The Burden Associated with Thrombocytopenia and Platelet Transfusions among Patients with Chronic Liver Disease.

The Burden Associated with Thrombocytopenia and Platelet Transfusions among Patients with Chronic Liver Disease. J Med Econ. 2019 Nov 28;:1 Authors: Elsaid MI, Rustgi VK, Loo N, Aggarwal K, Li-McLeod J, Niu X, Poordad F Abstract Background: Thrombocytopenia (TCP), a common complication of chronic liver disease (CLD), can cause uncontrolled bleeding during procedures. As such, CLD patients with TCP and platelet counts
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research

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Background: Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices.Objectives: We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic.Methods: We studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accuracy.Results: We...
Source: African Health Sciences - Category: African Health Source Type: research
Patients with chronic liver disease (CLD) have complex changes in their haemostatic system. These changes often include thrombocytopenia, low levels of coagulation factors and inhibitors, low levels of fibrinolytic proteins and elevated levels of endothelium-derived haemostatic proteins, including the platelet adhesive molecule von Willebrand factor. Patients often have prolongation of conventional coagulation tests (prothrombin time and associated international normalised ratio (PT/INR) and activated partial thromboplastin time [aPTT]), interpreted as indicating an increased risk of bleeding complications, particularly fr...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Editorial Source Type: research
AbstractLusutrombopag (Mulpleta®), an orally bioavailable, small molecule thrombopoietin receptor agonist, is approved for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure. In placebo-controlled phase  3 clinical trials, lusutrombopag significantly increased the proportion of patients who did not require a platelet transfusion prior to the procedure or rescue therapy for bleeding up to 7 days after the scheduled procedure. Lusutrombopag also significantly increased the proportion of patients wh o were responders (i.e. had a platelet count&...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
Authors: Xu H, Cai R Abstract Introduction: Thrombocytopenia is a common hematological abnormality in patients with chronic liver disease (CLD), occurring in 64%~84% of patients with cirrhosis or fibrosis. Due to the increased risk of bleeding, thrombocytopenia potentially affects management of CLD, such as surgery or liver biopsy. Avatrombopag is a new oral thrombopoietin (TPO) receptor agonist, activating TPO receptor and increasing megakaryocytic proliferation/differentiation and platelet production. Areas covered: This review summarizes the collected data concerning pharmacokinetics, clinical efficacy, safety a...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research
Authors: Brigo S, Mancuso E, Pellicano R Abstract The recent changes in terms of both epidemiology of chronic liver disease (CLD) and long-term survival of patients with CLD have had a great impact in the field of dentistry and oral and maxillofacial surgery. In this context, compared with the previous decades, today it is more probable to cure patients with CLD also at advanced stage (cirrhosis), that could remain asymptomatic for long, before the appearance of signs of decompensation. Hence, it is crucial to identify the patient with CLD and to define the stage of the latter. The main risks are the viral acquisit...
Source: Minerva Stomatologica - Category: Dentistry Tags: Minerva Stomatol Source Type: research
Conclusions: PSE is a safe and effective alternative in the management of pediatric PHTN in select populations. PSE may be a favorable alternative to splenectomy and portal systemic shunting because it preserves functional spleen mass and avoids postprocedure accelerated liver disease or encephalopathy.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
ConclusionThe modelling and simulation support lusutrombopag 3 mg once daily for 7  days without platelet monitoring.
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
ConclusionsThe addition of avatrombopag and lusutrombopag offers physicians an alternative to platelet transfusions in patients with CLD who have to undergo medical/dental procedures that could potentially put them at an increased risk of bleeding. There are several other drugs in the research pipeline at various stages of development, including a new class of monoclonal antibodies that can bind to and activate TPO-receptor agonists. The outlook for treatment choices for thrombocytopenia in patients with liver disease is promising.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Publication date: March 2019Source: Journal of Vascular and Interventional Radiology, Volume 30, Issue 3, SupplementAuthor(s): N. Reau, S. Saab, L. Allen, K. Aggarwal, M. Vredenburg, R. Kim
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Authors: Kellstein D, Fernandes L Abstract Consensus guidelines for treatment of dengue fever from the World Health Organization and US Centers for Disease Control recommend acetaminophen to manage pain and fever but contraindicate nonsteroidal anti-inflammatory agents (NSAIDs) because of potentially increased bleeding risk, with thrombocytopenia as a complication. Neither acetaminophen nor ibuprofen (the NSAID with lowest bleeding risk) have been evaluated for dengue treatment in randomized, controlled clinical trials. Epidemiologic and cohort studies and case series describing NSAID use in dengue generally point ...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
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