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Anticoagulant therapy

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https://www.readbyqxmd.com/read/28734880/dual-versus-single-antiplatelet-regimen-with-or-without-anticoagulation-in-transcatheter-aortic-valve-replacement-indirect-comparison-and-meta-analysis
#1
Monica Verdoia, Lucia Barbieri, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
INTRODUCTION AND OBJECTIVES: There is uncertainty on the correct management of antithrombotic therapies after transcatheter aortic valve replacement (TAVR), with dual antiplatelet therapy (DAPT) being currently recommended on an empirical basis. The aim of the present meta-analysis was to assess the safety and effectiveness of DAPT in patients undergoing TAVR. METHODS: Studies comparing different antithrombotic regimens after TAVR were included. The primary endpoint was 30-day overall mortality...
July 19, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28734839/recombinant-expression-of-ixolaris-a-kunitz-type-inhibitor-from-the-tick-salivary-gland-for-nmr-studies
#2
V S De Paula, F H S Silva, I M B Francischetti, R Q Monteiro, A P Valente
Ixolaris is an anticoagulant protein identified in the tick saliva of Ixodes scapularis. Ixolaris contains 2 Kunitz like domains and binds to Factor Xa or Factor X as a scaffold for inhibition of the Tissue Factor (TF)/Factor VIIa (FVIIa). In contrast to tissue factor pathway inhibitor (TFPI), however, Ixolaris does not bind to the active site cleft of FXa. Instead, complex formation is mediated by the FXa heparin-binding exosite. Due to its potent and long-lasting antithrombotic activity, Ixolaris is a promising agent for anticoagulant therapy...
July 19, 2017: Protein Expression and Purification
https://www.readbyqxmd.com/read/28733910/a-review-study-to-evaluate-holmium-yag-laser-lithotripsy-with-flexible-ureteroscopy-in-patients-on-ongoing-oral-anticoagulant-therapy
#3
Bulent Altay, Bulent Erkurt, Selami Albayrak
The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified...
July 22, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28733177/transjugular-local-thrombolysis-with-without-tips-in-patients-with-acute-non-cirrhotic-non-malignant-portal-vein-thrombosis
#4
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
BACKGROUND & AIMS: Therapeutic anticoagulation is the standard treatment in patients with acute non-cirrhotic portal vein thrombosis (PVT). In critically ill patients, anticoagulation only may not suffice to achive rapid and stable recanalization. This study evaluates efficacy and safety of transjugular interventional therapy in acute non-cirrhotic PVT. METHODS: This retrospective study includes 17 consecutive patients with acute noncirrhotic, non-malignant PVT...
June 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28733121/paradoxical-embolism-in-a-girl-with-atrial-septal-defect-after-paroxysmal-supraventricular-tachycardia-ablation
#5
Xiang Chen, Zhijun Zhu, Danning Wu
Paradoxical embolism is a kind of important pathogenesis of cardiocerebrovascular diseases. In our case, radiofrequency current catheter ablation was accomplished successfully in a 15-year-old girl who had been experiencing supraventricular tachycardia for 6 months. She presented with abrupt onset of left hemiplegia and loss of consciousness on the first postoperative day. An urgent cerebral computed tomography showed a hyperdense right middle cerebral artery. Transthoracic echocardiogram examination revealed an atrial septal defect (ASD), with the diameter measuring 39 mm...
July 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#6
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28730690/incorporating-comprehensive-management-of-direct-oral-anticoagulants-into-anticoagulation-clinics
#7
Insaf Mohammad, Bianca Korkis, Candice L Garwood
Anticoagulation clinics emerged as a means to optimize warfarin effectiveness and minimize bleeding risks. Anticoagulation clinics have traditionally been warfarin-based models due to the need for frequent blood level monitoring, drug interactions, dietary considerations, and periprocedural management with warfarin. These models have demonstrated improved anticoagulation control and reduced bleeding complications for patients taking warfarin. Direct oral anticoagulants (DOACs) emerged with the perception of improved convenience due to the lack of blood level monitoring and lack of dietary considerations...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28730619/real-world-adherence-and-persistence-with-direct-oral-anticoagulants-in-adults-with-atrial-fibrillation
#8
Beenish S Manzoor, Todd A Lee, Lisa K Sharp, Surrey M Walton, William L Galanter, Edith A Nutescu
BACKGROUND: Evidence of adherence and persistence patterns in anticoagulation (AC) therapy comparing treatment-naïve and non-naïve patients is lacking. The objective of this study was to evaluate patterns of medication adherence and persistence in a real-world setting among AC-naïve and AC-experienced atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs). METHODS: AF patients newly initiating a DOAC with a minimum of 6 months of continuous health plan enrollment pre and post-index date (first DOAC prescription) were identified from the Truven Health MarketScan(®) Commercial and Medicare Supplemental databases (2009-2013)...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28730501/the-pseudo-sah-sign-an-imaging-pitfall-in-postmortem-computed-tomography
#9
Go Shirota, Wataru Gonoi, Masako Ikemura, Masanori Ishida, Yukako Shintani, Hiroyuki Abe, Masashi Fukayama, Tomohiko Higashida, Hidemi Okuma, Osamu Abe
Postmortem computed tomography (PMCT) of the brain has an important role in detection of subarachnoid hemorrhage (SAH), which has a high mortality rate. However, a phenomenon known as "pseudo-SAH," or high-attenuation areas along the cisterns mimicking SAH, may be seen on CT. The aim of this study was to evaluate the diagnostic accuracy of brain PMCT for SAH and to identify the characteristics of pseudo-SAH. Findings on PMCT (sulcal effacement, asymmetry, maximum thickness of SAH signs, presence of acute/subacute intraventricular/intraparenchymal hemorrhage) and clinical history (left ventricular assist device [LVAD] implantation, anticoagulation therapy/coagulation disorder, global ischemia) were compared between subjects with true SAH and those with pseudo-SAH...
July 20, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#10
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28727645/retroperitoneal-hemorrhage-after-sacral-neurostimulator-placement-for-urgency-urinary-incontinence
#11
Casey L Kinman, Deslyn T G Hobson, Anubhav Agrawal, Martin S Vyleta, Sean L Francis
Sacral neuromodulation (SNM) is an effective therapy for patients who experience urinary incontinence, idiopathic urinary retention, and fecal incontinence. Although typically a low-risk procedure, rarely, it can be associated with significant hemorrhage. A 61-year-old woman on chronic anticoagulation underwent uncomplicated implantation of SNM for refractory urgency urinary incontinence. Anticoagulation was held on the day of surgery and resumed on postoperative day 1. On postoperative day 2, the patient developed an extensive retroperitoneal hemorrhage...
July 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#12
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28725494/apixaban-for-treatment-of-confirmed-heparin-induced-thrombocytopenia-a-case-report-and-review-of-literature
#13
Daniel E Ezekwudo, Rebecca Chacko, Bolanle Gbadamosi, Syeda Batool, Sussana Gaikazian, Theodore E Warkentin, Jo-Ann I Sheppard, Ishmael Jaiyesimi
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening condition caused by the binding of platelet-activating antibodies (IgG) to multimolecular platelet factor 4 (PF4)/heparin complexes because of heparin exposure. The by-product of this interaction is thrombin formation which substantially increases the risk of venous and/or arterial thromboembolism. Currently, only one anticoagulant, argatroban, is United States Food and Drug Administration-approved for management of HIT; however, this agent is expensive and can only be given by intravenous infusion...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28725249/two-years-results-of-electronic-brachytherapy-for-basal-cell-carcinoma
#14
Rosa Ballester-Sánchez, Olga Pons-Llanas, Cristian Candela-Juan, Blanca de Unamuno-Bustos, Francisco Javier Celada-Alvarez, Alejandro Tormo-Mico, Jose Perez-Calatayud, Rafael Botella-Estrada
PURPOSE: The use of radiation therapy (RT) for non-melanoma skin cancer (NMSC) has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT) devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28724879/infectious-complications-in-patients-with-cardiac-implantable-electronic-devices-risk-factors-prevention-and-prognosis
#15
Anna Polewczyk, Wojciech Jacheć, Aneta Maria Polewczyk, Andrzej Tomasik, Marianna Janion, Andrzej Kutarski
INTRODUCTION    Cardiac device infections (CDI) are still a significant problem. The knowledge of risk factors for CDI is crucial both for preventing infections and reducing mortality. OBJECTIVES    The assesment of the risk factors and long term survival of patients with CDI. PATIENTS AND METHODS    The clinical data of 1837 patients (40.9% CDI) undergoing transvenous leads extraction (TLE) at a single institution from 2006 to 2015 was analyzed. We compared the clinical and procedure-related factors for all types of CDI: isolated pocket infection (IPI), isolated lead-related infective endocarditis (ILRIE) and PI+LRIE...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28724563/management-of-anticoagulant-and-antiplatelet-therapy-in-patients-undergoing-interventional-pulmonary-procedures
#16
REVIEW
Vikas Pathak, J Erin Allender, Mollie W Grant
There has been great progress in antithrombotic therapy over the past several years. Its use has increased with the advent of novel anticoagulants, as these medications do not require frequent blood tests for monitoring. Antithrombotic therapy is aimed at reducing the risk of thromboembolic events in patients with atrial fibrillation, coronary artery disease, deep vein thrombosis, valvular heart disease and pulmonary embolism. These patients are often critically ill and frequently undergo urgent interventions requiring discontinuation of anticoagulant or antiplatelet therapy which can increase the risk of thrombosis; however, continuing these agents can lead to increased risk of haemorrhage...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28724320/statins-and-venous-thromboembolism-do-they-represent-a-viable-therapeutic-agent
#17
Setor K Kunutsor, Michael R Whitehouse, Ashley W Blom, Jari A Laukkanen
Venous thromboembolism (VTE) is an important cause of preventable morbidity and mortality. Though anticoagulants are effective in preventing VTE, they are associated with major bleeding risk. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (known as statins), are well established for the primary and secondary prevention of cardiovascular disease via their lipid-lowering properties. Emerging evidence suggests that statins may play a role in the prevention of VTE, but the evidence has been uncertain...
July 21, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28722795/influence-of-renal-function-on-anticoagulation-control-in-patients-with-non-valvular-atrial-fibrillation-taking-vitamin-k-antagonists
#18
José M Lobos-Bejarano, Angel Castellanos Rodríguez, Vivencio Barrios, Carlos Escobar, José Polo-García, José Carlos Del Castillo-Rodríguez, Diego Vargas-Ortega, Adriana Lopez-Pineda, Luis Prieto-Valiente, Gregory Y H Lip
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD...
July 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28721832/biomarkers-associated-with-bleeding-risk-in-the-setting-of-atrial-fibrillation
#19
Skevos Sideris, Stefanos Archontakis, George Latsios, George Lazaros, Konstantinos Toutouzas, Eleftherios Tsiamis, Manolis Vavuranakis, Charalampos Vlachopoulos, Konstantinos Gatzoulis, Konstantinos Tsioufis, Dimitris Tousoulis
Background Prevention of thromboembolic disease, mainly stroke, with oral anticoagulants remains a major therapeutic goal in patients with atrial fibrillation. Unfortunately, despite the high efficacy, anticoagulant therapy is associated with a significant risk of, frequently catastrophic, hemorrhagic complications. Among different clinical and laboratory parameters related to an increased risk of bleeding, several biological markers have been recognized and various risk scores for bleeding have been developed...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28721209/recent-advances-in-preventing-stroke-recurrence
#20
REVIEW
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
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