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warfarin counselling

Maria Luisa Fonte, Lauren Fietchner, Matteo Manuelli, Hellas Cena
BACKGROUND: The aim of this case report is to discuss the issue of nutritional therapy in patients taking warfarin. Patients are often prescribed vitamin K free diets without nutritional counseling, leading to possible health consequences. CASE PRESENTATION: A 52-year-old woman with obesity and hypertension was prescribed a low calorie diet by her family doctor in an effort to promote weight loss. After a pulmonary embolism, she was placed on anticoagulant therapy and on hospital discharge she was prescribed a vitamin K free diet to avoid interactions...
October 19, 2016: Nutrition Journal
Julie A Fusco, Eric J Paulus, Alexandra R Shubat, Sharminara Miah
A 62-year-old African American man received unintentional duplicate anticoagulation therapy with warfarin 5 mg and rivaroxaban 20 mg daily for the treatment of recurrent pulmonary embolism. The patient presented to the anticoagulation clinic 6 days after hospital discharge with an International Normalized Ratio (INR) of 2.3 and he was instructed to continue warfarin 5 mg daily. Seven days later, he returned to the clinic with an INR >8.0 using a point-of-care device. He denied any signs or symptoms of bleeding...
December 2015: Drug Saf Case Rep
Mary E Westerman, Joseph A Scales, Vidit Sharma, Derek J Gearman, Johann P Ingimarsson, Amy E Krambeck
OBJECTIVE: To analyze bleeding related complications among patients on long term anticoagulation (AC) undergoing ureteroscopy (URS). Current AUA/ICUD guidelines state it is safe to continue AC in routine URS; however, these recommendations are based on small case series. PATIENTS AND METHODS: 4,799 URS procedures performed at our institution between June 2009 and February 2016 were identified. Records were then retrospectively reviewed to confirm AC use and identify periprocedural complications...
October 5, 2016: Urology
Charlotte Gils, Anton Pottegård, Zandra Nymand Ennis, Per Damkier
BACKGROUND: Estimating the true risk of fetal malformations attributable to the use of medications is difficult and perception of risk by health professionals will impact their counseling and treatment of patients who need medication during pregnancy. The objective of this study was to assess the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited to participate in the study based on an online questionnaire...
2016: BMC Pregnancy and Childbirth
Michelle H Chua, Christoph J Griessenauer, Ajith J Thomas, Christopher S Ogilvy
OBJECTIVE: Neurologic condition at presentation is the most important predictor of morbidity and mortality from aneurysmal subarachnoid hemorrhage (aSAH). To guide management, it is important to identify patients who are at risk of presenting in poor neurologic condition after aSAH. METHODS: We retrospectively reviewed medical records and imaging studies for 387 consecutive cases of aSAH that were managed at a major academic neurovascular center in the United States from January 2008 to December 2013...
August 2016: World Neurosurgery
Mohamed N Al-Arifi, Syed Wajid, Nawaf K Al-Manie, Faisal M Al-Saker, Salmeen D Babelgaith, Yousif A Asiri, Ibrahim Sales
OBJECTIVES: To evaluate health care professionals' knowledge on warfarin interactions with drugs and herbs. METHODS: A self-administered questionnaire was developed to assess health care professionals' knowledge on warfarin interactions with drug and herb. Respondents were asked to classify 15 drugs that may effect on warfarin action as "enhance", "inhibit ", "no effect". The study sample involved health care professionals (physicians, pharmacists and nurses) from king Salman hospital, Saudi Arabia...
January 2016: Pakistan Journal of Medical Sciences Quarterly
Anjali Vivek Kanhere, Vivek Madhav Kanhere
Heart disease is one of the common, indirect obstetric causes of maternal death. Management of these cases may challenge the entire team providing care to the mother and fetus. Advances in cardiac surgery has improved quality of life and level of functioning of cardiovascular system of patients with congenital or acquired heart disease. These diseases complicate 0.1-4 % pregnancies. Maternal complications in the form of thromboembolic, hemorrhagic episode and heart failure may occur. The fetus is in danger of effects of oral anticoagulation therapy and other medications given to the patient in order to support cardiovascular system, intrauterine growth restriction and danger of hypoxia...
February 2016: Journal of Obstetrics and Gynaecology of India
Claudia Fischer, Ewout W Steyerberg, Gregg C Fonarow, Theodore G Ganiats, Hester F Lingsma
UNLABELLED: In recent years, readmission rates have been increasingly used as a measure of quality of hospital care for patients with heart failure. The aim of this systematic review is to assess the scientific evidence regarding the relation between hospital readmission rates and quality of hospital care for patients with heart failure. METHODS: We defined quality of hospital care for patients with heart failure by adhering to the performance measures developed by the American College of Cardiology (ACC)/American Heart Association (AHA)...
November 2015: American Heart Journal
Sweta Shrestha, Binaya Sapkota, Anjana Kumpakha, Upasana Acharya, Rashmi Sharma
BACKGROUND: Warfarin is widely used for the prevention and treatment of cardiac, thromboembolic and hypercoagulable diseases. Since warfarin is a narrow therapeutic index medicine, it requires close monitoring when used in the outpatient setting and on long term basis. Warfarin has been found to be associated with a number of complications especially bleeding. Patients' knowledge on warfarin can improve anticoagulation control with decrease in adverse drug reaction and other associated complications...
2015: BMC Research Notes
Colin Mendelsohn
Under the new NSW Health Smoke-free Health Care Policy, the smoke-free status of public hospital campuses has been reaffirmed and all clinical staff are required to provide routine brief interventions for all smoking patients. The policy creates a unique opportunity to assist smokers to quit permanently in a supportive environment when motivation to quit is high. Smoking remains the leading cause of preventable death and disability in New South Wales (NSW). Counselling beginning in hospital and continuing for at least 1 month after discharge significantly increases quit rates...
2015: Public Health Research & Practice
Sarah J Moore, Elizabeth A Blair, David R Steeb, Brent N Reed, J Heyward Hull, Jo Ellen Rodgers
BACKGROUND: Discharge anticoagulation counseling is important for ensuring patient comprehension and optimizing clinical outcomes. As pharmacy resources become increasingly limited, the impact of informational videos on the counseling process becomes more relevant. OBJECTIVE: To evaluate differences in pharmacist time spent counseling and patient comprehension (measured by the Oral Anticoagulation Knowledge [OAK] test) between informational videos and traditional face-to-face (oral) counseling...
June 2015: Annals of Pharmacotherapy
Megan R Barajas, Christine M Formea, Jennifer B McCormick, Ahmed D Abdalrhim, Leona C Han, Robert D McBane, Alexander S Fiksdal, Iftikhar J Kullo
OBJECTIVE: To describe an exploratory project to develop and pilot a novel patient educational tool that explains the concept of pharmacogenomics and its impact on warfarin dosing that can be utilized by health professionals providing patient counseling. METHODS: A pharmacogenomics educational tool prototype was developed by an interdisciplinary team. During the pilot of the tool, focus group methodology was used to elicit input from patients based upon their perspectives and experiences with warfarin...
March 2015: Currents in Pharmacy Teaching & Learning
Jacob A Akoh, Tahawar A Rana, Daniel Higgs
Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation...
2014: Surgery Research and Practice
Suber Dikici, Ayhan Saritas, Fahri Halit Besir, Gokhan Celbek, Guven Arslan
BACKGROUND: Cerebral venous thrombosis (CVT) is a rare disease and it has different etiologies. Inherited or acquired prothrombotic state plays a key role in the development of CVT. METHODS: A 28-year-old man who presented to our emergency department with persistent headache and accompanied by complaints of nausea and vomiting over a week. Neurologic examination revealed bilateral papilledema. Brain computed tomography showed a hyperdense area on the posterior part of the occipital lobe...
2013: World Journal of Emergency Medicine
Christine Damase-Michel, Juliette Pichereau, Atul Pathak, Isabelle Lacroix, Jean Louis Montastruc
UNLABELLED: Counselling or prescribing drugs during pregnancy requires health professionals to assess risk/benefit ratio for women and their baby. A misperception of the risk may lead to inappropriate decisions for pregnancy outcomes. The aim of the present study was to assess teratogenic and/or foetotoxic risk perception of common medications by general practitioners (GPs) and community pharmacists (CPs) from the Midi-Pyrenees area. METHODS: 103 GPs and 104 CPs were interviewed...
January 2008: Pharmacy Practice
Lauren Schwartz, Nissa Mazzola, Robert S Hoffman, Mary Ann Howland, Maria Mercurio-Zappala, Lewis S Nelson
OBJECTIVE: Warfarin is a high-risk medication whose safe use may be greatly improved by patient education. This study evaluate evaluated patients' understanding of warfarin instructions, medication management, the Food and Drug Administration's (FDA) warfarin medication guide content, and patient information recommendations. METHODS: Interviews conducted at 2 hospital-based outpatient primary care sites with patients initiated on warfarin therapy within the last year...
December 2015: Journal of Pharmacy Practice
Katie Young, Oliver Tunstall, Andrew Mumford
We report a previously well 9-year-old boy who presented with an acutely swollen left arm after horse riding. Left subclavian vein thrombosis was demonstrated by MR venography but there was no evidence of an underlying anatomical abnormality. The child was successfully treated with catheter directed thrombolysis and anticoagulation with intravenous unfractionated heparin and warfarin. We have identified 75 previously published case reports of effort-induced upper extremity deep vein thrombosis (UEDVT) and surveyed patient characteristics and precipitating activities...
2014: BMJ Case Reports
C-H Chang, Y-W Wang, P-Y Yeh Liu, Y-H Kao Yang
WHAT IS KNOWN AND OBJECTIVE: The many interactions between warfarin and other drugs and foods generate great challenges for clinicians and patients in maintaining stable anitcoagulation. Interactions due to variable vitamin K content of different dietary items influence the therapy of nearly all patients on warfarin. Unfortunately, there is no widely acceptable, patient-friendly strategy for managing such interactions. In this contribution, we propose a practical approach to managing this troublesome interaction, consisting of 'maintaining constant weekly dietary vitamin K intake scores'...
February 2014: Journal of Clinical Pharmacy and Therapeutics
Na Wang, Dong Zhao, Jing Liu, Jun Liu, Cheuk-man Yu, Wei Wang, Jia-yi Sun, Yan Li, Bu-xing Chen
BACKGROUND: Chronic heart failure (CHF) is a severe clinical syndrome associated with high morbidity and mortality, and with high health care expenditures. No nationwide data are currently available regarding the quality of clinical management of CHF patients in China. The aim of this study was to assess the quality of care of CHF inpatients in China. METHODS: The American College of Cardiology/American Heart Association Clinical Performance Measures for Adults with Chronic Heart Failure (Inpatient Measurement Set) with slight modifications was used to measure the performance status in 612 CHF patients with acute coronary syndrome (ACS) from 65 hospitals across all regions of China...
July 2013: Chinese Medical Journal
Cecilia Berardi, Alanna M Chamberlain, Francesca Bursi, Margaret M Redfield, Sheila M McNallan, Susan A Weston, Ruoxiang Jiang, Véronique L Roger
BACKGROUND: The goal of heart failure (HF) performance measures is to improve quality of care by assessing the implementation of guidelines in eligible patients. Little is known about the proportion of eligible patients and how performance measures are implemented in the community. METHODS: We determined the eligibility for and adherence to performance measures and β-blocker therapy in a community-based cohort of hospitalized HF patients from January 2005 to June 2011...
July 2013: American Heart Journal
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