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https://www.readbyqxmd.com/read/29656136/streptococcous-gallolyticus-subsp-pasteurianus-meningitis-complicated-by-venous-sinus-thrombosis-a-case-report
#1
Martin Wardle, Andre Mu, Steven Y C Tong
We describe a case of Streptococcus gallolyticus subsp pasteurianus meningitis, unusually occurring in a splenectomised patient and complicated by cerebral venous thrombosis. Following presentation with meningism and diagnosis and management of S. gallolyticus meningitis, the patient represented with a further four days of fevers and subsequently developed left sided paresthesias. Cerebral imaging revealed venous thrombus in the right frontal cortical veins and left sigmoid sinus. The patient recovered following four weeks of intravenous ceftriaxone and anticoagulation with enoxaparin and then warfarin...
April 12, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29649055/the-impact-of-once-versus-twice-daily-enoxaparin-prophylaxis-on-risk-for-venous-thromboembolism-and-clinically-relevant-bleeding
#2
Christopher J Pannucci, Kory I Fleming, Jayant Agarwal, W Bradford Rockwell, Ann Marie Prazak, Arash Momeni
INTRODUCTION: Venous thromboembolism (VTE) is a life or limb threatening complication that occurs in plastic surgery patients. At present, the optimal dose of enoxaparin that balances the risk of VTE and the risk of medication related adverse drug events, specifically bleeding, remains unknown. METHODS: This study compared pharmacodynamic and clinical outcomes, including 90-day VTE and 90-day clinically relevant bleeding, between two prospectively performed clinical trials whose sole difference was post-operative anticoagulation strategy...
March 30, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29648974/traumatic-brain-injury-induced-acute-lung-injury-evidence-for-activation-and-inhibition-of-a-neural-respiratory-inflammasome-axis
#3
Nadine Kerr, Juan Pablo De Rivero Vaccari, Sam Abbassi, Harmanpreet Kaur, Ronald Zambrano, Shu Wu, W Dalton Dietrich, Robert W Keane
Approximately 20-25 percent of Traumatic Brain Injury subjects develop Acute Lung Injury (ALI), but the pathomechanisms of TBI-induced ALI remain poorly defined. Our previous work has shown that the inflammasome plays a critical role in TBI-induced secondary pathophysiology and that inflammasome proteins are released in Extracellular Vesicles (EV) after TBI. Here we investigated whether EV-mediated inflammasome signaling contributed to the etiology of TBI-induced ALI. C57/BL6 male mice were subjected to controlled cortical impact, and the brains and lungs were examined for inflammasome activation and ALI at 4 hours and 24 hours after TBI...
March 5, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29628468/induction-of-anti-pf4-heparin-antibodies-after-arthroplasty-for-rheumatic-diseases
#4
Kiyoshi Migita, Tomoyuki Asano, Shuzo Sato, Satoru Motokawa
Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. These pathogenic antibodies against PF4/heparin bind and activate cellular FcγRIIa on platelets to induce a hypercoagulable state culminating in thrombosis. Recent studies indicate several conditions, including joint surgery, induce spontaneous HIT, which can occur without exposure to heparin. To determine the real-world evidences concerning the incidences of venous thromboembolism (VTE) after total joint arthroplasty for rheumatic disease, we conducted a multicenter cohort study (J-PSVT) designed to document the VTE and seroconversion rates of anti-PF4/heparin antibody in 34 Japanese National hospital organization (NHO) hospitals...
April 7, 2018: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/29628414/catheter-related-venous-thrombosis-in-hospitalized-pediatric-patients-with-inflammatory-bowel-disease-incidence-characteristics-and-role-of-anticoagulant-thromboprophylaxis-with-enoxaparin
#5
Carrie E Diamond, Carole Hennessey, Jennifer Meldau, Christine J Guelcher, Michael F Guerrera, Laurie S Conklin, Karun V Sharma, Yaser A Diab
OBJECTIVE: To describe the incidence and characteristics of central venous catheter (CVC)-related thrombosis in hospitalized pediatric patients with active inflammatory bowel disease (IBD) and report the potential usefulness of anticoagulant thromboprophylaxis (AT). STUDY DESIGN: We conducted a retrospective study of patients who were admitted to our children's hospital in the last 2 years with active IBD and required a CVC and identified all patients with an objectively confirmed symptomatic CVC-related thrombosis...
April 5, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29627150/postoperative-bleeding-risk-of-direct-oral-anticoagulants-after-oral-surgery-procedures-a-systematic-review-and-meta-analysis
#6
REVIEW
C Bensi, S Belli, D Paradiso, G Lomurno
Direct oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban; DOACs) have been introduced to improve safety and superior therapeutic value compared to their predecessors such as warfarin or enoxaparin. The aim of this systematic review and meta-analysis was to assess the postoperative bleeding risk of DOACs during oral surgery procedures. Systematic searches were performed in electronic databases including PubMed, Scopus, Web of Science and Cochrane Library. Thirteen studies were included in the qualitative synthesis: two retrospective case-control studies, five prospective case-control studies, three cross-sectional studies, two case series and a case report; while only six studies were statistically analysed...
April 4, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29626461/enoxaparin-40mg-per-day-is-inadequate-for-venous-thromboembolism-prophylaxis-after-thoracic-surgery
#7
Christopher J Pannucci, Kory I Fleming, Kathleen Holoyda, Lauren Moulton, Ann Marie Prazak, Thomas K Varghese
BACKGROUND: Many thoracic surgery patients have venous thromboembolism (VTE) events despite the receipt of chemical prophylaxis. Enoxaparin's pharmacologic impact can be quantified using anti-Factor Xa (aFXa) levels. We hypothesized that enoxaparin 40mg once daily would be inadequate for most thoracic surgery inpatients and that a real time dose adjustment algorithm would be impactful. METHODS: This prospective clinical trial enrolled thoracic surgery inpatients who were placed on enoxaparin 40mg once daily for VTE prophylaxis after surgical procedures...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29622713/uncommon-presentation-rare-complication-and-previously-undescribed-oncologic-association-of-pheochromocytoma-the-great-masquerader
#8
David Lawrence, Kevan Salimian, Thorsten Leucker, Seth Martin
We describe the case of a 67-year-old man presenting with ventricular tachycardia (VT) and systolic heart failure secondary to a left adrenal phaeochromocytoma. After treatment with amiodarone, the patient's VT resolved. However, his course was complicated by femoral deep venous thrombosis secondary to an incidentally discovered dedifferentiated liposarcoma of the thigh, for which he was prescribed a course of enoxaparin. The patient was discharged with plans for adrenalectomy following achievement of sufficient preoperative heart rate and blood pressure control with alpha-adrenergic receptor blockade, but re-presented to an outside facility in haemorrhagic shock, where he ultimately expired...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29617053/efficacy-and-safety-of-rivaroxaban-compared-to-enoxaparin-in-treatment-of-cancer-associated-venous-thromboembolism
#9
Benjamin Simmons, Waldemar Wysokinski, Rayya A Saadiq, Dalene Bott-Kitslaar, Stanislav Henkin, Ana Casanegra, Charles Lenz, Paul Daniels, Haraldur Bjarnason, Emily Vargas, David Hodge, Sara J Holton, James R Cerhan, Charles Loprinzi, Robert McBane
BACKGROUND: Low molecular weight heparin (LMWH) is the guideline endorsed treatment for cancer associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. METHODS: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry were compared to contemporary cancer patients receiving enoxaparin...
April 4, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29616156/a-case-of-postpartum-ovarian-vein-thrombosis
#10
Sidra Khalid, Aariez Khalid, Hamed Daw
Ovarian vein thrombosis (OVT) is an rare condition, which can present in the postpartum period. We present a case of a 35-year-old female who presented with right lower quadrant pain and fever. Her computed tomography (CT) abdomen revealed a dilated right ovarian vein with soft tissue attenuation material in its lumen that extended into the inferior vena cava, along with fat stranding of the surrounding soft tissues signifying thrombophlebitis. She was treated with enoxaparin and piperacillin-tazobactam, which lead to a resolution of the thrombus...
February 1, 2018: Curēus
https://www.readbyqxmd.com/read/29614521/targeting-coagulase-activity-in-staphylococcus-aureus-bacteraemia-a-randomized-controlled-single-centre-trial-of-staphylothrombin-inhibition
#11
Marijke Peetermans, Laurens Liesenborghs, Kathelijne Peerlinck, Eric Van Wijngaerden, Olivier Gheysens, Karolien E Goffin, Marc F Hoylaerts, Marc Jacquemin, Jan Verhaegen, Willy E Peetermans, Peter Verhamme, Thomas Vanassche
BACKGROUND:   Staphylococcus aureus ( S. aureus ) bacteraemia is frequent and carries a high morbidity and mortality. Coagulases secreted by S. aureus initiate blood coagulation by directly activating prothrombin. This pathogen-activated coagulation is insensitive to most antithrombotic drugs, with the exception of small molecule direct thrombin inhibitors (DTIs). DTIs inhibit the coagulase-prothrombin complex, or staphylothrombin, and improve outcome in preclinical models of S. aureus infection...
April 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29608533/twice-daily-enoxaparin-among-plastic-surgery-inpatients-an-examination-of-pharmacodynamics-90-day-vte-and-90-day-bleeding
#12
Christopher J Pannucci, Kory I Fleming, Arash Momeni, Ann Marie Prazak, Jayant Agarwal, W Bradford Rockwell
INTRODUCTION: Low anti-Factor Xa (aFXa) level, indicative of inadequate enoxaparin dosing, has a significant association with 90-day venous thromboembolism (VTE) events. We examined the pharmacodynamics of enoxaparin 40mg twice daily and its correlation with aFXa, post-operative VTE, and bleeding. METHODS: Adult patients were admitted after plastic and reconstructive surgery and received enoxaparin 40mg twice daily. Peak aFXa levels, which quantify enoxaparin's anti-thrombotic effect, were drawn, with goal level of 0...
March 21, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29602141/is-thromboprophylaxis-cost-effective-in-ovarian-hyperstimulation-syndrome-a-systematic-review-and-cost-analysis
#13
REVIEW
Kelly Comerford Wormer, Ayesha A Jangda, Farah A El Sayed, Katherine I Stewart, Sunni L Mumford, James H Segars
BACKGROUND: The majority of serious thromboembolic events occurring in assisted reproductive technologies (ART) are in women with ovarian hyperstimulation syndrome (OHSS). OBJECTIVES: The purpose of this study was to present a thorough review and cost analysis regarding the use of venous thromboembolism (VTE) prophylaxis in OHSS to inform clinical management. DATA SOURCES: Databases used were Pubmed and Embase, in addition to checking reference lists of retrieved articles (inception to November 2017)...
March 19, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29594815/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-no
#14
Francesco Marongiu, Doris Barcellona
Acutely ill hospitalized medical patients are at high risk of venous thromboembolism (VTE). Although thromboprophylaxis in these patients is recommended since 2004 by the American College of Chest Physicians, it is widely underused. The doubt as to whether or not to treat patients at high VTE risk after hospital discharge came from the knowledge that this risk may persist after the hospital admission period. Two meta-analyses comparing extended- versus short-duration prophylaxis are published. The results demonstrate an unfavorable balance between VTE prevention and incidence of major bleeding in patients assigned to extended-duration thromboprophylaxis...
March 28, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29594456/combined-pharmacotherapy-for-osteonecrosis-of-the-femoral-head-after-severe-acute-respiratory-syndrome-and-interstitial-pneumonia-two-and-a-half-to-fourteen-year-follow-up
#15
Weiguo Wang, Nianfei Zhang, Wanshou Guo, Fuqiang Gao
PURPOSE: The purpose of this study was to retrospectively analyze the clinical, functional, and radiological outcomes of combined pharmacotherapy to ONFH after high-dose corticosteroid therapy. METHOD: From August 2003 to June 2015, five patients (ten hips) of ONFH in ARCO stage I, after SARS and Interstitial pneumonia, were treated by combined pharmacotherapy. Lipo-prostaglandin E1 10 μg iv Bid × 28 days, enoxaparin 6000 iu H QD × 12 weeks, alendronate sodium tablet 10 mg QD × 1 year...
March 28, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29593380/bioequivalence-of-a-biosimilar-enoxaparin-sodium-to-clexane-%C3%A2-after-single-100-mg-subcutaneous-dose-results-of-a-randomized-double-blind-crossover-study-in-healthy-volunteers
#16
Javier Martínez González, Mayte Monreal, Ignacio Ayani Almagia, Jordi Llaudó Garín, Lourdes Ochoa Díaz de Monasterioguren, Ibón Gutierro Adúriz
Purpose: To demonstrate the pharmacokinetic/pharmacodynamic (PK/PD) equivalence of a biosimilar enoxaparin to the reference drug, and to assess its safety and tolerability in healthy volunteers. Patients and methods: A randomized, double-blind, crossover, 2-sequence, single-dose study was conducted in healthy volunteers of both sexes. Participants were sequentially and randomly administered single subcutaneous injections of enoxaparin 100 mg manufactured by Rovi (test; Madrid, Spain) and Clexane® (enoxaparin 100 mg manufactured by Sanofi, reference) separated by a 1-week washout period...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29592538/enoxaparin-dosing-at-extremes-of-weight-literature-review-and-dosing-recommendations
#17
Jamie Sebaaly, Kelly Covert
OBJECTIVE: To review the literature on both thromboprophylaxis and treatment of venous thromboembolism (VTE) with enoxaparin in low- and high-body-weight patients and to make dosing and monitoring recommendations in these patient populations. DATA SOURCES: A search using PubMed was conducted (1995 to January 2018) using the following key words: enoxaparin, body weight, AND thromboprophylaxis, or AND treatment. Additional references were identified from a review of citations...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29578118/low-dose-unfractionated-heparin-with-sequential-enoxaparin-in-patients-with-diabetes-mellitus-and-complex-coronary-artery-disease-during-elective-percutaneous-coronary-intervention
#18
Ji Huang, Nan Li, Zhao Li, Xue-Jian Hou, Zhi-Zhong Li
Background: Despite its limitations, unfractionated heparin (UFH) has been the standard anticoagulant used during percutaneous coronary intervention (PCI). This study compared the safety of low-dose UFH with sequential enoxaparin with that of UFH in patients with diabetes mellitus (DM) and complex coronary artery disease receiving elective PCI. Methods: In this retrospective study, 514 consecutive patients with atherosclerotic cardiovascular diseases and type 2 DM were admitted to the hospital and received selective PCI, from January 2013 to December 2015...
April 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29561989/is-there-any-relationship-between-tsh-levels-and-prognosis-in-acute-coronary-syndrome
#19
Alexandre de Matos Soeiro, Victor Arrais Araújo, Júlia Pitombo Vella, Aline Siqueira Bossa, Bruno Biselli, Tatiana de Carvalho Andreucci Torres Leal, Maria Carolina Feres de Almeida Soeiro, Carlos V Serrano, Christian Mueller, Mucio Tavares de Oliveira Junior
BACKGROUND: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain. OBJECTIVE: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission. METHODS: Observational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014...
February 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29560388/enoxaparin-induced-skin-necrosis-at-injection-site-after-total-knee-arthroplasty
#20
Max Haffner, Nasser Heyrani, John P Meehan, Mauro Giordani
Enoxaparin is a widely used low-molecular-weight heparin for perioperative thromboembolic prophylaxis. Enoxaparin-induced skin necrosis in the setting of arthroplasty has been rarely reported in the literature with varying outcomes and management decisions. Our patient developed skin necrosis at his injection site and thrombocytopenia 10 days following left total knee arthroplasty surgery and after receiving subcutaneous Lovenox injections postoperatively. The patient was started on an alternative anticoagulation based on a high suspicion for heparin-induced thrombocytopenia and the wound was monitored without surgical debridement...
March 2018: Arthroplasty Today
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