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https://www.readbyqxmd.com/read/28921890/phase-ii-study-of-dabigatran-in-children-with-venous-thrombosis-pharmacokinetics-safety-and-tolerabilty
#1
J M L Halton, M Albisetti, B Biss, L Bomgaars, M Brueckmann, S Gropper, R Harper, F Huang, M Luciani, H Maas, I Tartakovsky, L G Mitchell
BACKGROUND: The current standard-of-care treatments for pediatric venous thromboembolism (VTE) have limitations. Dabigatran etexilate (DE), a direct thrombin inhibitor, may offer an alternative therapeutic option. OBJECTIVES: To assess the pharmacokinetics (PK), pharmacodynamics (PD), safety and tolerability of DE oral liquid formulation (OLF) in pediatric patients with VTE. PATIENTS/METHODS: Patients who had completed planned treatment with low-molecular-weight heparin or oral anticoagulants for VTE were enrolled in two age groups (2-<12 and 1-<2 years) and received DE OLF based on an age- and weight-adjusted nomogram...
September 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28921763/implementation-and-preliminary-clinical-outcomes-of-a-pharmacist-managed-venous-thromboembolism-clinic-for-patients-treated-with-rivaroxaban-post-emergency-department-discharge
#2
Baely M DiRenzo, Daren M Beam, Jeffrey A Kline, Karishma S Deodhar, Christina M Davis, Zachary A Weber, Todd A Walroth
OBJECTIVE: To describe the implementation, work flow, and differences in outcomes between a pharmacist-managed clinic for the outpatient treatment of venous thromboembolism (VTE) using rivaroxaban versus care by a primary care provider. INTERVENTIONS: Patients in the studied health system that are diagnosed with low-risk VTE in the emergency department are often discharged without hospital admission. These patients are treated with rivaroxban and follow up either in a pharmacist-managed VTE clinic or with their primary care provider...
September 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28921408/catheter-ablation-for-af-improves-global-thrombotic-profile-and-enhances-fibrinolysis
#3
Maria Niespialowska-Steuden, Vias Markides, Mohamed Farag, David Jones, Wajid Hussain, Tom Wong, Diana A Gorog
Patients with atrial fibrillation (AF) are at increased risk of thrombotic events despite oral anticoagulation (OAC). Radiofrequency catheter ablation (RFCA) can restore and maintain sinus rhythm (SR) in patients with AF. To assess whether RFCA improves thrombotic status. 80 patients (71% male, 64 ± 12y) with recently diagnosed AF, on OAC and scheduled to undergo RFCA or DC cardioversion (DCCV) were recruited. Thrombotic status was assessed using the point-of-care global thrombosis test (GTT), before, and 4-6 weeks after DCCV and 3 months after RFCA...
September 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28919201/macitentan-for-the-treatment-of-inoperable-chronic-thromboembolic-pulmonary-hypertension-merit-1-results-from-the-multicentre-phase-2-randomised-double-blind-placebo-controlled-study
#4
Hossein-Ardeschir Ghofrani, Gérald Simonneau, Andrea M D'Armini, Peter Fedullo, Luke S Howard, Xavier Jaïs, David P Jenkins, Zhi-Cheng Jing, Michael M Madani, Nicolas Martin, Eckhard Mayer, Kelly Papadakis, Dominik Richard, Nick H Kim
BACKGROUND: Macitentan is beneficial for long-term treatment of pulmonary arterial hypertension. The microvasculopathy of chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension are similar. METHODS: The phase 2, double-blind, randomised, placebo-controlled MERIT-1 trial assessed macitentan in 80 patients with CTEPH adjudicated as inoperable. Patients identified as WHO functional class II-IV with a pulmonary vascular resistance (PVR) of at least 400 dyn·s/cm(5) and a walk distance of 150-450 m in 6 min were randomly assigned (1:1), via an interactive voice/web response system, to receive oral macitentan (10 mg once a day) or placebo...
September 8, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28918992/anti-factor-xa-levels-in-patients-undergoing-laparoscopic-sleeve-gastrectomy-2-different-dosing-regimens-of-enoxaparin
#5
Shaul Gelikas, Shai Meron Eldar, Guy Lahat
BACKGROUND: Morbidly obese patients undergoing bariatric surgery are at risk for developing venous thromboembolic events. Data regarding the appropriate dosing strategy in this special population is limited. OBJECTIVE: To evaluate 2 different dosing regimens of enoxaparin in a prospective cohort of patients undergoing laparoscopic sleeve gastrectomy. SETTING: University hospital, Israel METHODS: The study cohort consisted of 54 patients divided into 2 groups...
July 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28918657/direct-oral-anticoagulant-use-in-atypical-thrombosis-related-conditions
#6
Clement Chang, Mario Hoyos, Yaw Owusu, Hazem Elewa
OBJECTIVE: To review the published literature for evidence of the efficacy and safety of direct oral anticoagulants (DOACs) when used in the management of atypical thrombosis-related conditions. DATA SOURCES: A comprehensive MEDLINE database search (1948 to July 2017) and EMBASE search (1980 to July 2017) were conducted using the search terms direct oral anticoagulant in combination with acute coronary syndrome (ACS), antiphospholipid antibody syndrome (APLAS), and cancer-associated thrombosis (CAT)...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28917273/mechanisms-and-risk-factors-of-thrombosis-in-cancer
#7
REVIEW
Anna Falanga, Laura Russo, Viola Milesi, Alfonso Vignoli
The close relationship between cancer and thrombosis is known since more than a century. Venous thromboembolism (VTE) may be the first manifestation of an occult malignancy in an otherwise healthy individual. Cancer patients commonly present with abnormalities of laboratory coagulation tests, indicating an ongoing subclinical hypercoagulable condition. The results of laboratory tests demonstrate that a process of fibrin formation and removal parallels the development of malignancy, which is of particular interest since fibrin and other clotting products are important for both thrombogenesis and tumor progression...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#8
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#9
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28910988/anticoagulation-after-coronary-stenting-a-systemic-review
#10
Zhe Dong, Jingang Zheng
Introduction or background: Anticoagulant therapy is mainly used to prevent patients from suffering coronary and systemic thromboembolism after stenting. Many studies have been done to formulate an optimized regimen of a post-PCI or long-time anticoagulant therapy. Recent advances in the selection and duration of anticoagulant agents will be conducive to the management of patients who are considered to need anticoagulant therapy after stenting. Sources of data: Key recent published literature, including international guidelines and relevant reviews...
September 1, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28910333/reduced-proliferation-of-endothelial-colony-forming-cells-in-unprovoked-venous-thromboembolic-disease-as-a-consequence-of-endothelial-dysfunction
#11
Rubicel Hernandez-Lopez, Antonieta Chavez-Gonzalez, Patricia Torres-Barrera, Dafne Moreno-Lorenzana, Norma Lopez-DiazGuerrero, David Santiago-German, Irma Isordia-Salas, David Smadja, Mervin C Yoder, Abraham Majluf-Cruz, J Antonio Alvarado-Moreno
BACKGROUND: Venous thromboembolic disease (VTD) is a public health problem. We recently reported that endothelial colony-forming cells (ECFCs) derived from endothelial cells (EC) (ECFC-ECs) from patients with VTD have a dysfunctional state. For this study, we proposed that a dysfunctional status of these cells generates a reduction of its proliferative ability, which is also associated with senescence and reactive oxygen species (ROS). METHODS AND RESULTS: Human mononuclear cells (MNCs) were obtained from peripheral blood from 40 healthy human volunteers (controls) and 50 patients with VTD matched by age (20-50 years) and sex to obtain ECFCs...
2017: PloS One
https://www.readbyqxmd.com/read/28906352/clinical-and-angiographic-outcomes-following-endovascular-treatment-of-very-small-3%C3%A2-mm-or-smaller-intracranial-aneurysm-a-single-center-experience
#12
Yongsheng Liu, Feng Wang, Xiaochen Fu, Yongjian Liu, Guodong Zhang, Ke Xu
Treatments for very small (3 mm or smaller) intracranial aneurysms (VSAs) remain controversial. The aim of this study was to evaluate the efficacy of endovascular treatment for VSAs and to evaluate clinical risk factors associated with complications.This retrospective study enrolled 82 VSA patients who underwent coil embolization in our institution. Angiographic outcomes were assessed according to the Meyers classification. The clinical results were evaluated using the modified Rankin scale (mRS) immediately after coiling, at discharge, and during follow-up...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904820/successful-cerebral-thrombectomy-for-a-nonagenarian-with-stroke-in-the-subacute-phase-after-transcatheter-aortic-valve-implantation
#13
Kazuya Matsuo, Atsushi Fujita, Jun Tanaka, Tomoaki Nakai, Masaaki Kohta, Kohkichi Hosoda, Toshiro Shinke, Ken-Ichi Hirata, Eiji Kohmura
BACKGROUND: Thromboembolic events are infrequent but serious complications of transcatheter aortic valve implantation (TAVI), occurring in 2.3-10% of the patients. However, the cause of post-TAVI stroke is unclear. CASE DESCRIPTION: A 90-year-old female underwent transfemoral-TAVI for severe aortic stenosis. Ten days later, she presented with an ischemic stroke of the left middle cerebral artery territory due to new-onset atrial fibrillation (NOAF). She underwent emergent endovascular thrombectomy with good reperfusion approximately 6 hours after onset of symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#14
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902590/long-term-outcomes-of-patent-foramen-ovale-closure-or-medical-therapy-after-stroke
#15
Jeffrey L Saver, John D Carroll, David E Thaler, Richard W Smalling, Lee A MacDonald, David S Marks, David L Tirschwell
Background Whether closure of a patent foramen ovale reduces the risk of recurrence of ischemic stroke in patients who have had a cryptogenic ischemic stroke is unknown. Methods In a multicenter, randomized, open-label trial, with blinded adjudication of end-point events, we randomly assigned patients 18 to 60 years of age who had a patent foramen ovale (PFO) and had had a cryptogenic ischemic stroke to undergo closure of the PFO (PFO closure group) or to receive medical therapy alone (aspirin, warfarin, clopidogrel, or aspirin combined with extended-release dipyridamole; medical-therapy group)...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28899861/quality-initiative-to-introduce-pediatric-venous-thromboembolism-risk-assessment-for-orthopedic-and-surgery-patients
#16
Laura H Brower, Nathalie Kremer, Katie Meier, Christine Wolski, Molly M McCaughey, Emily McKenna, Jennifer Anadio, Emily Eismann, Erin E Shaughnessy
BACKGROUND AND OBJECTIVES: Pediatric hospital-acquired venous thromboembolism (VTE) is costly, has high morbidity, and is often preventable. The objective of this quality-improvement effort was to increase the percentage of general surgery and orthopedic patients ≥10 years of age screened for VTE risk from 0% to 80%. METHODS: At a freestanding children's hospital, 2 teams worked to implement VTE risk screening for postoperative inpatients. The general surgery team used residents and nurse practitioners to perform screening whereas the orthopedic team initially used bedside nursing staff...
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28899859/development-of-a-surveillance-system-for-pediatric-hospital-acquired-venous-thromboembolism
#17
Laura H Brower, Erin E Shaughnessy, Ranjit S Chima
BACKGROUND: Pediatric hospital-acquired (HA) venous thromboembolism (VTE) is a vexing problem with improvement efforts hampered by lack of robust surveillance methods to establish accurate rates of HA-VTE. METHODS: At a freestanding children's hospital, a multidisciplinary team worked to develop a comprehensive surveillance strategy for HA-VTE. Starting with diagnosis codes, we implemented complementary detection methods, including clinical and radiology data, to develop a robust surveillance system...
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28894528/notification-of-international-normalized-ratio-test-in-atrial-fibrillation-patients-treated-with-warfarin-via-short-message-service-study-protocol-for-a-randomized-controlled-trial
#18
Reza Sheibani, Mehdi Sheibani, Yamin Hejazi, Saeid Eslami
BACKGROUND: Atrial Fibrillation (AF) is the most common abnormal heart rhythm. AF patients usually use warfarin therapy. Safety and efficacy of warfarin are dependent on maintaining the International Normalized Ratio (INR) within the therapeutic range. OBJECTIVE: We will use a Short Message Service (SMS) to evaluate the effect of a reminder on carrying out the INR laboratory test in a timely manner. METHODS: This study (a Randomized Controlled Trial) will be done in Loghman hospital Tehran, Iran...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28892658/homozygous-antithrombin-deficiency-type-ii-causing-neonatal-thrombosis
#19
Vanessa Swoboda, Katharina Zervan, Katharina Thom, Christine Mannhalter, Peter Quehenberger, Ingrid Pabinger, Christoph Male
We report four children from different families with homozygous antithrombin (AT) deficiency type II affecting the heparin binding site (p.Leu131Phe mutation). All children had severe spontaneous venous and/or arterial thromboembolic events shortly after birth. This report intends to raise awareness among clinicians about this rare but severe condition. When thrombosis occurs in an otherwise healthy newborn, a severe congenital thrombophilic disorder should be considered. In homozygous AT deficiency type II, AT activity is typically reduced but may also be in the normal range, posing a diagnostic challenge...
September 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28888888/sepsis-induced-by-cecal-ligation-and-perforation-clp-alters-nucleotidase-activities-in-platelets-of-rats
#20
Renata S Pereira, Claudia M Bertoncheli, Stephen A Adefegha, Lívia G Castilhos, Karine L Silveira, João Felipe P Rezer, Pedro H Doleski, Fátima H Abdalla, Karen F Santos, Claudio A M Leal, Roberto C V Santos, Emerson A Casali, Cesar E J Moritz, Daniel R Stainki, Daniela B R Leal
Sepsis is a potentially lethal condition, and it is associated with platelet alterations. The present study sought to investigate the activity of ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), E-5'-nucleotidase, and ecto-adenosine deaminase (E-ADA) in the platelets of rats that were induced with sepsis. Male Wistar rats were divided into three groups of ten animals each: a negative control group (normal; NC); a group that underwent surgical procedures (sham); and a group that underwent cecal ligation and perforation (CLP)...
September 6, 2017: Microbial Pathogenesis
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