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Regional anticoagulation

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https://www.readbyqxmd.com/read/28342627/applicability-of-calf-subcutaneous-tissue-to-subcutaneous-injection-in-young-adults
#1
Serap Torun, Şükriye Deniz Mutluay
AIM: The aim of the study is to provide usage of subcutaneous tissue of lateral calf area (region of M. Gastrocnemius) in addition to the existing injection regions and to compare tissue thicknesses of the lateral upper arm, anterior and lateral thigh, anterior abdomen regions and calf regions. BACKGROUND: Subcutaneous injection (SC) is an application of 0.5cc drug with an injection (No. 25 and 8-15-18mm long) to the connective tissue under the skin. Individuals to which SC injection is frequently applied, should rotate the injection areas...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#2
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337775/effectiveness-and-safety-assessment-of-citrate-anticoagulation-during-albumin-dialysis-in-comparison-to-other-methods-of-anticoagulation
#3
Agnieszka Dyla, Wojciech Mielnicki, Joanna Bartczak, Tomasz Zawada, Piotr Garba
Liver failure is a serious and often deadly disease often requiring MARS (Molecular Adsorbent Recirculating System) therapy. Choosing the safe and effective method of anticoagulation during artificial liver support systems seems to be very difficult and extremely important. The aim of this study was to assess effectiveness and safety of regional anticoagulation with citrate in liver failure patients during MARS. We used a single center observational study. We analyzed 158 MARS sessions performed in 65 patients: 105 (66...
March 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28321019/myocardial-infarction-in-a-young-man-with-nephrotic-syndrome
#4
Zhenliang Chu, Hang Zhu, Bin Zhang, Liqin Jiang
A 26-year-old man diagnosed with nephrotic syndrome (NS) 2 years previously presented with chest pain. An electrocardiogram (ECG) performed at a local hospital showed ST-elevation in chest leads. Cardiac troponin-I was significantly positive. Echocardiography revealed mild regional wall-motion abnormalities in the heart apex. Seven days later, angiography (CAG) revealed a thrombus in the left anterior descending branch (LAD). Tirofiban was injected into the LAD for thromboclasis. ECG after CAG showed the ST-segment was much lower than before...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28318145/a-multicenter-study-on-pivka-reference-interval-of-healthy-population-and-establishment-of-pivka-cutoff-value-for-hepatocellular-carcinoma-diagnosis-in-china
#5
X Qin, G Tang, R Gao, Z Guo, Z Liu, S Yu, M Chen, Z Tao, S Li, M Liu, L Wang, L Hou, L Xia, X Cheng, J Han, L Qiu
INTRODUCTION: The aim of this study was to investigate the reference interval of protein-induced vitamin K absence or antagonist-II (PIVKA-II) in China population and to evaluate its medical decision level for hepatocellular carcinoma (HCC) diagnosis. METHODS: To determine the reference range for Chinese individuals, a total of 855 healthy subjects in five typical regions of China were enrolled in this study to obtain a 95% reference interval. In a case-control study which recruited the subjects diagnosed with HCC, metastatic liver cancer, bile duct cancer, hepatitis, cirrhosis, other benign liver diseases and the subjects administrated anticoagulant, receiver operating characteristic analysis was used to determine PIVKA-II cutoff value for a medical decision...
March 20, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28293127/care-pathways-in-thrombosis-management-the-innovate-peer-to-peer-educational-initiative
#6
REVIEW
Raj K Patel
CONTEXT: Anticoagulant options for the management of venous thromboembolism (VTE) now include the non-vitamin K antagonist oral anticoagulants (NOACs). The safe and effective integration of these agents into routine clinical practice within different health care settings presents common challenges. Bayer AG created the INternational Network fOr Venous and Arterial Thrombosis Excellence in practice (INNOVATE) program as a professional education network to foster best practice in thrombosis management in the NOAC era...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28286393/versatility-of-fibula-free-flap-in-reconstruction-of-facial-defects-a-center-study
#7
Sunil S Shroff, Sanjiv C Nair, Anjan Shah, Balasubramanya Kumar
PURPOSE: To study a series of cases where vascularised fibula flap was used in various combinations of bone with muscle and skin along with its modifications for reconstruction of simple and composite defects of the facial region. PATIENTS AND METHODS: The investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of maxilla or mandible with vascularised fibula free flap from 2009 to 2013. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28280082/bumpy-road-to-the-diagnosis-of-polycythaemia-vera
#8
Rita de Sousa Gameiro, Ana Rodrigues, Fernando Martos Gonçalves, José Pimenta da Graça
Polycythaemia vera (PV) is the most common myeloproliferative neoplasm, characterised by increased red cell mass that can present as an unspecified symptom or a thrombohaemorrhagic event. Its diagnosis is based on the presence of erythrocytosis, the identification of the Janus kinase 2 mutation and bone marrow aspirate or biopsy alterations. The challenge of this disease lies on the treatment approach. Its cornerstone is phlebotomy, but depending on the vascular risk, it can include cytoreductive agents, low-dose aspirin or even anticoagulation...
March 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28279164/erratum-to-a-new-prescription-model-for-regional-citrate-anticoagulation-in-therapeutic-plasma-exchanges
#9
Sébastien Kissling, Cécile Legallais, Menno Pruijm, Daniel Teta, Bruno Vogt, Michel Burnier, Eric Rondeau, Christophe Ridel
No abstract text is available yet for this article.
March 9, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28271510/anticoagulation-and-antiplatelet-therapy-in-awake-transcervical-injection-laryngoplasty
#10
Jennifer H Dang, Nelson Eddie Liou, Julina Ongkasuwan
OBJECTIVE: Vocal fold movement impairment (VFMI) due to neuronal injury occurs in 20% to 30% of surgeries in the region of the aortic arch. Early injection laryngoplasty can aid with postoperative pulmonary toilet in these high-risk cardiovascular patients. The purpose of this study is to determine whether continuing antiplatelet and anticoagulation therapy during awake transcervical injection laryngoplasty surgery is safe, and if there is any increase in bleeding complications in these patients...
March 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28271121/medication-use-among-veterans-across-health-care-systems
#11
Khoa A Nguyen, David A Haggstrom, Susan Ofner, Susan M Perkins, Dustin D French, Laura J Myers, Marc Rosenman, Michael Weiner, Brian E Dixon, Alan J Zillich
INTRODUCTION: Dual healthcare system use can create gaps and fragments of information for patient care. The Department of Veteran Affairs is implementing a health information exchange (HIE) program called the Virtual Lifetime Electronic Record (VLER), which allows providers to access and share information across healthcare systems. HIE has the potential to improve the safety of medication use. However, data regarding the pattern of outpatient medication use across systems of care is largely unknown...
March 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28270205/gps-and-dentists-experiences-and-expectations-of-interprofessional-collaboration-findings-from-a-qualitative-study-in-germany
#12
Khira Sippli, Monika A Rieger, Fabian Huettig
BACKGROUND: Against the background of well-described associations between oral and general health, collaboration between dentists and general practitioners (GP) is crucial to provide therapeutic and preventive patient care. However, in the German health system, GPs and dentists are organizationally separated, implying that interprofessional collaboration can only occur informally and on a voluntary basis. Given the scarce evidence of interprofessional collaboration between dentists and GPs, an explorative study was conducted...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28263863/the-influence-of-surface-chemistry-on-adsorbed-fibrinogen-conformation-orientation-fiber-formation-and-platelet-adhesion
#13
Liudi Zhang, Brendan Casey, Dennis K Galanakis, Clement Marmorat, Shelby Skoog, Katherine Vorvolakos, Marcia Simon, Miriam H Rafailovich
Thrombosis is a clear risk when any foreign material is in contact with the bloodstream. Here we propose an immunohistological stain-based model for non-enzymatic clot formation that enables a facile screen for the thrombogenicity of blood-contacting materials. We exposed polymers with different surface chemistries to protease-free human fibrinogen. We observed that on hydrophilic surfaces, fibrinogen is adsorbed via αC regions, while the γ400-411 platelet-binding dodecapeptide on the D region becomes exposed, and fibrinogen fibers do not form...
March 2, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28262339/safety-and-efficacy-of-warfarin-therapy-in-remote-communities-of-the-top-end-of-northern-australia
#14
Jahde Dennis, William Majoni, Jeffrey Tinsley, Nadarajah Kangaharan
BACKGROUND: Warfarin remains a widely used anticoagulant but application in the remote context is not well documented. This study aimed to assess in more detail whether warfarin is being utilised effectively in Australia's most isolated and remote areas. METHODS: Retrospective cohort analysis of 2013 captured international normalised ration (INR) results from people engaged in long term warfarin usage within a number of remote Northern Australian communities. Assessment of monitoring, effectiveness of dosing and complication rates was undertaken...
February 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28261098/oral-anticoagulants-initiation-in-patients-with-atrial-fibrillation-real-world-data-from-a-population-based-cohort
#15
Clara L Rodríguez-Bernal, Isabel Hurtado, Aníbal García-Sempere, Salvador Peiró, Gabriel Sanfélix-Gimeno
Objective: Little is known about initial prescription of currently used oral anticoagulants (OAC), and correlated characteristics in real-world practice. We aimed to assess patterns of initiation of Vitamin K antagonists (VKA) and non-VKA oral anticoagulants (NOAC) in naive patients with non-valvular atrial fibrillation and the factors associated with starting treatment with NOAC. Methods: Population-based retrospective cohort study of all patients with NVAF who had a first prescription of OAC from November 2011 to February 2014 in the Valencia region, Spain (n = 21,881)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28260714/a-case-of-collagenous-colitis-associated-with-novel-oral-anticoagulants-use
#16
Juri Ikemoto, Kouichi Nakadoi, Seiji Onogawa, Motomitsu Fukuhara, Takayoshi Shishido, Keiji Hanada, Shuji Yonehara
An 84-year-old man was referred to our hospital because of watery diarrhea. Due to cerebral infarction, he had started treatment with a novel oral anticoagulants (NOAC) 1 month prior to admission. The patient underwent blood tests, enhanced computed tomography, and colonoscopy, which indicated infectious or medicinal colitis. The diarrhea persisted and he developed hypokalemia, so a second colonoscopy was performed, which showed edematous mucosa. Colonic mucosal biopsies showed a thick collagen band in the subepithelial region, and collagenous colitis was diagnosed...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28255948/what-adverse-events-and-injuries-are-cited-in-anesthesia-malpractice-claims-for-nonspine-orthopaedic-surgery
#17
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
March 2, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28250865/scintigraphic-evidence-for-overdiagnosis-of-small-pe-on-ct-pulmonary-angiography
#18
Yang Lu
A 68-year-old man with recent history of a fall presented with dyspnea on exertion, and underwent computed tomography pulmonary angiography (CTPA) for possible pulmonary embolism (PE). The CTPA was first read by the radiology resident as nondiagnostic for segmental PE. Subsequent planar perfusion (Q) images were normal; meanwhile, the attending radiologist revised the CTPA results as subsegmental PE in the left upper lobe. Further Q-SPECT images were obtained and fused with CTPA for clarification, which showed normal perfusion in the region of PE...
March 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28249884/unusual-morel-lavallee-lesion-of-the-knee-region-in-an-elderly-patient
#19
Walid El Kininy, Shane Davy, Murali Sayana
The Morel-Lavallee lesion (MLL) of the knee region has been described in the Orthopaedic literature, and all of those were fit and healthy young participants sustaining sports-related trauma to the knee. We describe a case of an elderly woman, on aspirin and prophylactic clexane, who sustained a low-energy injury to the right knee and developed an MLL of the knee region. A delayed recognition, led to the persistence of the MLL as a diffuse haematoma, which subsequently became colonised with methicillin-resistant Staphylococcus aureus We discuss the management of a case and highlight the importance of early identification and management of MLL of the knee region...
March 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28249613/a-new-prescription-model-for-regional-citrate-anticoagulation-in-therapeutic-plasma-exchanges
#20
Sébastien Kissling, Cécile Legallais, Menno Pruijm, Daniel Teta, Bruno Vogt, Michel Burnier, Eric Rondeau, Christophe Ridel
BACKGROUND: Regional citrate anticoagulation (RCA) is proposed for various extracorporeal purification techniques to overcome the risk of bleeding that might result from systemic anticoagulation. Yet, no individualized treatment protocol has been proposed for therapeutic plasma exchange (TPE) so far. The objective of this study was to assess the determinants of blood citrate concentration needed and to develop an individualized RCA protocol useful for clinical practice. METHODS: The study population included 14 patients who underwent a total of 47 TPE sessions...
March 1, 2017: BMC Nephrology
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