaroxaban-vs-warfarin-on-extended-deep-venous-thromboembolism-treatment-a-cost-analysis
#17
Adem I Diken, Adnan Yalçınkaya, Muhammet O Hanedan, Mehmet E Erol, Özlem E Diken
Background Standard treatment for deep venous thromboembolism involves parenteral anticoagulation overlapping with a vitamin K antagonist, an approach that is effective but associated with limitations including the need for frequent coagulation monitoring. The direct oral anticoagulant rivaroxaban is similarly effective to standard therapy as a single-drug treatment for venous thromboembolism and does not require routine coagulation monitoring. The aim of this analysis was to project the long-term costs and outcomes for rivaroxaban compared to standard of care (tinzaparin/warfarin)...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28056524/venous-thromboembolism-requiring-extended-anticoagulation-among-hiv-infected-patients-in-a-rural-resource-constrained-setting-in-western-kenya
#18
John Kanyi, Rakhi Karwa, Sonak Dinesh Pastakia, Imran Manji, Simon Manyara, Collins Saina
BACKGROUND: HIV-infected patients are at an increased risk of developing venous thromboembolism (VTE), and minimal data are available to describe the need for extended treatment. OBJECTIVE: To evaluate the frequency of and determine predictive risk factors for extended anticoagulation of VTE in HIV-infected patients in rural, western Kenya. METHODS: A retrospective chart review was conducted at the Anticoagulation Monitoring Service affiliated with Moi Teaching and Referral Hospital and the Academic Model Providing Access to Healthcare...
December 1, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28055147/monitoring-of-treatment-with-vitamin-k-antagonists-recombinant-thromboplastins-are-more-sensitive-to-factor-vii-than-tissue-extract-thromboplastins
#19
Joseph S Biedermann, Antonius M H P van den Besselaar, Moniek P M de Maat, Frank W G Leebeek, Marieke J H A Kruip
BACKGROUND: Differences regarding sensitivity to factor VII (FVII) have been suggested for recombinant human and tissue-extract thromboplastins used for International Normalized Ratio (INR) measurement, but evidence is scarce. Differences in FVII sensitivity are clinically relevant since they can affect INR stability during treatment with vitamin K antagonists (VKA). OBJECTIVES: To determine if commercial thromboplastins react differently to changes in FVII. METHODS: We studied the effect of addition of FVII on the INR in plasma using three tissue-extract (Neoplastin C1+, Hepato Quick, Thromborel S) and three recombinant human (Recombiplastin 2G, Innovin, Coaguchek XS) thromboplastins...
January 5, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28054385/pre-liver-transplant-red-cell-distribution-width-predicts-post-liver-transplant-mortality
#20
M Thure Caire, Ambuj Kumar, R Todd Stravitz, Nyingi Kemmer
PURPOSE: Prognostication following liver transplantation is limited. Red cell distribution width has been associated with morbidity and mortality in a variety of diseases. We hypothesize Red cell distribution width is predictive of mortality post liver transplantation. METHODS: We performed a retrospective cohort study of all consecutive liver transplantation recipients at a tertiary care center from Jan 1 2012 - Dec 31 2012. The primary end point was association of red cell distribution width with 1 year mortality...
January 5, 2017: Clinical Transplantation
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