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Regional anticoagulation

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https://www.readbyqxmd.com/read/28738273/factors-influencing-warfarin-control-in-australia-and-singapore
#1
Nijole Bernaitis, Chi Keong Ching, Siew Chong Teo, Liping Chen, Tony Badrick, Andrew K Davey, Julia Crilly, Shailendra Anoopkumar-Dukie
INTRODUCTION: Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore...
July 14, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#2
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28706123/cerebral-microbleeds-in-murine-amyloid-angiopathy-natural-course-and-anticoagulant-effects
#3
Marilena Marinescu, Li Sun, Marc Fatar, Andreas Neubauer, Lothar Schad, Joanne van Ryn, Lorenz Lehmann, Roland Veltkamp
BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) predispose patients to intracerebral hemorrhage. Preclinical models to examine the effects of antithrombotic treatments on the development of clinically overt intracerebral hemorrhage are needed. We examined the natural course of CMB development and the effects of long-term anticoagulation with warfarin or dabigatran on cerebral micro- and macrohemorrhage in mice overexpressing the APP23 (amyloid precursor protein). METHODS: Repeated susceptibility-weighted magnetic resonance imaging was performed in APP23 mice at the age of 18 and 21 months, respectively...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28696521/characterization-of-the-rabbit-as-an-in-vitro-and-in-vivo-model-to-assess-the-effects-of-fibrinogenolytic-activity-of-snake-venom-on-coagulation
#4
Vance G Nielsen, Elda E Sánchez, Daniel T Redford
Several in vitro investigations have demonstrated that anticoagulant effects of fibrinogenolytic snake venom metalloproteinases have been abrogated in human plasma by modifying fibrinogen with iron (Fe) and carbon monoxide (CO) to prevent catalysis or by directly inhibiting these enzymes with CO. In order to translate these findings, we chose to assess the rabbit as a model of envenomation with Crotalus atrox venom. It was determined with thrombelastography that 15-fold the concentration of venom noted to compromise coagulation in plasma in vitro was required to cause coagulopathy in vivo, likely secondary to venom binding to blood cells and being cleared from the circulation rapidly...
July 11, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28695244/-diagnostic-and-treatment-standards-for-cerebral-sinus-venous-thrombosis-results-of-an-online-survey-of-german-stroke-units
#5
C Geisbüsch, P A Ringleb, O Busse, G F Hamann, S Nagel
BACKGROUND AND PURPOSE: The aim of this survey was to characterize the current diagnostic and therapeutic strategies for thrombosis of the cerebral sinus and veins (CVT) performed in German stroke units (SU). METHODS: Between September 2015 and January 2016 all clinical heads of certified SUs in Germany were invited to participate in a standardized online survey. The survey concentrated on the basic characteristics of SUs, diagnostic and therapeutic procedures and was made anonymous if so desired...
July 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28682569/-nephrologist-and-icu-the-need-of-new-expertise
#6
Filippo Mariano, Marco Pozzato
Episodes of dialytic Acute Kidney Injury (AKI stage III KDIGO) can lead to chronic kidney disease (CKD), even after a long time. Prelimary data indicate that the relationship between AKI and CKD is affected by dialysis technical modalities and factors in part modifiable, such as an early dialysis timing, dose adeguacy, continuous treatment, use of biocompatible membranes and regional citrate anticoagulation. However, in most ICUs involvement of nephrologist consultant is marginal. Of more, nephrological follow-up after discharge, which allows to slow down the progression rate of CKD even just by a correct pharmacological and dietetic approach (sartans, ACEis), is an uncommon practice...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28673899/outcomes-and-prognostic-impact-of-prophylactic-oral-anticoagulation-in-anterior-st-segment-elevation-myocardial-infarction-patients-with-left-ventricular-dysfunction
#7
Jay S Shavadia, Erik Youngson, Kevin R Bainey, Jeffrey Bakal, Robert C Welsh
BACKGROUND: The contemporary role of prophylactic anticoagulation following extensive anterior wall ST-segment myocardial infarction (STEMI) is unclear. METHODS AND RESULTS: We evaluated anterior STEMI patients with left ventricle dysfunction (left ventricular ejection fraction ≤40%) ("high risk"), categorized by prophylactic warfarin use, within a regional STEMI. Patients with pre-existing atrial fibrillation were excluded. The primary outcome was an adjusted (for Global Registry of Acute Coronary Events risk score) 1-year composite of recurrent ischemia, stroke/transient ischemic attack/systemic embolism, or all-cause death...
July 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28666576/assessment-of-coronary-artery-aneurysms-caused-by-kawasaki-disease-using-transluminal-attenuation-gradient-analysis-of-computerized-tomography-angiograms
#8
Noelia Grande Gutierrez, Olga Shirinsky, Nina Gagarina, Galina Lyskina, Ryuji Fukazawa, Shunichi Ogawa, Jane C Burns, Alison L Marsden, Andrew M Kahn
Patients with coronary artery aneurysms (CAAs) resulting from Kawasaki disease (KD) are at risk for thrombosis and myocardial infarction. Current guidelines recommend CAA diameter ≥8 mm as the criterion for initiating systemic anticoagulation. Transluminal attenuation gradient (TAG) analysis has been proposed as a noninvasive method for evaluating functional significance of coronary stenoses using computerized tomography angiography (CTA), but has not previously been used in CAA. We hypothesized that abnormal hemodynamics in CAA caused by KD could be quantified using TAG analysis...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28665993/knowledge-attitudes-and-practice-on-the-prevention-of-central-line-associated-bloodstream-infections-among-nurses-in-oncological-care-a-cross-sectional-study-in-an-area-of-southern-italy
#9
Maria Rosaria Esposito, Assunta Guillari, Italo Francesco Angelillo
The objectives of the cross-sectional study were to delineate the knowledge, attitudes, and behavior among nurses regarding the prevention of central line-associated bloodstream infections (CLABSIs) and to identify their predisposing factors. A questionnaire was self-administered from September to November 2011 to nurses in oncology and outpatient chemotherapy units in 16 teaching and non-teaching public and private hospitals in the Campania region (Italy). The questionnaire gathered information on demographic and occupational characteristics; knowledge about evidence-based practices for the prevention of CLABSIs; attitudes towards guidelines, the risk of transmitting infections, and hand-washing when using central venous catheter (CVC); practices about catheter site care; and sources of information...
2017: PloS One
https://www.readbyqxmd.com/read/28664840/anticoagulation-assessment-methods-in-plasma-exchange-with-regional-citrate-anticoagulation-evaluation-of-post-filter-and-filtered-plasma-ionized-calcium
#10
Manja Antonič, Jakob Gubenšek, Jadranka Buturović-Ponikvar, Rafael Ponikvar
AIM: To assess the possibility of using filtered plasma instead of postfilter ionized calcium (iCa) for the assessment of anticoagulation in plasma exchange (PE) with citrate anticoagulation. METHODS: 140 PE treatments were performed using either 4% or 15% citrate at a comparable dose. Paired samples of postfilter blood and filtered plasma were taken for iCa measurements with a point-of-care analyzer. Anticoagulation was also assessed with a bedside clotting time and visual assessment of the circuit after procedures...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28664360/factors-associated-with-antithrombotic-treatment-decisions-for-stroke-prevention-in-atrial-fibrillation-in-the-stockholm-region-after-the-introduction-of-noacs
#11
Joris Komen, Tomas Forslund, Paul Hjemdahl, Björn Wettermark
PURPOSE: The purpose of this study was to investigate the influence of patient characteristics such as age and stroke and bleeding risks on decisions for antithrombotic treatment in patients with atrial fibrillation (AF). METHODS: This was a retrospective, population-based study including AF patients initiated with either warfarin, dabigatran, rivaroxaban, apixaban, or low-dose aspirin (ASA) between March 2015 and February 2016. Multivariate models were used to calculate adjusted odds ratios (aOR) for factors associated with treatment decisions...
June 29, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28655815/geographic-variation-in-the-use-of-oral-anticoagulation-therapy-in-stroke-prevention-in-atrial-fibrillation
#12
Inmaculada Hernandez, Samir Saba, Yuting Zhang
BACKGROUND AND PURPOSE: Underuse of oral anticoagulation in stroke prevention in atrial fibrillation is common; however, it remains unknown how it varies geographically. The objective of this study was to evaluate geographic variation in oral anticoagulation use and in the initiation of new oral anticoagulants (NOACs). METHODS: Using 2013 to 2014 claims data from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated NOACs (n=8659), warfarin (n=11 771) or no oral anticoagulation therapy (n=18 226) in 2013 to 2014...
June 27, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#13
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28632284/benefits-and-risks-of-antithrombotic-therapy-in-essential-thrombocythemia-a-systematic-review
#14
Derek K Chu, Christopher M Hillis, Darryl P Leong, Sonia S Anand, Deborah M Siegal
Background: Patients with essential thrombocythemia (ET) are at high risk for both thrombosis and hemorrhage. Purpose: To evaluate the risks and benefits of antithrombotic therapy in adults with ET. Data Sources: Multiple databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, through 4 March 2017. Study Selection: Randomized and observational studies of antiplatelet or anticoagulant therapy, published in any language and reporting thrombotic or hemorrhagic events...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#15
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28618127/regional-citrate-anticoagulation-in-membrane-based-plasma-exchange-safety-efficacy-and-effect-on-calcium-balance
#16
Daniel Christiadi, Chari Mercado, Richard Singer
AIM: To assess the efficacy, safety and calcium balance of a membrane based regional citrate anticoagulation plasma exchange protocol METHODS: This was an observational, prospective, single center study of membrane separation plasma exchange using regional citrate anticoagulation. It was performed using a fixed dose pre-filter citrate infusion that was based on the plasma flow rate. Patients received a post filter calcium infusion which was modified during treatment based on systemic ionized calcium monitoring...
June 15, 2017: Nephrology
https://www.readbyqxmd.com/read/28614119/pump-priming-practices-and-anticoagulation-in-cardiac-surgery-results-from-the-global-cardiopulmonary-bypass-survey
#17
Lachlan F Miles, Timothy G Coulson, Carlos Galhardo, Florian Falter
BACKGROUND: Regional patterns of practice in cardiopulmonary bypass remain poorly understood with conflicting evidence regarding the best choices in pump priming preferences with respect to colloid and crystalloid and different types of fluid within these categories. In light of the variation in the literature, we hypothesized there would be considerable regional differences in cardiopulmonary bypass practice, particularly with respect to the type of fluid used to prime the extracorporeal circuit...
June 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28594321/pharmacogenomics-in-asia-a-systematic-review-on-current-trends-and-novel-discoveries
#18
Hazel Xiaohui Ang, Sze Ling Chan, Levana L Sani, Clarissa Bernice Quah, Liam R Brunham, Boon Ooi Patrick Tan, Michael D Winther
While early pharmacogenomic studies have primarily been carried out in Western populations, there has been a notable increase in the number of Asian studies over the past decade. We systematically reviewed all pharmacogenomic studies conducted in Asia published before 2016 to highlight trends and identify research gaps in Asia. We observed that pharmacogenomic research in Asia was dominated by larger developed countries, notably Japan and Korea, and mainly driven by local researchers. Studies were focused on drugs acting on the CNS, chemotherapeutics and anticoagulants...
June 8, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28592490/functional-analyses-yield-detailed-insight-into-the-mechanism-of-thrombin-inhibition-by-the-antihemostatic-salivary-protein-ce5-from-anopheles-gambiae
#19
Luciano Pirone, Jorge Ripoll-Rozada, Marilisa Leone, Raffaele Ronca, Fabrizio Lombardo, Gabriella Fiorentino, John F Andersen, Pedro José Barbosa Pereira, Bruno Arcà, Emilia Pedone
Saliva of blood-feeding arthropods carries several antihemostatic compounds whose physiological role is to facilitate successful acquisition of blood. The identification of novel natural anticoagulants and the understanding of their mechanism of action may offer opportunities for designing new antithrombotics disrupting blood clotting. We report here an in depth structural and functional analysis of the anophelin family member cE5, a salivary protein from the major African malaria vector Anopheles gambiae that specifically tightly and quickly binds and inhibitss thrombin...
June 7, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28580572/the-impact-of-low-molecular-weight-heparin-on-obstetric-outcomes-among-unexplained-recurrent-miscarriages-complicated-with-methylenetetrahydrofolate-reductase-gene-polymorphism
#20
Orkun Cetin, Erbil Karaman, Numan Cim, Deniz Dirik, Hanim Guler Sahin, Erdal Kara, Ramazan Esen
OBJECTIVES: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. MATERIAL AND METHODS: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively...
2017: Ginekologia Polska
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