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https://www.readbyqxmd.com/read/29156997/clinical-manifestations-and-outcomes-of-severe-warfarin-overanticoagulation-from-the-ewa-study
#1
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Aku Virta, K E Juhani Airaksinen
INTRODUCTION: Severe warfarin overanticoagulation is a risk factor for bleeding, but there is little information on its manifestations, prognosis and factors affecting the outcome. We describe the manifestations and clinical outcomes of severe warfarin overanticoagulation in a large group of patients with atrial fibrillation (AF). MATERIALS AND METHODS: All international normalized ratio (INR) samples (n = 961 431) in the Turku University Hospital region between 2003-2015 were screened...
November 20, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29155884/the-importance-of-mean-time-in-therapeutic-range-for-complication-rates-in-warfarin-therapy-of-patients-with-atrial-fibrillation-a-systematic-review-and-meta-regression-analysis
#2
Anne Sig Vestergaard, Flemming Skjøth, Torben Bjerregaard Larsen, Lars Holger Ehlers
BACKGROUND: \Anticoagulation is used for stroke prophylaxis in non-valvular atrial fibrillation, amongst other by use of the vitamin K antagonist, warfarin. Quality in warfarin therapy is often summarized by the time patients spend within the therapeutic range (percent time in therapeutic range, TTR). The correlation between TTR and the occurrence of complications during warfarin therapy has been established, but the influence of patient characteristics in that respect remains undetermined...
2017: PloS One
https://www.readbyqxmd.com/read/29137047/massive-neonatal-intracranial-hemorrhage-caused-by-bromadiolone-a-case-report
#3
Mingsheng Ma, Mengqi Zhang, Xiaoyan Tang, Zhenghong Li
RATIONALE: Bromadiolone, often called a super-warfarin, is a potent rodenticide with long half-life. Skin and mucosal bleeding is the most common clinical manifestations of its intoxication. Bromadiolone intoxications in adults and children have been reported, but this phenomenon is rarely seen in fetuses. This paper presents a case of neonate with massive intracranial hemorrhage mediated by bromadiolone intoxication, highlighting that the bromadiolone is potentially lethal to the fetus...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136681/assessment-of-multiple-cytochrome-p450-activities-in-metabolically-inactivated-human-liver-microsomes-and-roles-of-p450-2c-isoforms-in-reaction-phenotyping-studies
#4
Norie Murayama, Kanako Yajima, Mikiko Hikawa, Kanami Shimura, Yu Ishii, Masaki Takada, Yasuhiro Uno, Masahiro Utoh, Kazuhide Iwasaki, Hiroshi Yamazaki
The fraction of substrate metabolized (fm ) can be used to estimate drug interactions and can be determined by comparison of the intrinsic clearances (CLint ) of victim drugs obtained from inhibited and uninhibited hepatic enzymes. Commercially available human liver microsomes were recently developed in which one cytochrome P450 (P450) isoform is selectively inactivated. These inactivated liver microsomes were used to evaluate the roles of P450 2C isoforms in the depletion and oxidation of probe substrates...
November 14, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/29122636/clinical-outcomes-and-history-of-fall-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-insights-from-the-aristotle-trial
#5
Meena P Rao, Dragos Vinereanu, Daniel M Wojdyla, John H Alexander, Dan Atar, Elaine M Hylek, Michael Hanna, Lars Wallentin, Renato D Lopes, Bernard J Gersh, Christopher B Granger
PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population. METHODS: Of the 18,201 patients in ARISTOTLE, 16,491 had information about history of falling - 753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29105079/direct-oral-anticoagulants-versus-warfarin-for-preventing-stroke-and-systemic-embolic-events-among-atrial-fibrillation-patients-with-chronic-kidney-disease
#6
REVIEW
Miho Kimachi, Toshi A Furukawa, Kimihiko Kimachi, Yoshihito Goto, Shingo Fukuma, Shunichi Fukuhara
BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for atrial fibrillation (AF), which is more prevalent among CKD patients than the general population. AF causes stroke or systemic embolism, leading to increased mortality. The conventional antithrombotic prophylaxis agent warfarin is often prescribed for the prevention of stroke, but risk of bleeding necessitates regular therapeutic monitoring. Recently developed direct oral anticoagulants (DOAC) are expected to be useful as alternatives to warfarin...
November 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29095091/an-assessment-of-the-impact-of-pharmacogenomics-on-health-disparities-a-systematic-literature-review
#7
Antony Martin, Jennifer Downing, Michelle Maden, Nigel Fleeman, Ana Alfirevic, Alan Haycox, Munir Pirmohamed
This review assessed evidence of disparities in benefits of pharmacogenomics related to 'model performance' in subgroups of patients and studies which reported impact on health inequalities. 'Model performance' refers to the ability of algorithms including clinical, environmental and genetic information to guide treatment. A total of 4978 abstracts were screened by one reviewer and 30% (1494) were double screened by a second independent reviewer, after which data extraction was performed. Additional forward and backward citation searching of reference lists was conducted...
November 2, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/29093384/a-pilot-study-of-tranilast-for-cardiomyopathy-of-muscular-dystrophy
#8
Tsuyoshi Matsumura, Misa Matsui, Yuko Iwata, Masanori Asakura, Toshio Saito, Harutoshi Fujimura, Saburo Sakoda
Objective Heart failure is currently the most serious complication of muscular dystrophy. The transient receptor potential cation channel, subfamily V, member 2 (TRPV2) is a stretch-sensitive Ca channel. In damaged myocytes or cardiomyocytes, TRPV2 translocates to the cytoplasmic membrane and enhances Ca influx, triggering cell damage. Evidence suggests that the inhibition of TRPV2 may be a new therapeutic target in heart failure. We found that tranilast, which is widely used as an anti-allergic drug, inhibits TRPV2...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29075507/pilot-parallel-randomised-controlled-trial-of-protective-socks-against-usual-care-to-reduce-skin-tears-in-high-risk-people-stopcuts
#9
Roy J Powell, Christopher J Hayward, Caroline L Snelgrove, Kathleen Polverino, Linda Park, Rohan Chauhan, Philip H Evans, Rachel Byford, Carolyn Charman, Christopher J W Foy, Colin Pritchard, Andrew Kingsley
BACKGROUND: Skin tears are common in older adults and those taking steroids and warfarin. They are traumatic, often blunt injuries caused by oblique knocks to the extremities. The epidermis may separate from the dermis or both layers from underlying tissues leaving a skin flap or total loss of tissue, which is painful and prone to infection. 'Dermatuff™' knee-length socks containing Kevlar fibres (used in stab-proof vests and motorcyclists' clothing) aim to prevent skin tears. The acceptability of the socks and the feasibility of a randomised controlled trial (RCT) had not been explored...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29069359/a-biomarker-based-risk-score-to-predict-death-in-patients-with-atrial-fibrillation-the-abc-age-biomarkers-clinical-history-death-risk-score
#10
Ziad Hijazi, Jonas Oldgren, Johan Lindbäck, John H Alexander, Stuart J Connolly, John W Eikelboom, Michael D Ezekowitz, Claes Held, Elaine M Hylek, Renato D Lopes, Salim Yusuf, Christopher B Granger, Agneta Siegbahn, Lars Wallentin
Aims: In atrial fibrillation (AF), mortality remains high despite effective anticoagulation. A model predicting the risk of death in these patients is currently not available. We developed and validated a risk score for death in anticoagulated patients with AF including both clinical information and biomarkers. Methods and results: The new risk score was developed and internally validated in 14 611 patients with AF randomized to apixaban vs. warfarin for a median of 1...
October 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29068041/point-of-care-versus-central-laboratory-testing-of-inr-in-acute-stroke
#11
R Zenlander, M von Euler, J Antovic, A Berglund
OBJECTIVES: Effective anticoagulant therapy is a contraindication to thrombolysis, which is an effective treatment of ischemic stroke if given within 4.5 hours of symptom onset. INR above 1.7 is generally considered a contraindication for thrombolysis. Rapid measurement of INR in warfarin-treated patients is therefore of major importance in order to be able to decide on thrombolysis or not. We asked whether INR measured on a point-of-care instrument would be as good as a central laboratory instrument...
October 25, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29066923/setting-priorities-in-the-health-care-sector-the-case-of-oral-anticoagulants-in-nonvalvular-atrial-fibrillation-in-denmark
#12
Peter Bo Poulsen, Søren Paaske Johnsen, Morten Lock Hansen, Axel Brandes, Steen Husted, Louise Harboe, Lars Dybro
AIM: Resources devoted to health care are limited, therefore setting priorities is required. It differs between countries whether decision-making concerning health care technologies focus on broad economic perspectives or whether focus is narrow on single budgets ("silo mentality"). The cost perspective as one part of the full health economic analysis is important for decision-making. With the case of oral anticoagulants in patients with nonvalvular atrial fibrillation (NVAF), the aim is to discuss the implication of the use of different cost perspectives for decision-making and priority setting...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29066099/effects-of-home-prothrombin-international-ratio-pt-inr-management-in-children-with-mechanical-prosthetic-valves-importance-of-individual-correlations-between-laboratory-and-coaguchek-device-pt-inrs
#13
Naomi Ino, Satoshi Masutani, Shoyo Tanikawa, Yoichi Iwamoto, Hirofumi Saiki, Hirotaka Ishido, Masanori Tamura, Hideaki Senzaki
BACKGROUND: Warfarin administration is essential but requires difficult management and frequent clinic visits in patients with mechanical prosthetic atrioventricular valve replacement (MPAVVR). This study investigated how home prothrombin international ratio (PT-INR) monitoring with CoaguChek(®) (Roche Diagnostics, Basel, Switzerland) safely reduced clinic visits in children with MPAVVR. We also compared individual correlations between the CoaguChek and laboratory PT-INR. METHODS: This study included four pediatric patients who started frequent warfarin home-monitoring after MPAVVR (three mitral valves and one tricuspid valve)...
October 21, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29058165/clinical-characteristics-and-risk-factors-associated-with-mortality-in-calcific-uremic-arteriolopathy
#14
Peter W Santos, Jianghua He, Ahmad Tuffaha, James B Wetmore
BACKGROUND: Calcific uremic arteriolopathy (CUA) is an often-fatal condition in dialysis patients. The clinical descriptions and treatments of CUA patients have been confined mostly to case reports. We report a comprehensive characterization of CUA and its associated diagnosis, treatment patterns, and outcome. METHODS: An internet-based registry collected information about CUA in dialysis patients. Univariate analysis using Cox proportional hazards models estimated hazard ratios of the association between clinical characteristics, laboratory values, and treatments with all-cause mortality...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29044986/spectroscopic-investigation-of-the-anticancer-alkaloid-piperlongumine-binding-to-human-serum-albumin-from-the-viewpoint-of-drug-delivery
#15
Yu Liu, Qian-Yu Li, Yu-Ping Wang, Yi-Ming Liu, Bin Liu, Mei-Mei Liu, Bing-Mi Liu
Piperlongumine (PL) is a very promising natural agent with a high potential for cancer treatment. To overcome the poor water solubility of PL, there is a need to develop a novel water-soluble formulation in which PL is non-covalently bound to human serum albumin (HSA). PL binding to HSA was studied by various spectroscopic techniques under simulated physiological conditions. Spectroscopic evidence showed that the interaction of PL with HSA could form a PL-HSA complex. The binding constant (Ka ) values increased with increasing temperature, and a similar dependence was observed for the number of binding sites (n) values...
October 18, 2017: Luminescence: the Journal of Biological and Chemical Luminescence
https://www.readbyqxmd.com/read/29044861/comparison-of-bleeding-risk-scores-in-patients-with-atrial-fibrillation-insights-from-the-re-ly-trial
#16
M Proietti, Z Hijazi, U Andersson, S J Connolly, J W Eikelboom, M D Ezekowitz, D A Lane, J Oldgren, V Roldan, S Yusuf, L Wallentin
BACKGROUND: Oral anticoagulation is the mainstay of stroke prevention in atrial fibrillation (AF), but must be balanced against the associated bleeding risk. Several risk scores have been proposed for prediction of bleeding events in patients with AF. OBJECTIVES: To compare the performance of contemporary clinical bleeding risk scores in 18 113 patients with AF randomized to dabigatran 110 mg, 150 mg or warfarin in the RE-LY trial. METHODS: HAS-BLED, ORBIT, ATRIA and HEMORR2 HAGES bleeding risk scores were calculated based on clinical information at baseline...
October 16, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29040422/pharmacogenetics-a-general-review-on-progress-to-date
#17
Ann K Daly
Background: Pharmacogenetics is not a new subject area but its relevance to drug prescribing has become clearer in recent years due to developments in gene cloning and DNA genotyping and sequencing. Sources of data: There is a very extensive published literature concerned with a variety of different genes and drugs. Areas of agreement: There is general agreement that pharmacogenetic testing is essential for the safe use of drugs such as the thiopurines and abacavir...
October 11, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29018538/replacement-of-warfarin-with-a-novel-oral-anticoagulant-in-endoscopic-mucosal-resection-a-multicentre-open-label-randomised-controlled-trial
#18
Takuya Yamada, Akiko Kada, Toshio Uraoka, Toshio Kuwai, Noriko Watanabe, Yoshihiro Sasaki, Katsuhiro Mabe, Yasuo Takahashi, Takashi Kagaya, Toshihisa Kimura, Hiroshige Hamada, Akiko M Saito, Naohiko Harada
INTRODUCTION: This randomised controlled trial aims to compare the efficacy of warfarin replacement with apixaban without postoperative resumption of heparin with that of conventional heparin bridging in patients taking warfarin and scheduled to undergo endoscopic mucosal resection (EMR): specifically, by checking for reduction in proportion of postoperative bleeding following EMR. METHODS AND ANALYSIS: The multicentre, open-label randomised parallel-group, controlled intervention study regards patients taking warfarin who are scheduled to undergo colon EMR...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29016369/newly-developed-left-ventricular-apical-thrombus-under-dabigatran-treatment
#19
Adem Adar, Orhan Onalan, Fahri Cakan
: Left ventricular (LV) thrombi are mostly formed in the aneurysmal or akinetic segment of the LV apex. Thromboembolism to the brain is usually fatal. There is not enough information available regarding the use of these new oral anticoagulant agents in LV thrombi. In this case, we present a 56-year-old male patient who was given dabigatran (150 mg, twice a day) for paroxysmal atrial fibrillation after experiencing anterior myocardial infarction. During the use of dabigatran, thrombus formation, which was not present earlier, was observed in the LV apical aneurysm...
October 7, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28902450/current-status-of-portal-vein-thrombosis-in-japan-results-of-a-questionnaire-survey-by-the-japan-society-for-portal-hypertension
#20
Seiichiro Kojima, Norihito Watanabe, Jun Koizumi, Shigehiro Kokubu, Naoya Murashima, Shoichi Matsutani, Katsutoshi Obara
AIM: To investigate the current status of portal vein thrombosis (PVT) in Japan, the Clinical Research Committee of the Japan Society of Portal Hypertension undertook a questionnaire survey. METHODS: A questionnaire survey of 539 cases of PVT over the previous 10 years was carried out at institutions affiliated with the Board of Trustees of the Japan Society of Portal Hypertension. RESULTS: The most frequent underlying etiology of PVT was liver cirrhosis in 75...
September 13, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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