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Regional anticoagulation

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https://www.readbyqxmd.com/read/28219057/preventing-continuous-renal-replacement-therapy-induced-hypophosphatemia-an-extended-clinical-experience-with-a-phosphate-containing-solution-in-the-setting-of-regional-citrate-anticoagulation
#1
Valentina Pistolesi, Laura Zeppilli, Francesca Polistena, Maria Itala Sacco, Alessandro Pierucci, Luigi Tritapepe, Giuseppe Regolisti, Enrico Fiaccadori, Santo Morabito
AIMS: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. METHODS: In heart surgery patients undergoing continuous veno-venous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation...
February 21, 2017: Blood Purification
https://www.readbyqxmd.com/read/28218351/the-role-of-ionized-calcium-and-magnesium-in-regional-citrate-anticoagulation-and-its-impact-on-inflammatory-parameters
#2
Karin Strobl, Stephan Harm, Viktoria Weber, Jens Hartmann
INTRODUCTION: Regional anticoagulation with citrate has been found to be superior to heparin in terms of biocompatibility, and numerous protocols for regional citrate anticoagulation have been published, while a consensus on the target concentration of ionized calcium (Ca2+) in the extracorporeal circuit has not been reached so far. METHODS: The aim of this in vitro study was to assess the impact of different citrate concentrations on coagulation as well as on complement activation and cytokine secretion and to investigate the impact of ionized magnesium (Mg2+) on these parameters...
February 13, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28203197/a-case-of-syphilitic-uveitis-in-which-vitreous-surgery-was-useful-for-the-diagnosis-and-treatment
#3
Takatoshi Kobayashi, Chihiro Katsumura, Hiromi Shoda, Nanae Takai, Sayako Takeda, Takako Okamoto, Koichi Maruyama, Rei Tada, Kensuke Tajiri, Teruyo Kida, Tsunehiko Ikeda
PURPOSE: To report a case of atypical syphilitic uveitis complicated with retinal vasculitis, proliferative retinopathy, and vitreous hemorrhage in which vitreous surgery was useful for the diagnosis and treatment. CASE REPORT: A 38-year-old female was referred to our hospital after noticing visual disturbance in her right eye. Fundoscopy examination of that eye revealed retinal phlebitis accompanied by retinal hemorrhage and soft exudate, and remarkable exudative changes in the retinal vessels from the upper arcade to the macula region...
January 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28197045/experiences-with-continuous-venovenous-hemofiltration-using-18mmol-l-predilution-citrate-anticoagulation-and-a-phosphate-containing-replacement-solution
#4
Yuen Henry Jeffrey, Shum Hoi-Ping, Anne Leung Kit Hung, Lam Chung-Ling, Yan Wing-Wa, Lai King-Yiu
CONTEXT: Regional citrate anticoagulation for continuous renal replacement therapy is associated with a longer filter-life, less bleeding events and improved mortality. Problems associated with using Prismocitrate 10/2 solution in continuous renal replacement therapy, include hypomagnesemia, hypophosphatemia and the need for additional bicarbonate infusion. AIMS: This study uses the new Prismocitrate 18/0 solution for improved buffer balance and Phoxilium solution for a more favourable electrolyte profile...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28193526/identification-of-the-blood-coagulation-factor-interacting-sequences-in-staphylococcal-superantigen-like-protein-10
#5
Saotomo Itoh, Takemasa Takii, Kikuo Onozaki, Tsutomu Tsuji, Shigeaki Hida
Staphylococcal superantigen-like proteins (SSLs) are a family of exoproteins of Staphylococcus aureus. We have shown that SSL10 binds to vitamin K-dependent coagulation factors and inhibits blood coagulation induced by recalcification of citrated plasma. SSL10 was revealed to bind to coagulation factors via their γ-carboxyglutamic acid (Gla) domain. In this study we attempted to identify the responsible sequence of SSL10 for the interaction with coagulation factors. We prepared a series of domain swap mutants between SSL10 and its paralog SSL7 that does not interact with coagulation factors, and examined their binding activity to immobilized prothrombin using ELISA-like binding assay...
February 11, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28179389/homonymous-hemianopia-in-the-primary-antiphospholipid-syndrome
#6
Derek Kwun-Hong Ho, Rishi Ramessur, Mradul Gupta, John P Mathews
A woman aged 26 years was referred by her GP to the eye casualty department with sudden-onset left homonymous hemianopia and right-sided headache. Full ophthalmic examination was normal with the exception of a left homonymous hemianopia confirmed with automated perimetry. Urgent CT imaging revealed a non-haemorrhagic cerebral infarct in the right parieto-occipital region. Subsequent blood tests confirmed a diagnosis of antiphospholipid syndrome with positivity in IgG anticardiolipin antibody, IgG anti-β2-GP1 antibody and the Lupus anticoagulant screen...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28178158/life-threatening-bleeding-from-gastric-mucosal-angiokeratomas-during-anticoagulation-a-case-report-of-fabry-disease
#7
Eungu Kang, Yoon-Myung Kim, Dae-Hee Kim, Han-Wook Yoo, Beom Hee Lee
RATIONALE: Angiokeratomas are the earliest manifestation of Fabry disease (FD), and the extent of their appearance is related to disease severity. Angiokeratomas are mostly found on cutaneous regions. PATIENT CONCERNS, DIAGNOSES, INTERVENTIONS, AND OUTCOMES: Here we report an FD patient with widespread gastrointestinal angiokeratomas who developed life-threatening bleeding following anticoagulation for atrial fibrillation. LESSONS: Careful observation for gastrointestinal bleeding is warranted for patients on anticoagulation with extensive cutaneous angiokeratomas...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28126521/hs3st1-genotype-regulates-antithrombin-s-inflammomodulatory-tone-and-associates-with-atherosclerosis
#8
Nicole C Smits, Takashi Kobayashi, Pratyaksh K Srivastava, Sladjana Skopelja, Julianne A Ivy, Dustin J Elwood, Radu V Stan, Gregory J Tsongalis, Frank W Sellke, Peter L Gross, Michael D Cole, James T DeVries, Aaron V Kaplan, John F Robb, Scott M Williams, Nicholas W Shworak
The HS3ST1 gene controls endothelial cell production of HS(AT+) - a form of heparan sulfate containing a specific pentasaccharide motif that binds the anticoagulant protein antithrombin (AT). HS(AT+) has long been thought to act as an endogenous anticoagulant; however, coagulation was normal in Hs3st1(-/-) mice that have greatly reduced HS(AT+) (HajMohammadi et al., 2003). This finding indicates that HS(AT+) is not essential for AT's anticoagulant activity. To determine if HS(AT+) is involved in AT's poorly understood inflammomodulatory activities, Hs3st1(-/-) and Hs3st1(+/+) mice were subjected to a model of acute septic shock...
January 23, 2017: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#9
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28096015/association-of-medication-errors-with-drug-classifications-clinical-units-and-consequence-of-errors-are-they-related
#10
Maki Muroi, Jay J Shen, Alona Angosta
Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28076988/ischemic-stroke-risk-in-east-asian-patients-with-cha2ds2-vasc-score-of-1-systematic-review-and-meta-analysis
#11
REVIEW
Ying Bai, Alena Shantsila, Gregory Y H Lip
BACKGROUND: The use of anticoagulation for stroke prevention in patients with atrial fibrillation (AF) and CHA2DS2-VASc score of 1 has been debated, partially due to limited data on ischemic stroke risk and specific clinical trials in these patients. East Asian patients have a different stroke risk profile compared to non-East Asians. We performed a systematic review and meta-analysis of ischemic stroke risk in AF patients with a CHA2DS2-VASc score of 1 in East Asian countries. METHODS: A comprehensive literature search for studies evaluating ischemic stroke risk related with AF with CHA2DS2-VASc score of 1 was conducted by two reviewers...
February 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28070667/erratum-to-regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#12
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
No abstract text is available yet for this article.
January 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28040750/a-minimally-invasive-approach-for-open-surgical-thoracoabdominal-aortic-replacement-experimental-concept-for-a-novel-surgical-procedure
#13
Terézia B Andrási, Violetta Kékesi, Béla Merkely, Marius Grossmann, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28030601/calcium-mass-balance-during-citrate-hemodialysis-a-randomized-controlled-trial-comparing-normal-and-low-ionized-calcium-target-ranges
#14
Jakob Gubensek, Alesa Orsag, Rafael Ponikvar, Jadranka Buturovic-Ponikvar
BACKGROUND: Regional citrate anticoagulation (RCA) during hemodialysis interferes with calcium homeostasis. Optimal ionized calcium (iCa) target range during RCA and consequent calcium balance are unknown. METHODS: In a randomized controlled trial (ACTRN12613001029785) 30 chronic hemodialysis patients were assigned to normal (1.1-1.2 mmol/) or low (0.95-1.05 mmol/l) iCa target range during a single hemodialysis with RCA. The primary outcome was calcium mass balance during the procedure, using a partial spent dialysate collection method; magnesium mass balance was also measured...
2016: PloS One
https://www.readbyqxmd.com/read/28011798/stepwise-mass-screening-for-atrial-fibrillation-using-n-terminal-pro-b-type-natriuretic-peptide-the-strokestop-ii-study-design
#15
Johan Engdahl, Emma Svennberg, Leif Friberg, Faris Al-Khalili, Viveka Frykman, Katrin Kemp Gudmundsdottir, Tove Fredriksson, Mårten Rosenqvist
AIM: Atrial fibrillation (AF) is the most prevalent clinical arrhythmia and a major risk factor for ischaemic stroke. Treatment with oral anticoagulants (OACs) reduces the risk of stroke by two thirds in AF patients with risk factors. Due to its often paroxysmal and asymptomatic presentation, AF is sometimes challenging to diagnose. So far, AF screening studies have applied opportunistic or systematic screening, most often using a single 12-lead electrocardiogram (ECG) recording or ambulatory ECG...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28007598/identification-of-acap5-as-a-novel-factor-xa-inhibitor-with-both-direct-and-allosteric-inhibition
#16
Yuanjun Zhu, Yuan Lin, Xiaoyan Liu, Wenhui Hu, Yinye Wang
Ancylostoma caninum anticoagulant peptide 5 (AcAP5) is a potent inhibitor for coagulation factor Xa (FXa). Previous studies show that AcAP5 binds to FXa at the active site, and/or the exosite. The active site-binding contributes to direct blocking of FXa catalytic activity, but the effect of exosite-binding and the underlying mechanism remain unknown. To investigate whether and how the exosite-binding affects FXa function, we prepared several AcAP5 mutants with modifications to the active site-binding or exosite-binding region...
January 29, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/27996992/-ten-questions-awaiting-for-a-definitive-answer-on-the-use-of-non-vitamin-k-oral-anticoagulants-in-atrial-fibrillation
#17
Roberto Cemin, Giuseppe Di Pasquale, Paolo Colonna, Raffaele De Caterina
After more than 3 years from the appearance in Italy of the non-vitamin K antagonist oral anticoagulants (NOACs), their use for the prevention of thromboembolism in atrial fibrillation is still limited, with wide differences in prescriptions across regions. When NOACs became available for clinical practice, several doubts arose about their practical management in the "real world". This article analyses the 10 more frequent questions asked by clinicians dealing with NOACs in their daily activity with atrial fibrillation patients...
November 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27992547/the-impact-of-genetic-and-non-genetic-factors-on-warfarin-dose-prediction-in-mena-region-a-systematic-review
#18
Loulia Akram Bader, Hazem Elewa
BACKGROUND: Warfarin is the most commonly used oral anticoagulant for the treatment and prevention of thromboembolic disorders. Pharmacogenomics studies have shown that variants in CYP2C9 and VKORC1 genes are strongly and consistently associated with warfarin dose variability. Although different populations from the Middle East and North Africa (MENA) region may share the same ancestry, it is still unclear how they compare in the genetic and non-genetic factors affecting their warfarin dosing...
2016: PloS One
https://www.readbyqxmd.com/read/27987924/quantitative-analysis-of-the-major-linkage-region-tetrasaccharides-in-heparin
#19
Yin Chen, Kalib St Ange, Lei Lin, Xinyue Liu, Xing Zhang, Robert J Linhardt
Heparin is a polysaccharide based anticoagulant drug composed of a complex mixture of glycosaminoglycan chains and peptidoglycosaminoglycan chains. In an effort to better characterize this important polysaccharide based drug, we examined the peptide components of the minor peptidoglycosaminoglycan chains comprising heparin. Three different the glycan-peptide linkage regions tetrasaccharide fragments were isolated from pharmaceutical heparin using heparin lyase II and characterized the structure of these tetrasaccharides using nuclear magnetic resonance spectroscopy and mass spectrometry...
February 10, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/27982554/regional-anaesthesia-and-antithrombotic-agents-instructions-for-use
#20
Gennaro Scibelli, Lucia Maio, Gennaro Savoia
BACKGROUND: The use of anticoagulant agents represents a serious limitation of regional anesthesia, due to the risk of spinal hematoma. Examining all the principles currently available, it has been possible to notice that published guidelines are very often incomplete or also differ significantly on the rules to be followed relating to a specific drug. METHODS: We have carried out a comparison between the guidelines of major scientific societies in order to take a practical and simple user guide which operators can consult...
December 16, 2016: Minerva Anestesiologica
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