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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
#1
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/28424132/outcomes-of-recreational-activity-associated-trauma-in-elderly-persons-on-blood-thinning-medications
#2
Zachary M DeBoard, Jonathan Grotts, Lisa Ferrigno
With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28355459/laboratory-monitoring-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-review
#3
John W Eikelboom, Daniel J Quinlan, Jack Hirsh, Stuart J Connolly, Jeffrey I Weitz
Importance: The non-vitamin K antagonist oral anticoagulants (NOACs) apixaban, dabigatran, edoxaban, and rivaroxaban are administered in fixed doses without anticoagulant monitoring. Randomized trials show that unmonitored NOAC therapy is at least as effective as and safer than dose-adjusted warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Subgroup analyses indicate that plasma drug levels or anticoagulant activity of the NOACs predict stroke and bleeding...
May 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28340451/the-role-of-drug-drug-interactions-in-prostate-cancer-treatment-focus-on-abiraterone-acetate-prednisone-and-enzalutamide
#4
REVIEW
Marzia Del Re, Stefano Fogli, Lisa Derosa, Francesco Massari, Paul De Souza, Stefania Crucitta, Sergio Bracarda, Daniele Santini, Romano Danesi
Elderly patients with cancer may have comorbidities, each requiring additional pharmacologic treatment. Therefore, the occurrence of pharmacokinetic (PK) and pharmacodynamic (PD) interactions is very likely, and the risk of adverse reactions (ADRs), due to the narrow therapeutic window of anticancer drugs, is increased. Drug-drug interactions (DDIs) may occur in prostate cancer patients due to inhibition by abiraterone of liver cytochrome P450 (CYP)-dependent enzymes CYP2C8 and 2D6, which are involved in the metabolism of approximately 25% of all drugs, and induction by enzalutamide of CYP3A4, 2C9 and 2C19, which metabolize up to 50% of medications...
April 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28074382/engaging-hmong-adults-in-genomic%C3%A2-and%C3%A2-pharmacogenomic-research-toward-reducing-health-disparities-in-genomic-knowledge-using-a-community-based-participatory-research-approach
#5
Kathleen A Culhane-Pera, Robert J Straka, MaiKia Moua, Youssef Roman, Pachia Vue, Kang Xiaaj, May Xia Lo, Mai Lor
Advancing precision medicine relies in part on examining populations that may exhibit unique genetic variants that impact clinical outcomes. Failure to include diverse populations in genomic-based research represents a health disparity. We implemented a community-based participatory research (CBPR) process with the Hmong community in Minnesota, who were refugees from Laos, in order to assess the feasibility of conducting genomic and pharmacogenomic-based research for genetic variants that are relevant to the Hmong community...
April 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/27001354/a-tailored-treatment-strategy-a-modern-approach-for-stroke-prevention-in-patients-with-atrial-fibrillation
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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