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https://www.readbyqxmd.com/read/29113840/extended-venous-thromboembolism-prophylaxis-after-radical-cystectomy-a-call-for-adherence-to-current-guidelines
#1
REVIEW
Zachary Klaassen, Karan Arora, Hanan Goldberg, Thenappan Chandrasekar, Christopher J D Wallis, Rashid K Sayyid, Neil E Fleshner, Antonio Finelli, Alexander Kutikov, Philippe D Violette, Girish S Kulkarni
PURPOSE: Radical cystectomy (RC) is an inherently morbid procedure. The purpose of this review is to assess the timing and incidence of venous thromboembolism (VTE), review current guideline recommendations, and provide evidence for considering extended VTE prophylaxis among all patients undergoing RC. MATERIALS AND METHODS: We conducted a PubMed search of available literature for RC and VTE, focusing on: incidence and timing, evidence supporting extended VTE prophylaxis (among RC and abdominal surgical oncology patients), current guideline recommendations, safety considerations, and direct oral anticoagulants...
November 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#2
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29078245/-antiembolic-stockings-great-effects-in-edoxaban-approval-studies
#3
Knut Kroeger, Peter Kujath
In this age of evidence-based medicine, the use of medical thrombosis prophylaxis stockings (AES) as a physical strategy for the prevention of lower limb venous thrombosis has been questioned. The current German S3 guidelines even state that their non-application is, in the vast majority of cases, explicitly covered by the recommendations of this guideline. Low molecular weight heparins (NMH) and direct oral anticoagulants (DOAK) have received approval for thrombosis prophylaxis in elective knee and hip joint replacement, but the use of AES is absent from these approval studies...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29071124/management-of-anticoagulation-in-hip-fractures-a-pragmatic-approach
#4
Rafik Yassa, Mahdi Yacine Khalfaoui, Ihab Hujazi, Hannah Sevenoaks, Paul Dunkow
Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered in these patients which can delay surgical intervention. Despite this, there are no set national standards for management of drug-induced coagulopathy pre-operatively in the context of hip fractures.The aim of this study was to evaluate the management protocols available in the current literature for the commonly encountered coagulopathy-inducing agents...
September 2017: EFORT open reviews
https://www.readbyqxmd.com/read/29064044/management-of-elective-surgery-and-emergent-bleeding-with-direct-oral-anticoagulants
#5
REVIEW
Scott Kaatz, Charles E Mahan, Asaad Nakhle, Kulothungan Gunasekaran, Mahmoud Ali, Robert Lavender, David G Paje
PURPOSE OF REVIEW: The purpose of this review was to offer practical management strategies for when patients receiving direct oral anticoagulants require elective surgery or present with bleeding complications. RECENT FINDINGS: Clinical practice guidelines are now available on the timing of periprocedural interruption of treatment with the newer direct oral anticoagulants based on their pharmacodynamics and pharmacokinetics and based on findings from cohort studies and clinical trials...
October 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29055248/simultaneous-quantification-of-direct-oral-anticoagulants-currently-used-in-anticoagulation-therapy
#6
Kathrin I Foerster, Andrea Huppertz, Oliver J Müller, Timolaos Rizos, Lisa Tilemann, Walter E Haefeli, Jürgen Burhenne
Direct oral anticoagulants (DOACs) are among the most effective options to prevent serious thromboembolic events in patients with atrial fibrillation. Coagulation assays are used to assess DOAC activity, but lack the possibility to quantify drugs with concurrent pharmacodynamic effect. We developed a selective multi-drug assay to analyze apixaban, betrixaban, dabigatran, edoxaban, edoxaban M4, and rivaroxaban with ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC/MS/MS) in plasma fulfilling all requirements of the FDA und EMA guidelines for bioanalytical method validation...
October 16, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29043538/venous-thromboembolism-prophylaxis-in-medically-ill-patients-a-mixed-treatment-comparison-meta-analysis
#7
REVIEW
Majed S Al Yami, Matthew A Silva, Jennifer L Donovan, Abir O Kanaan
The American College of Chest Physicians guidelines recommend unfractionated heparin (UFH), low molecular weight heparins (LMWHs) or fondaparinux for prevention of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in medically-ill patients. Direct oral anticoagulants (DOACs) have been evaluated relative to enoxaparin for VTE prophylaxis though head-to-head comparisons of these agents are lacking. Therefore, we conducted a mixed treatment comparisons meta-analysis to evaluate the safety and efficacy of established treatments and DOACs for VTE prophylaxis in medically-ill patients...
October 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28992764/use-of-guidelines-for-reducing-stroke-risk-in-patients-with-nonvalvular-atrial-fibrillation-a-review-from-a-latin-american-perspective
#8
Carlos Cantú-Brito, Gisele Sampaio Silva, Sebastián F Ameriso
Atrial fibrillation (AF) is a prominent risk factor for stroke and a leading cause of death and disability throughout Latin America. Contemporary evidence-based guidelines for the management of AF and stroke incorporate the use of practical and relatively simple scoring methods to estimate both stroke and bleeding risk, in order to assist in matching patients with appropriate interventions. This review examines consistencies and differences among guidelines for reducing stroke risk in patients with AF, assessing the role of user-friendly scoring methods to determine appropriate patients for anticoagulation and other treatment options...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28942550/esc-position-paper-on-cardiovascular-toxicity-of-cancer-treatments-challenges-and-expectations
#9
Emanuel Raschi, Igor Diemberger, Benilde Cosmi, Fabrizio De Ponti
The recent position paper of the European Society of Cardiology (ESC) on cardiovascular toxicity of cancer treatments has attracted considerable interest by healthcare professionals, since it is the first concrete help in the difficult task of monitoring and approaching cardiovascular side effects of anticancer treatments. The ESC expert opinion was not intended as a clinical practice guideline; however, it reports major cardiovascular complications grouped into nine categories, addressing current clinical strategies for prevention and mitigation...
September 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28930804/venous-thromboembolism-in-gynecological-malignancy
#10
Abigail Cohen, Chung Sim Lim, Alun Huw Davies
OBJECTIVE: Venous thromboembolism (VTE) is a recognized complication of gynecological malignancy and represents a leading cause of morbidity and mortality in these patients. The review aimed to discuss the incidence, risk factors, and clinical presentation of VTE before examining the literature on the diagnosis, prevention, and management in the context of uterine, cervical, ovarian, and vulval cancers. METHODS/MATERIALS: A literature search was performed using Ovid Medline and Embase with the following words: "gynecological malignancy," "pelvic tumor," "venous thromboembolism," "deep vein thrombosis" and "pulmonary embolism...
November 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#11
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28910988/anticoagulation-after-coronary-stenting-a-systemic-review
#12
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/28883793/a-multilevel-analysis-of-real-world-variations-in-oral-anticoagulation-initiation-for-atrial-fibrillation-in-valencia-a-european-region
#13
Aníbal García-Sempere, Daniel Bejarano-Quisoboni, Julián Librero, Clara L Rodríguez-Bernal, Salvador Peiró, Gabriel Sanfélix-Gimeno
Introduction: Beyond clinical trials, clinical practice guidelines, and administrative regulation, treatment decision-making can be influenced by individual and contextual factors. Our goal was to describe variations in the patterns of initiation of anticoagulation therapy in patients with atrial fibrillation by Health Areas (HA) in the region of Valencia in Spain and to quantify the influence of the HAs on variations in treatment choice. Methods: We conducted a population-based retrospective cohort study of all atrial fibrillation patients who started treatment with oral anticoagulants between November 2011 and February 2014 in each of the region's 24 HAs...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28867369/-oral-anticoagulation-in-atrial-fibrillation-what-is-the-guideline-for-using-new-drugs
#14
J A Ibáñez Pérez de Viñaspre, J Gómez Bitrian, R Royo Hernández, M de Azúa Jiménez, C Marco López, L Urieta González
OBJECTIVE: To assess whether there are differences between atrial fibrillation (AF) patients initiating new direct-acting oral anticoagulants (DOAC) therapy and vitamin K antagonist (VKA) therapy in an emergency service. METHODS: Descriptive, observational, prospective study. We enrolled patients with AF who were visited in a hospital emergency service over one year. RESULTS: This study included 492 patients with AF, and 189 subjects received anticoagulant therapy, 104 with VKA (55%), and 85 with DOAC (45%)...
August 31, 2017: Semergen
https://www.readbyqxmd.com/read/28863196/impact-of-inr-monitoring-reversal-agent-use-heparin-bridging-and-anticoagulant-interruption-on-rebleeding-and-thromboembolism-in-acute-gastrointestinal-bleeding
#15
Naoyoshi Nagata, Toshiyuki Sakurai, Shiori Moriyasu, Takuro Shimbo, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Naomi Uemura
BACKGROUND: Anticoagulant management of acute gastrointestinal bleeding (GIB) during the pre-endoscopic period has not been fully addressed in American, European, or Asian guidelines. This study sought to evaluate the risks of rebleeding and thromboembolism in anticoagulated patients with acute GIB. METHODS: Baseline, endoscopy, and outcome data were reviewed for 314 patients with acute GIB: 157 anticoagulant users and 157 age-, sex-, and important risk-matched non-users...
2017: PloS One
https://www.readbyqxmd.com/read/28860793/evaluation-of-bleeding-in-patients-receiving-direct-oral-anticoagulants
#16
REVIEW
Erika L Hellenbart, Kathleen D Faulkenberg, Shannon W Finks
Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28832296/-continued-anticoagulation-for-unprovoked-venous-thromboembolism-guidance-through-the-maze-of-recent-studies
#17
F A Klok, M V Huisman
Recent American, European and Dutch guidelines recommend indefinite anticoagulation after a diagnosis of unprovoked venous thromboembolism in the absence of a high bleeding risk. The recommended approach would be to only stop anticoagulant therapy after three months in patients with one or more untreatable risk factors for bleeding such as prior major bleeding, uncorrectable hypertension or deep thrombocytopenia. Vitamin K-antagonists and direct oral anticoagulants (DOACs) were found to protect against recurrent venous thromboembolism at cost of major bleedings, although at a lower frequency than the number of prevented thrombotic events...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28822583/-misuse-and-adverse-effects-of-new-direct-oral-anticoagulants-a-prospective-observational-study-in-patients-admitted-to-an-emergency-unit-of-a-french-university-hospital
#18
Thomas Lafon, Christine Vallejo, Mathilde Hadj, Marie-Laure Laroche, Hélène Geniaux
INTRODUCTION: The use of direct oral anticoagulants (NOAC) is complex: indications, dosage adjustments and precautions. Emergency departments (ED) are increasingly faced with patients receiving NOAC. The aim of this study was to evaluate the misuse and the adverse effects (AE) of NOAC. METHODS: All subjects with NOAC admitted to the Limoges University Hospital ED from 1/8/2013 to 1/4/2014 were included in a prospective observational study. Misuse was identified from the NOAC summary of product characteristics and from the 2014 ANSM guideline (indication, dose, co-medications, age, hepatic and renal function); adverse effects were recorded...
July 19, 2017: Thérapie
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#19
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28808918/idarucizumab-in-dabigatran-treated-patients-with-acute-ischemic-stroke-receiving-alteplase-a-systematic-review-of-the-available-evidence
#20
REVIEW
Slaven Pikija, Laszlo K Sztriha, J Sebastian Mutzenbach, Stefan M Golaszewski, Johann Sellner
BACKGROUND AND PURPOSE: Current guidelines do not recommend the use of intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke who receive direct oral anticoagulants. While the humanized monoclonal antibody idarucizumab can quickly reverse the anticoagulant effects of the thrombin inhibitor dabigatran, safety data for subsequent tissue plasminogen activator treatment are sparse. Here, we review current knowledge about dabigatran reversal prior to systemic reperfusion treatment in acute ischemic stroke...
August 14, 2017: CNS Drugs
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