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International Normalized Ratio

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https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#1
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28915306/cost-utility-study-of-warfarin-genotyping-in-the-vachs-affiliated-anticoagulation-clinic-of-puerto-rico
#2
Carlos Martes-Martinez, Cristian Méndez-Sepúlveda, Joel Millán-Molina, Matthew French-Kim, Heriberto Marín-Centeno, Giselle C Rivera-Miranda, José J Hernández-Muñoz, Jorge Duconge-Soler
OBJECTIVE: To evaluate the cost-utility of the pharmacogenetic-guided dosing of warfarin (PGx), when compared to the current dosing strategy. METHODS: A Markov model was developed to assess the impact of the genotypingguided warfarin dosing in a hypothetical cohort of patients. The model was based on the percentage of time patients spent within the therapeutic international normalized ratio (INR) range (PTTR). PTTR estimates and genotype distribution were derived from a cohort of patients (n = 206) treated in the Veteran Affairs Caribbean Healthcare System (VACHS) and from results of other research study...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28914698/male-hepatitis-c-patients-sexual-functioning-and-its-determinants
#3
Christos K Triantos, Aggeliki Tsintoni, Katerina Karaivazoglou, Xristina Grigoropoulou, Chrysostomos Tsolias, Georgia Diamantopoulou, Gregoris Iconomou, Konstantinos Thomopoulos, Chrisoula Labropoulou-Karatza, Konstantinos Assimakopoulos
OBJECTIVE: The aim of the study was to detect sexual impairment in male hepatitis C virus patients and determine its associations. PATIENTS AND METHODS: A total of 61 male hepatitis C virus patients were enrolled in this cross-sectional study. Sexual functioning was assessed using the International Index of Erectile Function. Health-related quality of life (HRQOL) was evaluated using the Greek version of the Short Form 36 Health Survey, and the presence and severity of anxiety and depression were assessed using the Greek version of the Hospital Anxiety and Depression Scale...
September 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28912200/development-and-validation-of-electronic-quality-measures-to-assess-care-for-patients-with-transient-ischemic-attack-and-minor-ischemic-stroke
#4
Dawn M Bravata, Laura J Myers, Eric Cheng, Mathew Reeves, Fitsum Baye, Zhangsheng Yu, Teresa Damush, Edward J Miech, Jason Sico, Michael Phipps, Alan Zillich, Jason Johanning, Seemant Chaturvedi, Curt Austin, Jared Ferguson, Bailey Maryfield, Kathy Snow, Susan Ofner, Glenn Graham, Rachel Rhude, Linda S Williams, Greg Arling
BACKGROUND: Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy of such data is largely unknown. We sought to develop and validate transient ischemic attack and minor ischemic stroke electronic quality measures (eQMs) using EHR data. METHODS AND RESULTS: A random sample of patients with transient ischemic attack or minor ischemic stroke, cared for in Veterans Health Administration facilities (fiscal year 2011), was identified...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28910501/serum-cystatin-c-level-is-an-excellent-predictor-of-mortality-in-patients-with-cirrhotic-ascites
#5
Yeon Seok Seo, Soo Young Park, Moon Young Kim, Sang Gyune Kim, Jun Yong Park, Hyung Joon Yim, Byoung Kuk Jang, Seung Ha Park, Ji Hoon Kim, Ki Tae Suk, Jin Dong Kim, Tae Yeob Kim, Eun Young Cho, Jun Sung Lee, Soung Won Jung, Jae Young Jang, Hyonggin An, Won Young Tak, Soon Koo Baik, Jae Seok Hwang, Young Seok Kim, Joo Hyun Sohn, Soon Ho Um
BACKGROUND/AIMS: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. METHODS: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1)...
September 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28902040/long-term-rifaximin-therapy-as-a-primary-prevention-of-hepatorenal-syndrome
#6
El-Sayed Ibrahim, Ayman Alsebaey, Hassan Zaghla, Sabry Moawad Abdelmageed, Khalid Gameel, Eman Abdelsameea
BACKGROUND: Hepatorenal syndrome (HRS) is a severe complication of liver cirrhosis, with poor survival. Rifaximin is a gut-selective broad-spectrum antibiotic. AIM: The aim of this study was to evaluate the role of rifaximin as a primary prevention of HRS. PATIENTS AND METHODS: Eighty patients with liver cirrhosis and ascites were enrolled. They were randomized into two groups: control (n=40) and rifaximin group (n=40). Baseline liver function tests, renal function tests, complete blood count, international normalized ratio, urine analysis, and abdominal ultrasonography were carried out...
September 8, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28901605/enzalutamide-warfarin-interaction-necessitating-warfarin-dosage-adjustment-a-case-report-of-successful-clinical-management
#7
J L Parrett, A B Reaves, T H Self, R E Owens
WHAT IS KNOWN AND OBJECTIVES: Enzalutamide package labeling recommends avoiding concurrent warfarin use due to potential reductions in warfarin concentrations via enzalutamide-associated hepatic enzyme induction. A case of successful management of this interaction via warfarin adjustments is reported. CASE DESCRIPTION: A 77-year-old Caucasian male, previously relatively stable on warfarin 42-45 mg weekly, reported to clinic after the recent start of enzalutamide and subsequent hospitalization with a subtherapeutic International Normalized Ratio (INR)...
September 12, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#8
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28898990/real-time-clinical-decision-support-decreases-inappropriate-plasma-transfusion
#9
Neil Shah, Steven A Baker, David Spain, Lisa Shieh, John Shepard, Eric Hadhazy, Paul Maggio, Lawrence T Goodnough
Objectives: To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. Methods: The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period...
August 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28895444/d-dimer-elevation-as-a-blood-biomarker-for-detection-of-structural-disorder-in-mild-traumatic-brain-injury
#10
Kazutaka Sugimoto, Eiichi Suehiro, Mizuya Shinoyama, Hirokazu Sadahiro, Kouhei Haji, Yuichi Fujiyama, Reo Kawano, Mitsuaki Nishioka, Michiyasu Suzuki
Computed tomography (CT) scans are useful in patients with traumatic brain injury (TBI), but the potential risks associated with ionizing radiation are unknown. Furthermore, CT scans are not commonly available in developing countries. In this study, coagulopathy and abnormal fibrinolysis were investigated as blood biomarkers for detection of structural disorder in mild TBI. A total of 88 patients with mild and isolated TBI (Glasgow Coma Scale (GCS) score 14-15) were admitted to Kenwakai Ootemachi Hospital between October 2014 and March 2016...
September 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28894528/notification-of-international-normalized-ratio-test-in-atrial-fibrillation-patients-treated-with-warfarin-via-short-message-service-study-protocol-for-a-randomized-controlled-trial
#11
Reza Sheibani, Mehdi Sheibani, Yamin Hejazi, Saeid Eslami
BACKGROUND: Atrial Fibrillation (AF) is the most common abnormal heart rhythm. AF patients usually use warfarin therapy. Safety and efficacy of warfarin are dependent on maintaining the International Normalized Ratio (INR) within the therapeutic range. OBJECTIVE: We will use a Short Message Service (SMS) to evaluate the effect of a reminder on carrying out the INR laboratory test in a timely manner. METHODS: This study (a Randomized Controlled Trial) will be done in Loghman hospital Tehran, Iran...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28894377/hpip-a-predictor-of-lymph-node-metastasis-and-poor-survival-in-cervical-cancer
#12
Shan Cao, Jingxia Sun, Shuai Lin, Lu Zhao, Di Wu, Tian Liang, Wenji Sheng
BACKGROUND: The aim of this study was to explore the relationships of HPIP expression status with the clinicopathological variables and survival outcomes of patients with cervical cancer (CC). METHODS: We compared the HPIP expression of 119 samples from CC tissues, 20 from cervical intraepithelial tissues, and 20 from normal cervical tissues by using immunohistochemical staining. RESULTS: It was observed that the ratio of elevated HPIP expression was higher in CC tissues than in cervical intraepithelial neoplasia (P=0...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28892526/rivaroxaban-vs-warfarin-sodium-in-the-ultra-early-period-after-atrial-fibrillation-related-mild-ischemic-stroke-a-randomized-clinical-trial
#13
Keun-Sik Hong, Sun U Kwon, Sang Hun Lee, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu
Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation...
September 11, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#14
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28889724/effects-of-the-combined-administration-of-entecavir-and-adefovir-dipivoxil-to-improve-hepatic-fibrosis-in-hepatitis-b-patients-with-interferon-resistance
#15
Yuqiu Sun, Keqin Wu, Fei Shen, Ling Qiu, Binhe Chen, Lijun Yu, Shuzhen Chang
OBJECTIVE: To observe the effect of the combined administration of entecavir and adefovir dipivoxil to improve hepatic fibrosis in hepatitis B patients with interferon resistance. PATIENTS AND METHODS: This study comprised 90 hepatitis B patients with hepatic fibrosis and interferon (IFN) resistance who were admitted in the hospital's department of infectious disease for diagnosis and treatment between January 2013 and September 2015. They were randomly divided into two groups in accordance with the random number table: (1) the combination treatment group (n = 45), and (2) the entecavir group (n = 45)...
September 8, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28885999/weight-change-in-older-adults-and-mortality-the-multiethnic-cohort-study
#16
S-Y Park, L R Wilkens, G Maskarinec, C A Haiman, L N Kolonel, L L Marchand
OBJECTIVE: To investigate the association between weight change in older adults and mortality in a multiethnic population. METHODS: We performed a prospective analysis using data on weight change between the baseline (1993-1996) and the 10-year follow-up (2003-2007) surveys in relation to subsequent mortality among 63 040 participants in the Multiethnic Cohort Study in Hawaii and California. The participants were African American, Native Hawaiian, Japanese American, Latino and white, aged 45-75 years at baseline, and did not report heart disease or cancer at either survey...
August 14, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28885956/combat-casualties-and-severe-shock-risk-factors-for-death-at-role-3-military-facilities
#17
Michelle F Buehner, Brian J Eastridge, James K Aden, Joseph J DuBose, Lorne H Blackbourne, Ramon F Cestero
BACKGROUND: Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885525/variables-to-predict-mortality-in-hip-fractures-in-patients-over-65-years-of-age-a-study-on-the-role-of-anticoagulation-as-a-risk-factor
#18
Carmen M Sarabia-Cobo, María Sáenz-Jalón, Begoña Vélez-Carrera, M Eugenia Miguel Martín, Gema Rodríguez Landeras, Elena Roscales San Bartolomé, Marta Santiago Fernández, Carmen Higuero-Piris, Patricia Artabe Pozas, Sandra Espeso Salas, Sonia Briz Casares
The objective of this research was to study the possible relationship between the consumption of dicoumarinic agents (understanding the consumption of acenocoumarol as regulated and monitored anticoagulation) and the mortality rate in people older than 65 years undergoing a hip fracture (HF) intervention. It was a retrospective, observational and descriptive study. Nine hundred fifty-seven patients were included who underwent an intervention for HF between the years 2012 and 2014 in a third-level hospital. Patients took acenocoumarol (16...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28883749/student-selected-component-in-the-medical-curriculum-investigations-and-psychiatric-referral-for-paracetamol-overdose-in-an-accident-and-emergency-department
#19
James G Cowman, Manuel Bakheet
BACKGROUND: A student-selected component (SSC) of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28881666/more-precise-prediction-in-chinese-patients-with-penile-squamous-cell-carcinoma-protein-kinase-ck2%C3%AE-catalytic-subunit-ck2%C3%AE-as-a-poor-prognosticator
#20
Zai-Shang Li, Chuang-Zhong Deng, Yun-Lin Ye, Kai Yao, Sheng-Jie Guo, Jie-Ping Chen, Yong-Hong Li, Zi-Ke Qin, Zhuo-Wei Liu, Bin Wang, Qi Zhao, Peng Chen, Qi-Wu Mi, Xiao-Feng Chen, Hui Han, Fang-Jian Zhou
PURPOSE: In this study, we assess the CK2α expression in human penile squamous cell carcinoma (SCC) and its clinical significance. METHODS: A total of 157 human penile SCC tissue samples were immunohistochemically analyzed. In addition, 12 human penile SCC and adjacent normal tissues were examined for CK2α protein and mRNA expression by Western blotting and real-time quantitative PCR, respectively. Survival was analyzed using the Kaplan-Meier test and the log-rank test...
August 1, 2017: Oncotarget
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