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https://www.readbyqxmd.com/read/29560388/enoxaparin-induced-skin-necrosis-at-injection-site-after-total-knee-arthroplasty
#1
Max Haffner, Nasser Heyrani, John P Meehan, Mauro Giordani
Enoxaparin is a widely used low-molecular-weight heparin for perioperative thromboembolic prophylaxis. Enoxaparin-induced skin necrosis in the setting of arthroplasty has been rarely reported in the literature with varying outcomes and management decisions. Our patient developed skin necrosis at his injection site and thrombocytopenia 10 days following left total knee arthroplasty surgery and after receiving subcutaneous Lovenox injections postoperatively. The patient was started on an alternative anticoagulation based on a high suspicion for heparin-induced thrombocytopenia and the wound was monitored without surgical debridement...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29519571/sclerotherapy-for-intramuscular-vascular-malformations-a-single-center-experience
#2
Federico Scorletti, Manish N Patel, Adrienne M Hammill, Kiersten W Ricci, Charles M Myer, Roshni Dasgupta
BACKGROUND: Vascular malformations isolated to skeletal muscles are rare and often debilitating due to pain and very challenging to treat. Multi-modal management options include compression garments, medical therapy, sclerotherapy, and surgical resection. METHODS: A retrospective review of patients who underwent sclerotherapy for intramuscular venous malformations (IVM) between 2008 and 2016 was performed. Demographics, indications, and clinical follow-up were analyzed...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29339133/antithrombin-iii-binding-site-analysis-of-low-molecular-weight-heparin-fractions
#3
Yin Chen, Jing Zhao, Yanlei Yu, Xinyue Liu, Lei Lin, Fuming Zhang, Robert J Linhardt
Low-molecular-weight heparins (LMWHs) are widely used as clinical anticoagulant drugs. LMWHs are heterogeneous and highly negatively charged glycans prepared by chemical or enzymatic depolymerization of unfractionated heparin. The detailed structural analysis of a LMWH is essential for the drug quality control. In this study, an LMWH, enoxaparin sodium (a generic version of Lovenox) was separated into different molecular weight fractions by a Superdex peptide column. The disaccharide compositions, 3-O-sulfo group-containing tetrasaccharides composition, and antithrombin III-binding affinity of the fractions from this LMWH were analyzed...
January 12, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28414674/a-clot-possibly-due-to-loss-of-tnf-%C3%AE-supression
#4
J Broussard, M Berlinger, D Lauret
INTRODUCTION: Inflammation and venous thrombosis enjoy a close Relationship. We present a patient who had multiple DVTs following the discontinuation of anti- TNF-α therapy. CASE: A 34 year old African American female with a history of multiple DVT's, miscarriages, and reported Crohn's disease presented with shortness of breath. In the Emergency Department, CTA showed bilateral pulmonary emboli. The patient had been off adalimumab for one year and reported abdominal pain with 6-7 non-bloody bowel movements daily...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28300869/e-selectin-inhibition-with-gmi-1271-decreases-venous-thrombosis-without-profoundly-affecting-tail-vein-bleeding-in-a-mouse-model
#5
Dorian L Culmer, Misha L Dunbar, Angela E Hawley, Suman Sood, Robert E Sigler, Peter K Henke, Thomas W Wakefield, John L Magnani, Daniel D Myers
Selectins, such as E-selectin (CD62E), function in venous thrombosis by binding and activating immune cells to initiate the coagulation cascade. GMI-1271 is a small molecule antagonist that inhibits E-selectin activity. Here we determine whether inhibition of E-selectin is sufficient to decrease acute venous thrombosis and associated inflammatory events in both prophylactic and treatment protocols without significantly affecting haemostasis. Male C57BL/6 mice underwent surgery for experimental thrombosis induction and were harvested at peak thrombus formation in our animal model, two days post induction...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28224913/parent-heparin-and-daughter-lmw-heparin-correlation-analysis-using-lc-ms-and-nmr
#6
Xinyue Liu, Kalib St Ange, Xiaohua Wang, Lei Lin, Fuming Zhang, Lianli Chi, Robert J Linhardt
Heparin is a structurally complex, polysaccharide anticoagulant derived from livestock, primarily porcine intestinal tissues. Low molecular weight (LMW) heparins are derived through the controlled partial depolymerization of heparin. Increased manufacturing and regulatory concerns have provided the motivation for the development of more sophisticated analytical methods for determining both their structure and pedigree. A strategy, for the comprehensive comparison of parent heparins and their LMW heparin daughters, is described that relies on the analysis of monosaccharide composition, disaccharide composition, and oligosaccharide composition...
April 8, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28147712/evaluation-of-the-anticoagulant-potential-of-polysaccharide-rich-fractions-extracted-from-macroalgae
#7
Amandine Adrien, Delphine Dufour, Stanislas Baudouin, Thierry Maugard, Nicolas Bridiau
The aim of this study was to evaluate the potential anticoagulant activity of sulphated polysaccharide-containing extracts of six french edible marine macroalgae. Aqueous extracts of brown (Himanthalia elongata, Laminaria digitata, Ascophyllum nodosum, Fucus vesiculosus), green (Ulva lactuca) and red (Chondrus crispus) macroalgae were prepared and their biochemical properties were determined, including major biomolecules, sulphate and ash contents. The anticoagulant activity of each extract was investigated using different scales from the specific antithrombin-dependent pathway (anti-Xa and anti-IIa) to the intrinsic and/or common (Activated Partial Thromboplastin Time, APTT), extrinsic (Prothrombin Time, PT) or common (Thrombin Time, TT) anticoagulant pathways, and compared with those of commercial anticoagulants, heparin and Lovenox®...
September 2017: Natural Product Research
https://www.readbyqxmd.com/read/28011077/top-down-and-bottom-up-analysis-of-commercial-enoxaparins
#8
Xinyue Liu, Kalib St Ange, Lei Lin, Fuming Zhang, Lianli Chi, Robert J Linhardt
A strategy for the comprehensive analysis of low molecular weight (LMW) heparins is described that relies on using an integrated top-down and bottom-up approach. Liquid chromatography-mass spectrometry, an essential component of this approach, is rapid, robust, and amenable to automated processing and interpretation. Nuclear magnetic resonance spectroscopy provides complementary top-down information on the chirality of the uronic acid residues comprising a low molecular weight heparin. Using our integrated approach four different low molecular weight heparins prepared from porcine heparin through chemical β-eliminative cleavage were comprehensively analyzed...
January 13, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/27965129/comparative-subcutaneous-repeated-toxicity-study-of-enoxaparin-products-in-rats
#9
COMPARATIVE STUDY
Zina Kobbi, Hazar Kraiem, Zakaria Benlasfar, Ammar Marouani, Taieb Massoud, Samir Boubaker, Balkiss Bouhaouala-Zahar, Nadia Fenina
Enoxaparin is a low-molecular-weight heparin widely used for the prevention and treatment of thromboembolism. With the development of several enoxaparin biosimilars, real medical concerns about their safety and efficacy have been raised. This repeated dose toxicity study consists of preclinical toxicological evaluation of a biosimilar biological version of enoxaparin, the drug product "Enoxa", compared to the enoxaparin reference drug product, "Lovenox". Eighty white Wistar rats were treated with "Enoxa" versus the reference product, using subcutaneous therapeutic and toxic doses, varying from 3...
March 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/27942011/glyccompsoft-software-for-automated-comparison-of-low-molecular-weight-heparins-using-top-down-lc-ms-data
#10
Xiaohua Wang, Xinyue Liu, Lingyun Li, Fuming Zhang, Min Hu, Fuji Ren, Lianli Chi, Robert J Linhardt
Low molecular weight heparins are complex polycomponent drugs that have recently become amenable to top-down analysis using liquid chromatography-mass spectrometry. Even using open source deconvolution software, DeconTools, and automatic structural assignment software, GlycReSoft, the comparison of two or more low molecular weight heparins is extremely time-consuming, taking about a week for an expert analyst and provides no guarantee of accuracy. Efficient data processing tools are required to improve analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27789095/deep-venous-thrombosis-prophylaxis-after-unicompartmental-knee-arthroplasty-a-prospective-study-on-the-safety-of-aspirin
#11
Tom Schmidt-Braekling, Andrew D Pearle, David J Mayman, Geoffrey H Westrich, Wenzel Waldstein, Friedrich Boettner
BACKGROUND: Although venous thromboembolism is one of the leading causes of morbidity after knee arthroplasty, little data exist on the risk of deep venous thrombosis (DVT) after unicompartmental knee arthroplasty (UKA). METHODS: We prospectively enrolled 112 patients undergoing UKA to determine the incidence of DVT utilizing aspirin 325 mg twice a day (BID) for 4 weeks postoperatively as DVT prophylaxis. The data were compared with a recent randomized controlled trial of patients undergoing total knee arthroplasty utilizing aspirin and Lovenox in conjunction with pneumatic compression devices...
March 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27624773/heparin-and-lovenox-what-the-oral-and-maxillofacial-surgeon-needs-to-know
#12
REVIEW
LisaMarie Di Pasquale, Elie M Ferneini
For the oral and maxillofacial surgeon, many patients will be on heparin products during surgery. So far, there is no standardized approach to treating anticoagulated patients during oral and maxillofacial surgical procedures. When a patient is on heparin therapy, heparin may be stopped 4 to 6 hours before surgery and resumed once hemostasis is achieved, usually within 24 hours. If low-molecular-weight heparin is administered, the treatment is generally stopped at least 12 hours before surgery and then resumed in a similar fashion...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27609724/omnious-t-wave-inversions-wellens-syndrome-revisited
#13
Swe Zin Mar Win Htut Oo, Koroush Khalighi, Archana Kodali, Cho May, Thein Tun Aung, Richard Snyder
Wellens' syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens' syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27554782/rate-of-transfusions-after-total-knee-arthroplasty-in-patients-receiving-lovenox-or-high-dose-aspirin
#14
Kara N Radzak, Jennifer J Wages, Kimberly E Hall, Cass K Nakasone
BACKGROUND: Controversy continues regarding the use of powerful anticoagulants for venous thromboembolism prophylaxis in patients undergoing total knee arthroplasty (TKA). To comply with institution-mandated guidelines and pressure from hospitalist intent on complying with conventionally recommended anticoagulation guidelines, we singularly changed our chemoprophylaxis practice from using aspirin to Lovenox and noted that transfusion rates increased substantially. METHODS: A retrospective case review was performed to evaluate transfusion requirement differences in primary TKA patients receiving Lovenox (unilateral TKA: n = 135, bilateral TKA: n = 44) or aspirin (unilateral TKA: n = 153, bilateral TKA: n = 45) for venous thromboembolism prophylaxis...
November 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27489392/a-case-of-may-thurner-syndrome
#15
Emilia Calvaresi, Mahesh Swaminathan, Janet Jokela
May-Thurner syndrome is the condition of the left common iliac vein being compressed between the right common iliac artery and the associated vertebral body. This condition has been linked to spontaneous episodes of deep vein thrombosis (DVT), especially in women aged 20-50, and it may contribute to the slightly higher tendency to develop left-sided (~56%) versus right-sided DVTs. A 50-year-old morbidly obese (BMI 42.7 kg/m(2)) female presented to the emergency room with acute left leg pain. Past medical history included asthma...
2016: Carle Selected Papers
https://www.readbyqxmd.com/read/27313435/a-pilot-study-comparing-hospital-readmission-rates-in-patients-receiving-rivaroxaban-or-enoxaparin-after-orthopedic-surgery
#16
Melissa A Herschman, Frank S Rigelsky, Sandra S Axtell
PURPOSE: A pilot study was conducted to determine whether rivaroxaban (Xarelto, Janssen Pharmaceuticals) resulted in a lower 30-day all-cause readmission rate compared with enoxaparin (Lovenox, Sanofi-Aventis) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a community hospital. METHODS: The study was a single-center, retrospective, chart-review investigation involving patients who underwent THA or TKA between May 2013 and May 2014. The study's primary endpoint was the 30-day all-cause readmission rate...
June 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/26713301/the-need-to-emphasize-nephrology-knowledge-in-residents-in-training
#17
Sana R Akbar, Hafiz I Iqbal, Umair Ahmed
BACKGROUND: Chronic kidney disease is an increasingly prevalent health problem with the potential for poor outcome of end-stage renal disease. Hospitalized critically ill patients are prone to acute renal injury from numerous factors such as poor renal perfusion secondary to ischemia and hypotension, nephrotoxin exposure, and intravenous contrast exposure. AIMS: We set to explore resident awareness and knowledge about chronic kidney disease management, timely nephrology referrals, preventing inadvertent acute kidney injury (AKI), and the understanding of basic electrolyte physiology...
November 2015: North American Journal of Medical Sciences
https://www.readbyqxmd.com/read/26402133/focally-increased-mibg-activity-in-the-muscle-real-lesion-or-lovenox-injection-artifact
#18
Xia Bai, Hongming Zhuang
A 6-month-old female infant with known left adrenal neuroblastoma and liver metastasis underwent MIBG scan. The images not only revealed elevated activity in the abdomen, but also showed multiple foci of increased activity in the muscles of bilateral upper thighs, which corresponded to the injection sites of LOVENOX.
February 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/26270263/comparative-studies-on-biological-activity-of-generic-and-branded-enoxaparin-in-vivo-and-vitro
#19
Xiaoqing Tan, Huifei Cui
As per US Food and Drug Administration (FDA) requirement, the study was designed to conduct the fourth and fifth criteria of Abbreviated New Drug Application to demonstrate equivalence of generic and branded Enoxaparin in vivo and vitro.Pharmacodynamic behavior of branded and generic Enoxaparin was compared in a parallel study in rats based upon measurement of anti-FXa and anti-FIIa profiles. Blood samples collected at baseline and at 0.5, 1, 2, 4, 6, 8, 12 and 24 h postsubcutaneous administration of six batches of Lovenox and nine batches of generic Enoxaparin were evaluated for anti-FXa and anti-FIIa using chromogenic substrate method...
October 2015: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/26199895/lovenox-induced-tissue-necrosis-a-case-report-and-literature-review
#20
Abdelfatah Abou Issa, Richard Simman
Lovenox is a trade name for Enoxaparin. It is a low molecular weight heparin (LMWH) and has other trade names like Clexane and Xaparin. It is an anticoagulant used to prevent and treat venous thromboembolism events (VTE) like deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection. General speaking, the most common skin reactions as a result of enoxaparin use are: urticarial, ecchymosis, and even skin necrosis due to vasculitis. These side effects are usually located at the injection site...
December 2013: Journal of the American College of Clinical Wound Specialists
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