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anticoagulation in liver disease

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https://www.readbyqxmd.com/read/27899521/venous-thrombotic-events-after-liver-transplantation
#1
Annabel Blasi, Virginia Hernandez, Javier Fernandez, Jordi Colmenero, Joan Beltran, Juan Carlos Garcia-Valdecasas, Joan Carles Reverter
Thromboprophylaxis is not well defined after liver transplantation (LT). The aim of this study was to evaluate the incidence of splanchnic vein thrombosis (SVT) and nonsplanchnic vein thrombosis (NSVT) after LT. Liver transplantations performed between 2009 and 2013 in our institution were reviewed. Demographic, intraoperative, and postoperative data were recorded. Low-molecular-weight heparin was only administered postoperatively if intraoperative thrombectomy was performed or in patients preoperatively anticoagulated...
November 28, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27788809/hepatic-venous-and-inferior-vena-cava-morphology-no-longer-a-barrier-to-living-donor-liver-transplantation-for-budd-chiari-syndrome-surgical-techniques-and-outcomes
#2
H Pahari, R J Chaudhary, S Thiagarajan, V Raut, R Babu, P Bhangui, S Goja, A Rastogi, V Vohra, A S Soin
BACKGROUND: Living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) has been reported with <10 inferior vena cava (IVC) replacements with vascular/synthetic graft. The goal of this study was to review outcomes of LDLT for BCS at our center, with an emphasis on surgical techniques and postoperative anticoagulation therapy. METHODS: Between October 2011 and December 2015, a total of 1027 LDLTs were performed. Nine of these patients had BCS. We analyzed their etiologies, operative details, postoperative complications, and outcomes...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27753953/os-08-03-pharmacogenetic-markers-of-survival
#3
Vera Erdman, Ilsia Tuktarova, Timur Nasibullin, Ianina Timasheva, Olga Mustafina
OBJECTIVE: Physiological and biochemical changes during aging alter drug metabolism. Drug intake is increased with age because of cumulative morbidity, in particular, high prevalence of cardiovascular diseases. Antihypertensive medications are the most commonly used drugs. Individual drug sensitivity or resistance may be influenced by the variance of the "pharmacological response" genes.Our purpose was to search for the polymorphic variants of "pharmacological response" genes associated with survival in different age periods...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27740524/portal-vein-thrombosis-in-patients-with-cirrhosis-just-a-common-finding-or-a-predictor-of-poor-outcome
#4
Omar D Borjas-Almaguer, Carlos A Cortez-Hernández, Emmanuel I González-Moreno, Francisco J Bosques-Padilla, José A González-González, Aldo A Garza, Juan A Martínez-Segura, Diego García-Compean, Juan V Alejandre-Loya, Jesús García-García, Guillermo Delgado-García, Héctor J Maldonado-Garza
:  Background & Aims. It is unclear whether portal vein thrombosis (PVT) unrelated to malignancy is associated with reduced survival or it is an epiphenomenon of advanced cirrhosis. The objective of this study was to assess clinical outcome in cirrhotic patients with PVT not associated with malignancy and determine its prevalence. MATERIAL AND METHODS: Retrospective search in one center from June 2011 to December 2014. RESULTS: 169 patients, 55 women and 114 men, median age 54 (19-90) years...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27698722/analysis-of-the-first-therapeutic-target-achieving-time-of-warfarin-therapy-and-associated-factors-in-patients-with-pulmonary-embolism
#5
Xiaowei Gong, Haiyan Wang, Yadong Yuan
The present study aimed to investigate the factors affecting the first therapeutic-target-achieving (TTA) time of warfarin therapy in patients with acute pulmonary embolism (PTE). Between January 2008 and June 2013, patients with PTE confirmed by transpulmonary arterial enhanced computed tomographic pulmonary angiography or pulmonary ventilation perfusion scanning were included in the present study. Data collected included demographic information, history of tobacco and alcohol intake, basic diseases (stable and unstable hypertension, diabetes, heart failure, cancer/cerebral infarction, old myocardial infarction and atrial fibrillation), liver and kidney function, the haemoglobin and platelet count of the blood, international normalized ratio monitoring, warfarin dosage adjustment and medication combinations...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27683637/thromboelastographic-reference-ranges-for-a-cirrhotic-patient-population-undergoing-liver-transplantation
#6
Lesley De Pietri, Marcello Bianchini, Gianluca Rompianesi, Elisabetta Bertellini, Bruno Begliomini
AIM: To describe the thromboelastography (TEG) "reference" values within a population of liver transplant (LT) candidates that underline the differences from healthy patients. METHODS: Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease (MELD) score between 15 and 40 were studied. In particular the adult patients (aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded...
September 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27660567/using-the-minimally-invasive-impella-5-0-via-the-right-subclavian-artery-cutdown-for-acute-on-chronic-decompensated-heart-failure-as-a-bridge-to-decision
#7
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27643348/os-08-03-pharmacogenetic-markers-of-survival
#8
Vera Erdman, Ilsia Tuktarova, Timur Nasibullin, Ianina Timasheva, Olga Mustafina
OBJECTIVE: Physiological and biochemical changes during aging alter drug metabolism. Drug intake is increased with age because of cumulative morbidity, in particular, high prevalence of cardiovascular diseases. Antihypertensive medications are the most commonly used drugs. Individual drug sensitivity or resistance may be influenced by the variance of the "pharmacological response" genes.Our purpose was to search for the polymorphic variants of "pharmacological response" genes associated with survival in different age periods...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642112/temporal-trends-predictors-and-outcomes-of-in-hospital-gastrointestinal-bleeding-associated-with-percutaneous-coronary-intervention
#9
Nileshkumar J Patel, Dhaval Pau, Nikhil Nalluri, Parth Bhatt, Badal Thakkar, Ritesh Kanotra, Kanishk Agnihotri, Nitesh Ainani, Nilay Patel, Nish Patel, Sapna Shah, Sabeeda Kadavath, Shilpkumar Arora, Azfar Sheikh, Apurva O Badheka, James Lafferty, Carlos Alfonso, Mauricio Cohen
Since the introduction of new antiplatelet and anticoagulant agents in the last decade, large-scale data studying gastrointestinal bleeding (GIB) in patients undergoing percutaneous coronary intervention (PCI) are lacking. Using the Nationwide Inpatient Sample, we identified all hospitalizations from 2006 to 2012 that required PCI. Temporal trends in the incidence and multivariate predictors of GIB associated with PCI were analyzed. A total of 4,376,950 patients underwent PCI in the United States during the study period...
October 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27635482/treatment-of-coagulopathy-related-to-hepatic-insufficiency
#10
Cassie A Barton
OBJECTIVES: To provide a concise review of the medical management of coagulopathy related to hepatic insufficiency. This review will focus on prevention and management of bleeding episodes in patients with hepatic insufficiency. The treatment and prevention of thromboembolic complications will also be addressed. DATA SOURCES: Electronic search of PubMed database using relevant search terms, including hepatic coagulopathy, hemorrhage, liver diseases, blood coagulation disorders, blood transfusion, disseminated intravascular coagulation, and liver failure...
October 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27614403/safely-addressing-patients-with-atrial-fibrillation-to-early-anticoagulation-after-acute-stroke
#11
Isabella Canavero, Anna Cavallini, Lucia Sacchi, Silvana Quaglini, Natale Arnò, Patrizia Perrone, Maria Luisa DeLodovici, Simona Marcheselli, Giuseppe Micieli
BACKGROUND: It has been widely reported that anticoagulants (ACs) are underused for primary and secondary prevention of ischemic stroke in patients with atrial fibrillation (AFib). Furthermore, precise evidence-based guidelines about the best timing for AC initiation after acute stroke are currently lacking. METHODS AND RESULTS: In this retrospective, observational study, we analyzed prescription trends in AFib patients with acute ischemic stroke who were hospitalized in four neurologic stroke units of our region (Lombardia, Italy)...
September 7, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27598820/improving-accuracy-of-urinary-mirna-quantification-in-heparinized-patients-using-heparinase-i-digestion
#12
Henk P Roest, Cornelia J Verhoeven, Jubi E de Haan, Jeroen de Jonge, Jan N M IJzermans, Luc J W van der Laan
miRNAs have emerged as promising biomarkers because of their association with cell stress and diseases and their easy detection and stability in many body fluids. Because of the sensitivity, the method of choice to detect miRNAs is quantitative RT-PCR (RT-qPCR). Therapeutics, in particular circulating anticoagulants, are notorious for their inhibitory effect on RT-qPCR-based measurements. The effect of heparin contamination on inhibition of RT-qPCR from miRNAs isolated from urine has, however, never been investigated...
September 3, 2016: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/27595480/safety-of-bronchoscopy-in-patients-with-echocardiographic-evidence-of-pulmonary-hypertension
#13
Gilda Diaz-Fuentes, Bharat Bajantri, Muhammad Adrish
BACKGROUND: Bronchoscopy with transbronchial and endobronchial biopsy and transbronchial needle aspiration is an important diagnostic tool in the pulmonologist's armamentarium. Safety in patients with pulmonary hypertension is controversial and many bronchoscopists consider this as a contraindication for the procedure. OBJECTIVES: To evaluate safety of bronchoscopy in patients with echocardiographic pulmonary hypertension and to compare with patients without it...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27595469/bleeding-risk-and-management-in-interventional-procedures-in-chronic-liver-disease
#14
Gia A DeAngelis, Rachita Khot, Ziv J Haskal, Hillary S Maitland, Patrick G Northup, Neeral L Shah, Stephen H Caldwell
The coagulopathy of liver disease is distinctly different from therapeutic anticoagulation in a patient. Despite stable elevated standard clot-based coagulation assays, nearly all patients with stable chronic liver disease (CLD) have normal or increased clotting. Common unfamiliarity with the limitations of these assays in CLD may lead to inappropriate and sometimes harmful interventions, including blood product transfusions before a procedure. Knowledge of the distinct hemostatic alterations in CLD can allow identification of the small subset of patients with clinically significant coagulopathy who can benefit from hematologic optimization before invasive procedures...
August 29, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27580216/atrial-fibrillation-liver-disease-antithrombotics-and-risk-of-cerebrovascular-events-a-population-based-cohort-study
#15
Hui-Chin Lai, Wu-Chien Chien, Chi-Hsiang Chung, Wen-Lieng Lee, Tsu-Juey Wu, Kuo-Yang Wang, Chia-Ning Liu, Tsun-Jui Liu
BACKGROUND: Whether patients with atrial fibrillation (AF) and liver disease are also prone to cerebrovascular events and respond similarly favorably to antithrombotic therapy remains under-investigated. METHODS: Patients ≥18years with newly-diagnosed AF in the period 2005 to 2009 were scrutinized from the "Longitudinal Health Insurance Database 2005" (1 million beneficiaries) of Taiwan's National Health Insurance Institute. Patients were categorized into the Liver (N=433) or the Non-liver (N=3490) cohort according to whether they had a diagnosis of advanced liver disease...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27579036/clinical-risk-factors-for-gastroduodenal-ulcer-in-romanian-low-dose-aspirin-consumers
#16
Anca Negovan, Mihaela Iancu, Valeriu Moldovan, Septimiu Voidazan, Simona Bataga, Monica Pantea, Kinga Sarkany, Cristina Tatar, Simona Mocan, Claudia Banescu
Background. Aspirin use for cardiovascular or cancer prevention is limited due to its gastrointestinal side effects. Objective. Our prospective, observational case-control study aims to identify the predictive factors for ulcers in low-dose aspirin consumers (75-325 mg/day). Methods. The study included patients who underwent an upper digestive endoscopy and took low-dose aspirin treatment. Results. We recruited 51 patients with ulcer (ulcer group) and 108 patients with no mucosal lesions (control group). In univariate analysis, factors significantly associated with ulcers were male gender (p = 0...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27532238/oral-anticoagulation-in-octogenarians-with-atrial-fibrillation
#17
González Saldivar Hugo, Lourdes M Figueiras-Graillet, Manuel Anguita, Francisco Marín, Vicente Bertomeu, Inmaculada Roldán, Martín Ruiz, Javier Muñiz, Manuel Martínez-Sellés
BACKGROUND: Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial fibrillation (AF). Our aim was to study the clinical profile of octogenarians treated with oral anticoagulation and to study the effect of age on the quality of VKAs anticoagulation. METHODS: Data are from a prospective national registry in an adult Spanish population of nonvalvular AF. We included 1637 patients who had been receiving VKAs for at least 6months before enrolment...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27500240/living-donor-liver-transplantation-using-a-liver-graft-with-congenital-intrahepatic-portosystemic-shunt
#18
Hideya Kamei, Hisashi Imai, Yasuharu Onishi, Hiroyuki Sugimoto, Kojiro Suzuki, Yasuhiro Ogura
UNLABELLED: Despite of recent development of imaging modalities, congenital intrahepatic portosystemic shunt (IPSS) is rarely diagnosed. Therefore, living donor liver transplantation using a liver graft with IPSS has not been previously published. MATERIALS AND METHODS: We report a 28-year-old male patient with end-stage liver disease secondary to Wilson disease. His 26-year-old brother was a potential living donor, who had an IPSS of 25 mm in diameter at segment 6 as shown by computed tomography...
January 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27496475/predictive-value-of-the-model-for-end-stage-liver-disease-score-excluding-international-normalized-ratio-one-year-after-orthotopic-heart-transplantation
#19
B Szyguła-Jurkiewicz, M Zakliczyński, W Szczurek, P Nadziakiewicz, M Gąsior, M Zembala
BACKGROUND: The Model for End-Stage Liver Disease (MELD) scoring system incorporating a combination of hepatic and renal laboratory parameters does not adequately reflect the degree of multi-organ dysfunction in patients with heart failure, who need oral anticoagulation. In order to exclude the impact of oral anticoagulation on the international normalized ratio (INR), we used the MELD excluding INR (MELD-XI) score. The aims of the study were to calculate the individual preoperative MELD-XI score and its ability to predict 1-year mortality after heart transplantation and to identify other preoperative laboratory prognostic parameters...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27467004/budd-chiari-syndrome-current-perspectives-and-controversies
#20
L Liu, X-S Qi, Y Zhao, H Chen, X-C Meng, G-H Han
Budd-Chiari syndrome (BCS) is a rare disorder caused by hepatic venous outflow obstruction with a wide spectrum of etiologies. Clinical manifestations are so heterogeneous that the diagnosis should be considered in any patients with acute or chronic liver disease. Therapeutic modalities for BCS have improved dramatically during the last few years. The concept of a step-wise treatment strategy has been established, including anticoagulation, thrombolysis, percutaneous recanalization, transjugular intrahepatic portosystemic shunt, surgery and liver transplantation...
July 2016: European Review for Medical and Pharmacological Sciences
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