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Reversal anticoagulant

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https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#1
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29040174/reversal-agents-for-oral-anticoagulants
#2
(no author information available yet)
No abstract text is available yet for this article.
November 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/29037842/puerarin-inhibits-expression-of-tissue-factor-induced-by-oxidative-low-density-lipoprotein-through-activating-the-pi3k-akt-enos-pathway-and-inhibiting-activation-of-erk1-2-and-nf-%C3%AE%C2%BAb
#3
Hue-Fei Deng, Xiao-Li Wang, Hui Sun, Xian-Zhong Xiao
AIMS: The present study aimed to investigate whether puerarin regulated tissue factor (TF) expression induced by oxidative low-density lipoprotein (ox-LDL), an independent risk factor for atherosclerosis, and its mechanisms. MAIN METHODS: TF expression at the mRNA level was determined by reverse transcription-quantitative polymerase chain reaction, and its expression at the protein level, as well as other target proteins, was assessed by western blotting. Nitric oxide (NO) production was measured by a nitrate reduction method...
October 13, 2017: Life Sciences
https://www.readbyqxmd.com/read/29035553/construction-of-antithrombotic-tissue-engineered-blood-vessel-via-reduced-graphene-oxide-based-dual-enzyme-biomimetic-cascade
#4
Da Huo, Ge Liu, Yanzhao Li, Yuxin Wang, Ge Guan, Mingcan Yang, Keyu Wei, Jingyuan Yang, Lingqin Zeng, Gang Li, Wen Zeng, Chuhong Zhu
Thrombosis is one of the biggest obstacles in the clinical application of small-diameter tissue-engineered blood vessels (TEBVs). The implantation of an unmodified TEBV will lead to platelet aggregation and further activation of the coagulation cascade, in which the high concentration of adenosine diphosphate (ADP) that is released by platelets plays an important role. Inspired by the phenomenon that endothelial cells continuously generate endogenous antiplatelet substances via enzymatic reactions, we designed a reduced graphene oxide (RGO) based dual-enzyme biomimetic cascade to successively convert ADP into adenosine monophosphate (AMP) and AMP into adenosine...
October 16, 2017: ACS Nano
https://www.readbyqxmd.com/read/29029708/anticoagulation-in-pulmonary-embolism-update-in-the-age-of-direct-oral-anticoagulants
#5
Rachel Rosovsky, Geno Merli
The emergence of direct oral anticoagulants (DOACs) represents a major advancement and paradigm shift in the treatment of venous thromboembolism. Currently, dabigatran, rivaroxaban, apixiban, and edoxoban are approved and used routinely for the prevention and treatment of patients with venous thromboembolism. Because each of the DOACs has different doses and dosing regimens, clinicians need to become familiar with their use. This article focuses on the practical considerations of how and when to use the DOACs...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28993605/a-case-of-diffuse-alveolar-hemorrhage-as-a-possible-complication-of-bivalirudin-therapy
#6
Htun Latt, Sammy Aung, Kyaw Kyaw, Thein Tun Aung, Chanwit Roongsritong
BACKGROUND Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal complication of anticoagulant or antiplatelet therapy. Bivalirudin is a specific and reversible direct thrombin inhibitor (DTI). CASE REPORT We report a case of severe DAH, possibly related to bivalirudin use, in a 61-year-old patient undergoing coronary intervention. The patient had presented with an out-of-hospital cardiac arrest due to acute ST elevation myocardial infarction (STEMI). During the coronary intervention, shortly after receiving bivalirudin, the patient started having frank bleeding from the endotracheal tube and developed hemodynamic compromise...
October 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28987431/spontaneous-intracerebral-hemorrhage
#7
REVIEW
Stephen Alerhand, Cappi Lay
Although commonly arising from poorly controlled hypertension, spontaneous intracerebral hemorrhage may occur secondary to several other etiologies. Clinical presentation to the emergency department ranges from headache with vomiting to coma. In addition to managing the ABCs, the crux of emergency management lies in stopping hematoma expansion and other complications to prevent clinical deterioration. This may be achieved primarily through anticoagulation reversal, blood pressure, empiric management of intracranial pressure, and early neurosurgical consultation for posterior fossa hemorrhage...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987395/abciximab-heparin-therapy-for-left-ventricular-assist-device-implantation-in-patients-with-heparin-induced-thrombocytopenia
#8
Chia-Ling Lee, Paolo C Colombo, Andrew Eisenberger, David Diuguid, Douglas L Jennings, Jiho Han, Michael P Salna, Koji Takeda, Paul A Kurlansky, Melana Yuzefpolskaya, Arthur R Garan, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. METHODS: Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg(-1) · min(-1) throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28986001/a-bioprosthetic-total-artificial-heart-for-end-stage-heart-failure-results-from-a-pilot-study
#9
Christian Latrémouille, Alain Carpentier, Pascal Leprince, Jean-Christian Roussel, Bernard Cholley, Elodie Boissier, Eric Epailly, Antoine Capel, Piet Jansen, David M Smadja
BACKGROUND: The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. METHODS: Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled...
September 14, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28981174/reversal-of-warfarin-era-thinking
#10
Joseph J Shatzel, Molly M Daughety, Vinay Prasad, Thomas G DeLoughery
Anticoagulation offers benefits in appropriately selected patients, however, all anticoagulants increase the risk of bleeding, which can be, at times, life threatening. For decades, vitamin K antagonists were the only oral anticoagulants available to physicians and their patients. In recent years, we have witnessed the approval of five direct oral anticoagulants (DOACs), which have shifted prior paradigms in anticoagulation such as omitting the need for routine therapeutic monitoring and lessening concerns about food and drug interactions...
October 5, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28979172/reversing-factor-xa-inhibitors-clinical-utility-of-andexanet-alfa
#11
REVIEW
Scott Kaatz, Hardik Bhansali, Joseph Gibbs, Robert Lavender, Charles E Mahan, David G Paje
Approximately half of patients started on an oral anticoagulant in the USA now receive one of the newer direct oral anticoagulants (DOACs). Although there is an approved reversal agent for the direct thrombin inhibitor dabigatran, a specific reversal agent for the anti-factor Xa (FXa) DOACs has yet to be licensed. Unlike the strategy to reverse the only oral direct thrombin inhibitor with idarucizumab, which is a humanized monoclonal antibody fragment, a different approach is necessary to design a single agent that can reverse multiple anti-FXa medications...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28974132/comparison-of-activated-clotting-times-measured-using-the-hemochron-jr-signature-and-medtronic-act-plus-during-cardiopulmonary-bypass-with-acute-normovolemic-haemodilution
#12
Jung Min Lee, Eun Young Park, Kyung Mi Kim, Jong Chan Won, Tack Koon Jung, Soo Kyung Lee
Objective This study compared the activated clotting time (ACT) measured using the Hemochron Jr. Signature (HACT) with the ACT measured using the Medtronic ACT Plus (MACT) during cardiopulmonary bypass (CPB) with acute normovolemic haemodilution (ANH) in patients undergoing cardiac surgery. Methods The ACT was checked at baseline with both devices after inducing anaesthesia, and 400 to 800 mL of whole blood was withdrawn to induce moderate ANH. Before initiating CPB, a 300-IU/kg bolus dose of heparin was administered to maintain the HACT at >400 s; protamine was later given to reverse the anticoagulation...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28970015/scoparone-attenuates-high-glucose-induced-extracellular-matrix-accumulation-in-rat-mesangial-cells
#13
Yunqian Wang, Min Wang, Baoping Chen, Jun Shi
Scoparone, a major constituent of Artemisia capillaries, has a variety of biological properties including anticoagulant, hepatoprotective, anti-tumor, anti-fibrosis, anti-inflammatory, antioxidant, and antidiabetic activities. However, the renoprotective effect of scoparone under diabetic conditions remains elusive. Thus, the present study was undertaken to examine the role of scoparone in high glucose-induced mesangial cell proliferation and extracellular matrix (ECM) accumulation and elucidate the possible mechanism of action of scoparone...
September 29, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28962160/effect-of-eicosapentaenoic-acid-and-pitavastatin-on-electrophysiology-and-anticoagulant-gene-expression-in-mice-with-rapid-atrial-pacing
#14
Maoqing Tong, Jiewen Wang, Yunxin Ji, Xiaomin Chen, Jieru Wang, Shuangshuang Wang, Liemin Ruan, Hanbin Cui, Ying Zhou, Qingyu Zhang, Eiichi Watanabe
Atrial remodeling is considered to be any persistent change in atrial structure or function, and is responsible for the development and perpetuation of atrial fibrillation (AF). Oxidative stress and intracellular pH regulation may also be linked to AF; however it remains unclear whether eicosapentaenoic acid (EPA) or statins have beneficial therapeutic effects. The aim of the present study was to investigate the effects of EPA and pitavastatin on the electrophysiology of and gene expressions in mice with rapidly-paced atria...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28957948/reversal-agents-for-oral-anticoagulants
#15
Carrie L Griffiths, Mark L Vestal, Spencer J Livengood, Samantha Hicks
For more than half a century, warfarin, a vitamin K antagonist, has been the anticoagulant of choice. However, direct oral anticoagulants are rapidly gaining in popularity, which poses the need for efficacious reversal agents. This review article summarizes the strategies and agents used to reverse oral anticoagulants.
November 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28951796/iatrogenic-ivc-perforation-after-successful-catheter-directed-thrombolysis
#16
Ata Firoozi, Jamal Moosavi, Omid Shafe, Parham Sadeghipour
Central vein perforation as a rare complication of venous interventions is considered a nightmare if occurring in thoracic cage but behaves benignly in abdominal or pelvic region. This is not a rule, as we unfortunately encountered during the procedure of venous intervention in our patient. Although mechanical control of iatrogenic perforation or rupture is the first and most critical step during interventional procedures, the importance of anticoagulant and thrombolytic agents reversal should not be overlooked...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28950812/idarucizumab-what-should-we-know
#17
Francesca Cortese, Michele Gesualdo, Annagrazia Cecere, Annapaola Zito, Fiorella De Vito, Rossella Carbonara, Santa Carbonara, Anna Maria Cortese, Marco Matteo Ciccone
BACKGROUND: Idarucizumab, a humanized monoclonal antibody fragment acting as specific antidote for dabigatran, is approved for reversing the dabigatran-associated possible bleeding from critical sites or bleeding persisting despite local post-procedure haemostasis, moreover it can also be applied to reverse the dabigatran anticoagulant activity in emergency surgery or in other invasive procedure at high risk of bleeding. OBJECTIVE: In this manuscript, we discuss idarucizumab in light of the available literature data by conducting extensive research in the PubMed, EMBASE and Cochrane Library on the topic, using as Mesh terms idarucizumab, dabigatran and their combinations, and focusing on high impact investigations...
September 25, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28944131/ultrasound-assisted-catheter-directed-thrombolysis-of-acute-pulmonary-embolism-a-review-of-current-literature
#18
REVIEW
Muhammad A Mangi, Hiba Rehman, Vikas Bansal, Omer Zuberi
Pulmonary embolism continues as a very common and also presumably life-threatening disorder. For affected individuals with intermediate- as well as high-risk pulmonary embolism, catheter-based revascularization procedures have developed a possible substitute for systemic thrombolysis or for surgical embolectomy. Ultrasound-assisted catheter-directed thrombolysis is an innovative catheter-based approach; which is the main purpose of the present review article. Ultrasound-assisted catheter-directed thrombolysis is much more efficacious in reversing right ventricular dysfunction as well as dilatation in comparison to anticoagulation alone in individuals at intermediate risk...
July 19, 2017: Curēus
https://www.readbyqxmd.com/read/28913813/pharmacotherapy-pearls-for-emergency-neurological-life-support
#19
Gretchen M Brophy, Theresa Human
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913672/reversal-of-dabigatran-associated-bleeding-using-idarucizumab-review-of-the-current-evidence
#20
REVIEW
Michela Giustozzi, Melina Verso, Giancarlo Agnelli, Cecilia Becattini
Major bleeding occurs in about 4% of patients while on treatment with direct oral anticoagulants (DOACs). The case-fatality rate associated with these events is estimated to be about 5%. The specific roles of antidotes, when used with DOACs in reducing the case fatality or improving the overall clinical course of these events, are not thoroughly understood. To this regard, the US Food and Drug Administration as well as European Medicines Agency have recently licensed idarucizumab for the management of patients with life-threatening bleeding or the need for urgent surgery/procedures while on treatment with dabigatran...
September 14, 2017: Journal of Thrombosis and Thrombolysis
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