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https://www.readbyqxmd.com/read/29148292/cholestatic-liver-injury-as-a-side-effect-of-dabigatran-and-the-use-of-coagulation-tests-in-dabigatran-intoxication-and-after-reversal-by-idarucizumab-in-bleeding-and-sepsis
#1
Willemijn J Comuth, Anne-Mette Haase, Linda Ø Henriksen, Jerzy Malczynski, Daan van de Kerkhof, Anna-Marie B Münster
Idarucizumab, an antidote specific for dabigatran, became available recently. Dabigatran is not associated with increased risk of hepatotoxicity in comparison with warfarin, but it is seen as a rare side-effect. Cases of cholestatic liver injury due to dabigatran have not been reported previously. We present a case of severe gastro-intestinal bleeding with underlying dabigatran intoxication in a patient with renal failure and the effect of reversal of dabigatran using idaruzicumab on coagulation assays. International normalized ratio (INR) and activated partial thromboplastin time (APTT) results were elevated in a setting of sepsis, possibly due to liver failure...
November 17, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#2
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#3
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29147155/endovascular-stent-graft-repair-of-a-persistent-sciatic-artery-aneurysm
#4
Hayato Fukuda, Seiji Onitsuka, Shohei Yoshida, Yuichiro Hirata, Shinichi Hiromatsu, Hiroyuki Tanaka
Persistent sciatic artery (PSA) is a rare anomaly that may cause various symptoms, such as aneurysm, rupture, thromboembolism, and sciatica. Direct surgery can be performed to treat PSA aneurysm (PSAA), but is associated with complications; e.g., anatomical problems such as sciatic nerve injury. Herein we report a case of a 74-year-old woman with acute limb ischemia that developed from a distal embolism caused by a thrombus in the left PSAA; favorable results were obtained for her by treatment with a stent-graft after rapid anticoagulation therapy for limb salvage...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146668/percutaneous-left-atrial-appendage-closure-current-devices-and-clinical-outcomes
#5
REVIEW
Lluis Asmarats, Josep Rodés-Cabau
Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146484/association-between-ischemic-and-bleeding-risk-scores-and-the-use-of-new-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome
#6
Pedro J Flores-Blanco, Francisco Cambronero-Sánchez, Sergio Raposeiras-Roubin, Emad Abu-Assi, Gunnar Leithold, Rafael Cobas-Paz, Ana I Rodríguez Serrano, Francisco Calvo-Iglesias, Mariano Valdés, James L Januzzi, Andrés Iñiguez-Romo, Sergio Manzano-Fernández
INTRODUCTION AND OBJECTIVES: Acute coronary syndrome (ACS) guidelines recommend the use of newer P2Y12 inhibitors (prasugrel and ticagrelor) over clopidogrel in patients with moderate-to-high ischemic risk, unless they have an increased bleeding risk. The aim of our study was to assess the GRACE risk score and the CRUSADE bleeding risk score relative to prescription of newer P2Y12 inhibitors at discharge in ACS patients. METHODS: Retrospective analysis of a multicenter ACS registry; 3515 consecutive patients were included...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29146276/perioperative-management-of-oral-anticoagulation-in-patients-undergoing-implantation-of-subcutaneous-implantatble-defibrillator
#7
Muhammad R Afzal, Divyesh Mehta, Christopher Evenson, Daniel Pinkhas, Auroa Badin, Dilesh Patel, Michael K Essandoh, Hemant Godara, Jaret Tyler, Mahmoud Houmsse, Zhenguo Liu, Steven J Kalbfleisch, John D Hummel, Ralph Augostini, Raul Weiss, Emile G Daoud, Toshimasa Okabe
BACKGROUND: The perioperative anticoagulation management for subcutaneous implantable cardioverter defibrillator (S-ICD) is still evolving. OBJECTIVE: To assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin. METHODS: This is a single-center retrospective review of patients undergoing S-ICD implantation during 10/2012 to 6/2017. The most common indication for the implantation was primary prevention of sudden cardiac death...
November 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29146096/ten-year-review-of-isolated-spontaneous-mesenteric-arterial-dissections
#8
Courtney E Morgan, Neel A Mansukhani, Mark K Eskandari, Heron E Rodriguez
OBJECTIVE: Isolated spontaneous dissection of the superior mesenteric artery (SMA) and celiac artery (CA) remains a rare condition; however, it has been increasingly noted incidentally on diagnostic imaging. The purpose of this study was to examine the natural history and outcomes of patients presenting with isolated spontaneous mesenteric artery dissection (SMAD). We hypothesized that most SMADs can be treated nonoperatively. METHODS: This was a single-center retrospective review of patients presenting with the diagnosis of SMAD between 2006 and 2016...
November 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29145948/type-of-atrial-fibrillation-and-outcomes-in%C3%A2-patients-with-heart-failure-and-reduced%C3%A2-ejection%C3%A2-fraction
#9
Ulrik M Mogensen, Pardeep S Jhund, William T Abraham, Akshay S Desai, Kenneth Dickstein, Milton Packer, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Michael R Zile, Lars Køber, John J V McMurray
BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), but the outcome by type of AF is largely unknown. OBJECTIVES: This study investigated outcomes related to type of AF (paroxysmal, persistent or permanent, or new onset) in 2 recent large trials in patients with HF with reduced ejection fraction. METHODS: The study analyzed patients in the PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure) trials...
November 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29145930/assessment-of-predicted-rate-and-associated-factors-of-dabigatran-induced-bleeding-events-in-malaysian-patients-with-non-valvular-atrial-fibrillation
#10
Semira Abdi Beshir, Lok Bin Yap, Szyuin Sim, Kok Han Chee, Yoke Lin Lo
PURPOSE: To assess the predicted rate and the factors associated with bleeding events among patients with non-valvular atrial fibrillation (NVAF) receiving dabigatran therapy. METHODS: This retrospective cohort study includes adult patients of two tertiary hospitals in Malaysia. Potential study subjects were identified using pharmacy supply database or novel oral anticoagulant (NOAC) registry. Demographics, clinical data and laboratory test results were extracted from the medical records of the patients or electronic databases...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29145340/open-repair-of-intraoperative-popliteal-artery-injury-during-total-knee-arthroplasty-in-a-patient-with-severe-hemophilia-a-a-case-report-and-literature-review
#11
Bin Feng, Ke Xiao, Jiang Shao, Yu Fan, Xisheng Weng
RATIONALE: Arterial injuries during total knee arthroplasty (TKA) though rare may occur. Hemophilia may further challenge the management of such injury. PATIENT CONCERNS: A 48-year-old male patient with severe hemophilia type A and stiff knee arthropathy underwent bilateral TKAs. Left popliteal artery injury was detected at the end of the left TKA. DIAGNOSES: Urgent angiography confirmed the diagnosis of the left popliteal artery transection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145310/successful-treatment-with-rivaroxaban-of-cerebral-venous-thrombosis-and-bone-marrow-necrosis-induced-by-pegaspargase-a-case-report-and-literature-review
#12
Jingrui Sui, Yongming Zhang, Liqing Yang, Hui Wang, Junqing Xu, Rongxia Wei, Yaping Hao, Xiaolei Wang, Jun Peng, Junjie Ma
RATIONALE: Pegaspargase has been used in the treatment of acute lymphoblastic leukemia with promising results. However, it has also been associated with several potentially serious complications, including thrombosis. Pegaspargase-induced cerebral venous thrombosis and bone marrow necrosis are very rare. PATIENT CONCERNS: A 50-year-old female developed headache, weakness of the right lower extremity, fever, and bone pain after chemotherapy including pegaspargase for the treatment of acute lymphoblastic leukemia...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145278/safety-of-continuing-aspirin-therapy-during-spinal-surgery-a-systematic-review-and-meta-analysis
#13
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
BACKGROUND: Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. OBJECTIVE: The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. METHODS: Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145107/postoperative-thoracic-hemorrhage-after-right-upper-lobectomy-with-thoracic-wall-resection-during-rivaroxaban-anticoagulant-therapy-for-deep-leg-vein-thrombosis-a-case-report
#14
Taiji Kuwata, Masatoshi Kanayama, Ayako Hirai, Shuichi Shinohara, Masaru Takenaka, Soichi Oka, Yasuhiro Chikaishi, Naoko Imanishi, Koji Kuroda, Fumihiro Tanaka
INTRODUCTION: Postoperative pulmonary embolism (PE) is the one of the most important complications after thoracic surgery. This complicatin after the surgery is often treated by new anticoaglant drug, such as rivaroxaban, which dose not need to the monitoring of blood coaglation system. We experienced postoperative bleeding case during anticoaglant therapy using rivaroxaban. PRESENTATION OF CASE: The patient underwent a right upper lobectomy with lung and chest wall resection for lung cancer...
November 11, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29144846/anticoagulation-in-glaucoma-surgery
#15
Shiraaz I Rahman, Angela Turalba
Anticoagulation medications are used commonly, particularly in an elderly population. There are many systemic diseases and scenarios that require modulation of coagulation to prevent serious adverse outcomes. While there is some consensus about their use in cataract surgery, there is less certainty about their management with glaucoma surgery. Glaucoma surgery presents a unique challenge when considering anticoagulation. Currently, there is great diversity in surgeon practices regarding anticoagulation in glaucoma surgery...
November 16, 2017: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#16
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29141357/-prevention-for-glucocorticoid-induced-osteonecrosis-of-femoral-head-a-long-term-clinical-follow-up-trail
#17
B Y Liu, L Yang, B J Wang, Z H Wang, L L Cheng, H Xie, X Qiu, Z J Ma, D W Zhao
Objective: To evaluated the outcome of prevention and treatment for glucocorticoid-induced osteonecrosis of femoral head with anticoagulant and vasodilator drugs. Methods: A prospective, randomized, double-blind study was performed. From August 2003 to August 2006, 58 patients with large amounts of hormone therapy in the Zhongshan Hospital Affiliated Dalian University were enrolled and randomly assigned to the control group (placebo) or preventive group (anticoagulant and vasodilator drugs). And we prospectively analyzed the clinical outcomes of 24 patients with glucocorticoid-induced osteonecrosis of femoral head early stage (treatment group)treated by anticoagulant and vasodilator drugsat the same time...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29141075/treatment-for-livedoid-vasculopathy-a-systematic-review
#18
Robert Micieli, Afsaneh Alavi
Importance: Livedoid vasculopathy is a painful, ulcerative condition of the lower extremities for which no established treatment exists. Current treatment paradigms rely on low levels of evidence, primarily case reports and case series. Objective: To systematically review the treatment for livedoid vasculopathy and synthesize the available clinical data. Evidence Review: A systematic review of the literature using Ovid MEDLINE (covering the period January 1, 1946, through June 9, 2017) and Ovid EMBASE (covering January 1, 1947, through June 9, 2017) databases was performed with a broad and inclusive search strategy along with a subsequent search of the references of retrieved articles...
November 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29139019/pharmacists-confidence-when-providing-pharmaceutical-care-on-anticoagulants-a-multinational-survey
#19
John Papastergiou, Nadir Kheir, Katerina Ladova, Silas Rydant, Fabio De Rango, Sotiris Antoniou, Reka Viola, Maria Dolores Murillo, Stephane Steurbaut, Filipa Alves da Costa
Background Guidelines on the management of orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision. Objective To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation. Setting Pharmacists in different work settings in different countries. Method Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class...
November 14, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29137043/portal-vein-thrombosis-before-and-after-transjugular-intrahepatic-portosystemic-shunt-placement-an-observational-study-strobe-compliant
#20
Yue-Meng Wan, Yu-Hua Li, Hua-Mei Wu, Zhi-Yuan Xu, Ying Xu, Li-Hong Yang, Xi-Nan Wu, Jin-Hui Yang
Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS...
November 2017: Medicine (Baltimore)
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