• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Anticoagulation therapy among patients presenting to the emergency department with symptomatic atrial fibrillation – the FinFib2 study
Conclusion: These data showed that OAC was prescribed frequently to patients with symptomatic AF and risk factors for stroke. However, in patients using warfarin, international normalized ratio was not at the therapeutic level in a large proportion of the patients with previously diagnosed AF.
Source: European Journal of Emergency Medicine - August 30, 2017 Category: Emergency Medicine Tags: Original Articles Source Type: research

Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis
This study describes a cohort of patients with FXa inhibitor-associated life-threatening bleeding events, their clinical characteristics, interventions and outcomes.
Source: The American Journal of Emergency Medicine - August 19, 2017 Category: Emergency Medicine Authors: Truman J. Milling, Carol L. Clark, Charles Feronti, Shlee S. Song, Sam S. Torbati, Gregory J. Fermann, Jeffrey Weiss, Dony Patel Source Type: research

Is it reasonable to use a lower DOAC dose in some patients with VTE? NO
AbstractThe international guidelines recommend the use of direct oral anticoagulants (DOACs) over vitamin K antagonists for anticoagulation long-term therapy in patients diagnosed with venous thromboembolism (VTE), and for stroke prevention in patients with non-valvular atrial fibrillation (AF). Efficacy and safety of DOACS have been extensively evaluated in large phase III trials. According to the product label, dose reductions of DOACs are recommended for patients with AF and renal impairment, low body weight and concomitant use of interfering medications. Except for Edoxaban, dose reductions of DOACs are not recommended...
Source: Internal and Emergency Medicine - June 27, 2017 Category: Emergency Medicine Source Type: research

Systemic Thrombolysis, Catheter ‐Directed Thrombolysis and Anticoagulation for Intermediate‐Risk Pulmonary Embolism: A Simulation Modeling Analysis
ConclusionIn our model, for those eligible, CDT results in the largest number of QALYs for patients with intermediate‐risk PE, although it is relatively expensive and the absolute difference in QALYs between anticoagulation alone and CDT is small. Future studies that provide data on longitudinal quality‐of‐life outcomes of patients treated for PE and characteristics of CDT would be beneficial to augment model inputs, inform assumptions, and validate results.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 26, 2017 Category: Emergency Medicine Authors: Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur Tags: Original Contribution Source Type: research

Systemic Thrombolysis, Catheter-Directed Thrombolysis and Anticoagulation for Intermediate-Risk Pulmonary Embolism: A Simulation Modeling Analysis.
CONCLUSION: In our model, for those eligible, CDT results in the largest number of QALYs for patients with intermediate-risk PE, although it is relatively expensive and the absolute difference in QALYs between anticoagulation alone and CDT is small. Future studies that provide data on longitudinal quality-of-life outcomes of patients treated for PE and characteristics of CDT would be beneficial to augment model inputs, inform assumptions, and validate results. This article is protected by copyright. All rights reserved. PMID: 28650086 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - June 26, 2017 Category: Emergency Medicine Authors: Kabrhel C, Ali A, Choi J, Hur C Tags: Acad Emerg Med Source Type: research

Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients
AbstractDabigatran etexilate (DE) is a direct thrombin inhibitor, which has been approved for the treatment of non-valvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism (VTE). Despite large randomized clinical trials and independent observational studies providing robust data concerning DE safety and efficacy, some physicians still perceive mild-to-moderate renal impairment and old age as a relative contraindication to its use. In this article, we review the available scientific evidence supporting the use of DE in these clinical situations. Patients with AF and chronic kidney di...
Source: Internal and Emergency Medicine - April 24, 2017 Category: Emergency Medicine Source Type: research

CHA2DS2-VASc Scores and Major Bleeding in Patients With Nonvalvular Atrial Fibrillation Who Are Receiving Rivaroxaban
Conclusion Higher CHA2DS2-VASc scores are associated with increased incidence of major bleeding in nonvalvular atrial fibrillation patients receiving rivaroxaban.
Source: Annals of Emergency Medicine - April 23, 2017 Category: Emergency Medicine Source Type: research

Dabigatran: Important Considerations in the Elderly
We read, with keen interest, the report by Dezman et  al. regarding the severity of bleeding and mortality in trauma patients taking dabigatran (1). Stroke physicians frequently prescribe non-vitamin K antagonist oral anticoagulants (NOAC) like dabigatran for stroke prevention in the context of nonvalvular atrial fibrillation. Although the introducti on of NOAC into clinical practice has been a major advance with reduction of monitoring requirement, there remains ongoing concern about the risk of bleeding and the absence of an antidote.
Source: The Journal of Emergency Medicine - March 23, 2017 Category: Emergency Medicine Authors: Jatinder S. Minhas, Amit K. Mistri Tags: Letter to the Editor Source Type: research

Pre-hospital ct diagnosis of subarachnoid hemorrhage
Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent ass...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - February 28, 2017 Category: Emergency Medicine Authors: Maren Ranhoff Hov, Annette Ryen, Katrine Finsnes, Janne Storflor, Thomas Lindner, Jostein Gleditsch and Christian Georg Lund Source Type: research

Moderate Hypothermia Improves Cardiac and Vascular Function in a Pig Model of Ischemic Cardiogenic Shock Treated With Veno-Arterial ECMO
In conclusion, moderate and rapid hypothermia improves hemodynamics and cardiac and vascular function in a pig model of ischemic CS treated with ECMO.
Source: Shock - January 14, 2017 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Preclinical and clinical data for factor Xa and “Universal” reversal agents
Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development.
Source: The American Journal of Emergency Medicine - September 27, 2016 Category: Emergency Medicine Authors: Truman J. Milling, Scott Kaatz Tags: Review Source Type: research

Safety of Direct Oral Anticoagulants: Insights from Postmarketing Studies
Direct oral anticoagulants (DOACs) have been marketed in the United States since 2010. While numerous large-scale prospective phase 3 outcomes studies have documented the effectiveness of DOACs for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the primary safety concern with all of these drugs —as it is with the more established oral anticoagulant warfarin—is the risk of major bleeding. Postmarketing surveillance studies (PMSS) provide the opportunity to evaluate the safety of these recently approved drugs across a spectrum of patients that may be broader than those in...
Source: The American Journal of Emergency Medicine - September 27, 2016 Category: Emergency Medicine Authors: Todd C. Villines, W. Frank Peacock Tags: Review Source Type: research

How to manage patients on rivaroxaban in the emergency department: a statement of the Italian society of emergency medicine advisory board
Rivaroxaban, a new oral anticoagulant, has been approved in many countries and its everyday use in clinical practice is increasing. Thus, the chances for an emergency physician to encounter rivaroxaban-treated patients in emergency situations have increased. Here, the authors address the main issues in terms of the prescription of rivaroxaban and the management of these patients in cases of minor or major bleeding, urgent surgery, atrial fibrillation requiring cardioversion, acute ischemic stroke, ST-elevation myocardial infarction, and new onset of atrial fibrillation in recent ST-elevation myocardial infarction. The reco...
Source: European Journal of Emergency Medicine - September 8, 2016 Category: Emergency Medicine Tags: Review Articles Source Type: research

Direct oral anticoagulants: a practical guide for the emergency physician
The direct oral anticoagulants (DOACs) are the mainstay for stroke prophylaxis in nonvalvular atrial fibrillation and treatment of acute venous thrombosis. They are attractive alternatives to warfarin because of their efficacy, ease of prescription and safety profile. The emergency department has gained expertise in the management of DOAC bleeding complications, but has been slower to adopt prescription decisions. Emergency clinicians are in a unique position to identify patients who are prescribed DOACs and are at high risk of impending bleeding. This is a practical guide for the emergency clinician on how to prescribe DO...
Source: European Journal of Emergency Medicine - September 8, 2016 Category: Emergency Medicine Tags: Review Articles Source Type: research

The Severity of Bleeding and Mortality in Trauma Patients Taking Dabigatran
Dabigatran, a direct thrombin inhibitor, has been shown to be more effective than warfarin in the prevention of stroke in patients with atrial fibrillation. Until recently, it lacked a reversal agent, and its contribution to the risk of transfusion in injured patients is unknown.
Source: The Journal of Emergency Medicine - June 26, 2016 Category: Emergency Medicine Authors: Zachary D.W. Dezman, Angela C. Comer, Gordon S. Smith, Mayur Narayan, John R. Hess, Jon Mark Hirshon Tags: Brief Report Source Type: research

Pages: 1  2  3  4  5  6  7  8