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https://www.readbyqxmd.com/read/28875522/developments-in-the-synthesis-of-the-antiplatelet-and-antithrombotic-drug-s-clopidogrel
#1
REVIEW
Aamer Saeed, Danish Shahzad, Muhammad Faisal, Fayaz Ali Larik, Hesham R El-Seedi, Pervaiz Ali Channar
S-(+)-Methyl 2-(2-chlorophenyl)-2-(6,7-dihydrothieno[3,2-c]pyridin-5(4H)-yl)acetate, also known as (S)-clopidogrel, is marketed under the trade names Plavix and Iscover. It is a potent thienopyridine-class of antithrombotic and antiplatelet drug (antiaggregant). Among the two available stereoisomers of clopidogrel, for pharmaceutical activities only the S-enantiomer is applicable, as no antithrombotic activity is observed in the R-enantiomer and causes political upheavals and social turmoil in animal experiments...
September 6, 2017: Chirality
https://www.readbyqxmd.com/read/28820359/clinical-outcomes-of-direct-oral-anticoagulants-after-lower-extremity-arterial-procedures
#2
Afsha Aurshina, Pavel Kibrik, Justin Eisenberg, Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Enrico Ascher
Objectives The use of postoperative anticoagulation is not uncommon for patients undergoing lower extremity arterial procedures as adjunctive therapy. Longer postoperative length of stay is necessary to achieve adequate therapeutic international normalized ratio with traditional protocols that call for the use of unfractionated heparin and warfarin therapy. We hypothesized the direct oral anticoagulants are an attractive alternative to provide adequate anticoagulation in patients who undergo lower extremity arterial procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28810647/limb-graft-occlusion-following-endovascular-aortic-repair-incidence-causes-treatment-and-prevention-in-a-study-cohort
#3
Guoquan Wang, Shuiting Zhai, Tianxiao Li, Xuan Li, Danghui Lu, Bo Wang, Dongbin Zhang, Shuaitao Shi, Zhidong Zhang, Kai Liang, Kewei Zhang, Xiaoyang Fu, Kun Li, Weixiao Li
The present study investigated the incidence, causes, treatment and prevention of limb graft occlusion following endovascular aortic repair (EVAR). A total of 66 cases of abdominal aortic aneurysm receiving EVAR at our department from January 2005 to December 2013 were enrolled. After EVAR, patients received routine antiplatelet therapy of 75 mg PLAVIX for 6 months and then 100 mg Aspirin for another 6 months by oral administration. According to previous clinical experiences, antiplatelet therapy is able to effectively reduce the incidence of iliac occlusion after EVAR...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808507/cyp2c19-genetic-variation-and-individualized-clopidogrel-prescription-in-a-cardiology-clinic
#4
Seyed Abbas Mirabbasi, Koroush Khalighi, Yin Wu, Stanley Walker, Bahar Khalighi, Wuqiang Fan, Archana Kodali, Gang Cheng
Background: Clopidogrel (Plavix) is an antiplatelet medication that is routinely used in patients with cardiovascular disease. Cytochrome P2C19 enzymes play a major role in its metabolism, which determines its varied therapeutic level and its effectiveness. Objectives: To customize clopidogrel therapy and evaluate its efficacy by using CYP2C19 genotypic and phenotypic information to improve clinical outcomes in patients. Methods: A total of 465 patients with underlying cardiovascular disease were selected from our out-patient cardiology clinic...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28682888/spontaneous-recanalization-of-atherosclerotic-middle-cerebral-artery-occlusion-case-report
#5
Ying Mao, Yujing Huang, Li Zhang, Guangxian Nan
RATIONALE: Intracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare. PATIENT CONCERNS: The first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28409546/clinical-correlation-with-failure-of-endovenous-therapy-for-leg-swelling
#6
Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Yuriy Ostrozhynskyy, Enrico Ascher
Background The development and use of minimally invasive procedures provide improved options for the management of symptoms of chronic venous insufficiency. While many patients with iliac venous occlusive disease and superficial venous insufficiency improve with combined iliac venous stenting and correction of superficial venous reflux, some patients have symptoms which persist. The goal of this study was to identify clinical factors related to persistent symptoms in patients with leg swelling after treatment of both iliac vein stenting and thermal ablation...
June 2017: Vascular
https://www.readbyqxmd.com/read/28318956/carotid-endarterectomy-to-remove-retained-solitaire-stent-retriever-inside-carotid-stent-after-mechanical-thrombectomy
#7
Mary In-Ping Huang Cobb, Tony P Smith, Patrick A Brown, L Fernando Gonzalez, Ali R Zomorodi
BACKGROUND: Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT: A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot...
May 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28248487/practical-stereochemistry
#8
Richard M Kellogg
The relationship between fundamental and applied is often uneasy, particularly in modern political climates. A familiar political view, aimed negatively at the scientific community, is that the former is a waste of money whereas the latter gives value for investment. The answer that fundamental is required as the basis for practical suffers from the fact that the timelines between fundamental and practical are often long and the routes contorted and unexpected. This has been my experience. In this Account, examples are given from the research in which I have been involved wherein quite fundamental considerations have led to various applications...
March 1, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28130166/triage-patterns-of-traumatic-subarachnoid-hemorrhage-is-referral-to-a-tertiary-care-center-necessary
#9
Marcus Gates, Grant Mallory, Ryan Planchard, Georgia Nothdurft, Christopher Graffeo, John Atkinson
OBJECTIVE: Isolated traumatic subarachnoid hemorrhage (iTSAH) in mild head injuries has more evidence that triage to a tertiary care facility, intensive care unit admission, and repeat imaging is not warranted. Certain factors were identified that predict radiographic and clinical progression in hopes of preventing avoidable cost, which occur with transfer and subsequent management. METHODS: A retrospective analysis identified 67 patients transferred between January 2010 and December 2014 who met inclusion criteria...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28117563/patent-law-s-reproducibility-paradox
#10
Jacob S Sherkow
Clinical research faces a reproducibility crisis. Many recent clinical and preclinical studies appear to be irreproducible--their results cannot be verified by outside researchers. This is problematic for not only scientific reasons but also legal ones: patents grounded in irreproducible research appear to fail their constitutional bargain of property rights in exchange for working disclosures of inventions. The culprit is likely patent law’s doctrine of enablement. Although the doctrine requires patents to enable others to make and use their claimed inventions, current difficulties in applying the doctrine hamper or even actively dissuade reproducible data in patents...
January 2017: Duke Law Journal
https://www.readbyqxmd.com/read/28095326/additive-antithrombotic-effect-of-asp6537-a-selective-cyclooxygenase-cox-1-inhibitor-in-combination-with-clopidogrel-in-guinea-pigs
#11
Chinatsu Sakata, Ken-Ichi Suzuki, Yoshiaki Morita, Tomihisa Kawasaki
Clopidogrel (Plavix(®), Sanofi-Aventis), the adenosine diphosphate P2Y12 receptor antagonist, is reported to be effective in the prevention of cardiovascular events and is often used in combination with aspirin, particularly in high-risk patients. ASP6537 is a reversible cyclooxygenase (COX)-1 inhibitor that is under investigation as an anti-platelet agent. First, we investigated the reversibility of the antiplatelet effect of ASP6537 and its interaction with ibuprofen to compare the usability of ASP6537 with that of aspirin...
March 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28054898/pump-thrombosis-following-heartmate-ii-left-ventricular-assist-device-implantation-in-a-patient-with-aspirin-and-plavix-resistance
#12
Ali Ghodsizad, A Badiye, M Zeriouh, W Pae, M M Koerner, M Loebe
Despite advances in pump technology, thromboembolic events and pump thrombosis are potentially life-threatening complications in patients with continuous flow ventricular assist devices. Here we describe a patient with pump thrombosis following LVAD HeartMate II implantation presenting with Aspirin and Plavix resistance and signs of acute hemolysis as manifested by high LDH, changing pump power, pulse index and reduced pump flows.
December 14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27863918/discontinuation-of-plavix-%C3%A2-clopidogrel-for-hip-fracture-surgery-a-systematic-review-of-the-literature
#13
REVIEW
L Mattesi, T Noailles, N Rosencher, J-L Rouvillain
The elderly population is increasing worldwide, associated with an increase in diseases related to aging, such as hip fractures. These patients are sometimes treated with clopidogrel. There are no arguments at present to clearly determine the risk/benefit ratio of early surgical management of traumatic hip fractures in patients treated with clopidogrel (perioperative blood loss, postoperative complications). The goal of this systematic review of the literature was to show that early surgical management (<48h) of patients treated with clopidogrel does not increase postoperative morbidity or mortality...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27597810/prasugrel-results-in-higher-decrease-in-high-sensitivity-c-reactive-protein-level-in-patients-undergoing-percutaneous-coronary-intervention-comparing-to-clopidogrel
#14
Shokoufeh Hajsadeghi, Mandana Chitsazan, Mitra Chitsazan, Negar Salehi, Ahmad Amin, Arash Amin Bidokhti, Nima Babaali, Armin Bordbar, Maral Hejrati, Samar Moghadami
OBJECTIVES: A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). METHODS: The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix(®); loading dose and maintenance dose of 300 and 75 mg daily, respectively) and 40 patients in the second group received prasugrel (Effient(®); loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27595478/aspirin-plavix-and-other-antiplatelet-medications-what-the-oral-and-maxillofacial-surgeon-needs-to-know
#15
REVIEW
Andre E Ghantous, Elie M Ferneini
Most patients with coronary artery disease and peripheral vascular disease are on long-term antiplatelet therapy and dual therapy. Achieving a balance between ischemic and bleeding risk remains an important factor in managing patients on antiplatelet therapy. For most outpatient surgical procedures, maintenance and continuation of this therapy are recommended. Consultation with the patient's cardiologist, physician, and/or vascular surgeon is always recommended before interrupting or withholding this treatment modality...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27484348/implementing-shared-decision-making-in-federally-qualified-health-centers-a-quasi-experimental-design-study-the-office-guidelines-applied-to-practice-office-gap-program
#16
Adesuwa Olomu, William Hart-Davidson, Zhehui Luo, Karen Kelly-Blake, Margaret Holmes-Rovner
BACKGROUND: Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). OBJECTIVE: To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician communication and confidence in decision in low-income population with diabetes and coronary heart disease (CHD) in a Federally Qualified Healthcare Center (FQHC)...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27128595/clinical-utility-and-cost-analysis-of-routine-postoperative-head-ct-in-elective-aneurysm-clippings
#17
Corinna C Zygourakis, Ethan Winkler, Lawrence Pitts, Lisa Hannegan, Benjamin Franc, Michael T Lawton
OBJECTIVE Postoperative head CT scanning is performed routinely at the authors' institution on all neurosurgical patients after elective aneurysm clippings. The goal of this study was to determine how often these scans influence medical management and to quantify the associated imaging costs. METHODS The authors reviewed the medical records and accounting database of 304 patients who underwent elective (i.e., nonruptured) aneurysm clipping performed by 1 surgeon (M.T.L.) from 2010 to 2014 at the University of California, San Francisco...
February 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27016908/continued-antiplatelet-therapy-and-risk-of-bleeding-in-gastrointestinal-procedures-a-systematic-review
#18
REVIEW
Xiao Fang, Jacques G Baillargeon, Daniel C Jupiter
BACKGROUND: Management of perioperative antiplatelet medications in gastrointestinal (GI) surgery is challenging. The risk of intraoperative and postoperative bleeding is associated with perioperative use of antiplatelet medication. However, cessation of these drugs may be unsafe for patients who are required to maintain antiplatelet use due to cardiovascular conditions. The objective of this systematic review was to compare the risk of intraoperative or postoperative bleeding among patients who had GI surgery while on continuous antiplatelet therapy (aspirin, clopidogrel, or dual therapy) with the risk among those not taking continuous antiplatelet medication...
May 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26975576/bleeding-after-tooth-extraction-in-patients-taking-aspirin-and-clopidogrel-plavix%C3%A2-compared-with-healthy-controls
#19
Mohsen Sadeghi-Ghahrody, Seyed Hamid Yousefi-Malekshah, Hamidreza Karimi-Sari, Hamid Yazdanpanah, Mohammad Saeid Rezaee-Zavareh, Mohammadhosein Yavarahmadi
The risk of perioperative bleeding is high in patients who take aspirin and clopidogrel after a percutaneous coronary intervention, and whether to stop the drugs is a matter of concern for dentists. The aim of this study was to answer the specific question: should aspirin and clopidogrel bisulphate (Plavix®) be discontinued during a conventional forceps extraction? We studied 64 patients during the first year after percutaneous insertion of coronary stents who were taking aspirin (ASA) 80mg and clopidogrel (Plavix(®)) 75mg, and 50 healthy patients who were to have a conventional forceps extraction at this polyclinic in 2013-2014 and acted as controls...
June 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/26910300/self-powered-microfluidic-device-for-rapid-assay-of-antiplatelet-drugs
#20
Bincy Jose, Peter McCluskey, Niamh Gilmartin, Martin Somers, Dermot Kenny, Antonio J Ricco, Nigel J Kent, Lourdes Basabe-Desmonts
We report the development of a microfluidic device for the rapid assay in whole blood of interfacial platelet-protein interactions indicative of the efficacy of antiplatelet drugs, for example, aspirin and Plavix, two of the world's most widely used drugs, in patients with cardiovascular disease (CVD). Because platelet adhesion to surface-confined protein matrices is an interfacial phenomenon modulated by fluid shear rates at the blood/protein interface, and because such binding is a better indicator of platelet function than platelet self-aggregation, we designed, fabricated, and characterized the performance of a family of disposable, self-powered microfluidic chips with well-defined flow and interfacial shear rates suitable for small blood volumes (≤200 μL)...
March 22, 2016: Langmuir: the ACS Journal of Surfaces and Colloids
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