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https://www.readbyqxmd.com/read/28210454/managing-patients-taking-edoxaban-in-dentistry
#1
REVIEW
Adrian Curto, Daniel Curto, Jorge Sanchez
BACKGROUND: Anticoagulation therapy is used in several conditions to prevent or treat thromboembolism. A new group of oral anticoagulants with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. The Food and Drug Administration has approved edoxaban, dabigatran, rivaroxaban and apixaban. Their advantages include: predictable pharmacokinetics, drug interactions and limited food, rapid onset of action and short half-life...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28210451/dental-management-of-patients-taking-novel-oral-anticoagulants-noas-dabigatran
#2
REVIEW
Adrian Curto, Alberto Albaladejo, Alfonso Alvarado
BACKGROUND: A new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments. MATERIAL AND METHODS: A literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords "dabigatran", "rivaroxaban", "apixaban", "edoxaban", "new oral anticoagulants", "novel oral anticoagulants", "bleeding" and "dental treatment"...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#3
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#4
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28196633/old-and-new-oral-anticoagulants-food-herbal-medicines-and-drug-interactions
#5
REVIEW
Alessandro Di Minno, Beatrice Frigerio, Gaia Spadarella, Alessio Ravani, Daniela Sansaro, Mauro Amato, Joseph P Kitzmiller, Mauro Pepi, Elena Tremoli, Damiano Baldassarre
The most commonly prescribed oral anticoagulants worldwide are the vitamin K antagonists (VKAs) such as warfarin. Factors affecting the pharmacokinetics of VKAs are important because deviations from their narrow therapeutic window can result in bleedings due to over-anticoagulation or thrombosis because of under-anticoagulation. In addition to pharmacodynamic interactions (e.g., augmented bleeding risk for concomitant use of NSAIDs), interactions with drugs, foods, herbs, and over-the-counter medications may affect the risk/benefit ratio of VKAs...
February 5, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28188404/-direct-oral-anticoagulants-and-acute-stroke-insights-into-translational-research-studies
#6
C Foerch, J H Schäfer, W Pfeilschifter, F Bohmann
In recent years a considerable number of translational research studies on intracerebral hemorrhage and ischemic stroke have been published, which are characterized by a particular proximity to practical clinical questions. Animal research has provided insights into the pathophysiological processes and therapy effects, which have so far only been insufficiently investigated in clinical studies. This includes the effectiveness of a rapid reversal of anticoagulation in cases of anticoagulation-associated intracerebral hemorrhage and the safety of thrombolytic treatment in ischemic stroke occurring during treatment with anticoagulants...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28186939/cardiac-diagnostic-work-up-for-atrial-fibrillation-after-transient-ischaemic-attacks-in-england-and-wales-results-from-a-cross-sectional-survey
#7
Olivia Geraghty, Eleni Korompoki, Filippos T Filippidis, Anthony Rudd, Roland Veltkamp
OBJECTIVES: Transient ischaemic attacks (TIAs) are an important precursor of stroke. Atrial fibrillation (AF) is among the most dangerous aetiologies shared between TIAs and strokes. Detection of AF after TIAs is essential for the initiation of oral anticoagulants. We aimed to identify variations in the use of cardiac investigations used to detect AF and cardiac pathology in patients with TIA in the UK. SETTING: All TIA clinical leads in England and Wales received an invitation by email to participate in an online survey in February 2015...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#8
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
February 10, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28182051/warfarin-related-acute-kidney-injury-a-case-report
#9
S Mendonca, D Gupta, A Valsan, R Tewari
Warfarin is an oral anticoagulant used extensively in clinical practice; However, its side-effect of causing renal damage has been recently detected. The mechanism leading to renal damage is glomerular hemorrhage and red blood cell tubular casts prothrombin time. Recently, it was found that warfarin causes renal damage in patients with chronic kidney disease and is also associated with progression of renal disease. Warfarin causing acute kidney injury in patients with normal renal function is a rare manifestation...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28178413/spontaneous-intracerebral-hemorrhage-management
#10
REVIEW
Jun Yup Kim, Hee-Joon Bae
Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28170419/determination-of-rivaroxaban-in-patient-s-plasma-samples-by-anti-xa-chromogenic-test-associated-to-high-performance-liquid-chromatography-tandem-mass-spectrometry-hplc-ms-ms
#11
Priscilla Bento Matos Derogis, Livia Rentas Sanches, Valdir Fernandes de Aranda, Marjorie Paris Colombini, Cristóvão Luis Pitangueira Mangueira, Marcelo Katz, Adriana Caschera Leme Faulhaber, Claudio Ernesto Albers Mendes, Carlos Eduardo Dos Santos Ferreira, Carolina Nunes França, João Carlos de Campos Guerra
Rivaroxaban is an oral direct factor Xa inhibitor, therapeutically indicated in the treatment of thromboembolic diseases. As other new oral anticoagulants, routine monitoring of rivaroxaban is not necessary, but important in some clinical circumstances. In our study a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was validated to measure rivaroxaban plasmatic concentration. Our method used a simple sample preparation, protein precipitation, and a fast chromatographic run...
2017: PloS One
https://www.readbyqxmd.com/read/28164025/pulmonary-autograft-in-aortic-position-is-everything-known
#12
COMMENT
Francesco Nappi, Antonio Nenna, Cristiano Spadaccio, Massimo Chello
The Ross operation provides several advantages compared to other valve substitutes to manage aortic valve disease, such as growth potential, excellent hemodynamics, freedom from oral anticoagulation and hemolysis, and better durability. However, progressive dilatation of the pulmonary autografts after Ross operation reflects the inadequate remodeling of the native pulmonary root in the systemic circulation, which results in impaired adaptability to systemic pressure and risk of reoperation after the first decade...
January 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#13
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28153344/frequency-of-pocket-hematoma-in-patients-receiving-vitamin-k-antagonist-and-antiplatelet-therapy-at-the-time-of-pacemaker-or-cardioverter-defibrillator-implantation-from-the-pocket-study
#14
Michele Malagù, Filippo Trevisan, Antonella Scalone, Lina Marcantoni, Giuseppe Sammarco, Matteo Bertini
In patients undergoing cardiac device implantation, anticoagulant and antiplatelet therapy are associated with an increased risk of pocket hematoma. In case of vitamin K antagonist therapy, a strategy of continued warfarin with no heparin bridge showed a reduction of pocket hematoma. Evidence regarding antiplatelet therapy management is limited. This is a single-center observational study which reflects our systematic approach to the problem. In 2012, we proposed an improved management protocol for anticoagulant and antiplatelet therapy (no-bridge protocol) based on individual thromboembolic risk stratification, noninterruption of oral anticoagulation, no bridge with heparin and elastic adherence compression bandage...
January 6, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28148539/dtb-select-2-february-2017
#15
(no author information available yet)
MHRA clarifies spironolactone advice ● Statin dosing: morning or evening? ● PPI use and risk of community-acquired pneumonia ● Non-inferiority trials: caution needed ● CV safety of celecoxib? ● ADRs and emergency department visits ● Study questions use of duloxetine in stress incontinence ● New oral anticoagulants: more on GI bleeding risk.
February 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#16
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28136021/prevention-diagnosis-and-treatment-of-venous-thromboembolism
#17
Richard Greenall
Venous thromboembolism (VTE) occurs more frequently in older people. For those nursing older people in a variety of settings, knowledge of VTE prevention, diagnosis and treatment is essential. This article discusses simple, practical measures that can be used to reduce the risk of VTE, including good hydration and promotion of mobilisation. It also discusses how a VTE forms, the signs and symptoms, and the methods used to diagnose and treat VTE. In recent years new drugs have been licensed to treat patients with VTE called direct oral anticoagulants...
January 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28123977/use-of-novel-oral-anticoagulant-agents-in-venous-thromboembolism
#18
REVIEW
Shivanshu Madan, Shenil Shah, Patrick Dale, Sasan Partovi, Sahil A Parikh
New oral anticoagulants (NOAC) serve as alternatives for patients currently using warfarin for the prevention and treatment of venous thromboembolic (VTE) disease. This article provides a brief summary of the clinical use of these drugs as well as a review of the landmark clinical trials which evaluated described their safety and efficacy. As more data becomes available, a fundamental understanding of these medications will be vital to cardiovascular practitioners managing patients with VTE.
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28102773/the-optimal-duration-of-anticoagulant-therapy-after-unprovoked-venous-thromboembolism-still-a-challenging-issue
#19
Giovanna Elmi, Giuseppe Di Pasquale, Raffaele Pesavento
As about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102426/improved-anticoagulant-effect-of-fucosylated-chondroitin-sulfate-orally-administered-as-gastro-resistant-tablets
#20
Roberto J C Fonseca, Isabela D Sucupira, Stephan Nicollas M C G Oliveira, Gustavo R Santos, Paulo A S Mourão
Fucosylated chondroitin sulfate (FucCS) is a potent anticoagulant polysaccharide extracted from sea cucumber. Its anticoagulant activity is attributed to the presence of unique branches of sulfated fucose. Although this glycosaminoglycan exerts an antithrombotic effect following oral administration, high doses are necessary to achieve the maximum effect. The diminished activity of FucCS following oral administration is likely due to its degradation in the gastrointestinal tract and its limited ability to cross the intestinal cell membranes...
January 19, 2017: Thrombosis and Haemostasis
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