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Cirrhosis anticoagulation

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https://www.readbyqxmd.com/read/29778550/the-factors-associated-with-negative-colonoscopy-in-screening-subjects-with-positive-immunochemical-stool-occult-blood-test-outcomes
#1
Po-Hsiang Ting, Xi-Hsuan Lin, Jeng-Kai Jiang, Jiing-Chyuan Luo, Ping-Hsien Chen, Yen-Po Wang, I-Fang Hsin, Chin Lin Perng, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: The immunochemical fecal occult blood test (iFOBT) is an alternative method to colonoscopy that can be used for colorectal cancer (CRC) screening. If the iFOBT result is positive, a colonoscopy is recommended. In this retrospective study, we identify factors associated with negative colonoscopy and positive iFOBT results obtained during CRC screening. METHODS: We collected data for subjects who received a colonoscopy at Taipei Veterans General Hospital after receiving a positive iFOBT result during CRC screening from January 2015 to December 2015...
May 16, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29768734/in-vitro-efficacy-of-pro-and-anticoagulant-strategies-in-compensated-and-acutely-ill-patients-with-cirrhosis
#2
Ton Lisman, Simone Kleiss, Vishal C Patel, Caleb Fisher, Jelle Adelmeijer, Sarah Bos, Arjuna Singanayagam, Sidsel Hyldgaard Stoy, Debbie L Shawcross, William Bernal
BACKGROUND & AIMS: A simultaneous decline in pro- and anticoagulant drivers in patients with liver diseases results in a 'rebalanced' hemostatic system, even in acutely ill patients. Nevertheless, both bleeding and thrombotic events are common. Here, we explored efficacy of pro- and antihemostatic strategies in compensated and acutely ill cirrhotics which may be unpredictable given the profound hemostatic changes. METHODS: We tested the effects in vitro of the addition of clinically relevant doses of commonly used pro- and antihemostatic strategies in plasma from healthy individuals (n=30) and patients with compensated (n=18) and acutely decompensated cirrhosis (n=18), and acute-on-chronic liver failure (n=10)...
May 16, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29766730/-splanchnic-vein-thrombosis
#3
Sylva Lajzová, Radek Kroupa, Alena Buliková, Šárka Bohatá, Barbora Packová, Michal Šenkyřík
Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29738632/reversal-of-hypercoagulability-in-patients-with-hcv-related-cirrhosis-after-treatment-with-direct-acting-antivirals
#4
Francesco Paolo Russo, Alberto Zanetto, Elena Campello, Cristiana Bulato, Sarah Shalaby, Luca Spiezia, Sabrina Gavasso, Enrica Franceschet, Claudia Radu, Marco Senzolo, Patrizia Burra, Ton Lisman, Paolo Simioni
BACKGROUND AND AIMS: The long-term impact of sustained virological response (SVR) after direct-acting antivirals (DAAs) on the hypercoagulability associated with HCV cirrhosis is unknown. We longitudinally evaluated the effect of DAAs treatment on cirrhotic coagulopathy. METHODS: Pro- and anticoagulant factors levels and thrombin generation were assessed in patients with HCV-related cirrhosis at baseline, end of therapy (EOT), at 12, 24 and 48 weeks (W) after EOT...
May 8, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29731081/prevalence-of-antiphospholipid-antibody-positivity-and-association-of-pretransplant-lupus-anticoagulant-positivity-with-early-allograft-dysfunction-in-liver-transplantation
#5
H-M Kwon, K-W Jung, Y-J Moon, H-W Jung, Y-S Park, I-G Jun, J-G Song, G-S Hwang
BACKGROUND: Antiphospholipid antibodies (aPL), including anticardiolipin (aCL), anti-β2 -glycoprotein I (anti-β2GPI), and lupus anticoagulant (LA) antibodies, are frequently found in liver cirrhosis and associated with splanchnic vein thrombosis. Although the risk factors of early allograft dysfunction (EAD) are known, the association between EAD and aPL has been poorly investigated. We hypothesized that LA, potent aPL with thrombotic potential, may be associated with EAD development after living donor liver transplantation (LDLT)...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29723040/role-of-the-blood-coagulation-cascade-in-hepatic-fibrosis
#6
Asmita Pant, Anna K Kopec, James P Luyendyk
Liver is the primary source of numerous proteins critical for normal function of the blood coagulation cascade. Because of this, diseases of the liver, particularly when affiliated with severe complications like cirrhosis, are associated with abnormalities of blood clotting. Although conventional interpretation has inferred cirrhosis as a disorder of uniform bleeding risk, it is now increasingly appreciated as a disease wherein the coagulation cascade is precariously rebalanced. Moreover, prothrombotic risk factors are also associated with a more rapid progression of fibrosis in humans, suggesting that coagulation proteases participate in disease pathogenesis...
May 3, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29720857/portal-vein-thrombosis-in-cirrhosis-diagnosis-natural-history-and-therapeutic-challenges
#7
REVIEW
Aikaterini Mantaka, Aikaterini Augoustaki, Elias A Kouroumalis, Dimitrios N Samonakis
Portal vein thrombosis (PVT) is a frequent complication in cirrhosis and its prevalence increases with disease severity. Several factors are involved in the development and progression of PVT. The challenge for the management of PVT is the precise evaluation of the bleeding risk as opposed to life-threatening extension of thrombosis. Nevertheless, the impact on the progression and outcome of liver disease is unclear. A critical evaluation of the available data discloses that treating PVT in cirrhotics is safe and effective...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29704446/decreased-protein-c-function-predicts-mortality-in-patients-with-cirrhosis
#8
A G Patil, C Bihari, H D Shewade, N Nigam, S K Sarin
INTRODUCTION: Protein C (PrC), a physiological anticoagulant, regulates inflammation and cell death and has known predictive/therapeutic roles in sepsis. Accumulating evidences suggest plasma hypercoagulability results in progression of fibrosis and formation of microclots causing end-organ dysfunction. We investigated a possible association between natural anticoagulants-PrC, protein S (PrS) and antithrombin III (AT)-and clinical outcomes in cirrhotics. METHODS: Functional PrC, PrS and AT were analysed in 515 cirrhotic patients and compared with 229 noncirrhotics...
April 28, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29642951/use-of-oxidized-regenerated-cellulose-to-achieve-hemostasis-during-laparoscopic-cholecystectomy-a-retrospective-cohort-analysis
#9
Emilia Masci, Giuseppe Faillace, Mauro Longoni
OBJECTIVE: Laparoscopic cholecystectomy is the first-choice treatment for symptomatic cholelithiasis. Though generally safe, this procedure is not without complications, with bleeding the most frequent cause of conversion to open cholecystectomy. Oxidized regenerated cellulose (ORC) added to conventional hemostatic strategies, is widely used to control bleeding during surgery despite limited evidence supporting its use. This retrospective study analyzed patients undergoing laparoscopic cholecystectomy in an Italian center over a 16-month period, between October 2014 and February 2016, who experienced uncontrollable bleeding despite the use of conventional hemostatic strategies, requiring the addition of ORC gauze (Emosist® )...
April 11, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29620649/primary-medullary-hemorrhage-in-a-patient-with-coagulopathy-due-to-alcoholic-cirrhosis-a-case-report
#10
Guangxun Shen, Yu Gao, Kwee-Yum Lee, Guangxian Nan
RATIONALE: Mild-to-moderate alcoholic cirrhosis of the liver is related to spontaneous intracerebral hemorrhage (ICH). In terms of spontaneous brainstem hemorrhage, pontine is considered as the most common site in contrast to medulla oblongata where the hemorrhage is rarely seen. This rare primary medullary hemorrhage has been attributed so far to vascular malformation (VM), anticoagulants, hypertension, hemorrhagic transformation, and other undetermined factors. PATIENT CONCERNS: Herein, we describe a 53-year-old patient with 35-year history of alcohol abuse was admitted for acute-onset isolated hemianesthesia on the right side...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29607297/timing-of-anticoagulation-for-portal-vein-thrombosis-in-liver-cirrhosis-an-italian-internist-s-perspective
#11
Nicoletta Riva, Walter Ageno
No abstract text is available yet for this article.
March 2018: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29607296/timing-of-anticoagulation-for-portal-vein-thrombosis-in-liver-cirrhosis-a-us-hepatologist-s-perspective
#12
Patrick G Northup, Jessica P E Davis
No abstract text is available yet for this article.
March 2018: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29468795/suboptimal-use-of-pharmacological-venous-thromboembolism-prophylaxis-in-cirrhotic-patients
#13
Linda S Yang, Sumaya Alukaidey, Katherine Croucher, Damian Dowling
BACKGROUND: Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both pro-coagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. AIM: We aim to assess the rate of pharmacological prophylaxis for VTE among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld...
February 21, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29432256/portal-vein-thrombosis-yes-or-no-on-anticoagulation-therapy
#14
Fanny Turon, Virginia Hernández-Gea, Juan Carlos García-Pagán
PURPOSE OF REVIEW: To describe portal vein thrombosis (PVT) in the setting of cirrhosis especially in relation to its potential impact on liver transplantation. In addition, the safety and efficacy of anticoagulation is reviewed. RECENT FINDINGS: PVT in cirrhosis occurs in up to 26% of patients awaiting liver transplantation. Different studies have suggested that PVT impacts negatively post-liver transplantation survival, particularly in first year post-liver transplantation and when PVT is complete involving the porto-mesenteric confluence and not allowing physiological anastomosis...
April 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29407630/low-molecular-weight-heparin-treatment-for-portal-vein-thrombosis-in-liver-cirrhosis-efficacy-and-the-risk-of-hemorrhagic-complications
#15
Jihyun Kwon, Youngil Koh, Su Jong Yu, Jung-Hwan Yoon
INTRODUCTION: Portal vein thrombosis (PVT) is a well-known complication in patients with liver cirrhosis (LC). The aim of this study is to investigate the outcomes of cirrhotic patients with PVT treated with low-molecular-weight heparin (LMWH). METHOD: Ninety-one LC patients with PVT were treated with dalteparin or enoxaparin for six months. Patients with major bleeding during the last three months, severe thrombocytopenia, or impaired renal function were excluded...
March 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29330279/rare-cause-of-isolated-severe-coagulation-failure-in-cirrhosis-traditional-healing-with-fenugreek
#16
Cyriac A Philips, Philip Augustine
Patients with cirrhosis develop decompensation events during the natural history of the disease that encompass ascites, variceal bleeding, hepatic encephalopathy and jaundice. Coagulation failure, defined using the international normalised ratio, even though not a decompensation event, is important in patients with stratifying cirrhosis into those who require liver transplantation for long-term survival. Isolated coagulation failure in cirrhosis is rare and usually occurs with use of anticoagulants in the setting of vascular diseases...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29218132/portal-vein-thrombosis-in-adult-omani-patients-a-retrospective-cohort-study
#17
Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare
OBJECTIVES: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29161790/-anticoagulation-in-patients-with-liver-cirrhosis
#18
REVIEW
Jae Youn Cheong
Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29137043/portal-vein-thrombosis-before-and-after-transjugular-intrahepatic-portosystemic-shunt-placement-an-observational-study-strobe-compliant
#19
Yue-Meng Wan, Yu-Hua Li, Hua-Mei Wu, Zhi-Yuan Xu, Ying Xu, Li-Hong Yang, Xi-Nan Wu, Jin-Hui Yang
Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29122309/the-keys-to-successful-tips-in-patients-with-portal-vein-thrombosis-and-cavernous-transformation
#20
S Lombardo, J J Espejo, M E Pérez-Montilla, L J Zurera, Á González-Galilea
Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization...
November 6, 2017: Radiología
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