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https://www.readbyqxmd.com/read/29218901/using-simulation-and-optimization-approach-to-improve-outcome-through-warfarin-precision-treatment
#1
Chih-Lin Chi, Lu He, Kourosh Ravvaz, John Weissert, Peter J Tonellato
We apply a treatment simulation and optimization approach to develop decision support guidance for warfarin precision treatment plans. Simulation include the use of ∼1,500,000 clinical avatars (simulated patients) generated by an integrated data-driven and domain-knowledge based Bayesian Network Modeling approach. Subsequently, we simulate 30-day individual patient response to warfarin treatment of five clinical and genetic treatment plans followed by both individual and subpopulation based optimization. Sub-population optimization (compared to individual optimization) provides a cost effective and realistic means of implementation of a precision-driven treatment plan in practical settings...
2018: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/29196903/concurrent-use-of-prescription-drugs-and-herbal-medicinal-products-in-older-adults-a-systematic-review
#2
REVIEW
Taofikat B Agbabiaka, Barbara Wider, Leala K Watson, Claire Goodman
BACKGROUND: The use of herbal medicinal products (HMPs) is common among older adults; however, little is known about concurrent use with prescription drugs, as well as potential interactions associated with such combinations. OBJECTIVE: The aim of this systematic review was to identify and evaluate the literature on concurrent prescription and HMP use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. METHODS: Systematic searches were conducted in the MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane databases from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults ≥ 65 years of age...
December 1, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29193545/identification-and-characterization-of-a-single-high-affinity-fatty-acid-binding-site-in-human-serum-albumin
#3
Stefan Petry, Lea Wenskowsky, Herman Schreuder, Volker Derdau, Hans Matter, Julia Volkmar, Till Opatz
A single high-affinity fatty acid binding site in the important human transport protein serum albumin (HSA) is identified and characterized using a NBD (7-nitrobenz-2-oxa-1,3-diazol-4-yl)-C12 fatty acid. This ligand exhibits a 1:1 binding stoichiometry in its HSA complex with high site-specificity. The complex dissociation constant is determined by titration experiments as well as radioactive equilibrium dialysis. Competition experiments with known HSA-binding drugs warfarin and ibuprofen confirm the new binding site to be different from Sudlow-sites I and II...
November 28, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/29192498/membrane-protein-structure-in-live-cells-methodology-for-studying-drug-interaction-by-mass-spectrometry-based-footprinting
#4
Guo-Min Shen, Shuang Li, Weidong Cui, Shixuan Liu, Yihu Yang, Michael L Gross, Weikai Li
Mass spectrometry (MS) based footprinting is an emerging approach to study protein structure. Because integral membrane proteins are difficult targets for conventional structural biology, we recently developed a MS footprinting method to probe membrane protein/drug interactions in live cells. This method can detect structural difference between apo and drug-bound states of membrane proteins, with the changes inferred from MS quantification of the cysteine modification pattern, generated by residue-specific chemical labeling...
December 1, 2017: Biochemistry
https://www.readbyqxmd.com/read/29191640/incidence-of-visible-haematuria-among-antithrombotic-agents-a-systematic-review-of-over-175-000-patients
#5
Nikita R Bhatt, Niall F Davis, William J Nolan, Robert J Flynn, T E D McDermott, Arun Z Thomas, Rustom P Manecksha
OBJECTIVE: To determine the probability of visible haematuria with antithrombotic agents and to evaluate association of urological etiology in antithrombotic-related haematuria METHODS: PRISMA guidelines were followed to conduct a systematic review using search engines PUBMED and SCOPUS with the terms "(haematuria) OR (haematuria) OR urinary bleeding)) AND ((anticoagulants) OR anticoagulation) OR noac) OR novel anticoagulants) OR antiplatelet) OR dabigatran) OR rivaroxaban) OR apixaban) OR warfarin) OR aspirin) OR heparin) OR dipyridamole)"...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29189976/validation-of-knowledge-and-adherence-assessment-tools-among-patients-on-warfarin-therapy-in-a-saudi-hospital-anticoagulant-clinic
#6
Sireen Abdul Rahim Shilbayeh, Wejdan Ali Almutairi, Sarah Ahmed Alyahya, Nouf Hayef Alshammari, Eiad Shaheen, Alya Adam
Background Although it can result in serious complications due to its narrow therapeutic index, warfarin is widely used in the treatment and prevention of thromboembolic disorders. However, patients' adherence and knowledge are determinants of therapeutic success. Objective We sought to validate instruments to provide a reliable means of identifying gaps in patient understanding and nonadherence to inform targeted pharmacists' interventions to improve these measures. Methods A cross-sectional survey was conducted...
November 30, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29179605/anticoagulant-use-in-atrial-fibrillation-and-risk-of-dementia-review-of-contemporary-knowledge
#7
Victoria Jacobs, Kevin G Graves, Thomas J Bunch
Atrial fibrillation (AF) is strongly associated with dementia, including idiopathic dementias such as Alzheimer's disease. The relative risk of dementia is highest in AF patients 70 years and younger, and the burden of exposure to arrhythmia appears to underlie part of the risk. Areas covered: Anticoagulation choices and approach influence dementia risk. In warfarin patients, inadequate time spent in therapeutic range is highly associated with the increased dementia risk long-term. This risk is further accentuated with frequent over anticoagulation in patients also receiving aspirin...
November 28, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29178968/cohort-specific-imputation-of-gene-expression-improves-prediction-of-warfarin-dose-for-african-americans
#8
Assaf Gottlieb, Roxana Daneshjou, Marianne DeGorter, Stephane Bourgeois, Peter J Svensson, Mia Wadelius, Panos Deloukas, Stephen B Montgomery, Russ B Altman
BACKGROUND: Genome-wide association studies are useful for discovering genotype-phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into "gene level" effects. METHODS: Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions...
November 24, 2017: Genome Medicine
https://www.readbyqxmd.com/read/29170877/oral-anticoagulant-dosing-administration-and-storage-a-cross-sectional-survey-of-canadian-health-care-providers
#9
Siavash Piran, Sam Schulman, Mohamed Panju, Menaka Pai
Direct oral anticoagulant (DOAC) use is increasing worldwide. However, if not taken or prescribed correctly, DOACs have serious side effects. It is crucial that healthcare providers (HCPs) offer patients accurate information and counselling around DOACs, to optimize safe and effective use. To assess knowledge around oral anticoagulant indication, dosing, storage, and administration, an electronic survey was distributed to HCPs across Canada from June to August 2017, with 18 questions on the practical use of oral anticoagulants...
November 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29120007/incidence-of-heterotopic-ossification-following-a-multimodal-pain-protocol-in-total-hip-arthroplasty-with-the-posterior-approach
#10
Peter B White, Prem N Ramkumar, Morteza Meftah, Narges Ghazi, Amar S Ranawat, Chitranjan S Ranawat
Heterotopic ossification (HO) is prevalent after total hip arthroplasty (THA). Oral nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 (COX-2) inhibitors have reduced the incidence of HO; however, to the authors' knowledge, no studies have reported the incidence and severity of HO with a pain protocol highlighted by celecoxib in the pre- and postoperative period with a posterolateral approach. Between October 2014 and October 2015, a retrospective study was conducted of 687 consecutive primary THAs with minimum 1-year follow-up performed between January 2009 and December 2013...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29095762/acquired-hemophilia-with-thrombosis-in-a-cancer-patient-an-unusual-presentation
#11
Senem Maral, Sule Mine Bakanay, Imdat Dilek
: Acquired hemophilia A (AHA) which presents with spontaneous severe intramuscular, mucosal and/or subcutaneous bleeding is a rare bleeding disorder. Even 50% of AHA patients are defined as idiopathic; 10% of cases are related with malignancy. Here, we present a case of AHA in a 43-year-old lady who was diagnosed with malignancy and venous thromboembolism on vena cava 2 years ago. To the best of our knowledge, this is the first report in literature presented with both acquired hemophilia and thrombosis associated with malignancy...
November 1, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29064182/anti-thrombotic-therapy-for-atrial-fibrillation-in-patients-with-chronic-kidney-disease-current-views
#12
REVIEW
Rugheed Ghadban, Greg Flaker, Natraj Katta, Martin A Alpert
Chronic kidney disease (CKD) occurs in approximately one-third of patients with non-valvular atrial fibrillation (AF). The presence of CKD, particularly advanced CKD, confers increased risk of both thromboembolism and major bleeding in this group of patients who are already at risk for ischemic stroke and systemic embolism and at risk of bleeding due to anticoagulation. Studies assessing the effect of warfarin on risk of ischemic stroke, systemic embolism, and major bleeding have produced disparate results, particularly in patients with advanced CKD including those treated with hemodialysis...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29030869/evaluation-of-the-predictive-performance-of-bleeding-risk-scores-in-patients-with-non-valvular-atrial-fibrillation-on-oral-anticoagulants
#13
S A Beshir, Z Aziz, L B Yap, K H Chee, Y L Lo
WHAT IS KNOWN AND OBJECTIVE: Bleeding risk scores (BRSs) aid in the assessment of oral anticoagulant-related bleeding risk in patients with atrial fibrillation. Ideally, the applicability of a BRS needs to be assessed, prior to its routine use in a population other than the original derivation cohort. Therefore, we evaluated the performance of 6 established BRSs to predict major or clinically relevant bleeding (CRB) events associated with the use of oral anticoagulant (OAC) among Malaysian patients...
October 13, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28888264/availability-of-patient-decision-aids-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#14
REVIEW
Elizabeth S O'Neill, Stuart W Grande, Ariel Sherman, Glyn Elwyn, Megan Coylewright
BACKGROUND: Atrial fibrillation is a common irregular heart rhythm that increases patients' risk of stroke. Aspirin, warfarin, direct oral anticoagulants, and an implantable device can reduce this risk. Given the availability of multiple comparable options, this decision depends on patient preferences and is appropriate for the use of decision aids and other efforts to promote shared decision making. The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28874930/prevalence-of-intracranial-hemorrhage-after-blunt-head-trauma-in-patients-on-pre-injury-dabigatran
#15
James A Chenoweth, M Austin Johnson, Laura Shook, Mark E Sutter, Daniel K Nishijima, James F Holmes
INTRODUCTION: Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The prevalence of intracranial hemorrhage after blunt head trauma in patients on dabigatran is currently unknown, complicating adequate ability to accurately compare the risks and benefits of dabigatran to alternative anticoagulants. We aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. METHODS: This is a retrospective observational study of adult patients on dabigatran who presented to a Level I trauma center and received cranial computed tomography (CT) following blunt head trauma...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28869793/the-relationship-between-knowledge-health-literacy-and-adherence-among-patients-taking-oral-anticoagulants-for-stroke-thromboprophylaxis-in-atrial-fibrillation
#16
Chanelle A Rolls, Kehinde O Obamiro, Leanne Chalmers, Luke R E Bereznicki
BACKGROUND: Patients' knowledge regarding their oral anticoagulant (OAC) treatment for stroke prevention in atrial fibrillation (AF), their level of medication adherence, and health literacy are known to affect treatment outcomes. However, contemporary data regarding the relationships between these variables are lacking. OBJECTIVE: To investigate the relationships between anticoagulant knowledge, health literacy, and self-reported adherence in patients taking warfarin and the directly acting oral anticoagulants...
September 4, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28815127/a-knowledge-based-system-for-intelligent-support-in-pharmacogenomics-evidence-assessment-ontology-driven-evidence-representation-and-retrieval
#17
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
#18
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
#19
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
#20
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...
November 2017: Trends in Cardiovascular Medicine
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