Reversing the effects of the new anti-clotting drugs

The oral anticoagulant warfarin (Coumadin) became available for prescription in 1954. This anti-clotting drug commanded national attention when President Dwight Eisenhower received the drug as part of his treatment following a heart attack. No other oral anticoagulant was successfully developed and marketed in the United States until 2010. Warfarin is a dangerous drug. Along with insulin, it is responsible for the most emergency hospitalizations due to adverse drug reactions. Whereas insulin causes low blood sugar, warfarin is notorious for the complication of major bleeding. Warfarin is plagued by hundreds of drug-drug and drug-food interactions. The optimal dose is determined by monitoring the level of anticoagulant in the blood. Standard-intensity anticoagulation with warfarin is usually targeted to achieve prothrombin blood test results, expressed as international normalized ratio (INR), within a range of 2.0 to 3.0. If the INR is greater than 3.0, the warfarin dose is decreased to prevent excessive bleeding. If the INR is lower than 2.0, the warfarin dose is increased to prevent excessive blood clotting. This approach is slow, cumbersome, and frustrating. Even when the INR tests within the desired range, catastrophic bleeding complications, such as bleeding into the brain, can still occur. Patients and health care providers complain about the difficulties and inconveniences of trying to use warfarin properly. Multiple algorithms and even genetic testing have been underta...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke anti-clotting coumadin deep-vein-thrombosis DVT Source Type: news

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Authors: Atzema CL, Jackevicius CA, Chong A, Dorian P, Ivers NM, Parkash R, Austin PC Abstract BACKGROUND: Patients with atrial fibrillation frequently seek emergency care. Rates of guideline-concordant oral anticoagulant therapy for stroke prevention are suboptimal in the community. We assessed the association between prescribing of oral anticoagulants in the emergency department (relative to referral to a longitudinal care provider for treatment initiation) and long-term use of oral anticoagulants. METHODS: This retrospective cohort study performed at 15 hospitals in Ontario, Canada, involved patients aged 65...
Source: Canadian Medical Association Journal - Category: General Medicine Tags: CMAJ Source Type: research
In this study, the effects of the addition of various polysaccharides (konjac gum, gellan gum, and curdlan gum) on the rheological and textural properties of calcium sulfate-induced soy protein isolate gels were investigated. The incorporation of konjac gum and curdlan gum at 0.3 and 0.5% (w/v) concentrations and gellan gum at 0.5% concentration significantly enhanced (P 
Source: Food Chemistry - Category: Food Science Source Type: research
In this study, we investigated the effect of WDL on lytic human cytomegalovirus (HCMV) infection. We demonstrate a strong interference with HCMV replication as analyzed in multi-round replication settings. A more detailed analysis of the underlying mechanisms revealed that WDL acts at two distinct steps of the viral replication cycle. During immediate early (IE) times, we observe an inhibition of IE1/IE2 expression. Although WDL was reported to interfere with NF-κB signaling our results suggest the existence of additional mechanisms that impede viral IE expression. During later time points of infection, WDL induced a...
Source: Antiviral Therapy - Category: Virology Source Type: research
Authors: von Stumm M, Petersen J, Westermann D, Reichenspurner H, Girdauskas E Abstract Introduction: Mixed aortic valve disease (MAVD) is defined by simultaneously occurrence of aortic stenosis (AS) and aortic regurgitation (AR). In our review, we focus on treatment options for nonelderly MAVD patients (age
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
Diagnostic accuracy of troponin T measured ≥6h after symptom onset for ruling out myocardial infarction. Scand Cardiovasc J. 2019 Dec 09;:1-9 Authors: Khoshnood A, Erlandsson M, Isma N, Yndigegn T, Mokhtari A Abstract Objectives: Guidelines recommend a single high-sensitivity cardiac troponin T (hs-cTnT) ≤14 ng/L measured ≥6 h after chest pain onset combined with a GRACE score
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
Publication date: Available online 11 December 2019Source: Results in PhysicsAuthor(s): Biao Zheng, Cheng Zhang, Chunlei Huang, Jinquan Hong, Yuliang Li, Jun Wang, Lin Lin, Zhiqiang ZhengAbstractMultifunctional NiO@Gd2O3:Er3+,Yb3+ hollow nanocomposites (NCs) with mesoporous, upconversion (UC) luminescent and magnetic properties are synthesized by a facile hydrothermal process. Transmission electron microscope (TEM) and scanning electron microscope (SEM) images reveal that the samples have hollow structures with double shells of UC layer and magnetic layer. N2 adsorption/ desorption isotherm analysis shows the samples have ...
Source: Results in Physics - Category: Physics Source Type: research
Publication date: Available online 6 December 2019Source: Radiation Physics and ChemistryAuthor(s): Bo Gao, Brecht Laforce, Jelle Dhaene, Laszlo Vincze, Luc Van Hoorebeke, Matthieu N. BooneAbstractX-ray Fluorescence Computed Tomography (XFCT) is an emerging imaging technique that provides elemental distribution in objects non-invasively. To predict and optimize the experimental outcome of XFCT, data generated by Monte Carlo (MC) simulation is usually used. However, MC codes typically require extended computing times to generate sufficient data. In this paper, we report an XFCT simulation method based on analytical computat...
Source: Radiation Physics and Chemistry - Category: Physics Source Type: research
Publication date: Available online 10 December 2019Source: Journal of Physics and Chemistry of SolidsAuthor(s): İbrahim Yılmaz, Ali Gelir, Onder Yargi, Utkan Sahinturk, Oguz Kaan OzdemirAbstractElectrochemical properties of porous nickel (Ni) foam, electrodeposited zinc (Zn) on Ni foam (Ni–Zn) and electrodeposited reduced graphene oxide (rGO) on Ni–Zn foam electrodes (Ni–Zn-rGO) in 6 M KOH electrolyte were investigated. Cyclic voltammetry (CV) and galvanostatic charge–discharge cycling (GCD) techniques were used to carry out the redox interactions, and cycling capacitive properties of the electr...
Source: Journal of Physics and Chemistry of Solids - Category: Physics Source Type: research
In this study, AA loading PEGylated nanostructured lipid carriers (P-AA-NLC) were prepared. P-AA-NLC were characterized for particle size distribution, polydispersity index, entrapment efficiency, X-ray powder diffraction pattern (XRD), differential scanning colorimeter (DSC) and transmission electron microscopy (TEM). The intestinal absorption, in vivo distribution, pharmacokinetics and anti-fibrosis effects of P-AA-NLC were studied compared with that of AA-NLC. In situ single-pass intestinal perfusion model shown that there are significant differences in absorption between the free and NLCs formulation. The Peff values o...
Source: Drug Development and Industrial Pharmacy - Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research
Conclusion: The results of this randomised controlled trial with assessment of blood pressure and same-day self-reports will provide patients a tool to understand the interplay between blood pressure and lifestyle applicable to primary health care. The self-management support system may be of importance for improved adherence to treatment and persistence to treatment recommendations. PMID: 31814476 [PubMed - as supplied by publisher]
Source: Blood Pressure - Category: Hematology Tags: Blood Press Source Type: research
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