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https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#1
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429927/endovascular-correction-in-acute-bleeding-after-femoropopliteal-bypass-a-single-centre-experience
#2
Giulia Mazzitelli, Mariagnese Mele, Francesco Setacci, Giuseppe Galzerano, Gianmarco DE Donato, Domenico Benevento, Massimiliano W Guerrieri, Carlo Setacci
INTRODUCTION: The endovascular correction (EC) has emerged in recent years as a possible alternative to surgical revision (SR) in case of bleeding complications after peripheral bypass (PB) . The purpose of this study is to evaluate the efficacy and safety of EC compared to SR in case of bleeding complications of PB. METHODS: From January 2004 to December 2014, we have submitted 32 patients to surgery for acute bleeding in previous PB (25 venous bypass, in situ or reversed, 6 PTFE bypass and 1 composite bypass)...
April 21, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28429248/time-in-therapeutic-range-as-a-marker-for-thrombotic-and-bleeding-outcomes-in-fontan-patients
#3
Jenna M Faircloth, Kristin M Miner, Tarek Alsaied, Nicole Nelson, Julie Ciambarella, Tomoyuki Mizuno, Joseph S Palumbo, Alexander A Vinks, Gruschen R Veldtman
Fontan patients managed with warfarin are at risk not only for thrombotic events, but also for bleeding episodes as a consequence of anticoagulation treatment. The aim of this study was to determine whether time spent in patient specified therapeutic range (TTR), when managed in a cardiology-based pharmacist managed anticoagulation clinic (PMAC), is a useful target metric for monitoring, as well as improving outcomes. A single center retrospective review was conducted evaluating TTR of all Fontan patients (n = 45) on warfarin managed in our outpatient cardiology pharmacist managed anticoagulation clinic (PMAC) during a 19 month time frame...
April 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28429173/a-new-approach-to-local-dco-in-ankle-fracture-dislocations-external-fixation-with-diaphyseal-unicortical-screws-applied-by-local-anaesthesia
#4
F Lavini, T Maluta, G Carpeggiani, C Dall'Oca, E Samaila, G Marconato, B Magnan
PURPOSE: Ankle fracture dislocations represent a great threat for soft tissue viability and articular instability. The use of a temporary ankle bridging ExFix plays a fundamental role in the local damage control orthopaedics while waiting for definitive synthesis. METHODS: For this prospective research, we have developed a full application protocol of innovative diaphyseal monocortical screws fixator (Unyco-Orthofix(TM)) exclusively under local anaesthesia. Rigid selection criteria allowed us to collect nine patients during a period of almost 2 years...
April 20, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28429136/is-there-an-alternative-treatment-for-patients-intolerant-to-antiplatelet-therapy-if-percutaneous-left-atrial-appendage-closure-is-considered
#5
F Akca, N J Verberkmoes, S E Verstraeten, C van Laar, B P van Putte, A H M van Straten
INTRODUCTION: Left atrial appendage (LAA) closure has become of major interest for patients with atrial fibrillation intolerant to oral anticoagulation therapy (OAC). Patients with a contraindication to both OAC and antiplatelet therapy are not eligible for percutaneous LAA closure. We aimed to find an alternative treatment for these specific patients. METHODS: From March 2014 until December 2015 five patients were referred for percutaneous LAA closure. Alternative treatment was necessary due to an absolute contraindication to OAC and antiplatelet therapy (n = 4) or after previous failed percutaneous device implantation (n = 1)...
April 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28429121/renovascular-hypertension-results-in-adulthood-of-renal-autotransplantation-performed-in-children
#6
Bertrand Chavent, Ambroise Duprey, Marie-Pierre Lavocat, Christine Fichtner, Anne-Marie Beraud, Jean-Noel Albertini, Jean-Pierre Favre, Nicolas Maillard, Xavier Barral
BACKGROUND: This study describes the long-term results of renal autotransplantation for renovascular hypertension performed in children who are now 21 years of age or older. METHODS: Sixteen children (4 boys, 12 girls) with a mean age of 11.2 years at the time of the procedure underwent ex-vivo surgery at the university hospital of Saint-Etienne between 1992 and 2008. Acetylsalicylic acid was used for antiplatelet therapy in the postoperative period, without routine anticoagulation...
April 20, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#7
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28428567/novel-oral-anticoagulants-and-exodontia-the-evidence
#8
S Nathwani, C Wanis
Background Haemostasis is crucial for the success of oral surgical treatment as bleeding problems can cause complications both pre- and post-operatively. Patients on anticoagulant drugs present a challenge due to their increased risk of bleeding.Aims To review the evidence for the management of oral surgery patients on novel oral anticoagulant therapy.Methods A literature review was conducted in May 2016 of free-text and MESH searches (keywords: apixaban, dabigatran, rivaroxaban and dental extractions) in the Cochrane Library, PubMed and CINAHL...
April 21, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28428531/-effective-anticoagulation-therapy-prior-to-surgical-excision-of-an-aortic-valve-papillary-fibroelastoma-diagnosed-after-a-transient-cerebral-ischemic-attack-report-of-a-case
#9
Masashi Toyama, Tomonobu Abe, Masato Nakayama, Bummei Sato, Osamu Ohno
Cardiac papillary fibroelastoma is reported to be the 2nd most common cardiac tumor following myxoma. Owing to the risk of embolism, early surgical excision is the treatment of choice. We report a case of effective anticoagulation therapy prior to surgical excision of an aortic valve papillary fibroelastoma. A 78-year-old man was admitted to our hospital because of transient cerebral ischemic attack. The symptom was relieved in a short period. Echocardiography revealed a tumor at the aortic valve. Cardiac computed tomography revealed a sea-anemone-like appearance of the tumor...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428435/bet-1-a-glass-half-full-thrombolysis-for-the-treatment-of-submassive-pulmonary-embolism
#10
Liam Barrett, Dan Horner
A short-cut review was carried out to establish whether thrombolysis in addition to therapeutic anticoagulation could be of benefit in submassive (intermediate risk) pulmonary embolism (PE). 64 directly relevant papers were found using the reported search strategy. Of these, three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that there is insufficient evidence to support the routine use of adjuvant thrombolytic therapy at any dose for patients with submassive PE...
May 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28428030/complement-inhibition-with-eculizumab-for-thrombotic-microangiopathy-rescues-a-living-donor-kidney-transplant-in-a-patient-with-antiphospholipid-antibody-syndrome
#11
Praveen Ramakrishnan Geethakumari, Patrick Mille, Rakesh Gulati, Srikanth Nagalla
Antiphospholipid antibody syndrome (APS) is an enigmatic heterogeneous disorder despite several revelations in its pathobiology. Renal transplantation in patients with APS has been notoriously difficult due to the high risk of development of thrombotic microangiopathy (TMA), which is often refractory to conventional treatment modalities such as aggressive anticoagulation and plasmapheresis. We describe a case of a 58-year-old male with secondary APS undergoing living unrelated renal transplantation for end-stage renal disease from lupus nephritis...
March 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28427966/intravenous-immunoglobulin-for-treatment-of-severe-refractory-heparin-induced-thrombocytopenia
#12
Anand Padmanabhan, Curtis G Jones, Shannon M Pechauer, Brian R Curtis, Daniel W Bougie, Mehraboon S Irani, Barbara J Bryant, Jack B Alperin, Thomas G Deloughery, Kevin P Mulvey, Binod Dhakal, Renren Wen, Demin Wang, Richard H Aster
BACKGROUND: HIT complicated by severe thrombocytopenia and thrombosis can pose significant treatment challenges. Use of alternative anticoagulants in this setting may increase bleeding risks, especially in patients who have a protracted disease course. Additional therapies are lacking in this severely affected patient population. METHODS: We describe three HIT patients who had severe thromboembolism and prolonged thrombocytopenia refractory to standard treatment but achieved an immediate and sustained response to intravenous immunoglobulin G (IVIg) therapy...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28426914/recommended-dose-of-idarucizumab-may-not-always-be-sufficient-for-sustained-reversal-of-dabigatran
#13
Alexander Simon, Hans Domanovits, Cihan Ay, Gürkan Sengölge, Jerrold H Lewy, Alexander O Spiel
Idarucizumab is a monoclonal antibody fragment designed for reversing the anticoagulant effects of dabigatran. Administration is recommended as two intravenous boluses of 2.5 g within 15 minutes of each other or as a single 5 g bolus. However, in certain situations a second dose of the drug could be necessary. We report the case of a 77-year old man, treated with dabigatran for paroxysmal atrial fibrillation. He presented at our department with acute renal failure, concomitant massive dabigatran accumulation, and subsequent acute gastrointestinal bleeding...
April 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28426737/incidence-and-predictors-of-excessive-warfarin-anticoagulation-in-patients-with-atrial-fibrillation-the-ewa-study
#14
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Melina Issakoff, K E Juhani Airaksinen
Vitamin K antagonist warfarin is widely used in clinical practice and excessive anticoagulation is a well-known complication of this therapy. Little is known about permanent and temporary predictors for severe overanticoagulation. The aim of this study was to investigate the occurrence and predicting factors for episodes with very high (≥9) international normalized ratio (INR) values in warfarin treated patients with atrial fibrillation (AF). Excessive Warfarin Anticoagulation (EWA) study screened all patients (n = 13618) in the Turku University Hospital region with an INR ≥2 between years 2003-2015...
2017: PloS One
https://www.readbyqxmd.com/read/28425765/the-prevention-and-treatment-of-venous-thromboembolism-in-pregnancy
#15
Michela Villani, Walter Ageno, Elvira Grandone, Francesco Dentali
Venous thromboembolism (VTE) in pregnancy represents an important cause of maternal morbidity and mortality in developed countries, with an incidence of 0.5-2.2 per 1000 pregnancies. In addition to haemostatic occurring during normal pregnancy, several risk factors have been identified. Thus, a variety of clinical conditions as well as fetal and maternal risks linked to a possible anticoagulant therapy should be considered for the management of VTE during pregnancy. Unfortunately, there is a paucity of high-quality evidence from randomized trials in this field, and current recommendations are based on observational studies or evidence gathered from studies in the non-pregnant population...
April 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#16
Leon A Simons, Michael Ortiz, S Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28424481/the-first-genome-wide-association-study-identifying-new-susceptibility-loci-for-obstetric-antiphospholipid-syndrome
#17
Mayumi Sugiura-Ogasawara, Yosuke Omae, Minae Kawashima, Licht Toyo-Oka, Seik-Soon Khor, Hiromi Sawai, Tetsuya Horita, Tatsuya Atsumi, Atsuko Murashima, Daisuke Fujita, Tomio Fujita, Shinji Morimoto, Eriko Morishita, Shinji Katsuragi, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Katsushi Tokunaga
Antiphospholipid syndrome (APS) is the most important treatable cause of recurrent pregnancy loss. The live birth rate is limited to only 70-80% in patients with APS undergoing established anticoagulant therapy. Lupus anticoagulant (LA), but not anticardiolipin antibody (aCL), was found to predict adverse pregnancy outcome. Recent genome-wide association studies (GWAS) of APS focusing on aCL have shown that several molecules may be involved. This is the first GWAS for obstetric APS focusing on LA. A GWAS was performed to compare 115 Japanese patients with obstetric APS, diagnosed according to criteria of the International Congress on APS, and 419 healthy individuals...
April 20, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28423431/-treatment-and-secondary-prevention-of-venous-thromboembolism-change-in-oral-anticoagulation
#18
Thomas-Maria Helms, Dietrich Gulba, Ingo Ahrens, Andreas Schäfer, Johannes Hankowitz, Peter Kuhlencordt, Hans-Peter Lipp, Sigrid Nikol, Hanno Riess, Tom Stargardt, Peter Bramlage
With the recent approval of the fourth direct non vitamin K dependent oral anticoagulant (NOAC) edoxaban the range of available NOACs for the treatment of venous thromboembolism (VTE) has expanded. Shortly thereafter, two updated guidelines for the prevention and treatment of VTE have been published. In these NOACs are listed as equal anticoagulants to low-molecular weight heparin (LMWH), or fondaparinux (FDX), and VKA for the initial or maintenance treatment of VTE. All NOACs are approved for the maintenance therapy after VTE and two NOACs (rivaroxaban and apixaban) for the initial treatment in addition in an increased dose...
April 19, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28418370/-current-study-aimed-to-highlight-extent-of-clot-resolution-in-deep-veins-and-its-association-with-anticoagulation-pattern-in-vte-patients
#19
E A Shcheglov, N N Alontzeva
MATERIAL AND METHODS: Data of 70 patients with acute VTE of lower extremities (iliofemoral level) was analyzed. There were 42 patients in the study group which were treated with rivaroxaban (15 mg BID for 21 days, 20 mg od from day 22); 28 patients were in control group treated with conventional therapy (LMWH/VKA). Extent of clot resolution was assessed on ultrasound. Data was collected at a day of VTE diagnosis and further at 1, 3, 6 month. RESULTS: The results of the study demonstrated, that patients treated with rivaroxaban had earlier recanalization and extent of clot resolution was higher than in patients treated with conventional therapy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28417608/comparison-of-antithrombotic-agents-during-urgent-percutaneous-coronary-intervention-following-thrombolytic-therapy-a-retrospective-cohort-study
#20
Jaya R Mallidi, Peter Robinson, Paul F Visintainer, Amir S Lotfi, Scott Mulvey, Gregory R Giugliano
BACKGROUND: The optimal antithrombotic regimen for urgent percutaneous coronary interventions (PCI) following thrombolytic therapy for ST segment myocardial infarction (STEMI) is currently unknown. METHODS: We performed a retrospective analysis of all patients referred to our institution from January 2005 to July 2014 who underwent urgent PCI within 24 hr after receiving thrombolytic therapy. The patients were divided into three cohorts based on the anticoagulation strategy during PCI-bivalirudin, heparin alone or heparin plus Glycoprotein IIb/IIIa inhibitor (GPI)...
April 18, 2017: Catheterization and Cardiovascular Interventions
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