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https://www.readbyqxmd.com/read/28815127/a-knowledge-based-system-for-intelligent-support-in-pharmacogenomics-evidence-assessment-ontology-driven-evidence-representation-and-retrieval
#1
Chia-Ju Lee, Beth Devine, Peter Tarczy-Hornoch
Pharmacogenomics holds promise as a critical component of precision medicine. Yet, the use of pharmacogenomics in routine clinical care is minimal, partly due to the lack of efficient and effective use of existing evidence. This paper describes the design, development, implementation and evaluation of a knowledge-based system that fulfills three critical features: a) providing clinically relevant evidence, b) applying an evidence-based approach, and c) using semantically computable formalism, to facilitate efficient evidence assessment to support timely decisions on adoption of pharmacogenomics in clinical care...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#2
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/28768576/the-xenobiotic-sensor-pxr-in-a-marine-flatfish-species-solea-senegalensis-gene-expression-patterns-and-its-regulation-under-different-physiological-conditions
#3
Carlos Marques, Vânia P Roberto, Luís Granadeiro, Marlene Trindade, Paulo J Gavaia, Vincent Laizé, M Leonor Cancela, Ignacio Fernández
The pregnane X receptor (PXR) is a nuclear receptor belonging to the NR1I sub-family and a known master regulator of xenobiotic metabolism. New roles have been recently proposed in mammals through its activation by vitamin K (VK) such as regulation of glucose metabolism, bone homeostasis, reproduction, neuronal development and cognitive capacities. In marine fish species little is known about PXR and its potential roles. Here, expression patterns of pxr transcripts and conservation of protein domains were determined in the Senegalese sole (Solea senegalensis), a marine flatfish model species in aquatic ecotoxicology...
July 23, 2017: Marine Environmental Research
https://www.readbyqxmd.com/read/28750830/appropriate-dosing-of-nonvitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-atrial-fibrillation
#4
REVIEW
Benjamin A Steinberg, Jeffrey B Washam
The development of nonvitamin K antagonist oral anticoagulants (NOACs) has been a major advance in therapy for patients requiring oral anticoagulation, particularly for long-term indications such as stroke prevention in atrial fibrillation (AF). The NOACs are generally easier to dose and manage due to less heterogeneity of effect across individuals and fewer drug and food interactions, compared with warfarin. However, the treatment effect of NOACs may vary based on important patient characteristics, particularly renal function...
June 19, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28714498/chondrodysplasia-punctata-a-case-report-of-fetal-warfarin-syndrome
#5
S Songmen, O B Panta, S S Paudel, R K Ghimire
Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has been seen in association with deranged vitamin K metabolism. Warfarin, an oral anticoagulant acting on vitamin K dependent clotting factors is known to cause chondrodysplasia punctata. Despite the knowledge of the condition the management of patients with prosthetic heart valves might require use of the drug for anticoagulation. Here, we present a case of a fetal warfarin syndrome in a second born child of a 27 year lady under warfarin for prosthetic heart valve...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28709416/warfarin-induced-toxic-epidermal-necrolysis-in-combination-therapy-of-henoch-sch%C3%A3-nlein-purpura-nephritis-a-case-report
#6
Katsuaki Kasahara, Yoshimitsu Gotoh, Yoshiyuki Kuroyanagi, China Nagano
BACKGROUND: Toxic epidermal necrolysis (TEN) is a rare life-threatening condition almost exclusively attributed to drugs. The main etiologic factors for TEN are sulphonamides, anticonvulsants, and antibiotics; however, there are no published reports of warfarin causing TEN. CASE PRESENTATION: We present the case of a 3-year-old patient who developed TEN while receiving treatment for Henoch-Schönlein purpura nephritis (HSPN). With multiple-drug therapy comprising prednisolone, mizoribine, dipyridamole, and warfarin, it is difficult to detect which drug is the causative agent...
July 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28673245/takotsubo-cardiomyopathy-complicated-with-apical-thrombus-formation-on-first-day-of-the-illness-a-case-report-and-literature-review
#7
H M M T B Herath, S P Pahalagamage, Laura C Lindsay, S Vinothan, Sampath Withanawasam, Vajira Senarathne, Milinda Withana
BACKGROUND: Takotsubo cardiomyopathy is characterized by transient systolic dysfunction of the apical and mid segments of the left ventricle in the absence of obstructive coronary artery disease. Intraventricular thrombus formation is a rare complication of Takotsubo cardiomyopathy and current data almost exclusively consists of isolated case reports and a few case series. Here we describe a case of Takotsubo cardiomyopathy with formation of an apical thrombus within 24 h of symptom onset, which has been reported in the literature only once previously, to the best of our knowledge...
July 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28647419/intracerebral-hemorrhagic-expansion-occurs-in-patients-using-non-vitamin-k-antagonist-oral-anticoagulants-comparable-with-patients-using-warfarin
#8
Kara R Melmed, Patrick Lyden, Norman Gellada, Asma Moheet
BACKGROUND: Non-vitamin K antagonist oral anticoagulant (NOAC) use has significantly reduced intracerebral hemorrhagic (ICH) risk compared with standard anticoagulant treatment. Hematoma expansion (HE) is a known predictor of mortality in warfarin-associated ICH. Little is known about HE in patients using NOACs. METHODS: We conducted a retrospective chart review of patients with ICH admitted to Cedars-Sinai Medical Center from October 2010 to June 2016. We identified patients with concomitant administration of an oral anticoagulant and collected data including evidence of HE on imaging and modified Rankin Scale (mRS) at discharge...
August 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28646078/stereospecific-metabolism-of-r-and-s-warfarin-by-human-hepatic-cytosolic-reductases
#9
Dustyn A Barnette, Bryce P Johnson, Dakota L Pouncey, Robert Nshimiyimana, Linda P Desrochers, Thomas E Goodwin, Grover P Miller
Coumadin (rac-warfarin) is the most commonly used anticoagulant in the world; however, its clinical use is often challenging because of its narrow therapeutic range and interindividual variations in response. A critical contributor to the uncertainty is variability in warfarin metabolism, which includes mostly oxidative but also reductive pathways. Reduction of each warfarin enantiomer yields two warfarin alcohol isomers, and the corresponding four alcohols retain varying levels of anticoagulant activity. Studies on the kinetics of warfarin reduction have often lacked resolution of parent-drug enantiomers and have suffered from coelution of pairs of alcohol metabolites; thus, those studies have not established the importance of individual stereospecific reductive pathways...
September 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28592234/design-and-rationale-for-the-warfa-trial-a-randomized-controlled-cross-over-trial-testing-the-therapeutic-equivalence-of-branded-and-generic-warfarin-in-atrial-fibrillation-patients-in-brazil
#10
Carolina Gomes Freitas, Michael Walsh, Álvaro Nagib Atallah
BACKGROUND: Warfarin is a commonly used anticoagulant. Whether a given dose of the different formulations of Brazilian warfarin will result in the same effect on the international normalized ratio (INR) is uncertain. The aim of the WARFA trial is to determine whether the branded and two generic warfarins available in Brazil differ in their effect on the INR. METHODS: WARFA is a cross-over RCT comparing three warfarins. The formulations tested are the branded Marevan® (Uniao Quimica/Farmoquimica) and two generic warfarin (manufactured respectively by Uniao Quimica Farmaceutica Nacional and Laboratorio Teuto Brasileiro)...
June 7, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28567968/sudden-death-by-spontaneous-epiglottic-hematoma-secondary-to-high-blood-levels-of-warfarin
#11
Séverine Gilard-Pioc, Pascal Guerard, François Paraf, Irène François-Purssell
A 67-year-old man was found dead, at his home. On external examination, we found a voluminous purplish black ecchymosis of the anterior neck area. On internal examination, we found a voluminous epiglottis hematoma completely obstructing the upper airway. It was associated with other sites of intra-abdominal hemorrhage. Toxicological studies revealed the presence of warfarin at a concentration of 8.4 mg/L in peripheral blood, which supposes an INR well above 4.5. To conclude, we supposed death was due to asphyxia secondary to a spontaneous epiglottic hematoma caused by a high blood concentration of warfarin...
June 1, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28538931/cross-cultural-adaptation-of-the-oral-anticoagulation-knowledge-test-to-the-brazilian-portuguese
#12
Marcus Fernando da Silva Praxedes, Mauro Henrique Nogueira Guimarães Abreu, Daniel Dias Ribeiro, Milena Soriano Marcolino, Saul Martins de Paiva, Maria Auxiliadora Parreiras Martins
Patients' knowledge about oral anticoagulant therapy may favor the achievement of therapeutic results and the prevention of adverse pharmacotherapy-related events. Brazil lacks validated instruments for assessing the patient's knowledge about treatment with warfarin. This study aimed to perform the cross-cultural adaptation of the Oral Anticoagulation Knowledge (OAK) Test instrument from English into Portuguese. This is a methodological study developed in an anticoagulation clinic of a public university hospital...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#13
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban or enoxaparin...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#14
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28459661/predictors-of-direct-oral-anticoagulants-utilization-for-thromboembolism-prevention-in-atrial-fibrillation
#15
Caroline Brais, Josiane Larochelle, Marie-Hélène Turgeon, Lucie Blais, Paul Farand, Sylvie Perreault, Geneviève Letemplier, Marie-France Beauchesne
PURPOSE: Several factors have been associated with the prescription of direct oral anticoagulants (DOAC) over warfarin such as younger age, fewer concomitant medications, and lower CHADS2 or bleeding scores. The primary objective of this study was to identify predictors of DOAC choice compared with warfarin for patients who are starting a new oral anticoagulant (OAC) for atrial fibrillation (AF). The secondary objective was to describe the proportion of DOAC prescriptions in new users of OAC for AF...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28443575/the-time-in-therapeutic-range-and-bleeding-complications-of-warfarin-in-different-geographic-regions-of-turkey-a-subgroup-analysis-of-warfarin-tr-study
#16
Salih Kılıç, Ahmet Çelik, Hüseyin Altuğ Çakmak, Abdülmecit Afşin, Ahmet İlker Tekkeşin, Gönül Açıksarı, Mehmet Erdem Memetoğlu, Fatma Özpamuk Karadeniz, Ekrem Şahan, Mehmet Hayri Alıcı, Yüksel Dereli, Ümit Yaşar Sinan, Mehdi Zoghi
BACKGROUND: The time in therapeutic range values may vary between different geographical regions of Turkey in patients VKAs therapy. AIMS: The aim of this study is to evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in Turkish population) in Turkey...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and%C3%A2-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation%C3%A2-in%C3%A2-asia
#17
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review reported great variability in the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiologic studies on AF have been increasingly reported from Asia. METHODS: The goal of this updated systematic review was to present the current knowledge base of AF epidemiology in Asian countries since our previous review. We also explored AF incidence and the risk of stroke in AF by using a meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28411903/left-atrial-appendage-closure-device-in-atrial-fibrillation
#18
REVIEW
Michael C Giudici, Prashant D Bhave
The relationship of stroke and atrial fibrillation seems to become more complex as we gain more knowledge of the issue. Recent studies have questioned the temporal relationship between the two, which also questions causation. Left atrial appendage closure is an attractive, but unproven technology when compared with the 50-year experience with warfarin. In a patient who is on warfarin and having no issues with bleeding, medication intolerance, or lack of efficacy, it is difficult to justify stopping the drug and placing a closure device as sole therapy to prevent a stroke...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28406631/origin-of-remarkably-different-acidity-of-hydroxycoumarins-joint-experimental-and-theoretical-studies
#19
Paweł Mateusz Nowak, Filip Sagan, Mariusz Paweł Mitoraj
In the present work the origin of highly varied acidity of hydroxycoumarins (pKa values) has been for the first time investigated by joint experimental and computational studies. The structurally simple regio-isomers differing in the location of hydroxyl group, 3-hydroxycoumarin (3-HC), 4-hydroxycoumarin (4-HC), 6-hydroxycoumarin (6-HC), 7-hydroxycoumarin (7-HC), as well as 4,7-dihydroxycoumarin (4,7-HC) and the larger 4-hydroxycoumarin-based derivatives: warfarin (WAR), 7-hydroxywarfarin (W7), coumatetralyl (CT), and 10-hydroxywarfarin (W10), have been compared in terms of enthalpy-entropy relationships accounting for the observed pKa values...
May 4, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28353604/a-case-report-of-pvod-patient-combined-with-pulmonary-embolism-anticoagulation-or-not
#20
Xiaoling Yuan, Xianghe Hou, Weihong Guo, Haiming Jiang, Junmeng Zheng, Stuti Paudyal, Yanhua Lyu
RATIONALE: Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary arterial hypertension (PAH). Oral anticoagulation is confined to patients with idiopathic PAH (IPAH), but no oral anticoagulation has been recommended for PVOD, because occult pulmonary hemorrhage was a common finding in PVOD. PATIENT CONCERNS: We report a case of PVOD, who was misdiagnosed as IPAH for 5 years with worsening dyspnea and two episodes of pulmonary embolism (PE). DIAGNOSES: He was confirmed as PVOD combined with PE by biopsy of the explanted lung specimen...
March 2017: Medicine (Baltimore)
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