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https://www.readbyqxmd.com/read/27001354/a-tailored-treatment-strategy-a-modern-approach-for-stroke-prevention-in-patients-with-atrial-fibrillation
#1
REVIEW
G Y H Lip, T Potpara, G Boriani, C Blomström-Lundqvist
The main priority in atrial fibrillation (AF) management is stroke prevention, following which decisions about rate or rhythm control are focused on the patient, being primarily for management of symptoms. Given that AF is commonly associated with various comorbidities, risk factors such as hypertension, heart failure, diabetes mellitus and sleep apnoea should be actively looked for and managed in a holistic approach to AF management. The objective of this review is to provide an overview of modern AF stroke prevention with a focus on tailored treatment strategies...
May 2016: Journal of Internal Medicine
https://www.readbyqxmd.com/read/26093875/patients-time-in-therapeutic-range-on-warfarin-among-us-patients-with-atrial-fibrillation-results-from-orbit-af-registry
#2
Sean D Pokorney, DaJuanicia N Simon, Laine Thomas, Gregg C Fonarow, Peter R Kowey, Paul Chang, Daniel E Singer, Jack Ansell, Rosalia G Blanco, Bernard Gersh, Kenneth W Mahaffey, Elaine M Hylek, Alan S Go, Jonathan P Piccini, Eric D Peterson
BACKGROUND: Time in therapeutic range (TTR) of international normalized ratio (INR) of 2.0 to 3.0 is important for the safety and effectiveness of warfarin anticoagulation. There are few data on TTR among patients with atrial fibrillation (AF) in community-based clinical practice. METHODS: Using the US Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), we examined TTR (using a modified Rosendaal method) among 5,210 patients with AF on warfarin and treated at 155 sites...
July 2015: American Heart Journal
https://www.readbyqxmd.com/read/25953603/the-prevalence-incidence-management-and-risks-of-atrial-fibrillation-in-an-elderly-chinese-population-a-prospective-study
#3
Li-Hua Li, Chang-Sheng Sheng, Bang-Chuan Hu, Qi-Fang Huang, Wei-Fang Zeng, Ge-Le Li, Ming Liu, Fang-Fei Wei, Lu Zhang, Yuan-Yuan Kang, Jie Song, Shuai Wang, Yan Li, Shao-Wen Liu, Ji-Guang Wang
BACKGROUND: There is limited information on prevalent and incident atrial fibrillation in Chinese. We aimed to investigate the prevalence, incidence, management and risks of atrial fibrillation in an elderly Chinese population. METHODS: In a population--based prospective study in elderly (≥ 60 years) Chinese, we performed cardiovascular health examinations including a 12-lead electrocardiogram at baseline in 3,922 participants and biennially during follow-up in 2,017 participants...
2015: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/25636978/-drug-food-interactions-in-internal-medicine-what-physicians-should-know
#4
S Mouly, M Morgand, A Lopes, C Lloret-Linares, J-F Bergmann
Orally administered medications may interact with various fruits, vegetables, herbal medicines, functional foods or dietary supplements. Drug-food interactions, which are mostly unknown from prescribers, including internists, may be responsible for changes in drug plasma concentrations, which may decrease efficacy or led to sometimes life-threatening toxicity. Aging, concomitant medications, transplant recipients, patients with cancer, malnutrition, HIV infection and those receiving enteral or parenteral feeding are at increased risk of drug-food interactions...
August 2015: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/25334361/spontaneous-intrathyroidal-hemorrhage-rare-but-lethal-condition
#5
Mohan Rudrappa, Nikhil K Meena, Brendon Colaco, Clinton Colaco, Penchala Mittadodla
Miscellaneous Case Report Posters IIISESSION TYPE: Affiliate Case Report PosterPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Spontaneous thyroid hemorrhage is life threatening condition if not timely recognized. Despite the increasing use of oral vitamin k antagonists only few cases of thyroid hemorrhage causing airway compromise have been reported in literature. Our case reiterates the importance of timely diagnosis and managementCASE PRESENTATION: A 73 year old white woman with deep vein thrombosis on warfarin was admitted to a community hospital for management of urinary tract infection...
October 1, 2014: Chest
https://www.readbyqxmd.com/read/25294786/growth-differentiation-factor-15-a-marker-of-oxidative-stress-and-inflammation-for-risk-assessment-in-patients-with-atrial-fibrillation-insights-from-the-apixaban-for-reduction-in-stroke-and-other-thromboembolic-events-in-atrial-fibrillation-aristotle-trial
#6
RANDOMIZED CONTROLLED TRIAL
Lars Wallentin, Ziad Hijazi, Ulrika Andersson, John H Alexander, Raffaele De Caterina, Michael Hanna, John D Horowitz, Elaine M Hylek, Renato D Lopes, Signild Asberg, Christopher B Granger, Agneta Siegbahn
BACKGROUND: Growth differentiation factor 15 (GDF-15), high-sensitivity troponin, and N-terminal pro-brain natriuretic peptide levels are predictive of death and cardiovascular events in healthy elderly subjects, patients with acute coronary syndrome, and patients with heart failure. High-sensitivity troponin I and N-terminal pro-brain natriuretic peptide are also prognostic in patients with atrial fibrillation. We evaluated the prognostic value of GDF-15 alone and in addition to clinical characteristics and other biomarkers in patients with atrial fibrillation...
November 18, 2014: Circulation
https://www.readbyqxmd.com/read/25152787/balancing-risk-versus-benefit-the-elderly-patient-s-perspective-on-warfarin-therapy
#7
Beata V Bajorek, Susan J Ogle, Margaret J Duguid, Gillian M Shenfield, Ines Krass
UNLABELLED: Warfarin therapy is underused in the target at-risk elderly population. Clinicians perceive that older patients are reluctant to use this therapy, however the perspective of patients or their carers has yet to be explored. OBJECTIVE: To explore in-depth the perspectives of elderly patients and/or their carers regarding the use of warfarin therapy. METHOD: A qualitative study, using semi-structured group interviews was undertaken...
April 2009: Pharmacy Practice
https://www.readbyqxmd.com/read/25098413/attitudes-and-preferences-on-the-use-of-mobile-health-technology-and-health-games-for-self-management-interviews-with-older-adults-on-anticoagulation-therapy
#8
Jung-Ah Lee, Annie Lu Nguyen, Jill Berg, Alpesh Amin, Mark Bachman, Yuqing Guo, Lorraine Evangelista
BACKGROUND: Older adults are at substantial risk for cardiovascular disorders that may require anticoagulation therapy. Those on warfarin therapy report dissatisfaction and reduced quality of life (QOL) resulting from the treatment. Advances in the area of mobile health (mHealth) technology have resulted in the design and development of new patient-centric models for the provision of personalized health care services to improve care delivery. However, there is a paucity of research examining the effectiveness of mHealth tools on knowledge, attitudes, and patient satisfaction with treatment, as well as self-management, adherence to therapy, and QOL in older adults with chronic illness conditions requiring long-term warfarin therapy...
2014: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/24136011/improvement-of-adequate-use-of-warfarin-for-the-elderly-using-decision-tree-based-approaches
#9
REVIEW
K E Liu, C-L Lo, Y-H Hu
OBJECTIVES: Due to the narrow therapeutic range and high drug-to-drug interactions (DDIs), improving the adequate use of warfarin for the elderly is crucial in clinical practice. This study examines whether the effectiveness of using warfarin among elderly inpatients can be improved when machine learning techniques and data from the laboratory information system are incorporated. METHODS: Having employed 288 validated clinical cases in the DDI group and 89 cases in the non-DDI group, we evaluate the prediction performance of seven classification techniques, with and without an Adaptive Boosting (AdaBoost) algorithm...
2014: Methods of Information in Medicine
https://www.readbyqxmd.com/read/24128967/management-of-bleeding-and-reversal-strategies-for-oral-anticoagulants-clinical-practice-considerations
#10
REVIEW
Edith A Nutescu, William E Dager, James S Kalus, John J Lewin, Mark D Cipolle
PURPOSE: Currently available clinical data and optimal strategies for reversing oral anticoagulants in patients who are bleeding or need an urgent invasive procedure or operation are reviewed. SUMMARY: Bleeding from oral anticoagulants, including new target-specific oral agents (TSOAs), is a common cause of morbidity and mortality, especially in elderly patients. Limited clinical data are available to guide the reversal of warfarin or TSOAs in patients who are bleeding or need an urgent invasive procedure or operation...
November 1, 2013: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/24052775/care-transitions-in-anticoagulation-management-for-patients-with-atrial-fibrillation-an-emphasis-on-safety
#11
REVIEW
Steven Deitelzweig
BACKGROUND: Thromboprophylaxis with oral anticoagulants is an important but underused element of atrial fibrillation (AF) treatment. Reduction of stroke risk by anticoagulants comes at the price of bleeding risk. Patients with AF receiving anticoagulants require heightened attention with transition from one care setting to another. METHODS: This review of the literature focuses on issues specific to the anticoagulation treatment of patients with AF. RESULTS: Patients presenting for emergency care of anticoagulant-related bleeding should be triaged for the severity and source of the bleeding using appropriate measures, such as discontinuing the oral anticoagulant, administering vitamin K when appropriate to reverse warfarin-induced bleeding, or administering clotting factors for emergent bleeding...
2013: Ochsner Journal
https://www.readbyqxmd.com/read/23581399/improving-the-management-of-warfarin-in-aged-care-facilities-utilising-innovative-technology-a-proof-of-concept-study
#12
Luke R E Bereznicki, Shane L Jackson, Wiete Kromdijk, Peter Gee, Kimbra Fitzmaurice, Bonnie J Bereznicki, Gregory M Peterson
OBJECTIVE: In aged-care facilities (ACFs) monitoring of warfarin can be logistically challenging and International Normalised Ratio (INR control) is often suboptimal. We aimed to determine whether an integrated information and communications technology system and the use of point-of-care (POC) monitors by nursing staff could improve the INR control of aged-care facility residents who take warfarin. METHODS: Nursing staff identified residents who were prescribed warfarin in participating ACFs...
February 2014: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/23356721/small-bowel-angiodysplasia-and-novel-disease-associations-a-cohort-study
#13
Grainne Holleran, Barry Hall, Mary Hussey, Deirdre McNamara
OBJECTIVE: Gastrointestinal angiodysplasias recurrently bleed, accounting for 3-5% of obscure gastrointestinal bleeding. The advent of small bowel capsule endoscopy (SBCE) has led to an increased recognition of small bowel angiodysplasias (SBAs) but little is known about their etiology. Previous small cohorts and case reports suggest an equal gender incidence and associations with cardiovascular disease, renal impairment, and coagulopathies. METHODS: Patients with SBA were identified from our SBCE database...
April 2013: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/23299032/transitions-of-care-in-anticoagulation-management-for-patients-with-atrial-fibrillation
#14
Steven B Deitelzweig
Thromboprophylaxis with oral anticoagulants (OACs) is an important but underused element of atrial fibrillation (AF) treatment. Reduction of stroke risk with anticoagulants comes at the price of increased bleeding risk. Patients with AF receiving anticoagulants require heightened attention with transition from one care setting to another. Patients presenting for emergency care of anticoagulant-related bleeding should be triaged for the severity and source of the bleeding using appropriate measures, such as discontinuing the OAC, administering vitamin K, when appropriate, to reverse warfarin-induced bleeding, or administering clotting factors for emergent bleeding...
October 2012: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/23257951/stroke-and-bleeding-risk-assessment-in-atrial-fibrillation-when-how-and-why
#15
REVIEW
Gregory Y H Lip
Decision making with regard to thromboprophylaxis should be based upon the absolute risks of stroke/thromboembolism and bleeding and the net clinical benefit for a given patient. As a consequence, a crucial part of atrial fibrillation (AF) management requires the appropriate use of thromboprophylaxis, and the assessment of stroke as well as bleeding risk can help inform management decisions by clinicians. The objective of this review article is to provide an overview of stroke and bleeding risk assessment in AF...
April 2013: European Heart Journal
https://www.readbyqxmd.com/read/23206432/ct-pulmonary-angiography-in-elderly-patients-outcomes-in-patients-aged-85-years
#16
M J Laugharne, M Paravasthu, A Preston, K O Hill
AIM: To assess the quality, safety, and outcomes following computed tomography pulmonary angiography (CTPA) performed in elderly patients. MATERIALS AND METHODS: CTPA examinations were performed in 140 patients aged >85 years in three UK acute National Health Service (NHS) hospitals. Images were assessed for quality, pulmonary emboli, and other disease entities. Patients were assessed for contrast medium-induced nephropathy (CIN), and short-term and long-term survival...
May 2013: Clinical Radiology
https://www.readbyqxmd.com/read/22826692/an-evidence-based-review-of-apixaban-and-its-potential-in-the-prevention-of-stroke-in-patients-with-atrial-fibrillation
#17
Prakash Deedwania, Grace W Huang
Atrial fibrillation (AF) is a common cardiac arrhythmia, especially in the elderly population. It is associated with cardioembolic complications, particularly strokes, resulting in severe functional deficit or death. AF patients are first stratified into low, intermediate, and high risk for thromboembolic events using the CHADS(2) and CHA(2)DS(2)-VASc score systems. Depending on their risks, patients are treated with either therapeutic anticoagulation with warfarin or acetylsalicylic acid for stroke prevention...
2012: Core Evidence
https://www.readbyqxmd.com/read/22632777/no-significant-association-of-aspirin-use-with-cerebral-microbleeds-in-the-asymptomatic-elderly
#18
Chi Kyung Kim, Hyuk Tae Kwon, Hyung-Min Kwon
BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) may predict future risk for intracerebral hemorrhage (ICH). ICH is one of the most important complications of aspirin use. The association between aspirin use and CMBs is still controversial. In this context, we sought to investigate whether aspirin use is associated with CMBs in subjects without previous history of stroke. METHODS: Asymptomatic elderly subjects (n=1452; age ≥ 65 years) who visited for routine health check-ups were included in this study...
August 15, 2012: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/22616831/discrepancies-between-elderly-patient-s-self-reported-and-prescribed-medications-a-social-investigation
#19
Nada A Yasein, Farihan F Barghouti, Yacoub M Irshaid, Ahmad A Suleiman
Scand J Caring Sci; 2013; 27; 131-138 Discrepancies between elderly patient's self-reported and prescribed medications: a social investigation Aims:  To study some characteristics of the elderly people attending the family practice clinic at the Jordan University Hospital (JUH) and to evaluate their knowledge of the prescribed drugs. Methods:  A total of 400 elderly people (180 men and 220 women) aged 71 ± 5.8 years were studied regarding sociodemographic characteristics and the use of medicinal and nonmedicinal remedies...
March 2013: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/22380743/influence-of-adult-age-on-the-total-and-free-clearance-and-protein-binding-of-r-and-s-warfarin
#20
Berit Packert Jensen, Paul Ken Leong Chin, Rebecca Lee Roberts, Evan James Begg
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Hepatic drug clearance is thought to be reduced with age. However for highly protein bound drugs, which are cleared by capacity-limited metabolism, studies on total clearance have been conflicting. The hypothesis that protein binding decreases with age has been used to explain this. Warfarin is a highly protein bound drug, which is cleared by capacity-limited metabolism. There are conflicting or little data on the relationship between adult age and total and free clearance and protein binding of (R)- and (S)-warfarin...
November 2012: British Journal of Clinical Pharmacology
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