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International Normalized Ratio

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https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#1
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329347/off-treatment-hepatitis-b-virus-hbv-dna-levels-and-the-prediction-of-relapse-after-discontinuation-of-nucleos-t-ide-analogue-therapy-in-patients-with-chronic-hepatitis-b-a-prospective-stop-study
#2
Jiawei Cao, Heng Chi, Tao Yu, Zhandong Li, Bettina E Hansen, Xiaoyong Zhang, Chunxiu Zhong, Jian Sun, Jinlin Hou, Harry L A Janssen, Jie Peng
Background.: The optimal management remains unknown after nucleos(t)ide analogue (NA) discontinuation in patients with chronic hepatitis B (CHB). This prospective study investigated the role of off-treatment viral kinetics in predicting relapse after discontinuation of NA therapy. Methods.: A total of 82 noncirrhotic Asian patients with CHB who discontinued NA therapy according to international guidelines were prospectively followed. Patients with a hepatitis B virus (HBV) DNA level of >2000 IU/mL and an alanine aminotransferase (ALT) level of >2 times the upper limit of normal (clinical relapse) were retreated...
January 19, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329309/changes-in-oral-anticoagulation-for-elective-cardioversion-results-from-a-european-cardioversion-registry
#3
Judit Papp, Endre Zima, Ramon Bover, Rasa Karaliute, Andrea Rossi, Catherine Szymanski, Rossella Troccoli, Jonas Schneider, Morten Wang Fagerland, A John Camm, Dan Atar
Aims: In patients with atrial fibrillation (AF) pharmacological or electrical cardioversion may be performed to restore sinus rhythm. The procedure is associated with an increased risk of thromboembolic events, which can be significantly reduced by adequate anticoagulation (OAC). Our aim was to create a partly prospective, partly retrospective cardioversion registry, particularly focusing on OAC strategies in different European countries, and on emerging choice of OAC over time. Methods: From September 2014 to October 2015, cardioversions due to AF performed in six European city hospitals in five European countries (Hungary: Budapest-1 and -2; Italy: Bari and Pisa; France: Amiens; Spain: Madrid; and Lithuania: Kaunas) were recorded in the registry...
March 17, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28329135/low-target-inr-anticoagulation-is-safe-in-selected-aortic-valve-patients-with-the-medtronic-open-pivot-mechanical-prosthesis-long-term-results-of-a-propensity-matched-comparison-with-standard-anticoagulation
#4
Thierry Bové, Yves Van Belleghem, Katrien François, Frank Caes, Michel De Pauw, Yves Taeymans, Guido J Van Nooten
OBJECTIVES: To investigate the long-term results of a low international normalized ratio (INR)-anticoagulation program in selected patients after aortic valve replacement (AVR) with the Medtronic Open Pivot mechanical heart valve (OPMHV). METHODS: From January 1993 to December 2012, 909 OPMHV valves were used for single AVR. Patients with preserved sinus rhythm and left ventricular function (Low-INR, n  = 552), were managed to an INR of 1.5-2.5 and compared to patients (Standard-INR, n  = 357) treated with standard anticoagulation (INR 2...
March 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28323831/genetic-assessment-of-age-associated-alzheimer-disease-risk-development-and-validation-of-a-polygenic-hazard-score
#5
Rahul S Desikan, Chun Chieh Fan, Yunpeng Wang, Andrew J Schork, Howard J Cabral, L Adrienne Cupples, Wesley K Thompson, Lilah Besser, Walter A Kukull, Dominic Holland, Chi-Hua Chen, James B Brewer, David S Karow, Karolina Kauppi, Aree Witoelar, Celeste M Karch, Luke W Bonham, Jennifer S Yokoyama, Howard J Rosen, Bruce L Miller, William P Dillon, David M Wilson, Christopher P Hess, Margaret Pericak-Vance, Jonathan L Haines, Lindsay A Farrer, Richard Mayeux, John Hardy, Alison M Goate, Bradley T Hyman, Gerard D Schellenberg, Linda K McEvoy, Ole A Andreassen, Anders M Dale
BACKGROUND: Identifying individuals at risk for developing Alzheimer disease (AD) is of utmost importance. Although genetic studies have identified AD-associated SNPs in APOE and other genes, genetic information has not been integrated into an epidemiological framework for risk prediction. METHODS AND FINDINGS: Using genotype data from 17,008 AD cases and 37,154 controls from the International Genomics of Alzheimer's Project (IGAP Stage 1), we identified AD-associated SNPs (at p < 10-5)...
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28318185/neonatal-acute-liver-failure-a-diagnosis-challenge
#6
Mirta Ciocca, Fernando Álvarez
Neonatal acute liver failure is a rare, very severe disease with a high rate of mortality. It is clinically and etiologically different from acute liver failure seen in older children and adults. Coagulopathy with an international normalized ratio ≥ 3 is the critical parameter that defines it. The most common causes are fetal alloimmune hepatitis, previously called neonatal hemochromatosis, viral infections, metabolic disorders, and hemophagocytic lymphohistiocytosis. There is a group of treatable diseases that require a very early diagnosis for the prescription of an adequate treatment...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28317415/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#7
Hugh Calkins, Stephan Willems, Edward P Gerstenfeld, Atul Verma, Richard Schilling, Stefan H Hohnloser, Ken Okumura, Harvey Serota, Matias Nordaby, Kelly Guiver, Branislav Biss, Marc A Brouwer, Massimo Grimaldi
Background Catheter ablation of atrial fibrillation is typically performed with uninterrupted anticoagulation with warfarin or interrupted non-vitamin K antagonist oral anticoagulant therapy. Uninterrupted anticoagulation with a non-vitamin K antagonist oral anticoagulant, such as dabigatran, may be safer; however, controlled data are lacking. We investigated the safety of uninterrupted dabigatran versus warfarin in patients undergoing ablation of atrial fibrillation. Methods In this randomized, open-label, multicenter, controlled trial with blinded adjudicated end-point assessments, we randomly assigned patients scheduled for catheter ablation of paroxysmal or persistent atrial fibrillation to receive either dabigatran (150 mg twice daily) or warfarin (target international normalized ratio, 2...
March 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28317274/quality-of-warfarin-therapy-and-risk-of-stroke-bleeding-and-mortality-among-patients-with-atrial-fibrillation-results-from-the-nationwide-finwaf-registry
#8
Mika Lehto, Jussi Niiranen, Pasi Korhonen, Juha Mehtälä, Houssem Khanfir, Fabian Hoti, Riitta Lassila, Pekka Raatikainen
PURPOSE: The most important management strategy in atrial fibrillation (AF) patients is preventing stroke with oral anticoagulants. Warfarin is still used as a first-line anticoagulant, although non-vitamin K antagonist oral anticoagulants are currently recommended to manage AF. Using a large, unselected national sample of AF patients, we evaluated the relationships between quality of warfarin therapy and the risks of thromboembolism, bleeding complications, and mortality. METHODS: The nationwide FinWAF study included 54 568 AF patients taking warfarin...
March 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28317031/effect-of-tranexamic-acid-on-coagulation-and-fibrinolysis-in-women-with-postpartum-haemorrhage-woman-etac-protocol-and-statistical-analysis-plan-for-a-randomized-controlled-trial
#9
Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Sumaya Huque, Meghann Gregg, Ian Roberts
Background: Postpartum haemorrhage (PPH) is a leading cause of maternal death. Tranexamic acid has the potential to reduce bleeding and a large randomized controlled trial of its effect on maternal health outcomes in women with PPH (The WOMAN trial) is ongoing. We will examine the effect of tranexamic acid on fibrinolysis and coagulation in a subset of WOMAN trial participants. Methods. Adult women with clinically diagnosed primary PPH after vaginal or caesarean delivery are eligible for inclusion in the WOMAN trial...
December 16, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28316135/variability-of-cut-off-values-for-the-detection-of-lupus-anticoagulants-results-of-an-international-multicenter-multiplatform-study
#10
Armando Tripodi, Veena Chantarangkul, Michela Cini, Katrien Devreese, Jeffrey S Dlott, Roberta Giacomello, Elaine Gray, Cristina Legnani, Marta E Martinuzzo, Paola Pradella, Annelie Siegemund, Sitalakshmi Subramanian, Pierre Suchon, Sophie Testa
BACKGROUND: Cut-off values for results interpretation of lupus anticoagulant (LA) detection are poorly investigated. AIMS: (i) To assess whether results from healthy donors were normally distributed and (ii) the between-laboratories differences of cut-off values for screening, mixing and LA confirmation when calculated as 99(th) or 95(th) centiles, and (iii) to assess their impact on LA detection-rate. METHODS: Each of 11 labs using one of the 3 widely-used commercial platforms for LA detection was asked to collect plasmas from 120 healthy donors and to perform screening, mixing and LA confirmation with two methods (activated partial thromboplastin time [APTT]- and dilute Russell viper venom [dRVV]-derived)...
March 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28315904/prognostic-value-of-bone-marrow-18-f-fdg-uptake-on-pet-ct-in-lymphoma-patients-with-negative-bone-marrow-involvement
#11
Jeong Won Lee, Sang Cheol Lee, Han Jo Kim, Sang Mi Lee
OBJECTIVE: The study evaluated the significance of 18F fluorodeoxyglucose ((18)F-FDG) uptake of bone marrow (BM) for predicting progression-free survival (PFS) in lymphoma patients without BM involvement. SUBJECTS AND METHODS: Ninety-five patients with histopathologically proven lymphoma, 7 Hodgkin's lymphoma and 88 non-Hodgkin's lymphoma, who underwent (18)F-FDG positron emission tomography/computed tomography (PET/CT) and BM biopsy for staging work-up and 40 normal subjects were retrospectively enrolled...
March 20, 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28304106/therapeutic-plasma-exchange-versus-double-plasma-molecular-absorption-system-in-hepatitis-b-virus-infected-acute-on-chronic-liver-failure-treated-by-entercavir-a-prospective-study
#12
Yue-Meng Wan, Yu-Hua Li, Zhi-Yuan Xu, Jing Yang, Li-Hong Yang, Ying Xu, Jin-Hui Yang
BACKGROUND: Therapeutic plasma exchange (TPE) and double plasma molecular absorption system (DPMAS) were two extracorporeal liver support systems. Few studies compared their efficacy profile. OBJECTIVE: This study was to compare the efficacy of TPE and DPMAS on acute-on-chronic liver failure (ACLF) caused by hepatitis B virus (HBV-ACLF). METHODS: 60 HBV-ACLF patients were enrolled and prospectively studied. All patients received entecavir therapy, and were assigned to TPE group (n = 33) and DPMAS group (n = 27)...
March 17, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28302116/portals-design-of-an-innovative-approach-to-anticoagulation-management-through-ehealth
#13
E P W A Talboom-Kamp, N A Verdijk, I J S H Talboom, L M Harmans, M E Numans, N H Chavannes
BACKGROUND: For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes...
March 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28301912/potential-causes-and-implications-of-low-target-therapeutic-ratio-in-warfarin-treated-patients-for-thrombosis-prophylaxis
#14
Halil Atas, Ahmet Anıl Sahin, Dilek Barutçu Atas, Murat Sunbul, Alper Kepez, Mehmet Agirbasli
Time in therapeutic range (TTR) of international normalized ratio is crucial for the safety and efficacy of anticoagulation with warfarin and it is influenced by many factors. There are limited data about the quality of warfarin therapy and its effects on clinical outcomes in Turkey. The aim of this study is to demonstrate the quality of anticoagulant therapy with warfarin and evaluate the parameters that affect the quality of warfarin therapy. A total of 170 patients with atrial fibrillation (AF; mean age: 62...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#15
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296356/positional-changes-of-the-ocular-organs-during-craniofacial-development
#16
Miho Osaka, Aoi Ishikawa, Shigehito Yamada, Chigako Uwabe, Hirohiko Imai, Tetsuya Matsuda, Akio Yoneyama, Tohoru Takeda, Tetsuya Takakuwa
The present study aimed to describe the positional changes of the ocular organs during craniofacial development; moreover, we examined the relationships among the ocular organs and other internal structures. To do this, we traced the positions of the ocular organs in 56 human early fetal samples at different stages of development using high-resolution magnetic resonance imaging and phase-contrast X-ray computed tomography. The eyes were located on the lateral side in the ventral view at Carnegie stage (CS) 16, and then changed their positions medially during development...
March 13, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28296129/comparing-thrombin-generation-in-patients-with-hemophilia-a-and-patients-on-vitamin-k-antagonists
#17
M L Y de Koning, K Fischer, B de Laat, A Huisman, M Ninivaggi, R E G Schutgens
BACKGROUND: It is unknown whether patients with hemophilia A with atrial fibrillation require treatment with vitamin K antagonists (VKA) to the same extent as the normal population. OBJECTIVE: To compare hemostatic potential in hemophilia patients and patients on VKA using thrombin generation (TG). METHODS: In this cross-sectional study, TG, initiated with 1pM tissue factor, was measured in 133 patients with severe (FVIII <1%, n=15) and non-severe (FVIII 1-50%, n=118) hemophilia A, 97 patients on VKA with an international normalized ratio (INR) ≥1...
March 15, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28292814/critical-international-normalized-ratio-results-after-hours-to-call-or-not-to-call
#18
Darlene Korn, M Sean McMurtry, Kirsten George-Phillips, Tammy J Bungard
OBJECTIVE: To determine whether the timing of notification of critical international normalized ratio (INR) results (during or after clinic hours) altered the clinician's ability to affect same-day patient care. DESIGN: Retrospective chart review. SETTING: The Anticoagulation Management Service at the University of Alberta Hospital in Edmonton. PARTICIPANTS: A total of 276 patients with critical INR results (> 5.0) separated by at least 30 days were identified to have 200 critical INR results reported during clinic hours and 200 reported after hours...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28291892/association-of-preceding-antithrombotic-treatment-with-acute-ischemic-stroke-severity-and-in-hospital-outcomes-among-patients-with-atrial-fibrillation
#19
MULTICENTER STUDY
Ying Xian, Emily C O'Brien, Li Liang, Haolin Xu, Lee H Schwamm, Gregg C Fonarow, Deepak L Bhatt, Eric E Smith, DaiWai M Olson, Lesley Maisch, Deidre Hannah, Brianna Lindholm, Barbara L Lytle, Michael J Pencina, Adrian F Hernandez, Eric D Peterson
Importance: Antithrombotic therapies are known to prevent stroke for patients with atrial fibrillation (AF) but are often underused in community practice. Objectives: To examine the prevalence of patients with acute ischemic stroke with known history of AF who were not receiving guideline-recommended antithrombotic treatment before stroke and to determine the association of preceding antithrombotic therapy with stroke severity and in-hospital outcomes. Design, Setting, and Participants: Retrospective observational study of 94 474 patients with acute ischemic stroke and known history of AF admitted from October 2012 through March 2015 to 1622 hospitals participating in the Get With the Guidelines-Stroke program...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28291768/case-report-of-serratus-plane-catheter-for-pain-management-in-a-patient-with-multiple-rib-fractures-and-an-inferior-scapular-fracture
#20
Peter Fu, Paul D Weyker, Christopher A J Webb
We placed a superficial serratus anterior plane catheter in an elderly woman with dementia and elevated clotting times who presented with multiple rib fractures after a mechanical fall. She was not a surgical candidate, and treatment consisted of conservative management with physical therapy and pain control. She was not a candidate for a patient-controlled analgesia regimen because of her dementia. Given her elevated international normalized ratio, thoracic epidural and paravertebral analgesia was also contraindicated...
March 15, 2017: A & A Case Reports
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