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https://www.readbyqxmd.com/read/28821169/predictors-of-pre-procedural-concentrations-of-direct-oral-anticoagulants-a-prospective-multicentre-study
#1
Anne Godier, Anne-Sophie Dincq, Anne-Céline Martin, Adrian Radu, Isabelle Leblanc, Marion Antona, Marc Vasse, Jean-Louis Golmard, François Mullier, Isabelle Gouin-Thibault
Aims: Patients receiving direct oral anticoagulants (DOACs) frequently undergo elective invasive procedures. Their management is challenging. We aimed to determine the optimal duration of DOAC discontinuation that ensures a minimal anticoagulant effect during the procedure. Methods and results: This prospective multicentre study included 422 DOAC-treated patients requiring an invasive procedure. Pre-procedural DOAC concentration ([DOAC]) and routine haemostasis assays were performed to determine i/the proportion of patients who achieved a minimal pre-procedural [DOAC] (≤30 ng/mL) according to the duration of DOAC discontinuation, ii/the predictors of minimal [DOAC] and, iii/the ability of routine assays to predict minimal [DOAC]...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28820780/clinical-effectiveness-of-intravenous-exenatide-infusion-in-perioperative-glycemic-control-after-coronary-artery-bypass-graft-surgery-a-phase-ii-iii-randomized-trial
#2
Guillaume Besch, Andrea Perrotti, Frederic Mauny, Marc Puyraveau, Maude Baltres, Guillaume Flicoteaux, Lucie Salomon du Mont, Benoit Barrucand, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
BACKGROUND: We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients. METHODS: Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III nonblinded randomized superiority trial. Current insulin use and creatinine clearance of less than 60 ml/min were exclusion criteria. Two groups were compared: the exenatide group, receiving exenatide (1-h bolus of 0...
August 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28818163/evaluation-of-ckd-epi-pakistan-equation-for-estimated-glomerular-filtration-rate-egfr-acomparison-of-egfr-prediction-equations-in-pakistani-population
#3
Sibtain Ahmed, Lena Jafri, Aysha Habib Khan
OBJECTIVE: To evaluate the results of 24-hour urinary creatinine clearance (CrCl) with estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI Pakistan (CKD-EPI Pak), Cockcroft Gault (CG) and 4-variable Modification of Diet in Renal Disease (MDRD) equations. STUDY DESIGN: Descriptive, cross-sectional study. PLACE AND DURATION OF STUDY: Section of Clinical Chemistry, Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, from June to October 2013...
July 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28815425/methodological-study-of-vancomycin-dosing-in-elderly-patients-using-actual-serum-creatinine-versus-rounded-serum-creatinine
#4
Tramaine Young, Matt Daniel, Stephanie Baumhover, Duke Eidson, Jane Green
PURPOSE: The practice of intentional rounding up of serum creatinine (SCr) in elderly patients with low measured values can lead to an underestimation of creatinine clearance and subsequent inaccurate dosing of medications. Thus, the purpose of this study was to evaluate the accuracy of vancomycin dose calculations for patients aged ≥65 years using an SCr rounded up to 1 mg/dL versus actual SCr. METHODS: This study compared the difference between measured steady-state vancomycin trough concentrations with predicted trough concentrations that have been calculated using rounded SCr and actual SCr...
August 16, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#5
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28808888/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-yes
#6
Walter Ageno
Betrixaban is a direct factor Xa inhibitor with a renal excretion of only approximately 5-7%. On June 23rd 2017, it became the first direct oral anticoagulant to receive Food and Drug Administration approval for the prevention of venous thromboembolism in acutely ill medical patients, and the first anticoagulant agent to be approved for extended-duration thromboprophylaxis after hospital discharge in this setting. Approval followed the results of the APEX trial, a phase III clinical trial comparing betrixaban (80 mg) administered for 35-42 days with enoxaparin (40 mg) administered for 10 ± 4 days...
August 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28807922/are-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-adequate-for-the-management-of-febrile-neutropenia-answers-from-population-pharmacokinetic-modelling-and-monte-carlo-simulations
#7
Fekade Bruck Sime, Uwe Hahn, Morgyn S Warner, Ing Soo Tiong, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Changes in the pharmacokinetics of piperacillin in febrile neutropenic patients have been reported to result in sub-optimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for haematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Non-parametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with Pmetrics® package for R...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#8
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28802734/adding-markers-of-organ-damage-to-risk-score-models-improves-cardiovascular-risk-assessment-prospective-analysis-of-a-large-cohort-of-adult-outpatients
#9
Giuliano Tocci, Ilaria Figliuzzi, Vivianne Presta, Nadia Attalla El Halabieh, Barbara Citoni, Roberta Coluccia, Allegra Battistoni, Andrea Ferrucci, Massimo Volpe
INTRODUCTION: Global cardiovascular (CV) risk stratification is recommended in all outpatients. Risk score charts, however, do not include markers of organ damage (OD). AIM: To evaluate the potential added value of including different markers of subclinical OD to US Framingham, European SCORE and Italian Cuore risk score calculators. METHODS: We prospectively evaluated adult outpatients, who underwent blood pressure (BP) assessment and global CV risk stratification...
July 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28801938/factors-in-variability-of-serial-gabapentin-concentrations-in-elderly-patients-with-epilepsy
#10
Jeannine M Conway, Lynn E Eberly, Joseph F Collins, Flavia M Macias, R Eugene Ramsay, Ilo E Leppik, Angela K Birnbaum
OBJECTIVES: To characterize and quantify the variability of serial gabapentin concentrations in elderly patients with epilepsy. METHODS: This study included 83 patients (age ≥60 years) from an 18-center, randomized, double-blind, double dummy, parallel study from the Veterans Affairs Cooperative 428 Study. All patients were taking 1500 mg/day of gabapentin. Within-person coefficient of variation (CV) in gabapentin concentrations, measured weekly to bimonthly for up to 52 weeks, then quarterly, was computed...
August 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28801680/population-pharmacokinetics-of-peginterferon-%C3%AE-2a-in-patients-with-chronic-hepatitis-b
#11
Jingfeng Bi, Xingang Li, Jia Liu, Dawei Chen, Shuo Li, Jun Hou, Yuxia Zhou, Shanwei Zhu, Zhigang Zhao, Enqiang Qin, Zhenman Wei
There were significant differences in response and pharmacokinetic characteristics to the peginterferon α2a treatment among Chronic Hepatitis B (CHB) patients. The aim of this study is to identify factors which could significantly impact the peginterferon α2a pharmacokinetic characteristics in CHB patients. There were 208 blood samples collected from 178 patients who were considered as CHB and had been treated with peginterferon α2a followed by blood concentration measurement and other laboratory tests. The covariates such as demographic and clinical characteristics of the patients were retrieved from medical records...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28801477/type-2-diabetes-mellitus-and-impaired-renal-function-are-associated-with-brain-alterations-and-poststroke-cognitive-decline
#12
Einor Ben Assayag, Roy Eldor, Amos D Korczyn, Efrat Kliper, Shani Shenhar-Tsarfaty, Oren Tene, Jeremy Molad, Itzhak Shapira, Shlomo Berliner, Viki Volfson, Ludmila Shopin, Yehuda Strauss, Hen Hallevi, Natan M Bornstein, Eitan Auriel
BACKGROUND AND PURPOSE: Type 2 diabetes mellitus (T2DM) is associated with diseases of the brain, kidney, and vasculature. However, the relationship between T2DM, chronic kidney disease, brain alterations, and cognitive function after stroke is unknown. We aimed to evaluate the inter-relationship between T2DM, impaired renal function, brain pathology on imaging, and cognitive decline in a longitudinal poststroke cohort. METHODS: The TABASCO (Tel Aviv brain acute stroke cohort) is a prospective cohort of stroke/transient ischemic attack survivors...
August 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#13
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28795982/treatment-of-patients-with-hepatitis-c-virus-infection-genotype-4-with-ledipasvir-sofosbuvir-in-the-liver-transplant-setting
#14
Faisal Abaalkhail, Hussein Elsiesy, Hany Elbeshbeshy, Mohamed Shawkat, Sarra Yousif, Waheed Ullah, Saleh Alabbad, Ahmed Al-Jedai, Aziza Ajlan, Dieter Broering, Sammy Saab, Mohammed Al Sebayel, Waleed Al-Hamoudi
BACKGROUND: Hepatitis C virus infection is a major cause of liver cirrhosis and hepatocellular carcinoma and the leading indication for liver transplantation. In the Middle East, genotype 4 HCV infection is the most common genotype. However, limited data exists on the treatment of genotype-4 in the liver transplant setting. We evaluated the safety and efficacy of ledipasvir-sofosbuvir (LDV/SOF) in treating HCV genotype-4 infected patients with cirrhosis or postliver transplantation. METHODS: This prospective, single-arm, observational study includes cohort of patients with cirrhosis before liver transplantation (Cohort A) and a cohort of postliver transplantation patients (Cohort B)...
August 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28795146/refining-the-policy-for-timing-of-kidney-transplant-waitlist-qualification
#15
Benjamin J Lee, Charles E McCulloch, Barbara A Grimes, Sindhu Chandran, Isabel Elaine Allen, Cynthia Delgado, Chi-Yuan Hsu
BACKGROUND: Earlier qualification for the kidney transplant waitlist expedites transplant and is therefore associated with improved outcomes. U.S. Organ Procurement and Transplantation Network policies state that "measured or calculated creatinine clearance or glomerular filtration rate less than or equal to 20 mL/min" triggers waitlist time accrual. The choice of qualification method is somewhat arbitrary, and the policy implies that decline in renal function is monotonic. METHODS: (1) We used survival analysis to quantify temporal differences in waitlist qualification by applying 3 kidney-function-estimating equations (Cockcroft-Gault, Modification of Diet in Renal Disease study, Chronic Kidney Disease Epidemiology Collaboration) to serial creatinine measurements from 3 patient cohorts: 1 of waitlisted patients at a major U...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28793036/effect-of-mild-hypothermia-on-renal-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-in-a-swine-model
#16
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded...
July 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28791494/adherence-with-perindopril-therapy-a-pilot-study-using-therapeutic-drug-monitoring-of-perindoprilat-and-an-evaluation-of-the-clearance-estimation
#17
Martin Šíma, Martin Vodička, Věra Marešová, Tomáš Šálek, Radomír Čabala, Ondřej Slanař
Background Although measurement of drug serum levels is an objective direct method for testing compliance, it can be distorted by "white-coat compliance" or by variations in drug elimination. Objective The aim of this prospective study was to evaluate the prevalence of noncompliance with perindopril therapy in adult out-patients using pharmacokinetic simulations. The additional aim was to compare the predictive performance of two glomerular filtration rate markers-creatinine and cystatin C. Setting Department of Cardiology, Tomas Bata Regional Hospital in Zlín, Czech Republic...
August 8, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28777392/long-term-follow-up-of-continuous-flow-left-ventricular-assist-devices-complications-and-predisposing-risk-factors
#18
Tolulope A Adesiyun, Rhondalyn C McLean, Ryan J Tedford, Glenn J R Whitman, Chris M Sciortino, John V Conte, Ashish S Shah, Stuart D Russell
PURPOSE: To assess LVAD complications and their overall effect on mortality and determine factors associated with development of early and long-term complications. METHODS: A retrospective cohort study of patients who underwent continuous flow LVAD placement between January 1, 2000 and November 30, 2013 was performed. The incidence of complications (sepsis or bacteremia, driveline infections, gastrointestinal bleeding, pump thrombosis, cerebrovascular accidents and anemia requiring transfusion) was collected and logistic regression and Cox proportional hazards analyses were performed...
August 2, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28769004/pharmacokinetic-pharmacodynamic-analysis-for-doripenem-regimens-in-intensive-care-unit-patient
#19
Ryota Tanaka, Yuhki Sato, Koji Goto, Norihisa Yasuda, Yoshifumi Ohchi, Yosuke Suzuki, Tamio Ueno, Kentaro Ito, Tetsuya Kaneko, Shusaku Kurogi, Ko Nonoshita, Hiroki Itoh
Doripenem (DRPM) is a broad-spectrum antibacterial agent often used as empirical therapy for critically ill patients, although there is a lack of studies validating the recommended dosage regimen for patients admitted to intensive care unit (ICU), based on pharmacokinetic (PK)/pharmacodynamic (PD) index. In this study, we estimated the free time above minimum inhibitory concentration (fT>MIC (%)) of DRPM using population PK analysis of 12 patients in ICU, and evaluated the validity of the dosage regimen stratified by creatinine clearance...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28768341/prediction-model-of-serum-lithium-concentrations
#20
Kazunari Yoshida, Hiroyuki Uchida, Takefumi Suzuki, Masahiro Watanabe, Nariyasu Yoshino, Hitoshi Houchi, Masaru Mimura, Noriyasu Fukuoka
Introduction Therapeutic drug monitoring is necessary for lithium, but clinical application of several prediction strategies is still limited because of insufficient predictive accuracy. We herein proposed a suitable model, using creatinine clearance (CLcr)-based lithium clearance (Li-CL). Methods Patients receiving lithium provided the following information: serum lithium and creatinine concentrations, time of blood draw, dosing regimen, concomitant medications, and demographics. Li-CL was calculated as a daily dose per trough concentration for each subject, and the mean of Li-CL/CLcr was used to estimate Li-CL for another 30 subjects...
August 2, 2017: Pharmacopsychiatry
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