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Novel anticoagulants

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https://www.readbyqxmd.com/read/28226413/thrombalexin-use-of-a-cytotopic-anticoagulant-to-reduce-thrombotic-microangiopathy-in-a-highly-sensitized-model-of-kidney-transplantation
#1
Miriam Manook, Jean Kwun, Christian Burghuber, Kannan Samy, Michael Mulvihill, Janghoon Yoon, He Xu, Andrea L MacDonald, Kyle Freischlag, Verna Curfman, Evelyn Branum, David Howell, Alton Brad Farris, Richard A Smith, Stephen Sacks, Anthony Dorling, Nizam Mamode, Stuart Knechtle
Early activation of coagulation is an important factor in the initiation of innate immunity, as characterized by thrombotic microangiopathy (TMA). In transplantation, systemic anti-coagulation is difficult due to bleeding. A novel 'cytotopic' agent, 'Thrombalexin', (TLN) combines a cell-membrane bound (mirystoyl tail) anti-thrombin (HLL peptide) which can be perfused directly to the donor organ or cells.. Thromboelastography (TEG) was used to measure time to clot formation (r-time) in both rhesus and human blood, comparing TLN vs...
February 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28225876/anticoagulation-in-acute-ischemic-stroke-a-systematic-search
#2
Nayara L Froio, Richard Murdoch Montgomery, Elias David-Neto, Ivan Aprahamian
INTRODUCTION: Stroke is one of the most important diseases worldwide. Several clinical scenarios demand full dose of anticoagulants primary to stroke etiology or to the treatment of comorbidity. However, controversy exists over many issues regarding anticoagulation treatment in stroke such as time for initiation, efficacy according to stroke etiology, the ideal dose of anticoagulants, and whether novel anticoagulants should be used. METHOD: Computerized search for clinical trials and randomized controlled clinical trials was done to the present date at Medline, Scielo, Embase, PsychInfo, and Cochrane Library using MeSH terms and the keywords stroke, ischemic stroke, anticoagulation, anticoagulants, heparin, low-molecular-weight heparin, warfarin, dabigatran, rivaroxaban, apixaban...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28223868/assessment-of-novel-oral-anticoagulant-use-within-a-community-teaching-hospital
#3
Sultan Alghadeer, Lori Hornsby
: Background: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. SETTING: A community teaching hospital in the United States...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#4
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#5
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28210454/managing-patients-taking-edoxaban-in-dentistry
#6
REVIEW
Adrian Curto, Daniel Curto, Jorge Sanchez
BACKGROUND: Anticoagulation therapy is used in several conditions to prevent or treat thromboembolism. A new group of oral anticoagulants with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. The Food and Drug Administration has approved edoxaban, dabigatran, rivaroxaban and apixaban. Their advantages include: predictable pharmacokinetics, drug interactions and limited food, rapid onset of action and short half-life...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28210451/dental-management-of-patients-taking-novel-oral-anticoagulants-noas-dabigatran
#7
REVIEW
Adrian Curto, Alberto Albaladejo, Alfonso Alvarado
BACKGROUND: A new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments. MATERIAL AND METHODS: A literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords "dabigatran", "rivaroxaban", "apixaban", "edoxaban", "new oral anticoagulants", "novel oral anticoagulants", "bleeding" and "dental treatment"...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28210286/bilastine-in-allergic-rhinoconjunctivitis-and-urticaria-a-practical-approach-to-treatment-decisions-based-on-queries-received-by-the-medical-information-department
#8
REVIEW
Amalia Leceta, Ander Sologuren, Román Valiente, Cristina Campo, Luis Labeaga
BACKGROUND: Bilastine is a safe and effective commonly prescribed non-sedating H1-antihistamine approved for symptomatic treatment in patients with allergic disorders such as rhinoconjunctivitis and urticaria. It was evaluated in many patients throughout the clinical development required for its approval, but clinical trials generally exclude many patients who will benefit in everyday clinical practice (especially those with coexisting diseases and/or being treated with concomitant drugs)...
2017: Drugs in Context
https://www.readbyqxmd.com/read/28208196/the-novel-oral-anticoagulants-for-acute-venous-thromboembolism-is-warfarin-dead
#9
Alexander T Cohen, Serena Granziera, Nicola Veronese, Giacomo Zoppellaro
The direct oral anticoagulants (DOACs) have been compared with parenteral anticoagulants and vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) in several robust studies. DOACs have shown similar efficacy in preventing recurrent VTE and significant reductions in critical site (intracranial) bleeding, fatal bleeding, major and nonmajor bleeding. Warfarin and other VKAs are not dead as treatment modalities for VTE. A better way to describe the current situation is to use a boxing expression, "down but not out...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28188243/effectiveness-and-safety-of-reduced-dose-non-vitamin-k-antagonist-oral-anticoagulants-and-warfarin-in-patients-with-atrial-fibrillation-propensity-weighted-nationwide-cohort-study
#10
Peter Brønnum Nielsen, Flemming Skjøth, Mette Søgaard, Jette Nordstrøm Kjældgaard, Gregory Y H Lip, Torben Bjerregaard Larsen
Objective To examine clinical effectiveness and safety of apixaban 2.5 mg, dabigatran 110 mg, and rivaroxaban 15 mg compared with warfarin among patients with atrial fibrillation who had not previously taken an oral anticoagulant.Design Propensity weighted (inverse probability of treatment weighted) nationwide cohort study.Setting Individual linked data from three nationwide registries in Denmark.Participants Patients with non-valvular atrial fibrillation filling a first prescription for an oral anticoagulant from August 2011 to February 2016...
February 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28188221/successful-use-of-laboratory-monitoring-to-facilitate-an-invasive-procedure-for-a-patient-treated-with-dabigatran
#11
Mackenzie Byron, Sara Zochert, Thaddaus Hellwig, Marioara Gavozdea-Barna, Michael P Gulseth
PURPOSE: A case in which novel and traditional laboratory markers were successfully used to determine surgical intervention timing in an elderly patient receiving dabigatran for atrial fibrillation is reported. SUMMARY: An 86-year-old woman who was taking dabigatran for atrial fibrillation suffered a right femoral neck fracture requiring surgical intervention. Dabigatran was withheld once the patient was admitted to the hospital, and the pharmacy inpatient anticoagulation management team was consulted for guidance on determining appropriate scheduling of surgical intervention with regard to the time since her most recent dabigatran dose to minimize bleeding complications...
February 10, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28185693/advances-in-oral-anticoagulation-therapy-what-s-in-the-pipeline
#12
REVIEW
P S S Rao, T Burkart
Approximately 900,000 people are affected by some sort of venous thromboembolic (VTE) event every year in the United States. VTE diagnosis used to mean treatment with medications that required routine lab monitoring for safety and efficacy. Activated factor X (FXa) inhibition has emerged as a convenient pathway for management of VTE and currently three FXa inhibitors are available for anticoagulation management - rivaroxaban, apixaban, and edoxaban. Continued development of medications utilizing this pathway may offer advantages via novel pharmacokinetic or pharmacodynamic properties that may minimize the adverse effects associated with traditional anticoagulant therapy...
February 5, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28183598/immobilization-of-heparin-poly-l-lysine-microspheres-on-medical-grade-high-nitrogen-nickel-free-austenitic-stainless-steel-surface-to-improve-the-biocompatibility-and-suppress-thrombosis
#13
Menghua Li, Haide Wu, Yi Wang, Tieying Yin, Hans Gregersen, Xiaojuan Zhang, Xiaoling Liao, Guixue Wang
Thrombosis formation, restenosis, and delayed endothelium regeneration continue to be a challenge for coronary artery stent therapy. To improve the hemocompatibility of cardiovascular implants and to selectively direct vascular cell behavior, a novel heparin/poly-l-lysine microsphere was developed and immobilized on a dopamine-coated surface. We chose medical grade high nitrogen nickel-free austenitic stainless steel as the stent material since it has better biocompatibility. The stability and structural characteristics of the microspheres changed with the heparin: poly-l-lysine concentration ratio...
April 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28182051/warfarin-related-acute-kidney-injury-a-case-report
#14
S Mendonca, D Gupta, A Valsan, R Tewari
Warfarin is an oral anticoagulant used extensively in clinical practice; However, its side-effect of causing renal damage has been recently detected. The mechanism leading to renal damage is glomerular hemorrhage and red blood cell tubular casts prothrombin time. Recently, it was found that warfarin causes renal damage in patients with chronic kidney disease and is also associated with progression of renal disease. Warfarin causing acute kidney injury in patients with normal renal function is a rare manifestation...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181272/left-atrial-appendage-closure-for-stroke-prevention-more-choice-is-always-a-good-thing
#15
EDITORIAL
Rong Bai
While oral anticoagulants (OACs) remains the main strategy of prevention of thromboembolic event in patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) has become an alternative recently. The concept of this technique is based on the understanding that in more than 90% non-valvular AF patients, the thrombi form in the left atrial appendage (LAA), so excluding the LAA from the systemic circulation can prevent stroke or peripheral arterial embolization. To achieve this goal, novel trans-catheter techniques have been developed to either occlude the LAA endocardially or ligate the LAA epicardially...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28180234/pharmacokinetics-and-pharmacodynamics-of-tecarfarin-a-novel-vitamin-k-antagonist-oral-anticoagulant
#16
Detlef Albrecht, David Ellis, Daniel M Canafax, Daniel Combs, Pascal Druzgala, Peter G Milner, Mark G Midei
Tecarfarin is a vitamin K antagonist (VKA) with reduced propensity for drug interactions. To evaluate the pharmacokinetic (PK), pharmacodynamic (PD), and safety of tecarfarin, we performed single ascending dose (SAD) (n=66), multiple ascending dose (MAD) (n=43), and tecarfarin versus warfarin (n=28) studies in human volunteers. In the SAD, tecarfarin was administered to 5 of 6 subjects (1 received placebo) in each of 11 cohorts. AUC0-∞ exhibited linearity and dose proportionality. Elimination T1/2 ranged from 87-136 hours (h) across all doses...
February 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28168447/how-to-achieve-ultrasound-guided-femoral-venous-access-the-new-standard-of-care-in-the-electrophysiology-laboratory
#17
REVIEW
Benedict M Wiles, Nicholas Child, Paul R Roberts
PURPOSE: Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised...
February 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28165420/behavior-of-gingival-fibroblasts-on-titanium-implant-surfaces-in-combination-with-either-injectable-prf-or-prp
#18
Xuzhu Wang, Yufeng Zhang, Joseph Choukroun, Shahram Ghanaati, Richard J Miron
Various strategies have been employed to speed tissue regeneration using bioactive molecules. Interestingly, platelet concentrates derived from a patient's own blood have been utilized as a regenerative strategy in recent years. In the present study, a novel liquid platelet formulation prepared without the use of anti-coagulants (injectable-platelet-rich fibrin, i-PRF) was compared to standard platelet-rich plasma (PRP) with gingival fibroblasts cultured on smooth and roughened titanium implant surfaces. Standard PRP and i-PRF (centrifuged at 700 rpm (60× g) for 3 min) were compared by assays for fibroblast biocompatibility, migration, adhesion, proliferation, as well as expression of platelet-derived growth factor (PDGF), transforming growth factor-β (TGF-β), collagen1 (COL1) and fibronectin (FN)...
February 4, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#19
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28153461/purification-structural-characterization-and-anticoagulant-properties-of-fucosylated-chondroitin-sulfate-isolated-from-holothuria-mexicana
#20
Jiaojiao Mou, Cong Wang, Wenjing Li, Jie Yang
A novel fucosylated chondroitin sulfate (HmG) was isolated from sea cucumber Holothuria mexicana, the structure of which was characterized by monosaccharide composition, disaccharide composition, IR, (1)H and (13)C NMR spectrum, additionally with two dimensional NMR spectrum of degraded HmG (DHmG). The backbone of HmG was identified as chondroitin 6-O sulfate, while the major O-4 sulfated fucose branches linked to O-3 position of glucuronic acid in almost every disaccharide unit. The anticoagulant activities of HmG and DHmG were assessed and compared with heparin and low molecular weight heparin...
January 30, 2017: International Journal of Biological Macromolecules
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