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International Normalized Ratio

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https://www.readbyqxmd.com/read/28812008/evaluation-of-adrenal-function-in-nonhospitalized-patients-with-cirrhosis
#1
Maryam Moini, Mitra Yazdani Sarvestani, Mesbah Shams, Masood Nomovi
BACKGROUND: Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. MATERIALS AND METHODS: In this study we prospectively evaluated adrenal function in a population of nonhospitalized cirrhotic patients. Categorization of liver disease severity was done according to model for end-stage liver disease (MELD) score...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28811593/prognostic-value-of-routine-laboratory-variables-in-prediction-of-breast-cancer-recurrence
#2
Zhu Zhu, Ling Li, Zhong Ye, Tong Fu, Ye Du, Aiping Shi, Di Wu, Ke Li, Yifan Zhu, Chun Wang, Zhimin Fan
The prognostic value of routine laboratory variables in breast cancer has been largely overlooked. Based on laboratory tests commonly performed in clinical practice, we aimed to develop a new model to predict disease free survival (DFS) after surgical removal of primary breast cancer. In a cohort of 1,596 breast cancer patients, we analyzed the associations of 33 laboratory variables with patient DFS. Based on 3 significant laboratory variables (hemoglobin, alkaline phosphatase, and international normalized ratio), together with important demographic and clinical variables, we developed a prognostic model, achieving the area under the curve of 0...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28806200/quality-of-anticoagulation-control-and-hemorrhage-risk-among-african-american-and-european-american-warfarin-users
#3
Nita A Limdi, Todd M Brown, Aditi Shendre, Nianjun Liu, Charles E Hill, Timothy M Beasley
OBJECTIVE: We evaluated whether percent time in target range (PTTR), risk of over-anticoagulation [international normalized ratio (INR)>4], and risk of hemorrhage differ by race. As PTTR is a strong predictor of hemorrhage risk, we also determined the influence of PTTR on the risk of hemorrhage by race. PARTICIPANTS AND METHODS: Among 1326 warfarin users, PTTR was calculated as the percentage of interpolated INR values within the target range of 2.0-3.0. PTTR was also categorized as poor (PTTR<60%), good (60≤PTTR<70%), or excellent (PTTR≥70%) anticoagulation control...
August 11, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28806096/results-of-anterior-cruciate-ligament-reconstruction-with-patellar-tendon-autografts-objective-factors-associated-with-the-development-of-osteoarthritis-at-20-to-33-years-after-surgery
#4
K Donald Shelbourne, Rodney W Benner, Tinker Gray
BACKGROUND: Few studies exist that report objective radiographic and physical examination results at >20 years after anterior cruciate ligament (ACL) reconstruction. HYPOTHESIS: The risk of osteoarthritis (OA) at >20 years after surgery would be statistically significantly higher if an increased severity of factors was present. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 1982 and 1994, 1428 knees met the inclusion criteria of being primary ACL surgery, having no existing OA or other ligamentous laxity, and having no known graft tear...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28804828/lupus-anticoagulant-testing-diluted-russell-viper-venom-time-drvvt
#5
Vittorio Pengo, Elisa Bison, Alessandra Banzato, Giacomo Zoppellaro, Seena Padayattil Jose, Gentian Denas
Diluted Russell Viper Venom Time (dRVVT) has become the most popular test to detect Lupus Anticoagulant (LA). dRVVT is more sensitive than other global tests employed to detect LA and is not affected by inhibitors of factor VIII or IX. The test is most successfully implemented if you observe three steps in its execution: screening, mixing, and confirmatory studies. Interference due to the presence of heparin in tested plasma must be excluded by means of thrombin time (TT). The prior use of Vitamin K Antagonists (VKAs) or Non-vitamin K Oral Anticoagulants (NOACs) must also be evaluated by means of International Normalized Ratio, or specific tests, respectively...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804818/optimizing-the-verification-of-mean-normal-prothrombin-time-mnpt-and-international-sensitivity-index-isi-for-accurate-conversion-of-prothrombin-time-pt-to-international-normalized-ratio-inr
#6
Emmanuel J Favaloro
The Prothrombin Time (PT) assay is the most common test performed in hemostasis laboratories, most commonly as converted to an international normalized ratio (INR) to monitor anticoagulant therapy using vitamin K antagonists (VKAs) such as warfarin. Although the INR is meant to standardize PT values by taking into consideration reagent and instrument variability, substantial inter-laboratory variation in INRs still exists and suggests that this can be further improved. This paper describes the PT test, its conversion to an INR value, and methods to improve the accuracy of INRs by improving the determination of critical components to the INR, namely the mean normal prothrombin time (MNPT) and the international sensitive index (ISI)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#7
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#8
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
August 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28800176/catheter-ablation-of-left-atrial-arrhythmias-on-uninterrupted-oral-anticoagulation-with-vitamin-k-antagonists-how-is-the-relationship-between-international-normalized-ratio-activated-clotting-time-and-procedure-related-complications
#9
Marc Kottmaier, Felix Bourier, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Carsten Lennerz, Sarah Lengauer, Marielouise Kornmayer, Elena Rousseva, Stephanie Brooks, Amir Brkic, Christian Grebmer, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
BACKGROUND: Ablation of atrial fibrillation (AF) on uninterrupted phenprocoumon reduces periprocedural thromboembolic and bleeding complications. Heparin is administered intraprocedurally to achieve activated clotting times (ACT) of 300-400 seconds. We investigated the effect of international normalized ratio (INR) on ACT and intraprocedural heparin requirements. Moreover, safety of a target ACT of 250-300 seconds was investigated. METHODS AND RESULTS: We studied 949 patients referred for AF or left atrial tachycardia ablation...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28798146/bloody-stools-in-a-3-day-old-term-infant
#10
Amelia Bray-Aschenbrenner, L Richard Feldenberg, Amelia Kirby, Colleen M Fitzpatrick, Justin B Josephsen
A 3-day-old term, male infant presented to the emergency department for evaluation of bloody stools. The infant was born after an uncomplicated pregnancy followed by a normal spontaneous vaginal delivery. The mother was group B Streptococcus colonized, and received antenatal penicillin prophylaxis. The infant received routine delivery room care, and was given ophthalmic erythromycin and intramuscular vitamin K. Circumcision was performed without bleeding and he was discharged from the newborn nursery and the hospital after 48 hours...
August 10, 2017: Pediatrics
https://www.readbyqxmd.com/read/28796860/trends-in-visual-health-inequalities-in-childhood-through-associations-of-visual-function-with-sex-and-social-position-across-3-uk-birth-cohorts
#11
Vasiliki Bountziouka, Phillippa M Cumberland, Jugnoo S Rahi
Importance: Despite the existing country-specific strategies tackling social inequalities in visual health in adults, little is known about trends in visual function in childhood and its association with social position. Objective: To investigate the distribution of childhood visual function in the United Kingdom and associations with early-life social position between 1961 and 1986, a period of significant social change. Design, Setting, and Participants: Longitudinal cohort study using harmonized data sets from the British 1946, 1958, and 1970 national birth cohorts...
August 10, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28795244/a-retrospective-study-on-the-risk-factors-for-bleeding-events-in-warfarin-therapy-focusing-on-renal-function
#12
Toshinori Hirai, Yukihiro Hamada, Yujiro Geka, Shiori Kuwana, Koji Hirai, Mai Ishibashi, Yutaka Fukaya, Toshimi Kimura
PURPOSE: The anticoagulant effect of warfarin used to treat stroke has been shown to vary with the concomitant use of medications and comorbidity. Concomitant use of antithrombotic drugs and underlying chronic kidney disease (CKD) represent risk factors for bleeding events. We conducted a comprehensive investigation of the background characteristics and concomitant use of drugs to identify the risk factors for warfarin-related bleeding, focusing on renal function. METHODS: The study population consisted of patients prescribed warfarin at the Tokyo Women's Medical University Hospital...
August 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28795139/elevated-preoperative-serum-bilirubin-improves-reperfusion-injury-and-survival-postliver-transplantation
#13
Vinzent Spetzler, Nicolas Goldaracena, Johann Moritz Kaths, Max Marquez, Markus Selzner, Nazia Selzner
BACKGROUND: The cytoprotective effects of hemeoxygenase-1 and its product biliverdin/bilirubin are widely acknowledged in experimental transplant medicine. However, its potentially beneficial effect during organ reperfusion is not established. METHODS: In a matched study, we compared markers of reperfusion injury (alanine aminotransferase/aspartate aminotransferase) and transplantation outcome (complication rates, liver function, and survival) between recipient groups with "normal" versus "increased" preoperative bilirubin values...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28790123/prognostic-significance-of-nonobstructive-left-main-coronary-artery-disease-in-women-versus-men-long-term-outcomes-from-the-confirm-coronary-ct-angiography-evaluation-for-clinical-outcomes-an-international-multicenter-registry
#14
Joe X Xie, Parham Eshtehardi, Tina Varghese, Abhinav Goyal, Puja K Mehta, William Kang, Jonathon Leipsic, Bríain Ó Hartaigh, C Noel Bairey Merz, Daniel S Berman, Heidi Gransar, Matthew J Budoff, Stephan Achenbach, Tracy Q Callister, Hugo Marques, Ronen Rubinshtein, Mouaz H Al-Mallah, Daniele Andreini, Gianluca Pontone, Filippo Cademartiri, Erica Maffei, Kavitha Chinnaiyan, Gilbert Raff, Martin Hadamitzky, Joerg Hausleiter, Gudrun Feuchtner, Philipp A Kaufmann, Todd C Villines, Benjamin J W Chow, James K Min, Leslee J Shaw
BACKGROUND: Patients with obstructive (≥50% stenosis) left main (LM) coronary artery disease (CAD) are at high risk for adverse events; prior studies have also documented worse outcomes among women than men with severe multivessel/LM CAD. However, the prognostic significance of nonobstructive (1%-49% stenosis) LM CAD, including sex-specific differences, has not been previously examined. METHODS AND RESULTS: In the long-term CONFIRM (Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter) registry, patients underwent elective coronary computed tomographic angiography for suspected CAD and were followed for 5 years...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28782264/anal-sphincter-defects-and-faecal-incontinence-15-24-years-after-first-delivery-a-cross-sectional-study
#15
Rodrigo A Guzmán Rojas, Kjell Å Salvesen, Ingrid Volløyhaug
OBJECTIVES: To establish the prevalence of external (EAS) and internal anal sphincter (IAS) defects 15-24 years after childbirth in association to mode of delivery and faecal incontinence (FI), and compare the proportion of obstetric anal sphincter injuries (OASIS) reported at delivery with defects on ultrasound. METHODS: This was a cross-sectional study including 563 women, who delivered their first child from 1990-97. Women responded to a validated questionnaire (PFDI) in 2013-14...
August 6, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28777135/hematologic-disorders-in-children-with-continuous-renal-replacement-therapies
#16
Celia Fabra, Sara Infante, Isabel Miras, Susana Pretus, María José Santiago, Sarah N Fernández, Jesús López-Herce
The objective of this study was to analyze hematologic disorders, coagulation disorders, and transfusion requirements in children with continuous renal replacement therapies (CRRT). This is a retrospective analysis of a prospectively collected database of children receiving CRRT between 2010 and 2015. Patient characteristics, CRRT parameters, hematologic and coagulation parameters, and need for transfusions were recorded and analyzed. We compared patients after heart surgery and noncardiac patients, those requiring extracorporeal membrane oxygenation (ECMO) and those without ECMO, and patients with different anticoagulation therapies: heparin and citrate...
August 1, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28768953/effects-of-tramadol-coadministration-on-prothrombin-time-international-normalized-ratio-in-patients-receiving-warfarin
#17
Tomomi Hosono, Aiko Kondo, Yasuyuki Kambayashi, Masato Homma
 Several case studies have reported a possible drug interaction between warfarin and tramadol where tramadol coadministration enhanced the antithrombotic effects of warfarin. To assess this drug interaction, changes in prothrombin time-international normalized ratio (PT-INR) before and after tramadol coadministration were investigated in patients receiving warfarin. For this study, we examined 54 patients (male/female: 22/32, 68.4±12.7 years) who were being treated with warfarin for deep vein thrombosis, atrial fibrillation, arteriosclerosis obliterans, congestive heart failure, and other vascular diseases...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28767558/liver-function-in-patients-with-nonalcoholic-fatty-liver-disease-randomized-to-roux-en-y-gastric-bypass-versus-sleeve-gastrectomy-a-secondary-analysis-of-a-randomized-clinical-trial
#18
Piotr Kalinowski, Rafał Paluszkiewicz, Bogna Ziarkiewicz-Wróblewska, Tadeusz Wróblewski, Piotr Remiszewski, Mariusz Grodzicki, Marek Krawczyk
OBJECTIVES: The aim of the study was to compare the influence of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB) on liver function in bariatric patients with non-alcoholic fatty liver disease (NAFLD) in a randomized clinical trial (NCT01806506). BACKGROUND: Rapid weight loss and malabsorption after bariatric surgery in patients with NAFLD or steatohepatitis (NASH) may impair liver function. METHODS: Sixty-six morbidly obese patients randomized to SG or RYGB were included in a secondary outcome analysis...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28766070/prothrombin-time-international-normalized-ratio-is-a-useful-marker-for-edoxaban-efficacy-in-preventing-venous-thromboembolism-after-total-knee-arthroplasty
#19
Kazuki Kodato, Kazunari Ishida, Nao Shibanuma, Akihiko Toda, Koji Takayama, Shinya Oka, Shinya Hayashi, Shingo Hashimoto, Masahiro Kurosaka, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Deep vein thrombosis (DVT) is one of the main complications following total knee arthroplasty (TKA). In this study, oral administration of 15 mg edoxaban (a factor Xa inhibitor) once daily for 14 days efficiently prevented the incidence of DVT. Our hypothesis was that prothrombin time-international normalized ratio (PT-INR) on the third postoperative day could predict the incidence of DVT following TKA. METHODS: In this study, 286 subjects were enrolled and divided into two groups according to the presence or absence of DVT...
August 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28763307/comparison-of-3-factor-versus-4-factor-prothrombin-complex-concentrate-with-regard-to-warfarin-reversal-blood-product-use-and-costs
#20
Jessica DeAngelo, Daniel Jarrell, Richard Cosgrove, James Camamo, Christopher Edwards, Asad E Patanwala
BACKGROUND: Prothrombin complex concentrates (PCCs) are drug products containing varying amounts of vitamin K-dependent coagulation factors II, VII, IX, and X. The evidence comparing 3-factor PCC (3-PCC) versus 4-factor PCC (4-PCC) for warfarin reversal is conflicting. It has been hypothesized that 3-PCC may be less effective than 4-PCC because of relatively lower factor VII content. STUDY QUESTION: The primary objective of this study was to compare international normalized ratio (INR) reversal between 3-PCC and 4-factor PCC (4-PCC) in warfarin-treated patients...
July 26, 2017: American Journal of Therapeutics
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