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Patients ’ Priorities for Oral Anticoagulation Therapy in Non-valvular Atrial Fibrillation: a Multi-criteria Decision Analysis
DiscussionAlthough the relative impact of convenience on therapy value is small, patients have different preferences for options within convenience criteria. Besides considerations on safety and effectiveness, physicians should also discuss attributes of convenience with patients, as it can be assumed that alignment to patient preferences in drug prescription and better patient education could result in higher adherence.
Source: American Journal of Cardiovascular Drugs - August 22, 2018 Category: Cardiology Source Type: research

The Canadian Community Utilization of Stroke Prevention Study in Atrial Fibrillation in the Emergency Department (C-CUSP ED)
ConclusionAn oral anticoagulation prescription tool was associated with an increase in new oral anticoagulation prescription in the ED, irrespective of whether an atrial fibrillation clinic follow-up was scheduled. The use of an atrial fibrillation clinic was associated with a trend to a higher rate of oral anticoagulation at 6-month follow-up.
Source: Annals of Emergency Medicine - October 27, 2018 Category: Emergency Medicine Source Type: research

Oxidative Modified Fibrinogen in Cardiovascular Diseases
ConclusionsThe results show that the degree of impairment of fibrinogen functions in the cardiovascular diseases is related to the level of oxidative stress. Characterization of oxidative fibrinogen modification and its precise meaning to the function of fibrinogen in hemostasis appears to be extremely helpful to better understanding of thrombotic/bleeding complications linked with various cardiovascular diseases.AcknowledgementsThis work was supported by the Ministry of Health, Czech Republic, no. 00023736, by the Academy of Sciences, Czech Republic no. P205/12/G118 and NV18-08-00149, by ERDF OPPK CZ.2.16/3.1.00/24001 and...
Source: Blood - November 21, 2018 Category: Hematology Authors: Štikarova, J., Suttnar, J., Sovova, Z., Ceznerova, E., Novak, J., Louzil, J., Kotlin, R., Roselova, P., Kaufmanova, J., Chrastinova, L., Hlavackova, A., Majek, P., Kucerka, O., Hajsl, M., Maly, M., Dyr, J. E. Tags: 321. Blood Coagulation and Fibrinolytic Factors Source Type: research

Adult and pediatric mechanical circulation: a guide for the hematologist.
Authors: Kreuziger LB, Massicotte MP Abstract Mechanical circulatory support (MCS) is the overarching term that encompasses the temporary and durable devices used in patients with severe heart failure. MCS disturbs the hematologic and coagulation system, leading to platelet activation, activation of the contact pathway of coagulation, and acquired von Willebrand syndrome. Ischemic stroke and major hemorrhage occur in up to 30% of patients. Hematologists are an essential part of the MCS team because they understand the delicate balance between bleeding and clotting and alteration of hemostasis with antithrombotic th...
Source: Hematology ASH Education Program - December 7, 2018 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Sex Difference of Radiation Response in Occupational and Accidental Exposure
Conclusion and Outlook This review summarizes the data from major human studies on the health risks of radiation exposure and shows that sex can potentially influence the prolonged response to radiation exposure (Figure 1 and Tables 1, 2). These data suggest that long-term radiosensitivity in females is higher than that in males who receive a comparable dose of radiation. Our analysis of the literature agrees with the conclusions of the recent report on the Biological effects of ionizing radiation (BEIR VII) published in 2006 by the National Academy of Sciences (NAS), United States (National Research Council, 2006). The B...
Source: Frontiers in Genetics - May 2, 2019 Category: Genetics & Stem Cells 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 opening question ...
Source: Kidney Cancer Association - December 15, 2011 Category: Urology & Nephrology Source Type: news

Mechanical Circulatory Support Driveline Infection Reduction through Nursing Quality Improvement
Infection in patients with left ventricular assist device is a leading cause of morbidity and mortality resulting in increased risk for additional complications such as bleeding, thrombosis and stroke. The purpose of this quality improvement project was to reduce driveline infections through implementation of an evidence-based bundled dressing kit and education to nursing staff.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Tania V. Randell, Tim Madeira, Noelle V. Pavlovic, Martha Abshire Tags: 335 Source Type: research

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial
Publication date: 24–30 August 2019Source: The Lancet, Volume 394, Issue 10199Author(s): Gholamreza Roshandel, Masoud Khoshnia, Hossein Poustchi, Karla Hemming, Farin Kamangar, Abdolsamad Gharavi, Mohammad Reza Ostovaneh, Alireza Nateghi, Masoud Majed, Behrooz Navabakhsh, Shahin Merat, Akram Pourshams, Mahdi Nalini, Fatemeh Malekzadeh, Masoumeh Sadeghi, Noushin Mohammadifard, Nizal Sarrafzadegan, Mohammad Naemi-Tabiei, Abdolreza Fazel, Paul BrennanSummaryBackgroundA fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income ...
Source: The Lancet - August 23, 2019 Category: General Medicine Source Type: research

Many take anticoagulants and OTC supplements, which poses risk
FINDINGSNearly 98% percent of people prescribed direct-acting oral anticoagulants such as apixaban also used  over-the-counter products. Of those, 33% took at least one such product that, in combination with the anticoagulants, could cause dangerous internal bleeding. People taking these medications largely lacked knowledge of some potentially serious interactions.BACKGROUNDDirect-acting oral anticoagulants are the drug of choice for stroke prevention in patients with atrial fibrillation, which occurs most frequently in older patients. Apixaban is one of the most frequently prescribed. However, most people prescribed apix...
Source: UCLA Newsroom: Health Sciences - October 31, 2019 Category: Universities & Medical Training Source Type: news

Is there a role for low-dose DOACs as prophylaxis?
Authors: Cohen AT, Hunt BJ Abstract The direct oral anticoagulants (DOACs) have transformed the management of thrombotic disorders. Large clinical trials have demonstrated that DOACs can replace vitamin K antagonists (VKAs) in the 2 existing major indications for anticoagulation: the prevention of stroke in atrial fibrillation and the acute treatment and secondary prevention of venous thromboembolism (VTE); this literature is widely known. In this article, we will concentrate on the less well-discussed benefits of the use of DOACs-using low doses as primary and secondary prophylaxis in both venous and arterial thro...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Bleeding in critical care associated with left ventricular assist devices: pathophysiology, symptoms, and management.
Authors: Leebeek FWG, Muslem R Abstract Chronic heart failure (HF) is a growing health problem, and it is associated with high morbidity and mortality. Left ventricular assist devices (LVADs) are nowadays an important treatment option for patients with end-stage HF not only as a bridging tool to heart transplantation but also, as a permanent therapy for end-stage HF (destination therapy). The use of LVAD is associated with a high risk for bleeding complications and thromboembolic events, including pump thrombosis and ischemic stroke. Bleeding is the most frequent complication, occurring in 30% to 60% of patients, b...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

The Hospital Zambrano Hellion venous thromboembolism rapid response team (PREVENTION-team): Improving pulmonary embolism and deep venous thrombosis patient care.
Abstract Background: Fast-track worldwide reperfusion programs improve outcomes in ST-elevation myocardial infarction and stroke. Similar programs called Program Evaluation and Review Technique (PERT) focus on submassive and massive pulmonary embolism (PE) excluding deep venous thrombosis (DVT). Methods: PREVENTION-team (Hospital Zambrano Hellion Venous Thromboembolism [VTE] Rapid Response). Primary objective: Fast-track stratification, diagnostics, and treatment (60-90 min) to improve proximal DVT and submassive and massive PE patients care. Secondary objectives: Increase diagnosis rate of low-risk...
Source: Archivos de Cardiologia de Mexico - February 1, 2020 Category: Cardiology Authors: Toro-Mijares RD, Jerjes-Sánchez C, Rodríguez D, Panneflek J, Vázquez-Guajardo M, Fabiani MA, Quintanilla J, Manautou L, Peña-Almaguer E, Cadena A, Cassagne G, Torre-Amione G Tags: Arch Cardiol Mex Source Type: research

Patient perspectives on left main stem revascularization strategies, the OPINION-2 study.
CONCLUSIONS: Overall, patients who are informed about risk and benefits of each treatment modality clearly favor PCI over CABG and particularly value lower short-term morbidity while being aware of higher risk of repeat revascularization. Lower educational level was associated with a higher prevalence of psychosomatic phenotypes and a 14% preference for CABG. Educational and psychosocial background matter in the revascularization strategy decision-making process. PMID: 33041162 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - October 8, 2020 Category: Cardiology Authors: Nuis RJ, Jadoon A, van Dalen BM, Dulfer K, Snelder SM, Yazdi MT, Masdjedi K, den Dekker WK, Diletti R, Wilschut J, Daemen J, Lenzen MJ, Zijlstra F, Smits PC, Van Mieghem NM Tags: J Cardiol Source Type: research

VAD 911: Process Improvement for First Responders Treating Ventricular Assist Device Patients
This study conducted an assessment of first responders generalized knowledge and self-reported competency regarding VAD use, provided an education course, and tested for improvement immediately after and 1 month postintervention. Two hundred thirty-six first responders participated from communities with known VAD patients. Responses indicated poor knowledge, experience, and competency. Twenty-one percent had seen a manufacturer training video, 26% had attended prior training, and 38% knew who to contact with a VAD emergency. Generalized knowledge of VAD therapy was poor with majority not understanding use of anticoagulatio...
Source: ASAIO Journal - November 1, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Association between use of amiodarone for non-valvular atrial fibrillation and patient survival: from the prospective China Atrial Fibrillation Registry.
CONCLUSIONS: Our study indicated that amiodarone use was not significantly associated with a lower risk of 1-year all-cause mortality compared with a non-AAD strategy in "real-world" patients with NVAF. PMID: 33273373 [PubMed - as supplied by publisher]
Source: Chinese Medical Journal - December 1, 2020 Category: General Medicine Authors: Hou XX, He L, Du X, Wang GH, Dong JZ, Ma CS Tags: Chin Med J (Engl) Source Type: research