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Regional anticoagulation

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https://www.readbyqxmd.com/read/29351783/simple-citrate-anticoagulation-protocol-for-low-flux-haemodialysis
#1
Eng Kuang Lim, Ying-Ying T Seow, Shun E Chen, Gao Yang, Min Er Liaw, Shimi Isaac
BACKGROUND: For patients unable to receive heparin anticoagulation during haemodialysis, saline flushes to reduce circuit clotting are often the norm. Regional citrate anticoagulation (RCA) although effective is not used by many centres including in Singapore. We wanted to demonstrate the superiority and safety of a simple regional citrate anticoagulation regime, compared to saline flushes, for heparin-free low flux haemodialysis. METHODS: This is a prospective, open label, cross over study on 25 sequential haemodialysis sessions for inpatients receiving heparin-free haemodialysis...
January 19, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29337813/heparin-free-regional-anticoagulation-there-are-significant-differences-between-citrate-containing-dialysate-and-regional-citrate-anticoagulation
#2
Jakob Gubensek, Jadranka Buturovic-Ponikvar
No abstract text is available yet for this article.
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29331946/management-of-patients-on-antithrombotic-agents-undergoing-emergency-and-elective-endoscopy-joint-asian-pacific-association-of-gastroenterology-apage-and-asian-pacific-society-for-digestive-endoscopy-apsde-practice-guidelines
#3
Francis K L Chan, Khean-Lee Goh, Nageshwar Reddy, Kazuma Fujimoto, Khek Yu Ho, Seiji Hokimoto, Young-Hoon Jeong, Takanari Kitazono, Hong Sik Lee, Varocha Mahachai, Kelvin K F Tsoi, Ming-Shiang Wu, Bryan P Yan, Kentaro Sugano
This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29324487/renal-replacement-therapy-in-critically-ill-patients-who-when-why-and-how
#4
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: The increasing incidence of acute kidney injury has the immediate effect of a growing need for renal replacement therapy (RRT). Shedding light on the questions of who, when, why, and how RRT should be performed is difficult to accomplish because of ambiguous study results, poor quality evidence, and low standardization. RECENT FINDINGS: Critically ill patients are exposed to multiple factors known to deteriorate kidney function. Especially severe fluid overload is strongly associated with worse outcome and may be considered as a trigger for initiating RRT...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29321072/tissue-specific-transcriptomes-of-anisakis-simplex-sensu-stricto-and-anisakis-pegreffii-reveal-potential-molecular-mechanisms-involved-in-pathogenicity
#5
Serena Cavallero, Fabrizio Lombardo, Xiaopei Su, Marco Salvemini, Cinzia Cantacessi, Stefano D'Amelio
BACKGROUND: Larval stages of the sibling species of parasitic nematodes Anisakis simplex (sensu stricto) (s.s.) (AS) and Anisakis pegreffii (AP) are responsible for a fish-borne zoonosis, known as anisakiasis, that humans aquire via the ingestion of raw or undercooked infected fish or fish-based products. These two species differ in geographical distribution, genetic background and peculiar traits involved in pathogenicity. However, thus far little is known of key molecules potentially involved in host-parasite interactions...
January 10, 2018: Parasites & Vectors
https://www.readbyqxmd.com/read/29319605/epidural-hematoma-following-interlaminar-epidural-injection-in-patient-taking-aspirin
#6
Rebecca A Sanders, Markus A Bendel, Susan M Moeschler, William D Mauck
OBJECTIVE: We present a case report of a patient who developed an epidural hematoma following an interlaminar epidural steroid injection with no risk factors aside from old age and aspirin use for secondary prevention. CASE REPORT: A 79-year-old man developed an epidural hematoma requiring surgical treatment following an uncomplicated interlaminar epidural steroid injection performed for neurogenic claudication. In the periprocedural period, he continued aspirin for secondary prophylaxis following a myocardial infarction...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29305675/efficacy-and-safety-of-outpatient-treatment-with-direct-oral-anticoagulation-in-pulmonary-embolism
#7
REVIEW
R Ghazvinian, A Gottsäter, J L Elf
Anticoagulant treatment of acute pulmonary embolism (PE) has traditionally been hospital-based. The lesser need for monitoring with the increasingly used direct acting oral anticoagulants (DOAC) in comparison to warfarin potentially facilitates outpatient treatment of PE with these drugs. This study aimed to evaluate efficacy and safety of outpatient treatment of PE with DOAC. We extracted data from the Swedish quality registry for patients on oral anticoagulation (AuriculA) for all 245 patients in the southernmost hospital region in Sweden (1...
January 5, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29278603/interventional-spine-and-pain-procedures-in-patients-on-antiplatelet-and-anticoagulant-medications-second-edition-guidelines-from-the-american-society-of-regional-anesthesia-and-pain-medicine-the-european-society-of-regional-anaesthesia-and-pain-therapy-the
#8
Samer Narouze, Honorio T Benzon, David Provenzano, Asokumar Buvanendran, José De Andres, Timothy Deer, Richard Rauck, Marc A Huntoon
The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines committee was formed. After preliminary review of published complications reports and studies, the committee stratified interventional spine and pain procedures according to potential bleeding risk: low-, intermediate-, and high-risk procedures...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29248145/renal-replacement-therapy-and-anticoagulation
#9
REVIEW
Timo Brandenburger, Thomas Dimski, Torsten Slowinski, Detlef Kindgen-Milles
Today, up to 20% of all intensive care unit patients require renal replacement therapy (RRT), and continuous renal replacement therapies (CRRT) are the preferred technique. In CRRT, effective anticoagulation of the extracorporeal circuit is mandatory to prevent clotting of the circuit or filter and to maintain filter performance. At present, a variety of systemic and regional anticoagulation modes for CRRT are available. Worldwide, unfractionated heparin is the most widely used anticoagulant. All systemic techniques are associated with significant adverse effects...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29237655/evaluation-using-cardiac-insertable-devices-and-telephone-in-hypertrophic-cardiomyopathy-elucidate-hcm-rationale-and-design-a-prospective-observational-study-on-incidence-of-arrhythmias-in-sweden
#10
Peter Magnusson, Stellan Mörner
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease associated with sudden cardiac death (SCD) mainly due to ventricular tachycardia (VT) or fibrillation even though life-threatening bradycardia occurs. Risk stratification takes several variables into consideration including non-sustained VT (NSVT). An implantable cardioverter defibrillator effectively prevents SCD.Atrial fibrillation (AF) is common among patients with HCM and warrants anticoagulation even without conventional risk factors according to European guidelines...
December 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29222322/inferior-vena-cava-filter-use-and-patient-safety-legacy-or-science
#11
REVIEW
William Geerts, Rita Selby
There has been a dramatic increase in vena cava filter (VCF) use over the past 20 years in the absence of evidence that filters provide a net patient benefit or are required in most cases. This increase is largely attributable to the availability of retrievable filters and expanded indications, particularly as primary prophylaxis in patients thought to be at high risk of pulmonary embolism. Substantial variability in VCF use, unrelated to patient clinical factors, has been shown between hospitals, from region to region, and among various countries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29208276/development-of-novel-ph-sensitive-thiolated-chitosan-pmla-nanoparticles-for-amoxicillin-delivery-to-treat-helicobacter-pylori
#12
Muhammad Arif, Quan-Jiang Dong, Mazhar Ali Raja, Shah Zeenat, Zhe Chi, Chen-Guang Liu
The cysteine conjugated chitosan/PMLA multifunctional nanoparticles were synthesized as targeted Nano-drug delivery system to eradicate Helicobacter pylori. Helicobacter pylori specifically express urea transport protein on its membrane to carrying urea to the cytoplasm urease to supply ammonia that protects bacteria in the acid environment of the stomach. The clinical suitability of topical antimicrobial agents is required to get rid of Helicobacter pylori inside the inflamed basal region. In this work, cysteine conjugated chitosan derivative, Cys-CS for their mucoadhesive and anticoagulant properties was designed and synthesized, for the preparation of multifunctional nanoparticles...
February 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/29198761/diagnostics-treatment-and-secondary-prevention-of-ischemic-stroke-in-the-silesian-province-poland-between-2009-and-2015
#13
Beata Łabuz-Roszak, Anna Starostka-Tatar, Anetta Lasek-Bal, Marek Gierlotka, Mariusz Gąsior, Michał Skrzypek
BACKGROUND: The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated. OBJECTIVE: Therefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population. MATERIALS & METHODS: Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193)...
November 14, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29197624/intravascular-hemolysis-induced-by-phospholipases-a2-from-the-venom-of-the-eastern-coral-snake-micrurus-fulvius-functional-profiles-of-hemolytic-and-non-hemolytic-isoforms
#14
María Laura Fernández, Pablo Yunes Quartino, Ruth Arce-Bejarano, Julián Fernández, Luis F Camacho, José María Gutiérrez, Daniel Kuemmel, Gerardo Fidelio, Bruno Lomonte
A unique feature of the venom of Micrurus fulvius (Eastern coral snake) is its ability to induce severe intravascular hemolysis in particular species, such as dogs or mice. This effect was previously shown to be induced by distinct phospholipase A2 (PLA2) isoforms which cause direct hemolysis in vitro, an uncommon finding for such enzymes. The functional profiles of PLA2-17, a direct hemolytic enzyme, and PLA2-12, a co-existing venom isoform lacking such effect, were compared. The enzymes differed not only in their ability to cause intravascular hemolysis: PLA2-17 additionally displayed lethal, myotoxic, and anticoagulant actions, whereas PLA2-12 lacked these effects...
November 29, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/29195906/patterns-and-predictors-of-emergency-department-visits-among-older-patients-after-breast-cancer-surgery-a-population-based-cohort-study
#15
Tracy Westley, Ania Syrowatka, David Henault, Young-Soo Rho, Francois Khazoom, Sue-Ling Chang, Robyn Tamblyn, Nancy Mayo, Ari N Meguerditchian
OBJECTIVES: To characterize rates, reasons for, and associated predictors for emergency department (ED) visits after breast cancer (BC) surgery. METHODS: All women over 65 years undergoing curative surgery for non-metastatic incident BC (1998-2012) were identified using Quebec's universal healthcare administrative databases. Reasons for ED visits within 45days of operation were reported. Associated factors were estimated using Cox regression. RESULTS: Of 24,463 patients, 12...
November 28, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29187232/long-term-continuous-renal-replacement-therapy-and-anticoagulation-with-citrate-in-critically-ill-patients-with-severe-liver-dysfunction
#16
Matthias Klingele, Theresa Stadler, Danilo Fliser, Timo Speer, Heinrich V Groesdonk, Alexander Raddatz
BACKGROUND: As of 2009, anticoagulation with citrate was standard practice in continuous renal replacement therapy (CRRT) for critically ill patients at the University Medical Centre of Saarland, Germany. Partial hepatic metabolism of citrate means accumulation may occur during CRRT in critically ill patients with impaired liver function. The aim of this study was to evaluate the actual influence of hepatic function on citrate-associated complications during long-term CRRT. METHODS: In a retrospective study conducted between January 2009 and November 2012, all cases of dialysis therapy performed in the interdisciplinary surgical intensive care unit were analysed...
November 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29185591/safety-and-efficacy-of-regional-citrate-anticoagulation-in-continuous-blood-purification-treatment-of-patients-with-multiple-organ-dysfunction-syndrome
#17
B Tuerdi, L Zuo, H Sun, K Wang, Z Wang, G Li
The aim of this study was to discuss the safety and efficacy of regional citrate anticoagulation (RCA) on continuous blood purification (CBP) during the treatment of multiple organ dysfunction syndrome (MODS). Thirty-five patients with MODS were divided into two groups: the local citrate anticoagulation (RCA) group, and the heparin-free blood purification (hfBP) group. The MODS severity was assessed according to Marshall's MODS score criteria. Blood coagulation indicators, blood pressure, filter lifespan, filter replacement frequency, anticoagulation indicators, and main metabolic and electrolyte indicators were analyzed and compared between RCA and hfBP groups...
November 17, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29171099/regional-citrate-anticoagulation-for-intermittent-hemodialysis-in-dogs
#18
T Francey, A Schweighauser
BACKGROUND: The traditional systemic heparinization used for anticoagulation in extracorporeal therapies may cause fatal complications in animals at risk of bleeding. HYPOTHESIS/OBJECTIVES: To develop and validate a protocol of regional citrate anticoagulation (RCA) for intermittent hemodialysis in dogs. ANIMALS: A total of 172 dogs treated with hemodialysis for acute kidney injury. METHODS: In vitro titration was performed, adding trisodium citrate and calcium chloride to heparinized canine blood...
November 24, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#19
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29165583/modelling-projections-for-the-risks-related-with-atrial-fibrillation-in-east-asia-a-focus-on-ischaemic-stroke-and-death
#20
Ying Bai, Shi-Dong Guo, Alena Shantsila, Gregory Y H Lip
Aims: In the Far East, there has generally been low uptake of oral anticoagulants (OACs) using vitamin K antagonists (VKA, e.g. warfarin) for stroke prevention in atrial fibrillation (AF), but OAC use has been increasing more recently, with the introduction of the non-vitamin K antagonist oral anticoagulants (NOACs). To explore the risks of ischaemic stroke (IS) and death related to AF in East Asia using modelling projections. Methods and results: We performed a modelling analysis of possible trends of IS and death rates in AF patients from the time period of only VKA use to current increasing trends of NOAC use projecting until 2050 in East Asia...
November 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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