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Target-specific anticoagulant

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https://www.readbyqxmd.com/read/28413976/laboratory-monitoring-or-measurement-of-direct-oral-anticoagulants-doacs-advantages-limitations-and-future-challenges
#1
Emmanuel J Favaloro, Leonardo Pasalic, Jennifer Curnow, Giuseppe Lippi
BACKGROUND: The Direct Oral Anticoagulants (DOACs) represent a new generation of antithrombotic agents, providing direct inhibition of either thrombin (factor IIa; FIIa) or activated factor X (FXa). Around the globe, their use is progressively rising, as these new agents replace the historical anticoagulants (heparin and vitamin K antagonists including warfarin) for various clinical conditions in medical practice. Other acronyms used to designate DOACs include TSOAC (target specific oral anticoagulants) and NOAC (novel; or non-vitamin K antagonist oral anticoagulants)...
April 17, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28412907/review-of-the-pharmacology-of-the-emerging-possibilities-of-the-direct-oral-anticoagulants-reversal
#2
Matej Samos, Lucia Stanciakova, Ingrid Skornova, Tomas Bolek, Frantisek Kovar, Jan Stasko, Peter Galajda, Marian Mokan, Peter Kubisz
BACKGROUND: Direct oral anticoagulants (DOACs) offer consistent and predictable anticoagulation, oral administration with good patient compliance and a good safety profile. Dabigatran - a direct thrombin inhibitor, apixaban and rivaroxaban - direct factor Xa inhibitors are now largely used for anticoagulation in patients with non-valvular atrial fibrillation and in patients with venous thromboembolism. These agents have emerged as an expediential clinical choice in long-term anticoagulation for an increasing number of patients...
April 13, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28400185/purification-and-characterization-of-cc-lec-c-type-lactose-binding-lectin-a-platelet-aggregation-and-blood-clotting-inhibitor-from-cerastes-cerastes-venom
#3
Saoud Samah, Chérifi Fatah, Berjeaud Jean-Marc, Kellou-Taîri Safia, Laraba-Djebari Fatima
In this study, we reported for the first time the biochemical and structural characterization of Cc-Lec, a C-type lectin purified from Cerastes cerastes venom by affinity chromatography. This lectin was homogeneous by SDS-PAGE, and was shown to be a 34 271.59Da polypeptide by Electrospray mass spectrometry MS-ES-TOF. Its identified sequence of 160 amino acids corresponding to one subunit, revealed a high identity with other related proteins. Cc-Lec modeled 3D structure appeared as homodimer cross-linked by one disulfide bridge...
April 8, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28376529/role-of-direct-oral-anticoagulants-in-the-management-of-anticoagulation
#4
Rajiv N Thakkar, Suman W Rathbun, Scott M Wright
For decades, vitamin K antagonists (VKAs) have been the oral treatment of choice for many thromboembolic conditions. The limitations of VKAs include the need for monitoring through blood testing, drug interactions, and narrow therapeutic windows. These shortcomings have led to the development of direct oral anticoagulants. These new oral agents act on specific targets in the coagulation cascade (eg, factor Xa, thrombin) and negate some of the shortcomings of VKAs. This article reviews the roles of dabigatran, rivaroxaban, apixaban, and edoxaban in stroke prevention in nonvalvular atrial fibrillation, for prevention of venous thromboembolism after orthopedic surgery, and in the treatment of venous thromboembolism...
April 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28362634/site-selective-conjugation-of-an-anticoagulant-aptamer-to-recombinant-albumins-and-maintenance-of-neonatal-fc-receptor-binding
#5
Julie Schmøkel, Anders Voldum, Georgia Tsakiridou, Matthias Kuhlmann, Jason Cameron, Esben Sørensen, Jesper Wengel, Kenneth A Howard
Aptamers are an attractive molecular medicine that offers high target specificity. Nucleic acid-based aptamers however, are prone to nuclease degradation and rapid renal excretion that require blood circulatory half-life extension enabling technologies. The long circulatory half-life, predominately facilitated by engagement with the cellular recycling neonatal Fc receptor (FcRn), and ligand transport properties of albumin promote it as an attractive candidate to improve the pharmacokinetic profile of aptamers...
March 31, 2017: Nanotechnology
https://www.readbyqxmd.com/read/28349046/venous-thromboembolism-in-critical-illness-and-trauma-pediatric-perspectives
#6
REVIEW
Ranjit S Chima, Sheila J Hanson
Critically ill children and those sustaining severe traumatic injuries are at higher risk for developing venous thromboembolism (VTE) than other hospitalized children. Multiple factors including the need for central venous catheters, immobility, surgical procedures, malignancy, and dysregulated inflammatory state confer this increased risk. As well as being at higher risk of VTE, this population is frequently at an increased risk of bleeding, making the decision of prophylactic anticoagulation even more nuanced...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28339096/pathogenesis-and-management-of-antiphospholipid-syndrome
#7
REVIEW
Deepa R J Arachchillage, Mike Laffan
Antiphospholipid antibodies are a heterogeneous group of autoantibodies that have clear associations with thrombosis and pregnancy morbidity, and which together constitute the 'antiphospholipid syndrome' (APS). However, the pathophysiology of these complications is not well understood and their heterogeneity suggests that more than one pathogenic process may be involved. Diagnosis remains a combination of laboratory analysis and clinical observation but there have been significant advances in identifying specific pathogenic features, such as domain I-specific anti-β2-glycoprotein-I antibodies...
March 24, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28302764/-18-f-gp1-a-novel-fluorine-18-labeled-tracer-designed-for-pet-imaging-of-thrombi-with-high-detection-sensitivity-and-low-background
#8
Jessica Lohrke, Holger Siebeneicher, Markus Berger, Michael Reinhardt, Mathias Berndt, Andre Mueller, Marion Zerna, Norman Koglin, Felix Oden, Marcus Bauser, Matthias Friebe, Ludger M Dinkelborg, Joachim Huetter, Andrew W Stephens
Thromboembolic diseases such as myocardial infarction, stroke, transient ischemic attacks and pulmonary embolism are major causes of morbidity and mortality worldwide. GPIIb/IIIa is the key receptor involved in platelet aggregation and is a validated target for therapeutic approaches and diagnostic imaging. The aim of this study was to develop and characterize a specific small molecule tracer for positron emission tomography (PET) imaging that binds with high affinity to GPIIb/IIIa receptors and has suitable pharmacokinetic properties to overcome limitations of previous approaches...
March 16, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28265127/management-of-cavoatrial-deep-venous-thrombosis-incorporating-new-strategies
#9
REVIEW
Mohamed A Zayed, Gayan S De Silva, Raja S Ramaswamy, Luis A Sanchez
Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28255434/efficacy-and-safety-of-the-target-specific-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation-the-real-life-evidence
#10
REVIEW
Vincenzo Russo, Anna Rago, Riccardo Proietti, Federica Di Meo, Andrea Antonio Papa, Paolo Calabrò, Antonio D'Onofrio, Gerardo Nigro, Ahmed AlTurki
The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF)...
February 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#11
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared to non-cancer patients. The specific profile of cancer patients combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of that choice among available drugs for the long-term antithrombotic strategy linked to their pharmacology, mechanism of action, evidence of clinical benefits, advantages and limitations in such a complex clinical context...
February 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#12
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28178413/spontaneous-intracerebral-hemorrhage-management
#13
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/28164512/critical-deviations-of-ionized-calcium-measurements-when-using-blood-gas-analyzers-to-monitor-citrate-dialysis
#14
Thorsten Feldkamp, Norbert Weiler, Michael Marx, Peter B Luppa, Ralf Junker
BACKGROUND: During the course of acute kidney injury (AKI) patients may require renal replacement therapy (RRT). The preferred therapeutic measure for such patients is continuous RRT (CRRT). Anticoagulation is required to prevent clotting of the extracorporeal circuit. The actual KDIGO guidelines recommend citrate as the first line anticoagulant. METHODS: Citrate dose infused into the extracorporeal circuit should achieve an extracorporeal calcium concentration of 0...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#15
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28112193/potentially-high-risk-medication-categories-and-unplanned-hospitalizations-a-case-time-control-study
#16
Chih-Wan Lin, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
Empirical data of medication-related hospitalization are very limited. We aimed to investigate the associations between 12 high risk medication categories (diabetic agents, diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, antiplatelets, antihypertensives, antiarrhythmics, anticonvulsants, antipsychotics, antidepressants, benzodiazepine (BZD)/Z-hypnotics, and narcotics) and unplanned hospitalizations. A population-based case-time-control study was performed using Taiwan's National Health Insurance Research Database...
January 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28076631/targeting-stroke-risk-and-improving-outcomes-in-patients-with-atrial-fibrillation-in-latin-america
#17
Bruce Stambler, Fernando Scazzuso
CONTEXT AND OBJECTIVE: To examine stroke risk factors, including atrial fibrillation, management and prevention, and stroke outcomes across Latin America. DESIGN AND SETTING: Narrative review conducted at Piedmont Heart Institute, United States. METHODS: The PubMed, Embase and Cochrane databases were searched for stroke AND "Latin America" AND epidemiology (between January 2009 and March 2015). Further studies in the SciELO, World Health Organization and Pan-American Health Organization databases were used to address specific points...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28049606/an-insight-into-the-sialome-of-hyalomma-excavatum
#18
José M C Ribeiro, Mirko Slovák, Ivo M B Francischetti
Tick saliva contains hundreds or thousands of proteins that help blood feeding by impairing their hosts' hemostasis, inflammation and immunity. Salivary gland transcriptomes allow the disclosure of this pharmacologically active potion that consists of several multi-gene families, many of which are tick-specific. We here report the "de novo" assembly of ∼138 million reads deriving from a cDNA library from salivary glands of adult male and female Hyalomma excavatum leading to the public deposition of 5337 coding sequences to GenBank...
February 2017: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/28033586/core-shell-lc-ms-ms-method-for-quantification-of-second-generation-anticoagulant-rodenticides-diastereoisomers-in-rat-liver-in-relationship-with-exposure-of-wild-rats
#19
Isabelle Fourel, Marlène Damin-Pernik, Etienne Benoit, Virginie Lattard
Second generation anticoagulant rodenticides (SGARs), pesticides used worldwide to control rodent populations, exist in two diastereoisomer chemical species because they own two stereogenic centers. A core-shell LC-MS/MS multi-residue method for comprehensive quantitative analysis of the diastereoisomers of five SGARs as well as three first generation anticoagulant rodenticide molecules has been fully validated in liver of rats according to a bioanalytical guideline. A core-shell column (superficially porous particles) has been chosen for its ability to separate the diastereomers of bromadiolone, difenacoum, brodifacoum, flocoumafen and difethialone and for its robustness to rat liver extracts...
January 15, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28007364/factor-eight-inhibitor-bypassing-agent-feiba-for-reversal-of-target-specific-oral-anticoagulants-in-life-threatening-intracranial-bleeding
#20
Gordon Mao, Lauren King, Sarah Young, Richard Kaplan
INTRODUCTION: As increasing number of patients present to emergency departments with life threatening hemorrhages, particularly intracranial hemorrhage on anticoagulation physicians must be cognizant of the limitations of the available reversal options. Based upon the available literature, our institution formulated a reversal algorithm for patients with life-threatening bleeding on factor Xa inhibitors by administering factor eight inhibitor bypassing agent (FEIBA) 20 units/kg. METHODS: A retrospective chart review was performed to include all patients who received FEIBA per institutional protocol...
December 19, 2016: Journal of Emergency Medicine
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