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Total 134 results found since Jan 2013.

Novel Oral Anticoagulants
Abstract: Warfarin has a proven record as an oral anticoagulant; almost every study, however, has found that it is not prescribed for 40–60% of patients who are eligible and should receive it, and of those who do receive it, serum warfarin levels only achieved a time in therapeutic range (TTR) equal to INR 2–3 about 55–60% of the time (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This means that only about 1 in 4 patients are adequately anticoagulated with warfarin, and thus there is a large unmet need for achieving better anticoagulation in these patients. Although...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: James A. Reiffel Tags: CME multimedia activities Source Type: research

AFib in Special Populations
Abstract: For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This review addresses the clinical characteristics of each of these presentations in order. For all patients with AFib, of either gender or any age, the greatest risk is failure to prescrib...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: William J. French Tags: CME multimedia activities Source Type: research

NICE: 'schools should provide morning-after pill'
Conclusion Everyone makes mistakes, but if you find yourself relying on the morning-after pill as a regular method of contraception, you may want to speak to a healthcare professional about what would be the most suitable form of ongoing contraception for you to use. This could include methods that do not involve needing to take a daily pill, such as contraceptive patches, injections or an implant. However, none of these methods will protect you against sexually transmitted infections (STIs). Condoms are cheap, free of side effects and they will protect you against STIs such as chlamydia. For more information about your ...
Source: NHS News Feed - March 26, 2014 Category: Consumer Health News Tags: QA articles Pregnancy/child Source Type: news

Oral Anticoagulant Therapy Is Associated with Cerebral Microbleeds (I2-2.001)
Conclusions: OAT relates to both prevalent and incident microbleeds. Furthermore, maximum INR values and variability in INR are risk factors for microbleeds, particularly deep or infratentorial microbleeds.Study Supported by: Erasmus Medical Center;Research Institute for Diseases in the Elderly;Ministry of Education, Health,Welfare and Sports.Disclosure: Dr. Akoudad has nothing to disclose. Dr. Darweesh has nothing to disclose. Dr. Leening has nothing to disclose. Dr. Koudstaal has nothing to disclose. Dr. Hofman has received personal compensation in an editorial capacity for the European Journal of Epidemiology. Dr. Van D...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Akoudad, S., Darweesh, S., Leening, M., Koudstaal, P., Hofman, A., Van Der Lugt, A., Stricker, B., Ikram, M., Vernooij, M. Tags: New Antithrombotic Agents for Stroke Prevention Data Blitz Presentations Source Type: research

Intermittent pneumatic compression is effective in reducing venous thromboembolism risk in hospitalised patients
Commentary on: Ho KM, Tan JA. Stratified meta-analysis of intermittent pneumatic compression of the lower limbs to prevent venous thromboembolism in hospitalized patients. Circulation 2013;128:1003–20. Context The Center for Disease Control and Prevention reports incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in 1–2 patients/1000/year. A total of 60–100 000 patients in the USA die of DVT or PE annually, with 10–30% expiring within 1 month of diagnosis. Recurrence rates of DVT/PE are as high as 33% within 10 years.1 Increased incidence of DVT and PE has been report...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Pascarella, L. Tags: EBM Prognosis, Medical education, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Venous thromboembolism, Pulmonary embolism, Medical humanities Prevention Source Type: research

Aspirin risks in perspective: A comparison against marathon running
Aspirin has public health potential to reduce the risk of ischaemic vascular events and sporadic cancer. One objection to the wider use of aspirin for primary prevention, however, is the undesirable effects of the medicine, which include increasing risk of bleeding and haemorrhagic stroke. Marathons also carry risks of serious events such as cardiac arrests and sudden death. Based on epidemiological estimates, a person running a marathon might be 20 to 100 times more likely to end up in hospital than a person who is taking an aspirin tablet. Yet the cumulative risk of daily aspirin use for primary prophylaxis may be import...
Source: Health Education Journal - June 10, 2014 Category: Health Management Authors: Morgan, G. Tags: Short Report Source Type: research

Appropriateness of Prescribing Dabigatran Etexilate and Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation: A Prospective Study.
CONCLUSIONS:: Inappropriate use of DE and rivaroxaban in patients with NVAF is frequent and possibly leads to AEs. Reinforcing education of health care professionals and patients is needed. Collaboration with clinical pharmacists can contribute to better use. PMID: 24982310 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - June 30, 2014 Category: Drugs & Pharmacology Authors: Larock AS, Mullier F, Sennesael AL, Douxfils J, Devalet B, Chatelain C, Dogné JM, Spinewine A Tags: Ann Pharmacother Source Type: research

Who might benefit from early aspirin after coronary artery surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been show...
Source: Interactive CardioVascular and Thoracic Surgery - August 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Gukop, P., Gutman, N., Bilkhu, R., Karapanagiotidis, G. T. Tags: Cardiac - physiology, Education, Congestive Heart Failure, Molecular biology Adult Cardiac Source Type: research

Reversing targeted oral anticoagulants.
Authors: Hoffman M, Monroe DM Abstract Dabigatran, rivaroxaban, and apixaban are orally active anticoagulants that are approved in many countries. Dabigatran inhibits thrombin, whereas rivaroxaban and apixaban are factor Xa inhibitors. In clinical trials, these novel oral anticoagulants were at least as effective as warfarin for preventing stroke in patients with atrial fibrillation, but with a lower rate of serious bleeding. However, the lack of true antidotes for these agents has caused concern when patients suffer life-threatening bleeding or trauma or require emergent invasive procedures. True antidotes are und...
Source: Hematology ASH Education Program - February 20, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Monitoring target-specific oral anticoagulants.
Authors: Konkle BA Abstract Target-specific oral anticoagulants are approved for use for the prevention of stroke in atrial fibrillation and for the prevention and treatment of venous thrombosis without the need for laboratory monitoring. However, there are clinical settings in which laboratory measurement of anticoagulant effect is needed. These may include patients with life-threatening bleeding or those requiring emergency surgery, in the setting of renal or hepatic failure, or patients with thrombosis on therapy. This chapter reviews the use of laboratory testing to assess the anticoagulant effect of these drug...
Source: Hematology ASH Education Program - February 20, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Future prospects for contact factors as therapeutic targets.
Authors: Gailani D Abstract Anticoagulants currently used in clinical practice to treat or prevent thromboembolic disease are effective, but place patients at increased risk for serious bleeding because they interfere with plasma enzymes (thrombin and factor Xa) that are essential for hemostasis. In the past 10 years, work with genetically altered mice and studies in baboons and rabbits have demonstrated that the plasma contact proteases factor XI, factor XII, and prekallikrein contribute to the formation of occlusive thrombi despite having limited roles in hemostasis. In the case of factor XI, epidemiologic data f...
Source: Hematology ASH Education Program - February 20, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research

Vicky's Story
My older sister, Vicky, never listened to authority. One of my earliest childhood memories was around age four, seeing my Mom whip Vicky with a long tree twig to the point she was bleeding. My mother, a frustrated widow raising five girls on meager Social Security benefits in rural southeast Missouri used the only form of discipline she knew -- corporal punishment. As Vicky's 10-year-old old legs, back, and buttocks became covered in red dotted lines, she never cried or moaned. Instead she looked straight ahead, stone-faced. Mom perceived her look as defiance and gave her more lashings than she should have that day. Event...
Source: Healthy Living - The Huffington Post - July 31, 2015 Category: Consumer Health News Source Type: news

Mechanical circulatory support: balancing bleeding and clotting in high-risk patients.
Authors: Baumann Kreuziger L, Massicotte MP Abstract Mechanical circulatory support (MCS) provides a bridge to heart transplant in children and adults with life-threatening heart failure and sustains patients ineligible for transplant. Extracorporeal membrane oxygenation (ECMO) provides temporary support for patients in cardiac or pulmonary failure through external gas exchange and continuous flow of blood. Because the median time to heart transplant exceeds event-free time on ECMO, pulsatile left ventricular assist devices (LVADs) are used to support infants and children. Continuous flow LVADs are preferred in ado...
Source: Hematology ASH Education Program - December 10, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Summary: International Kidney Cancer Symposium
Conclusions:  Ideal ischemia time is 20-25 minutes or less improves short and long term renal function.  >25 minutes carried 5 year risk of new onset stage 4 CKD No differences on GFR for cold vs. warm ischemia times Preoperative GFR and the percent of kidney preserved was a better predictor of post op GFR.  No ischemia preserves renal function better than warm. Longer cold ischemia times were equivalent to shorter warm ischemia times. Quality and quantity of the remaining kidney is associated with ultimate renal function. Robotics in RCC Surgery Gennady Bratslavsky, MD The...
Source: Kidney Cancer Association - December 15, 2011 Category: Urology & Nephrology Source Type: news