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Unfractionated heparin

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https://www.readbyqxmd.com/read/29158367/safety-pharmacokinetics-pharmacodynamics-and-antitumor-activity-of-necuparanib-combined-with-nab-paclitaxel-and-gemcitabine-in-patients-with-metastatic-pancreatic-cancer-phase-i-results
#1
Eileen M O'Reilly, James Roach, Paul Miller, Kenneth H Yu, Catherine Tjan, Molly Rosano, Silva Krause, William Avery, Julie Wolf, Keith Flaherty, Darrell Nix, David P Ryan
LESSONS LEARNED: Despite the compelling preclinical rationale of evaluating the genetically engineered heparin derivative, necuparanib, combined with standard therapy in metastatic pancreas adenocarcinoma, the results were ultimately disappointing.Safety was documented, although dose escalation was limited by the number of subcutaneous injections, the potential for skin toxicity (cellulitis), and low-level anticoagulant effect. Nonetheless, the hypothesis of targeting prothrombotic pathways in pancreas adenocarcinoma remains compelling...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29131355/interaction-of-albumins-and-heparinoids-investigated-by-affinity-capillary-electrophoresis-and-free-flow-electrophoresis
#2
Mona Mozafari, Sami El Deeb, Friederike Krull, Robert Wildgruber, Gerhard Weber, Christian G Reiter, Hermann Wätzig
A fast and precise affinity capillary electrophoresis (ACE) method has been applied to investigate the interactions between two serum albumins (HSA and BSA) and heparinoids. Furthermore, different free flow electrophoresis methods were developed to separate the species which appears owing to interaction of albumins with pentosan polysulfate sodium (PPS) under different experimental conditions. For ACE experiments, the normalized mobility ratios (∆R/Rf ), which provided information about the binding strength and the overall charge of the protein-ligand complex, were used to evaluate the binding affinities...
November 13, 2017: Electrophoresis
https://www.readbyqxmd.com/read/29126457/chest-compression-related-fatal-internal-mammary-artery-injuries-manifesting-after-venoarterial-extracorporeal-membrane-oxygenation-a-case-series
#3
Toshinobu Yamagishi, Masahiro Kashiura, Kazuhiro Sugiyama, Kazuha Nakamura, Takuto Ishida, Takahiro Yukawa, Kazuki Miyazaki, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: Cardiopulmonary resuscitation-related bleeding, especially internal mammary artery injuries, can become life-threatening complications after initiating venoarterial extracorporeal membrane oxygenation owing to the frequent involvement of concomitant anticoagulant treatment, antiplatelet treatment, targeted temperature management, and bleeding coagulopathy. We report the cases of five patients who experienced this complication and discuss their management. CASE PRESENTATION: We retrospectively evaluated five patients with cardiopulmonary resuscitation-related internal mammary artery injuries who were treated between February 2011 and February 2016 at our institution...
November 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29126301/coagulation-testing-in-the-core-laboratory
#4
William E Winter, Sherri D Flax, Neil S Harris
Primary hemostasis begins with endothelial injury. VWF, produced by endothelial cells, binds to platelets and links them to subendothelial collagen. Platelet-derived ADP and thromboxane activate non-adhered platelets via their GPIIb/IIIa receptors, allowing these platelets to participate in platelet aggregation. Secondary hemostasis is initiated with the binding of factor VII to extravascular tissue factor (TF). Factors II, VII, IX and X are vitamin K-dependent factors. The role of vitamin K is to assist in the addition of gamma carboxylate groups to glutamic acids in the "GLA" domains of these factors...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29120972/comparison-of-anti-xa-and-activated-partial-thromboplastin-time-monitoring-for-heparin-dosing-in-vascular-surgery-patients-a-single-center-retrospective-study
#5
Elsie Rizk, Allison D Wilson, Michelle U Murillo, David R Putney, Bcps-Aq Cardiology
BACKGROUND: Vascular surgery patients often require anticoagulation with intravenous unfractionated heparin monitored via anti-Xa levels or the activated partial thromboplastin time (aPTT). This study compares the two monitoring strategies in terms of major bleeding events in the vascular surgery population. METHODS: This was a single center, retrospective study that included patients treated with a pharmacy-managed heparin protocol monitored by either anti-Xa or aPTT after vascular surgery...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29117862/successful-medical-management-of-acute-mesenteric-ischemia-due-to-superior-mesenteric-and-portal-vein-thrombosis-in-a-27-year-old-man-with-protein-s-deficiency-a-case-report
#6
N P Osti, D N Sah, R S Bhandari
BACKGROUND: Acute mesenteric ischemia poses a diagnostic challenge due to nonspecific clinical clues and lack of awareness owing to its rarity. Ischemia due to mesenteric venous thrombosis has a good prognosis compared to arterial cause and can be managed conservatively with early diagnosis. The portomesenteric venous system is an unusual site of thrombosis in patients with protein S deficiency, and its thrombosis is an uncommon cause of acute mesenteric ischemia. CASE PRESENTATION: We present a case of a 27-year-old Mongolian man who presented with acute abdominal pain increasing in severity, and refractory to repeated attempts at treatment with a misdiagnosis of acute peptic ulcer disease...
November 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29112542/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-neurosurgery
#7
David Faraoni, Raquel Ferrandis, William Geerts, Matthew D Wiles
: Although there are numerous publications addressing venous thromboembolism and its prevention in neurosurgery, there are relatively few high-quality studies to guide decisions regarding thromboprophylaxis. In patients undergoing craniotomy, we recommend that if intermittent pneumatic compression (IPC) is used, it should be applied before the surgical procedure or on admission (Grade 1C). In craniotomy patients at particularly high risk for venous thromboembolism, we suggest considering the initiation of mechanical thromboprophylaxis with IPC preoperatively with addition of low molecular weight heparin (LMWH) postoperatively when the risk of bleeding is presumed to be decreased (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29111221/portomesentric-and-splenic-vein-thrombosis-pmsvt-after-bariatric-surgery-a-systematic-review-of-110-patients
#8
Saeed Shoar, Alan A Saber, Rebecca Rubenstein, Saeed Safari, Stacy A Brethauer, Hassan Al-Thani, Armand P Asarian, Ali Aminian
BACKGROUND: Portomesenteric and splenic vein thrombosis (PMSVT) is a rare but potentially serious complication after bariatric surgery. No study has systematically analyzed its incidence and risk factors. OBJECTIVES: To pool the data regarding PMSVT after bariatric surgery and determine its incidence and risk factors. METHODS: A meta-analysis and systematic review was conducted to retrieve studies on PMSVT after bariatric surgery. RESULTS: A total of 41 eligible studies including 110 patients with postbariatric PMSVT were enrolled; the estimated incidence rate based on 13 studies was ...
September 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29109853/mesenteric-vein-thrombosis-following-impregnation-via-in-vitro-fertilization-embryo-transfer
#9
Masaaki Hirata, Hiroko Yano, Tomoe Taji, Yoshiharu Shirakata
Pregnancy is an acquired hypercoagulable state. Most patients with thrombosis that develops during pregnancy present with deep vein leg thrombosis and/or pulmonary embolism, whereas the development of mesenteric vein thrombosis (MVT) in pregnant patients is rare. We report a case of MVT in a 34-year-old woman who had achieved pregnancy via in vitro fertilization-embryo transfer (IVF-ET). At 7 wk of gestation, the patient was referred to us due to abdominal pain accompanied by vomiting and hematochezia, and she was diagnosed with superior MVT...
October 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29105331/anticoagulation-with-heparin-the-art-of-simplicity-even-in-patients-on-dialysis
#10
EDITORIAL
Jorge A Belardi, Mariano Albertal
In current PCI practice, anticoagulation with either bivalirudin or unfractionated heparin in patients with ACS share comparable efficacy and safety. Nonetheless, their individual performance in patients on dialysis remains unclear. This observational PCI study reported in-hospital clinical outcome in patients on dialysis undergoing PCI according to drug regimen: bivalirudin versus heparin. Similar clinical outcome was observed with both drug regimens.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102541/nonbacterial-thrombotic-endocarditis-complicated-by-cerebral-infarction-in-a-patient-with-adenomyosis-with-high-serum-ca125-level-a-case-report
#11
Kenji Uchino, Takahiro Shimizu, Heisuke Mizukami, Kenji Isahaya, Hana Ogura, Kensuke Shinohara, Yasuhiro Hasegawa
We report a case of a 48-year-old woman with multiple cerebral infarctions caused by nonbacterial thrombotic endocarditis (NBTE) because of adenomyosis with high serum carbohydrate antigen (CA)125 level. Transesophageal echocardiography (TEE) showed a vegetation, 4 mm in diameter, adjacent to the anterior leaflet of the mitral valve on day 2. Soluble CA125 level was elevated to 901 U/mL. Intravenous infusion of unfractionated heparin sodium was started. On day 35, TEE revealed reduction of the vegetation in size, 2 mm in diameter...
November 1, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29090459/slow-versus-fast-subcutaneous-heparin-injections-for-prevention-of-bruising-and-site-pain-intensity
#12
REVIEW
Mina Mohammady, Leila Janani, Ali Akbari Sari
BACKGROUND: Heparin is an anticoagulant medication that is usually injected subcutaneously. Subcutaneous administration of heparin may result in complications such as bruising, haematoma, and pain at the injection site. One of the factors that may affect pain, haematoma, and bruising is injection speed. For patients and healthcare providers, strategies that can reduce pain and bruising are considered important. Reducing patients' discomfort and concerns whenever and wherever possible is an important aim of nursing...
November 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29081908/utility-and-correlation-of-known-anticoagulation-parameters-in-the-management-of-pediatric-ventricular-assist-devices
#13
Ajay K Bhatia, Mouhammad Yabrodi, Mallory Carroll, Silvia Bunting, Kirk Kanter, Kevin O Maher, Shriprasad R Deshpande
AIM: To assess utility and correlation of known anticoagulation parameters in the management of pediatric ventricular assist device (VAD). METHODS: Retrospective study of pediatric patients supported with a Berlin EXCOR VAD at a single pediatric tertiary care center during a single year. RESULTS: We demonstrated associations between activated thromboplastin time (aPTT) and R-thromboelastography (R-TEG) values (rs = 0.65, P < 0.001) and between anti-Xa assay and R-TEG values (rs = 0...
September 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29076942/evaluation-of-systemic-heparin-versus-bivalirudin-in-adult-patients-supported-by-extracorporeal-membrane-oxygenation
#14
Theodore J Berei, Matthew P Lillyblad, Kelly J Wilson, Ross F Garberich, Katarzyna M Hryniewicz
Systemic anticoagulation is a standard of care in adult patients supported by extracorporeal membrane oxygenation (ECMO) to prevent circuit thrombosis and subsequent thromboembolic events. Unfractionated heparin has long been considered the anticoagulant of choice, but emerging evidence reports successful ECMO runs with direct thrombin inhibitors. This retrospective study sought to determine whether bivalirudin offers distinct clinical benefits as the anticoagulant of choice in ECMO. Primary end points included thrombotic events during the initial 96 hours of anticoagulation, over the course of their entire ECMO run, and at any time during the admission, as well as in-hospital and 30-day mortality...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29056565/risk-factors-and-pharmacologic-prophylaxis-for-venous-thromboembolism-in-elective-spine-surgery
#15
Ryan P McLynn, Pablo J Diaz-Collado, Taylor D Ottesen, Nathaniel T Ondeck, Jonathan J Cui, Patawut Bovonratwet, Blake N Shultz, Jonathan N Grauer
BACKGROUND CONTEXT: Venous thromboembolism (VTE) is a known complication after spine surgery, but prophylaxis guidelines are ambiguous for patients undergoing elective spine surgery. PURPOSE: To characterize the incidence and risk factors for VTE and the association of pharmacologic prophylaxis with VTE and bleeding complications after elective spine surgery. STUDY DESIGN/SETTING: Retrospective cohort study of patients undergoing elective spine surgery in the National Surgical Quality Improvement Program (NSQIP) database and a retrospective cohort analysis at an academic medical center...
October 19, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29054205/corrigendum-to-administration-of-low-molecular-weight-and-unfractionated-heparin-during-percutaneous-coronary-intervention-indian-heart-j-68-2-2016-213-224
#16
Sadeq Ali-Hasan-Al-Saegh, Seyed Jalil Mirhosseini, Azadeh Shahidzadeh, Parisa Mahdavi, Mahbube Tahernejad, Fatemeh Haddad, Mohammad Reza Lotfaliani, Anton Sabashnikov, Aron Frederik Popov
No abstract text is available yet for this article.
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29043538/venous-thromboembolism-prophylaxis-in-medically-ill-patients-a-mixed-treatment-comparison-meta-analysis
#17
REVIEW
Majed S Al Yami, Matthew A Silva, Jennifer L Donovan, Abir O Kanaan
The American College of Chest Physicians guidelines recommend unfractionated heparin (UFH), low molecular weight heparins (LMWHs) or fondaparinux for prevention of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in medically-ill patients. Direct oral anticoagulants (DOACs) have been evaluated relative to enoxaparin for VTE prophylaxis though head-to-head comparisons of these agents are lacking. Therefore, we conducted a mixed treatment comparisons meta-analysis to evaluate the safety and efficacy of established treatments and DOACs for VTE prophylaxis in medically-ill patients...
October 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29034033/novel-anticoagulant-therapy-of-venous-thromboembolism-current-status-and-future-directions
#18
REVIEW
Mashio Nakamura, Norikazu Yamada, Masaaki Ito
The first-line treatment of venous thromboembolisms (VTE) is anticoagulant therapy, and unfractionated heparin and warfarin are used in Japan. However, as both drugs require dosage adjustments that are difficult, VTE recurrences occur relatively frequently, and hemorrhagic complications are extremely common. The parenteral factor Xa inhibitor fondaparinux and the direct oral anticoagulants (DOACs) edoxaban, rivaroxaban, and apixaban have recently become available as treatments for VTE in Japan. These novel anticoagulants have more stable effects than traditional therapies and are thus considered safer and more effective than the traditional agents...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29027082/factors-associating-with-the-presence-of-residual-thrombosis-after-3-month-treatment-of-acute-pulmonary-embolism
#19
Jingluan Wang, Mingling Xu, Nina Sun, Zhaozhong Cheng, Jingjing Sui
The present study aimed to investigate the factors associating with the presence of residual thrombosis in patients with acute pulmonary embolism (APE) after at least 3-month anticoagulant therapy. Demographic and clinical data of 180 cases in the affiliated hospital of Qingdao University from January 2005 to June 2015 were retrospectively analyzed. APE in all patients were confirmed by computed tomography pulmonary angiography (CTPA). Patients were then detected for the presence of residual thrombosis according to a second CTPA...
October 12, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29016910/left-atrial-appendage-occluder-implantation-in-europe-indications-and-anticoagulation-post-implantation-results-of-the-european-heart-rhythm-association-survey
#20
Roland Richard Tilz, Tatjana Potpara, Jian Chen, Dan Dobreanu, Torben Bjerregaard Larsen, Kristina Herman Haugaa, Nikolaos Dagres
The aim of this EP Wire survey was to assess the indications and anticoagulation strategies post-left atrial appendage occluder (LAAO) implantation for stroke prevention in patients with non-valvular atrial fibrillation in Europe. A total of 33 centres in 13 European countries completed the survey. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Left atrial appendage occluder procedures were performed by electrophysiologists in 52% of the centres and by interventional cardiologists in the remaining centres...
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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