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Coagulation monitoring

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https://www.readbyqxmd.com/read/27913535/reversing-vitamin-k-antagonists-making-the-old-new-again
#1
Sabine Eichinger
Vitamin K antagonists (VKAs) are commonly used for the prevention and treatment of thrombotic disorders. The response to VKAs is highly variable due to their specific interaction with the vitamin K cycle, and hence interference with hepatic synthesis of vitamin K-dependent coagulation factors. Monitoring the anticoagulant effect of VKAs by assessing the patient's international normalized ratio (INR) is essential because complications are closely related to the intensity of anticoagulation. Treatment with VKAs contains a substantial risk of bleeding with a high case fatality rate...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27909537/a-comparison-between-noacs-and-warfarin-on-time-to-elective-cardioversion
#2
REVIEW
Siva Krothapalli Md, Prashant D Bhave Md Fhrs
Cardioversion of atrial fibrillation is a procedure that has been commonly performed for over half a century. There is known to be an elevated risk of thromboembolism around the time of cardioversion, which has been shown to be drastically reduced with oral anticoagulation. The consistency of therapeutic anticoagulation in the weeks leading up to elective cardioversion is an important factor in the safety of the procedure. Until recently, the only option for oral anti-coagulation was Warfarin. The challenges of dosing Warfarin to achieve a therapeutic INR are well documented...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27896780/development-of-a-user-friendly-app-for-assisting-anticoagulation-treatment
#3
Johannes Vegt
Blood coagulation time is an important factor to consider for postoperative and cardiac disorder patients who have been prescribed anticoagulant coagulant medications. This chapter describes a patient self-management system for assessment of blood coagulation times and determining appropriate anticoagulant dosages using a test strip device and the Coagu app. This app can also be used as a patient reminder of treatment times and to monitor treatment and effects over time.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27889194/usefulness-of-thromboelastography-in-the-detection-and-management-of-tissue-plasminogen-activator-associated-hyperfibrinolysis
#4
Francesca Rosafio, Laura Vandelli, Guido Bigliardi, Francesco Cavallieri, Maria Luisa Dell'Acqua, Livio Picchetto, Andrea Zini
Rotation thromboelastometry is a viscoelastometric method that provides a rapid assessment of a patient's hemostatic processes in emergency settings, allowing prompt identification of specific coagulation abnormalities. Its results thus might guide targeted replacement therapy in hemorrhagic conditions, in case of platelet or coagulation factor deficiency, or hyperfibrinolysis, which is difficult to identify otherwise. Although currently used in emergency and traumatic surgery, there are limited data about thromboelastometry in ischemic stroke, particularly in monitoring the coagulative response to recombinant tissue plasminogen activator after intravenous thrombolysis (IVT)...
November 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27872768/hip-replacement-surgery-in-14-year-old-girl-with-factor-v-deficiency-haemostatic-treatment-and-thromboprophylaxis
#5
María Eva Mingot-Castellano, Josefina Pérez-Núñez, Lourdes Baeza-Montañez
Factor V (FV) is a pivotal coagulation factor present in plasma and platelets. It plays an essential role in secondary haemostasis acting as a cofactor in the prothrombinase complex, catalysing the conversion of prothrombin to thrombin. There is little evidence on the management of mayor orthopaedic surgery in paediatric or adolescents subjects with this coagulopathy and almost no information about thromboprophylaxis in these situations. We report a case of a hip replacement in a 14-year-old girl with moderate FV deficiency (0...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27868461/a-new-approach-to-feedback-control-of-radiofrequency-ablation-systems-for-large-coagulation-zones
#6
Bing Zhang, Michael A J Moser, Edwin M Zhang, Yigang Luo, Wenjun Zhang
PURPOSE: The purpose of this study was to investigate the feasibility of achieving relatively large coagulation zones (i.e. ≥ 3 cm in diameter) with radiofrequency ablation (RFA) using a broad control system. MATERIALS AND METHODS: A broad control system consists of such information as (i) the area of the tumour tissue for feedback control, (ii) the set-point temperature, and (iii) the control law. The proposed approach has advanced knowledge in (i) and (ii) in particular...
November 21, 2016: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/27858919/massive-intoxication-with-rivaroxaban-phenprocoumon-and-diclofenac-a-case-report
#7
Hella Pfeiffer, Larissa Herbst, Bernd Schwarze, Reinhold Eckstein, Volker Weisbach
RATIONALE: Oral anticoagulants and painkillers, some with an additional effect on the coagulation system, are widely used and are therefore prone to abuse and (intentional) overdose. We report the case of a patient with a massive mixed anticoagulant intoxication. PATIENT CONCERNS: The patient had ingested 1960 mg rivaroxaban, 31.5 mg phenprocoumon, 1425 mg diclofenac, and 21,000 mg metamizole in suicidal intention. DIAGNOSES: Massive mixed anticoagulant overdose...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#8
Anthony Logaraj, Venessa H M Tsang, Shahrir Kabir, Julian C Y Ip
: Adrenal haemorrhage is a rare cause of adrenal crisis, which requires rapid diagnosis, prompt initiation of parenteral hydrocortisone and haemodynamic monitoring to avoid hypotensive crises. We herein describe a case of bilateral adrenal haemorrhage after hemicolectomy in a 93-year-old female with high-grade colonic adenocarcinoma. This patient's post-operative recovery was complicated by an acute hypotensive episode, hypoglycaemia and syncope, and subsequent computed tomography (CT) scan of the abdomen revealed bilateral adrenal haemorrhage...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27849854/212-ecmo-and-cardiac-assist-devices-rotational-thromboelastometry-guided-coagulation-monitoring
#9
Dorothea Rosenberger, Heather Henry
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#10
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27847701/the-effect-of-desmopressin-on-the-amount-of-bleeding-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-a-cardiopulmonary-bypass-pump-after-taking-anti-platelet-medicine
#11
Ali Mirmansoori, Farnoush Farzi, Abbas Sedighinejad, Vali Imantalab, Ali Mohammadzadeh, Zahra Atrkar Roushan, Samaneh Ghazanfar Tehran, Maryam Nemati, Afsaneh Dehghan
BACKGROUND: Coronary artery bypass grafting (CABG) is a common surgical intervention at the end-stages of coronary artery occlusion disease. Despite the effectiveness of CABG, it may have particular complications, such as bleeding during and after surgery. So far, there have been many drugs used to reduce bleeding. OBJECTIVES: This study aimed at investigating the effects of desmopressin on the amount of bleeding in patients undergoing CABG with a cardiopulmonary bypass pump (CPBP) who were taking anti-platelet medicine...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843091/cause-of-death-in-children-with-mitochondrial-diseases
#12
Soyong Eom, Ha Neul Lee, Sunho Lee, Hoon-Chul Kang, Joon Soo Lee, Heung Dong Kim, Young-Mock Lee
BACKGROUND: We investigated the clinical characteristics that represent risk factors for death in pediatric patients with mitochondrial diseases. METHODS: The medical records of mitochondrial disease pediatric patients attended between 2006 and 2015 (n = 221) were reviewed for clinical characteristics, diagnosis, hospitalization, follow-up, survival, and cause of death. RESULTS: The global mortality rate in the cohort was 14% (average age at death, six years)...
October 13, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27836741/guidelines-of-the-french-society-of-otorhinolaryngology-sforl-managing-epistaxis-under-coagulation-disorder-due-to-antithrombotic-therapy
#13
V Escabasse, E Bequignon, B Vérillaud, L Robard, J Michel, O Malard, L Crampette
OBJECTIVE: The authors present the guidelines of the French Society of Otorhinolaryngology concerning the management of epistaxis during antithrombotic therapy. METHODS: A review of the literature was performed by a multidisciplinary work group. Guidelines were drafted, then re-edited by a reading group independent of the work group to produce the final text. The proposed recommendations were graded A, B, C or expert opinion, on decreasing levels of evidence. RESULTS: Before any decision to modify antithrombotic treatment, it is recommended to screen for overdose and assess the risk of thrombosis...
November 8, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/27836495/duration-of-systemic-inflammatory-response-syndrome-influences-serum-vancomycin-concentration-in-patients-with-sepsis
#14
Masayuki Chuma, Makoto Makishima, Toru Imai, Naohiro Tochikura, Takako Sakaue, Norikazu Kikuchi, Kosaku Kinoshita, Morio Kaburaki, Yoshikazu Yoshida
PURPOSE: Vancomycin (VCM) is used in the treatment of methicillin-resistant Staphylococcus aureus infection. The dosage of VCM must be adjusted by using therapeutic drug monitoring because of the drug's narrow therapeutic concentration window. Although optimal administration based on population pharmacokinetic (PPK) analysis and/or a Bayesian method has improved prediction accuracy, serum concentrations of VCM in patients with sepsis often deviate significantly from predicted values. We investigated factors influencing prediction errors with PPK analysis in VCM dosing...
November 8, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27836023/coagulation-factor-abnormalities-related-to-discordance-between-anti-factor-xa-and-activated-partial-thromboplastin-time-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#15
Sirtaz Adatya, Roy Sunny, Megan J Fitzpatrick, Monica Colvin, Thennapan Thennapan, Ranjit John, Nicole Dodge Zantek, Marc Pritzker, Peter Eckman, Nir Uriel
BACKGROUND: High levels of discordance between activated partial thromboplastin time (aPTT) and anti-factor Xa (anti-FXa) have been reported in patients with continuous-flow left ventricular assist devices (CF-LVADs). We sought to determine the biochemical basis for discordance by simultaneous measurement of coagulation factors with aPTT and anti-FXa. METHODS: Consecutive CF-LVAD patients admitted for intravenous unfractionated heparin (IV-UFH) therapy were studied...
November 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27832560/the-effect-of-dabigatran-on-the-kaolin-activated-whole-blood-thromboelastogram
#16
A 'Aho, K Byrne
Dabigatran is a direct thrombin inhibitor, which is increasingly likely to be encountered in patients presenting for surgery. This study examines whether there is a consistent effect of dabigatran on the thromboelastogram (TEG) and whether this correlates with the effects of dabigatran on traditional coagulation parameters. Twenty patients taking dabigatran had blood sampled for kaolin-activated whole blood TEG analysis and routine coagulation testing. There was a statistically significant correlation between thrombin clotting time (TCT) and R-time (R=0...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27832552/current-limitations-of-the-assessment-of-haemostasis-in-adult-extracorporeal-membrane-oxygenation-patients-and-the-role-of-point-of-care-testing
#17
K Venkatesh, P S Nair, D J Hoechter, H Buscher
Haemostatic perturbations are commonly seen in extracorporeal membrane oxygenation (ECMO) patients and remain a clinical challenge, contributing significantly to morbidity and mortality. The approach to anticoagulation monitoring and the management of bleeding varies considerably across ECMO centres. Routine laboratory tests have their limitations in terms of turnaround time and specificity of information provided. Newer point-of-care testing (POCT) for coagulation may overcome these issues, as it provides information about the entire coagulation pathway from clot initiation to lysis...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27810492/molecular-initiating-events-of-the-intersex-phenotype-low-dose-exposure-to-17%C3%AE-ethinylestradiol-rapidly-regulates-molecular-networks-associated-with-gonad-differentiation-in-the-adult-fathead-minnow-testis
#18
April Feswick, Jennifer R Loughery, Meghan A Isaacs, Kelly R Munkittrick, Christopher J Martyniuk
Intersex, or the presence of oocytes in the testes, has been documented in fish following exposure to wastewater effluent and estrogenic compounds. However, the molecular networks underlying the intersex condition are not completely known. To address this, we exposed male fathead minnows to a low, environmentally-relevant concentration of 17alpha-ethinylestradiol (EE2) (15ng/L) and measured the transcriptome response in the testis after 96h to identify early molecular initiating events that may proceed the intersex condition...
December 2016: Aquatic Toxicology
https://www.readbyqxmd.com/read/27797452/refrigerated-platelets-stored-in-whole-blood-up-to-5-days-adhere-to-thrombi-formed-during-hemorrhagic-hypotension-in-rats
#19
Ivo P Torres Filho, Luciana N Torres, Celina Valdez, Christi Salgado, Andrew P Cap, Michael A Dubick
There is renewed interest in the therapeutic use of cold-stored platelets for bleeding patients. However, critical information is absent or partially available in vitro. Therefore, thrombus formation and platelet adhesion were studied in vivo, in situ, using bleeding and thrombosis models in instrumented rats, and confocal intravital videomicroscopy OBJECTIVES: We tested the hypothesis that refrigerated (4°C) platelets (stored for 24 hours or 5 days) participated in thrombus formation as well as platelets stored at room temperature (RT, 22°C)...
October 31, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27789605/reversal-of-anticoagulation-and-management-of-bleeding-in-patients-on-anticoagulants
#20
Prajwal Dhakal, Supratik Rayamajhi, Vivek Verma, Krishna Gundabolu, Vijaya R Bhatt
Bleeding is the most common complication of all anticoagulants. Any bleeding patient on an anticoagulant should be risk-stratified based on hemodynamic instability, source of bleeding, and degree of blood loss. Although minor bleed may be managed with discontinuation of anticoagulant, major bleed may require transfusion of blood products and use of specific antidote. The residual effects of each anticoagulant may be monitored with distinct coagulation assay. Intravenous or oral vitamin K can reverse the effect of warfarin within 24 to 48 hours and is indicated for any bleeding, international normalized ratio of >10 or 4...
October 26, 2016: Clinical and Applied Thrombosis/hemostasis
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