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Evaluation of the Safety of Uninterrupted Warfarin Anticoagulation With Tranexamic Acid in Total Joint Arthroplasty
CONCLUSION: Many factors must be considered when choosing perioperative thromboembolic prophylaxis for arthroplasty candidates with medical comorbidities requiring long-term anticoagulation. This study presents data indicating that it could be safe and effective to continue therapeutic warfarin while using prophylactic TXA. [Orthopedics. 202x;4x(x):xx-xx.].PMID:38466825 | DOI:10.3928/01477447-20240304-04 (Source: Orthopedics)
Source: Orthopedics - March 11, 2024 Category: Orthopaedics Authors: Michael G Johnston Matthew A Porter Kade E Eppich Celeste G Gray David F Scott Source Type: research

Inconclusive Findings in Non-Vitamin K Antagonist Oral Anticoagulants Study
To the Editor We read with interest the nationwide population-based cohort study with meta-analysis by Tsai et al. The study findings showed that patients who received non-vitamin K antagonist oral anticoagulants (NOACs) before a stroke, compared with those receiving warfarin and those without oral anticoagulant treatment (non-OAC), did not experience a higher risk of intracranial hemorrhage (ICH), major bleeding events, or mortality when treated with intravenous alteplase for acute ischemic stroke. In comparison with the active comparator (warfarin group), the odds ratios (ORs) were 0.88 (95% CI, 0.32-2.40) for ICH, 0.82 ...
Source: JAMA Internal Medicine - March 11, 2024 Category: Internal Medicine Source Type: research

Air pollution and serious bleeding events in high-risk older adults
CONCLUSIONS: Among older adults at high risk for cardiovascular and thromboembolic events, increasing PM2.5 exposure was significantly associated with increased risk of gastrointestinal bleeding, intracranial bleeding, and epistaxis. In addition, PM2.5 exposure and anticoagulant use may act together to increase risks of severe gastrointestinal and intracranial bleeding. Thus, clinicians may recommend that high-risk individuals limit their outdoor air pollution exposure during periods of increased PM2.5 concentrations. Our findings may inform environmental policies to protect the health of vulnerable populations.PMID:384606...
Source: Environmental Research - March 9, 2024 Category: Environmental Health Authors: Rindala Fayyad Kevin Josey Poonam Gandhi Melanie Rua Aayush Visaria Benjamin Bates Soko Setoguchi Rachel C Nethery Source Type: research

Association between gene polymorphisms and initial warfarin therapy in patients after heart valve surgery
CONCLUSION: The genotypes of CYP2C9, VKORC1, and GGCX were found to have a significant impact on INR variability during the initial phase of warfarin therapy. However, no significant association was observed between TTR and gene polymorphisms. These findings suggest that focusing on INR variability is crucial in clinical practice, and preoperative detection of gene polymorphisms should be considered to assist in the initiation of warfarin therapy.PMID:38457019 | DOI:10.1007/s43440-024-00575-8 (Source: Pharmacological Reports)
Source: Pharmacological Reports - March 8, 2024 Category: Drugs & Pharmacology Authors: Zhaohui Liu Fengming Luo Juan Zhao Weinan Chen Wei Gao Zhou Zhou Source Type: research

Challenging in pulmonary thromboembolism diagnosis in patients with disproportionate pulmonary hypertension and severe mitral stenosis: Report of two cases
This report presented two cases with disproportionate PH and severe MS who were scheduled for percutaneous mitral valvuloplasty (PMV). The pre-procedural echocardiography revealed systolic pulmonary artery pressure (sPAP) of 90 and 120 mmHg, mitral valve area of 0.80 and 0.55 cm2 by three-dimensional (3D) planimetry, and diastolic pressure gradient (DPG) of 13 and 18.8 mmHg, respectively. Furthermore, in the first patient, 3D transesophageal echocardiography (TEE) revealed multiple saddle-type organized thrombi in the proximal parts of the right and left pulmonary arteries, extending to the distal branches. In the ...
Source: Clinical Case Reports - March 8, 2024 Category: General Medicine Authors: Naser Khezerlouy ‐Aghdam, Mehrnoush Toufan Tabrizi, Kia Seyed Toutounchi, Amirreza Jabbaripour Sarmadian, Shahab Masoumi Tags: CASE REPORT Source Type: research

Skin erythematous migrant lesions consistent with histologically confirmed dermal arteriolar thrombosis connected to APS
We present a case of a woman with APS with both arterial and venous thrombotic involvement associated with an atypical dermatological manifestation histologically consistent with a pauci-inflammatory intermediate-deep dermal arteriolar platelet-mediated thrombosis that appeared despite anticoagulation with warfarin and responding to the addition of antiplatelet therapy.PMID:38444066 | DOI:10.1177/09612033241238270 (Source: Lupus)
Source: Lupus - March 6, 2024 Category: Rheumatology Authors: Silvia Suardi Jacopo Croce Chiara Colato Paola Chiara Rizzo Simonetta Friso Francesca Pizzolo Source Type: research

Safflower Yellow for injection enhances anti-coagulation of warfarin in rats: Implications in pharmacodynamics and pharmacokinetics
This study investigated whether Safflower Yellow for injection (SYI) would affect the anticoagulation of warfarin in rats.Wistar male rats were divided into six groups randomly and administered with SYI (9 mg/kg, intraperitoneal injection) in single-dose and steady-dose warfarin (0.2 mg/kg, oral gavage) respectively. The pharmacodynamic parameters of PT and APTT were measured by a coagulation analyzer. R/S-warfarin concentration was measured by UHPLC-MS/MS, and pharmacokinetic parameters calculated using DAS 2.0 software.The single-dose study demonstrated that SYI, alone or co-administered with warfarin, could significantl...
Source: Xenobiotica - March 6, 2024 Category: Research Authors: Yan Liu Jiahui Sun Chunjuan Yang Mengnan Qin Shiwei Xu Yue Zhao Gaofeng Liu Source Type: research

Nonuremic Calciphylaxis: A Rare and Unexpected Diagnosis of Necrotic Ulcers
We present a fatal case of nonuremic calciphylaxis with delayed and unexpected diagnosis despite early biopsy and testing. The patient presented with a 2-month history of painful ulceration to the left leg. Early biopsy was negative for calciphylaxis. Laboratory tests were negative for renal disease and autoimmune disorders. There was elevated parathyroid hormone (96 pg/mL) 3 months after initial presentation and documented cobalamin deficiency. The patient went on to develop wounds to both legs and her thighs. A second biopsy of a left thigh wound by means of the dermatology service revealed calciphylaxis. The purpose of ...
Source: Journal of the American Podiatric Medical Association - March 6, 2024 Category: Podiatry Authors: Beth B Richardson Marc A Stees Brandon R Gumbiner Source Type: research