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Thrombin generation estimates the anticoagulation effect of direct oral anticoagulants with significant interindividual variability observed

Direct oral anticoagulants (DOACs) are increasingly being used, primarily due to their drug stability and patient convenience. Although these drugs have been evaluated to be well tolerated in numerous clinical trials, their impact on in-vivo anticoagulation effect, variability and therapeutic drug level remains unknown. Hence, we aim to study the effect and variability of DOACs on thrombin generation via the calibrated automated thrombogram. Anonymized coagulation specimens from outpatients on warfarin were collected. Pooled normal plasma samples were spiked with increasing concentrations of dabigatran, rivaroxaban and apixaban. Similarly, plasma samples with normal coagulation profiles were spiked with two concentrations each of dabigatran, rivaroxaban and apixaban. Thrombin generation via calibrated automated thrombogram was run using the above samples and compared with a dataset of normal controls. Increasing international normalized ratio was associated with a reduction of endogenous thrombin potential (ETP) and thrombin peak and increasing lag time. Factor Xa inhibitors produced a flattened thrombin generation curve with a reduction of thrombin peak and relative preservation of ETP. Direct thrombin inhibitors produced a reduction of both ETP and thrombin peak and increasing lag time. Seventy-one citrated plasma samples (26 dabigatran, 21 rivaroxaban and 24 apixaban) were evaluated. The two concentrations produced a reduction of thrombin generation parameters with signifi...
Source: Blood Coagulation and Fibrinolysis - Category: Hematology Tags: Original Articles Source Type: research

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You're reading What is a Tremor of Truth?, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles. My courage is faith—faith in the eternal resilience of me—that joy’ll come back, and hope and spontaneity. —F. Scott Fitzgerald At this writing, I can bench press 150 pounds. It wasn’t easy. I put everything I had into it. My personal trainer kept saying, “Let me see your tremor of truth.” Raising an eyebrow at her, I grunted and trembled and sweated before reaching the goal, but I got ther...
Source: PickTheBrain | Motivation and Self Improvement - Category: Consumer Health News Authors: Tags: featured self improvement writing tips creativity motivation pickthebrain tremor of truth Source Type: blogs
Source: American Journal of Hematology - Category: Hematology Authors: Tags: Correspondence Source Type: research
Publication date: 21 February 2018 Source:The Lancet, Volume 391, Supplement 1 Author(s): Akram M Abu Salah Background Antenatal care is an effective means of reducing risk for the mothers and fetuses during pregnancy. It is intended to prevent obstetric complications by improving the quality of antenatal care, hygiene, and knowledge about signs and symptoms of common medical problems during pregnancy. Low birthweight (<2·5 kg at birth) is an important factor affecting neonatal mortality and a predictor of health of the newborn child. The aim of this study was to assess the association between antenatal care pro...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionElagolix pharmacokinetics were not affected by patient demographics and were similar between healthy women and women with endometriosis.Clinical Trial Registration Numbers NCT01403038, NCT01620528, NCT01760954, NCT01931670, NCT02143713.
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
ConclusionsLMWH does not increase the risk of post‐procedural bleeding and does not affect survival of cirrhotic patients undergoing prophylactic EVL.This article is protected by copyright. All rights reserved.
Source: Liver International - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Authors: Salzmann M, Hoesel B, Haase M, Mussbacher M, Schrottmaier WC, Kral-Pointner JB, Finsterbusch M, Mazharian A, Assinger A, Schmid JA Abstract Transfusion of platelet concentrates represents an important treatment for various bleeding complications. However, the short half-life and frequent contaminations with bacteria restrict the availability of platelet concentrates and raise a clear demand for platelets generated ex vivo. Therefore, in vitro platelet generation from megakaryocytes represents an important research topic. A vital step for this process represents accurate analysis of thrombopoiesis and propl...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
CONCLUSIONS: EMR for NASDA is effective with a favorable long-term outcome. Local recurrences can be retreated endoscopically. A recall system, patient's compliance to endoscopic follow-up are mandatory to detect recurrences and their prompt treatment. PMID: 29458293 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Acquired Hemophilia A (AHA) is rare bleeding disorder caused by inhibitors (auto-antibodies) to factor VIIIA. (1,2) It is associated with severe bleeding. AHA clinical presentation is different from the inherited hemophilia that leads to misdiagnosis.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Tags: Case Report Source Type: research
[Guardian] A recent study has shown how substandard drug used to stop post partum haemorrhage (PPH) fuels maternal deaths in Nigeria. Earlier studies had identified PPH as the leading cause of maternal mortality across the country.
Source: AllAfrica News: Pregnancy and Childbirth - Category: OBGYN Source Type: news
This article aims to discuss the problem of AF in dialysis patients, summarise the current evidence around the use of oral anticoagulants for AF in ESRD and provide some practical suggestions on management of AF in the haemodialysis population.
Source: British Journal of Haematology - Category: Hematology Authors: Tags: Review Source Type: research
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