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https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#1
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28424125/thromboelastography-utilization-in-delayed-recurrent-coagulopathy-after-severe-eastern-diamondback-rattlesnake-envenomation
#2
Katherine M McBride, William Bromberg, James Dunne
Venomous snakebites are fairly common in the United States and can present with a wide range of symptoms. A 48-year-old man presented after Eastern Diamondback rattlesnake envenomation. His hospital course was complicated by right leg compartment syndrome and delayed recurrent coagulopathy, requiring multiple doses of Crotalidae Polyvalent Immune Fab (CroFab) antivenom and transfusions. Thromboelastography was used as an adjunct to standard coagulation studies in monitoring his delayed recurrent coagulopathy...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423431/-treatment-and-secondary-prevention-of-venous-thromboembolism-change-in-oral-anticoagulation
#3
Thomas-Maria Helms, Dietrich Gulba, Ingo Ahrens, Andreas Schäfer, Johannes Hankowitz, Peter Kuhlencordt, Hans-Peter Lipp, Sigrid Nikol, Hanno Riess, Tom Stargardt, Peter Bramlage
With the recent approval of the fourth direct non vitamin K dependent oral anticoagulant (NOAC) edoxaban the range of available NOACs for the treatment of venous thromboembolism (VTE) has expanded. Shortly thereafter, two updated guidelines for the prevention and treatment of VTE have been published. In these NOACs are listed as equal anticoagulants to low-molecular weight heparin (LMWH), or fondaparinux (FDX), and VKA for the initial or maintenance treatment of VTE. All NOACs are approved for the maintenance therapy after VTE and two NOACs (rivaroxaban and apixaban) for the initial treatment in addition in an increased dose...
April 19, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28411285/monitoring-of-hypercoagulability-by-thromboelastography-in-bariatric-surgery
#4
Kristina Kupcinskiene, Darius Trepenaitis, Ruta Petereit, Juozas Kupcinskas, Rita Gudaityte, Almantas Maleckas, Andrius Macas
BACKGROUND Obesity is known as a major risk factor for postoperative vein thrombosis. Thromboelastography (TEG) is used to monitor viscoelastic features of blood clots. The aim of this study was to determine hypercoagulable states in patients undergoing bariatric surgery and to assess dynamics of coagulation parameters in the perioperative setting using TEG. MATERIAL AND METHODS We included 60 consecutive patients undergoing bariatric surgery. TEG alterations were assessed at 4 time points: at baseline, after the surgery, and on postoperative day 1 (POD1) and 2 (POD2)...
April 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28400024/impact-of-a-combined-processing-technology-involving-ultrasound-and-pulsed-light-on-structural-and-physiological-changes-of-saccharomyces-cerevisiae-ke-162-in-apple-juice
#5
Mariana Ferrario, Sandra Guerrero
This study analyzed the effect of single ultrasound (US) (600 W, 20 kHz and 95.2 μm wave amplitude, 10 or 30 min at 20 or 44 ± 1 °C), or combined with pulsed light technology (PL) with controlled heat build-up (Xenon lamp, 3 pulses/s, 71.6 J/cm(2), temperature ranges: 2-20 ± 1 °C and 44-56 ± 1 °C) on the inactivation of Saccharomyces cerevisiae KE 162 cells in commercial (pH: 3.5 ± 0.1; 12.5 ± 0.1 °Brix) and freshly pressed (pH: 3.4 ± 0.1; 12.6 ± 0.1 °Brix) apple juices...
August 2017: Food Microbiology
https://www.readbyqxmd.com/read/28384182/global-measurement-of-coagulation-in-plasma-from-normal-and-haemophilia-dogs-using-a-novel-modified-thrombin-generation-test-demonstrated-in-vitro-and-ex-vivo
#6
Daniel Elenius Madsen, Timothy C Nichols, Elizabeth P Merricks, Emily K Waters, Bo Wiinberg
INTRODUCTION: Canine models of severe haemophilia resemble their human equivalents both regarding clinical bleeding phenotype and response to treatment. Therefore pre-clinical studies in haemophilia dogs have allowed researchers to make valuable translational predictions regarding the potency and efficacy of new anti-haemophilia drugs (AHDs) in humans. To refine in vivo experiments and reduce number of animals, such translational studies are ideally preceded by in vitro prediction of compound efficacy using a plasma based global coagulation method...
2017: PloS One
https://www.readbyqxmd.com/read/28383473/pro-coagulant-activity-of-human-mesenchymal-stem-cells
#7
Barbara A Christy, Maryanne C Herzig, Robbie K Montgomery, Christopher Delavan, James A Bynum, Kristin M Reddoch, Andrew P Cap
BACKGROUND: Allogeneic mesenchymal stem cells (MSCs) show great potential for the treatment of military and civilian trauma, based on their reduced immunogenicity and ability to modulate inflammation and immune function in the recipient. Although generally considered to be safe, MSCs express tissue factor (TF), a potent activator of coagulation. In the current study, we evaluated multiple MSC populations for tissue factor expression and pro-coagulant activity in order to characterize safety considerations for systemic use of MSCs in trauma patients who may have altered coagulation homeostasis...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28376529/role-of-direct-oral-anticoagulants-in-the-management-of-anticoagulation
#8
Rajiv N Thakkar, Suman W Rathbun, Scott M Wright
For decades, vitamin K antagonists (VKAs) have been the oral treatment of choice for many thromboembolic conditions. The limitations of VKAs include the need for monitoring through blood testing, drug interactions, and narrow therapeutic windows. These shortcomings have led to the development of direct oral anticoagulants. These new oral agents act on specific targets in the coagulation cascade (eg, factor Xa, thrombin) and negate some of the shortcomings of VKAs. This article reviews the roles of dabigatran, rivaroxaban, apixaban, and edoxaban in stroke prevention in nonvalvular atrial fibrillation, for prevention of venous thromboembolism after orthopedic surgery, and in the treatment of venous thromboembolism...
April 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28365976/new-anticoagulants-for-the-prevention-and-treatment-of-venous-thromboembolism
#9
REVIEW
Joo Hee Kim, Kyung-Min Lim, Hye Sun Gwak
Anticoagulant drugs, like vitamin K antagonists and heparin, have been the mainstay for the treatment and prevention of venous thromboembolic disease for many years. Although effective if appropriately used, traditional anticoagulants have several limitations such as unpredictable pharmacologic and pharmacokinetic responses and various adverse effects including serious bleeding complications. New oral anticoagulants have recently emerged as an alternative because of their rapid onset/offset of action, predictable linear dose-response relationships and fewer drug interactions...
April 6, 2017: Biomolecules & Therapeutics
https://www.readbyqxmd.com/read/28365134/utility-of-sonoclot-in-prediction-of-postoperative-bleeding-in-pediatric-patients-undergoing-cardiac-surgery-for-congenital-cyanotic-heart-disease-a-prospective-observational-study
#10
Vishwakarma Rajkumar, Bhupesh Kumar, Vikas Dutta, Anand K Mishra, Goverdhan Dutt Puri
OBJECTIVES: To assess the utility of Sonoclot in prediction of postoperative bleeding in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass for congenital cyanotic heart disease. DESIGN: Prospective, observational study. SETTING: Single university hospital. PARTICIPANTS: Eighty-seven pediatric patients undergoing cardiac surgery for congenital cyanotic heart disease. INTERVENTIONS: Laboratory coagulation parameters (prothrombin time, international normalization ratio, activated partial thromboplastin time, fibrinogen, D-dimer) as well as point-of-care Sonoclot glass bead activation time, clot rate, and platelet function (gbPF) were done before induction of anesthesia and following heparin reversal after termination of cardiopulmonary bypass (CPB) in all patients...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28360822/impact-of-blood-hypercoagulability-on-in-vitro-fertilization-outcomes-a-prospective-longitudinal-observational-study
#11
Grigoris T Gerotziafas, Patrick Van Dreden, Emmanuelle Mathieu d'Argent, Eleftheria Lefkou, Matthieu Grusse, Marjorie Comtet, Rabiatou Sangare, Hela Ketatni, Annette K Larsen, Ismail Elalamy
BACKGROUND: Blood coagulation plays a crucial role in the blastocyst implantation process and its alteration may be related to in vitro fertilization (IVF) failure. We conducted a prospective observational longitudinal study in women eligible for IVF to explore the association between alterations of coagulation with the IVF outcome and to identify the biomarkers of hypercoagulability which are related with this outcome. METHODS: Thirty-eight women eligible for IVF (IVF-group) and 30 healthy, age-matched women (control group) were included...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28359136/point-of-care-testing-in-burn-patients
#12
Marion Wiegele, Sibylle Kozek-Langenecker, Eva Schaden
Severe burn injury has an impact on the coagulation system, but a unique definition regarding these changes is still missing. The results of conventional coagulation assays (CCAs) measured in daily clinical practice are often interpreted as coagulopathic, which implies a bleeding tendency. However, viscoelastic coagulation assays (VCA) like Rotational Thromboelastometry (ROTEM) and Thromboelastography (TEG) depict a hypercoagulable state. Therefore, hemostatic interventions should not be indicated according to deranged CCA results, but only in case of clinically relevant bleeding plus indicative VCA results...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28359134/circulating-extracellular-dna-cause-or-consequence-of-thrombosis
#13
Miguel Jiménez-Alcázar, Natalie Kim, Tobias A Fuchs
Thrombosis leads to ischemic organ damage in cardiovascular and thromboembolic diseases. Neutrophils promote thrombosis in vitro and in vivo by releasing neutrophil extracellular traps (NETs). NETs are composed of DNA filaments coated with histones and neutrophil enzymes such as myeloperoxidase (MPO). Circulating extracellular DNA (ceDNA) is widely used as a surrogate marker to monitor NET formation in thrombosis. This narrative review summarizes the association of ceDNA with human thrombosis. Levels of ceDNA indicate the extent and outcome of several cardiovascular and thromboembolic diseases, including myocardial infarction, stroke, and venous thromboembolism...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28359133/point-of-care-coagulation-testing-in-cardiac-surgery
#14
Daniel Bolliger, Kenichi A Tanaka
Bleeding complications after cardiac surgery are common and are associated with increased morbidity and mortality. Their etiology is multifactorial, and treatment decisions are time sensitive. Point-of-care (POC) testing has an advantage over standard laboratory tests for faster turn-around times, and timely decision on coagulation intervention(s). The most common POC coagulation testing is the activated clotting time (ACT), used to monitor heparin therapy while on cardiopulmonary bypass. Viscoelastic coagulation tests including thromboelastometry (ROTEM) and thromboelastography (TEG) have been recommended for the treatment of postoperative bleeding after cardiac surgery because the ROTEM/TEG-guided treatment algorithms reduced the use of blood products...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28359132/point-of-care-testing-in-liver-disease-and-liver-surgery
#15
Lasitha Abeysundara, Susan V Mallett, Ben Clevenger
The alterations in coagulation and hemostasis that accompany liver disease are complex, and while patients with this disease have traditionally been perceived as having a bleeding diathesis, it is now understood that in stable patients hemostasis is "re-balanced." Hepatic surgery, and particularly liver transplantation, can be associated with large fluid shifts, massive bleeding, and coagulopathy, as well as postoperative thrombosis. Point-of-care tests (POCTs) of coagulation facilitate goal-directed treatments and hemostatic monitoring in dynamic environments where the coagulation status can alter rapidly and often unpredictably...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28359041/ambient-temperature-and-cardiovascular-biomarkers-in-a-repeated-measure-study-in-healthy-adults-a-novel-biomarker-index-approach
#16
Shaowei Wu, Di Yang, Lu Pan, Jiao Shan, Hongyu Li, Hongying Wei, Bin Wang, Jing Huang, Andrea A Baccarelli, Masayuki Shima, Furong Deng, Xinbiao Guo
BACKGROUND: Associations of ambient temperature with cardiovascular morbidity and mortality have been well documented in numerous epidemiological studies, but the underlying pathways remain unclear. We investigated whether systemic inflammation, coagulation, systemic oxidative stress, antioxidant activity and endothelial function may be the mechanistic pathways associated with ambient temperature. METHODS: Forty study participants underwent repeated blood collections for 12 times in Beijing, China in 2010-2011...
March 27, 2017: Environmental Research
https://www.readbyqxmd.com/read/28355459/laboratory-monitoring-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-review
#17
John W Eikelboom, Daniel J Quinlan, Jack Hirsh, Stuart J Connolly, Jeffrey I Weitz
Importance: The non-vitamin K antagonist oral anticoagulants (NOACs) apixaban, dabigatran, edoxaban, and rivaroxaban are administered in fixed doses without anticoagulant monitoring. Randomized trials show that unmonitored NOAC therapy is at least as effective as and safer than dose-adjusted warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Subgroup analyses indicate that plasma drug levels or anticoagulant activity of the NOACs predict stroke and bleeding...
March 29, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28353255/development-of-a-user-friendly-app-for-testing-blood-coagulation-status-in-schizophrenia-patients
#18
Johannes Vegt, Paul C Guest
Blood coagulation time is an important factor to consider for postoperative and cardiac disorder patients who have been prescribed anticoagulant coagulant medications. The coagulation process is also known to be perturbed in some individuals with psychiatric disorders, such as schizophrenia. This chapter describes a patient self-management system for a functional assessment of blood coagulation activity, determining the appropriate anticoagulant dosages using a test strip device and the Coagu app. The app can also be used as a patient reminder of treatment times and to monitor treatment and effects over time...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28348360/an-uncommon-case-of-lower-limb-deep-vein-thrombosis-with-multiple-etiological-causes
#19
Jing Miao, Geetha Naik, Sivakumar Muddana, Xiaohuan Li, Supriya Bhimasani, Ronald Alvin Mitchell, Dariush Alaie, Richard L Petrillo
BACKGROUND Deep vein thrombosis (DVT) is a type of venous thromboembolism with diverse clinical and environmental risk factors. Very few cases of DVT with multiple high risk factors have been reported. Here, we report an uncommon DVT case with multiple etiological causes, including appendicitis/appendectomy, morbid obesity, immobilization, positive phosphatidylserine IgG, and heterozygous factor V Leiden mutation. CASE REPORT A 43-year-old female was brought to the emergency room because of 2-week history of pain and swelling and ultrasound revealing evidence of DVT in the right leg...
March 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28347872/ultrasonic-method-for-monitoring-the-clotting-process-during-whole-blood-coagulation
#20
A Voleisis, R Kazys, B Voleisiene, R Sliteris, L Mazeika
The purpose of this work was to develop a multichannel ultrasonic measurement method for monitoring a spatially non-uniform blood clotting process. This novel method is based on simultaneous multi-channel measurements of ultrasound propagation velocities in different horizontal cross-sections of clotting blood. The most common method used for determining blood-clotting time is the capillary tube method. For this purpose ultrasonic methods based on measurements of the velocities of ultrasound waves in clotting blood are also used...
February 24, 2017: Ultrasonics
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