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https://www.readbyqxmd.com/read/29079069/spontaneous-spinal-epidural-hematoma-in-a-patient-on-rivaroxaban-case-report-and-literature-review
#1
Raed Ismail, Elie Zaghrini, Eveline Hitti
BACKGROUND: Spinal hematomas (SHs) are rare yet potentially debilitating causes of acute back pain. Although spontaneous SHs have been described in the setting of anticoagulation with warfarin or enoxaparin, few cases of spontaneous SH on direct oral anticoagulants (DOACs) have been reported. CASE REPORT: We report a case of spontaneous spinal epidural hematoma in a patient on rivaroxaban. A 72-year-old man on rivaroxaban and aspirin presented with a 4-day history of nontraumatic back pain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29019431/synthesis-and-spectroscopic-characterization-study-of-new-palladium-complexes-containing-bioactive-o-o-chelated-ligands-evaluation-of-the-dna-protein-bsa-interaction-in-vitro-antitumoral-activity-and-molecular-docking
#2
Kazem Karami, Zohreh Mehri Lighvan, Hossein Farrokhpour, Maryam Dehdashti Jahromi, Amir Abbas Momtazi-Borojeni
[Pd{(C,N)-C6H4CH2NH(Et) (Qu)] (2) and [Pd{(C,N)-C6H4CH2NH(Et) (Nar)] (3) (Qu=Quercetin, Nar=Naringin) mononuclear palladium (II) complexes have been synthesized and characterized using elemental analysis, IR and electronic spectroscopy. The interaction of the prepared complexes with calf thymus DNA (CT DNA) and bovine serum albumin (BSA), monitored by UV-visible and fluorescence titrations, respectively, have been carried out to better understand the mode of their action under biological conditions. Intercalative binding mode between the complexes and DNA is suggested by the binding constant (Kb) values of 2...
October 11, 2017: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/28867752/genotyping-of-cyp2c9-and-vkorc1-polymorphisms-predicts-south-indian-patients-with-deep-vein-thrombosis-as-fast-metabolizers-of-warfarin-acenocoumarin
#3
Ganesan Arunkumar, Durairajpandian Vishnuprabu, Bitt Nupur, Thiruvengadam Vidyasagaran, Avaniyapuram Kannan Murugan, Arasambattu Kannan Munirajan
Deep vein thrombosis (DVT) is a life-threatening disease. Warfarin and acenocoumarol are anticoagulants used to treat DVT and vary among individuals in terms of treatment response/toxicity. Single nucleotide polymorphisms (SNPs) in CYP2C9 and VKORC1 play a role in the pharmacokinetics and dynamics of warfarin and acenocoumarol and they determine the efficacy of treatment by controlling drug clearance in treated individuals. The aim of the current study was to genotype the critical SNPs of CYP2C9 and VKORC1 genes in a south Indian population in order to understand the metabolizer phenotype of patients with DVT...
2017: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/28792790/recent-developments-and-future-directions-for-the-use-of-pharmacogenomics-in-cardiovascular-disease-treatments
#4
REVIEW
Elliot Berinstein, Andrew Levy
Cardiovascular disease is still the leading cause of death worldwide. There are many environmental and genetic factors that play a role in the development of cardiovascular disease. The treatment of cardiovascular disease is beginning to move in the direction of personalized medicine by using biomarkers from the patient's genome to design more effective treatment plans. Pharmacogenomics have already uncovered many links between genetic variation and response of many different drugs. Areas covered: This article will focus on the main polymorphisms that impact the risk of adverse effects and response efficacy of statins, clopidogrel, aspirin, β-blockers, warfarin dalcetrapib and vitamin E...
September 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#5
Brystana G Kaufman, Sunghee Kim, Karen Pieper, Larry A Allen, Bernard J Gersh, Gerald V Naccarelli, Michael D Ezekowitz, Gregg C Fonarow, Kenneth W Mahaffey, Daniel E Singer, Paul S Chan, James V Freeman, Jack Ansell, Peter R Kowey, James A Rieffel, Jonathan Piccini, Eric Peterson, Emily C O'Brien
OBJECTIVE: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. METHODS: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites...
August 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28768548/the-anticoagulated-trauma-patient-in-the-age-of-the-direct-oral-anticoagulants-a-canadian-perspective
#6
Brendan Wood, Barto Nascimento, Sandro Rizoli, Michelle Sholzberg, Amanda McFarlan, Andrea Phillips, Alun D Ackery
BACKGROUND: The anticoagulated trauma patient presents a particular challenge to the critical care physician. Our understanding of these patients is defined and extrapolated by experience with patients on warfarin pre-injury. Today, many patients who would have been on warfarin are now prescribed the Direct Oral Anticoagulants (DOACs) a class of anticoagulants with entirely different mechanisms of action, effects on routine coagulation assays and approach to reversal. METHODS: Trauma registry data from Toronto's (Ontario, Canada) two Level 1 trauma centres were used to identify patients on oral anticoagulation pre-injury from June 1, 2014 to June 1, 2015...
August 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28745065/assessment-of-oral-anticoagulant-use-in-residents-of-long-term-care-homes-evidence-for-contemporary-suboptimal-use
#7
Carlos H Rojas-Fernandez, Joslin Goh, Jennifer Hartwick, Ruth Auber, Aein Zarrin, Melissa Warkentin, Zain Hudani
OBJECTIVE: To describe the quality of warfarin use in residents of long-term care facilities and investigate potential predictors oral anticoagulant use. DESIGN: Retrospective chart review (August 2013 to September 2014). SETTING: Thirteen long-term care (LTC) and assisted living facilities (ALF). PARTICIPANTS: Residents from LTC or ALF settings who ( a) received warfarin or direct-acting oral anticoagulants (DOACs) and ( b) residents with a valid indication for oral anticoagulants such as atrial fibrillation, venous thromboembolism, but were not receiving these drugs...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28740848/patient-characteristics-and-clinical-outcomes-with-low-dose-dabigatran
#8
Ramin Ebrahimi, Janet K Han, Seung H Goe, Michelle Treadwell, Zenaida Feliciano
BACKGROUND/AIMS: Dabigatran, an oral direct thrombin inhibitor, is used in patients with non-valvular atrial fibrillation to reduce thromboembolic events. Whereas the 150 mg dosing regimen has been extensively studied in clinical setting, to date, there is no clinical data on the 75 mg (low dose, "LD") regimen. In this study, we evaluated patient characteristics and clinical outcomes in 49 patients treated with LD dabigatran. METHODS: Electronic medical records were utilized to compare patients from one medical center treated with LD dabigatran to those from the warfarin arm of the RE-LY trial...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28707518/interaction-of-copper-ii-complexes-by-bovine-serum-albumin-spectroscopic-and-calorimetric-insights
#9
Namrata Singh, Darshana Pagariya, Surbhi Jain, Sunil Naik, Nand Kishore
Serum albumins being the most abundant proteins in the blood and cerebrospinal fluid are significant carriers of essential transition metal ions in the human body. Studies of copper (II) complexes have gained attention because of their potential applications in synthetic, biological and industrial processes. Study of binding interactions of such bioinorganic complexes with serum albumins improves our understanding of biomolecular recognition process essential for rational drug desig. In the present investigation, we have applied quantitative approach to explore interactions of novel synthesized copper (II) complexes viz...
July 14, 2017: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/28673899/outcomes-and-prognostic-impact-of-prophylactic-oral-anticoagulation-in-anterior-st-segment-elevation-myocardial-infarction-patients-with-left-ventricular-dysfunction
#10
Jay S Shavadia, Erik Youngson, Kevin R Bainey, Jeffrey Bakal, Robert C Welsh
BACKGROUND: The contemporary role of prophylactic anticoagulation following extensive anterior wall ST-segment myocardial infarction (STEMI) is unclear. METHODS AND RESULTS: We evaluated anterior STEMI patients with left ventricle dysfunction (left ventricular ejection fraction ≤40%) ("high risk"), categorized by prophylactic warfarin use, within a regional STEMI. Patients with pre-existing atrial fibrillation were excluded. The primary outcome was an adjusted (for Global Registry of Acute Coronary Events risk score) 1-year composite of recurrent ischemia, stroke/transient ischemic attack/systemic embolism, or all-cause death...
July 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28634997/working-toward-precision-medicine-predicting-phenotypes-from-exomes-in-the-critical-assessment-of-genome-interpretation-cagi-challenges
#11
Roxana Daneshjou, Yanran Wang, Yana Bromberg, Samuele Bovo, Pier L Martelli, Giulia Babbi, Pietro Di Lena, Rita Casadio, Matthew Edwards, David Gifford, David T Jones, Laksshman Sundaram, Rajendra Rana Bhat, Xiaolin Li, Lipika R Pal, Kunal Kundu, Yizhou Yin, John Moult, Yuxiang Jiang, Vikas Pejaver, Kymberleigh A Pagel, Biao Li, Sean D Mooney, Predrag Radivojac, Sohela Shah, Marco Carraro, Alessandra Gasparini, Emanuela Leonardi, Manuel Giollo, Carlo Ferrari, Silvio C E Tosatto, Eran Bachar, Johnathan R Azaria, Yanay Ofran, Ron Unger, Abhishek Niroula, Mauno Vihinen, Billy Chang, Maggie H Wang, Andre Franke, Britt-Sabina Petersen, Mehdi Pirooznia, Peter Zandi, Richard McCombie, James B Potash, Russ B Altman, Teri E Klein, Roger A Hoskins, Susanna Repo, Steven E Brenner, Alexander A Morgan
Precision medicine aims to predict a patient's disease risk and best therapeutic options by using that individual's genetic sequencing data. The Critical Assessment of Genome Interpretation (CAGI) is a community experiment consisting of genotype-phenotype prediction challenges; participants build models, undergo assessment, and share key findings. For CAGI 4, three challenges involved using exome-sequencing data: Crohn's disease, bipolar disorder, and warfarin dosing. Previous CAGI challenges included prior versions of the Crohn's disease challenge...
September 2017: Human Mutation
https://www.readbyqxmd.com/read/28604566/novel-oral-anticoagulants-in-the-peri-endoscopic-period
#12
Michael Genualdi, Edward Lebovics, And William H Frishman
Millions of patients in the United States are currently prescribed some form of anticoagulation therapy. Recently, novel oral anticoagulants (NOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, have begun to replace warfarin as the drugs of choice for anticoagulation. As the use of these medications becomes more widespread, it is increasingly important for gastroenterologists to understand the risks associated with performing endoscopic procedures on patients who are taking NOACs. In this review, we provide an overview of the NOACs and current guidelines from international societies regarding the management of patients scheduled to undergo endoscopic procedures who are prescribed these medications...
September 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28592190/genetic-variants-associated-with-warfarin-dosage-in-kuwaiti-population
#13
Sumi Elsa John, Dinu Antony, Muthukrishnan Eaaswarkhanth, Prashantha Hebbar, Fadi Alkayal, Jaakko Tuomilehto, Osama Alsmadi, Thangavel Alphonse Thanaraj
Assessing the distinct prevalence or absence of genetic variants associated with differential response to the anticoagulant medication of warfarin in different population groups is actively pursued by pharmacogenomics community. Populations from Arabian Peninsula are underrepresented in such studies. By way of examining exome- and genome-wide genotype data from 1395 Arab individuals in Kuwait, we report distinct occurrence of warfarin response-related variants rs12460590_A/CYP2A7, rs2108622_T/CYP4F2, rs2884737_C/VKORC1 and distinct absence of rs11150606_C/PRSS53 in Kuwaiti population...
June 8, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28569372/venous-thromboembolism-prophylaxis-after-tka-aspirin-warfarin-enoxaparin-or-factor-xa-inhibitors
#14
COMPARATIVE STUDY
Abiram Bala, James I Huddleston, Stuart B Goodman, William J Maloney, Derek F Amanatullah
BACKGROUND: There is considerable debate regarding the ideal agent for venous thromboembolism (VTE) prophylaxis after TKA. Numerous studies and meta-analyses have yet to provide a clear answer and often omit one or more of the commonly used agents such as aspirin, warfarin, enoxaparin, and factor Xa inhibitors. QUESTIONS/PURPOSES: Using a large database analysis, we asked: (1) What are the differences in VTE incidence in primary TKA after administration of aspirin, warfarin, enoxaparin, or factor Xa inhibitors? (2) What are the differences in bleeding risk among these four agents? (3) How has use of these agents changed with time? METHODS: We queried a combined Humana and Medicare database between 2007 and Quarter 1 of 2016, and identified all primary TKAs performed using ICD-9 and Current Procedural Terminology codes...
September 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28553032/stroke-in-patients-with-chronic-kidney-disease%C3%A2-how-do-we-approach-and-manage-it
#15
REVIEW
S Nayak-Rao, M P Shenoy
Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28536415/late-obstructive-transcatheter-heart-valve-thrombosis-resolved-by-rivaroxaban
#16
Ole Norling Mathiassen, Erik Lerkevang Grove, Nicolaj Christoffer Hansson, Bjarne Linde Norgaard
BACKGROUND Although transcatheter aortic valve replacement (TAVR) has become a worldwide and generally accepted treatment of patients with aortic stenosis at high surgical risk, there is a rising concern and debate about the occurrence of transcatheter heart valve (THV) thrombosis and its impact on TAVR outcome. It seems that the incidence of THV thrombosis is higher than first anticipated, but uncertainty remains regarding how to prevent and how to treat it. Hence, there is an urgent need for understanding THV thrombosis and to communicate experiences within the field...
May 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28530526/warfarin-management-and-outcomes-in-patients-with-nonvalvular-atrial-fibrillation-within-an-integrated-health-care-system
#17
JaeJin An, Fang Niu, Chengyi Zheng, Nazia Rashid, Robert A Mendes, Diana Dills, Lien Vo, Prianka Singh, Amanda Bruno, Daniel T Lang, Paul T Le, Kristin P Jazdzewski, Gustavus Aranda
BACKGROUND: Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes is important for quality improvement; however, currently little evidence associating outcomes with management patterns exists. OBJECTIVES: To (a) describe warfarin management patterns and (b) evaluate associations between warfarin treatment and clinical outcomes for patients with NVAF in an integrated health care system...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28459916/direct-oral-anticoagulants-doacs-current-status-among-distinct-patient-subgroups
#18
Peter Riley, Abhishek Maan, Kenneth S Korr
The landscape of anticoagulant therapy for atrial fibrillation and deep-vein thrombosis has evolved considerably in the last decade with the advent of Novel or Direct-Acting Oral Antiocoagulants (DOACs). The initial phase III randomized controlled trials established the individual DOACs as viable alternatives to warfarin for thromboprophylaxis but generalizations to the larger population were limited by the small number of protocol subjects with renal insufficiency, congestive heart failure, advanced age and other comorbidities...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28441541/molecular-interaction-of-2-4-diacetylphloroglucinol-dapg-with-human-serum-albumin-hsa-the-spectroscopic-calorimetric-and-computational-investigation
#19
Pragna Lakshmi T, Moumita Mondal, Krishna Ramadas, Sakthivel Natarajan
Drug molecule interaction with human serum albumin (HSA) affects the distribution and elimination of the drug. The compound, 2,4-diacetylphloroglucinol (DAPG) has been known for its antimicrobial, antiviral, antihelminthic and anticancer properties. However, its interaction with HSA is not yet reported. In this study, the interaction between HSA and DAPG was investigated through steady-state fluorescence, time-resolved fluorescence (TRF), circular dichroism (CD), Fourier transform infrared (FT-IR) spectroscopy, isothermal titration calorimetry (ITC), molecular docking and molecular dynamics simulation (MDS)...
April 18, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/28390791/edoxaban-how-does-the-newest-agent-fit-into-the-doac-landscape
#20
REVIEW
Caitlin M Gibson, Shannon W Finks
Edoxaban is the most recently approved factor Xa inhibitor within the class of direct oral anticoagulants (DOACs). Like other DOACs, edoxaban was approved by the US Food and Drug Administration for treatment of venous thromboembolism and prevention of stroke in patients with nonvalvular atrial fibrillation. Similar to other DOACs, edoxaban has fewer drug-drug interactions than warfarin and does not require routine laboratory monitoring. Unlike other DOACs, edoxaban has yet to be approved for secondary or postoperative venous thromboembolism thromboprophylaxis...
August 2017: American Journal of Medicine
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