Anticoagulant treatment of portal thrombosis associated with cirrhosis: a real challenge!

2021 ◽  
Vol 30 (5) ◽  
pp. 339-344
Author(s):  
Hakima Abid ◽  
Maryam El Khayari ◽  
Maria Lahlali ◽  
Nada Lahmidani ◽  
Mounia El Yousfi ◽  
...  
Keyword(s):  
Anticoagulant Treatment ◽  
Portal Thrombosis ◽  
Real Challenge

Oral Anticoagulant Treatment with and without Aspirin

1995 ◽  
Vol 74 (01) ◽  
pp. 506-510 ◽  
Author(s):  
Raul Altman ◽  
Jorge Rouvier ◽  
Enrique Gurfinkel
Keyword(s):  
Oral Anticoagulant ◽  
Anticoagulant Treatment ◽  
Oral Anticoagulant Treatment

A Comparison of a Moderate with Moderate-high Intensity Oral Anticoagulant Treatment in Patients with Mechanical Heart Valve Prostheses

1997 ◽  
Vol 77 (05) ◽  
pp. 0839-0844 ◽  
Author(s):  
Vittorio Pengo ◽  
Fabio Barbero ◽  
Alberto Banzato ◽  
Elisabetta Garelli ◽  
Franco Noventa ◽  
...  
Keyword(s):  
Heart Valve ◽  
High Intensity ◽  
Oral Anticoagulant ◽  
Oral Anticoagulants ◽  
Mechanical Heart Valve ◽  
Moderate Intensity ◽  
Minor Bleeding ◽  
Anticoagulant Treatment ◽  
Oral Anticoagulant Treatment ◽  
Valve Prostheses

SummaryBackground. The long-term administration of oral anticoagulants to patients with mechanical heart valve prostheses is generally accepted. However, the appropriate intensity of oral anticoagulant treatment in these patients is still controversial.Methods and Results. From March 1991 to March 1994, patients referred to the Padova Thrombosis Center who had undergone mechanical heart valve substitution at least 6 months earlier were randomly assigned to receive oral anticoagulants at moderate intensity (target INR = 3) or moderate-high intensity (target INR = 4). Principal end points were major bleeding, thromboembolism and vascular death. Minor bleeding was a secondary end-point.A total of 104 patients were assigned to the target 3 group and 101 to the target 4 group; they were followed for from 1.5 years to up 4.5 years (mean, 3 years). Principal end-points occurred in 13 patients in the target 3 group (4 per 100 patient-years) and in 20 patients in the target 4 group (6.9 per 100 patient-years). Major hemorrhagic events occurred in 15 patients, 4 in the target 3 group (1.2 per 100 patient-years) and 11 in the target 4 group (3.8 per 100 patient-years) (p = 0.019). The 12 recorded episodes of thromboembolism, 4 of which consisted of a visual deficit, were all transient ischemic attacks, 6 in the target 3 group (1.8 per 100 patient-years) and 6 in the target 4 group (2.1 per 100 patient- years). There were 3 vascular deaths in each group (0.9 and 1 per 100 patient-years for target 3 and target 4 groups, respectively). Minor bleeding episodes occurred 85 times (26 per 100 patient-years) in the target 3 group and 123 times (43 per 100 patient-years) in the target 4 group (p = 0.001).Conclusions. Mechanical heart valve patients on anticoagulant treatment who had been operated on at least 6 months earlier experienced fewer bleeding complications when maintained on a moderate intensity regimen (target INR = 3) than those on a moderate-high intensity regimen (target INR = 4). The number of thromboembolic events and vascular deaths did not differ between the two groups.

Spectrophotometric Assays of Prothrombin in Plasma of Patients Using Oral Anticoagulants

1979 ◽  
Vol 42 (04) ◽  
pp. 1296-1305 ◽  
Author(s):  
R M Bertina ◽  
W van der Marel-van Nieuwkoop ◽  
E A Loeliger
Keyword(s):  
Prothrombin Time ◽  
Vitamin K ◽  
Oral Anticoagulation ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Factor Xa ◽  
Factor V ◽  
Anticoagulant Treatment ◽  
Factor Ii ◽  
K Deficiency

SummaryTwo spectrophotometric assays for prothrombin have been developed and compared with a one stage coagulant and an immunological assay. One of these assays (called the XAPC assay) uses a combination of factor Xa, phospholipid, Ca2+ and factor V as activator of prothrombin, and measures only normal prothrombin. The second (the ECAR assay) uses Echis carinatus venom as activator. This assay measures both normal prothrombin and PIVKA II (protein induced by vitamin K antagonists/absence). Combination of the results obtained by the XAPC and ECAR assays provides rapid and reliable information on the degree of “subcarboxylation” of prothrombin (oral anticoagulation, vitamin K deficiency).For patients on long term anticoagulant treatment the prothrombin time (Thrombotest) shows better correlation with the ratio prothrombin/prothrombin plus PIVKA II (XAPC/ ECAR) than with the factor II concentration. For patients starting the anticoagulant treatment there is no correlation between the Thrombotest time and the XAPC/ECAR ratio.It seems doubtful that (a) spectrophotometric factor II assay(s) will be as useful as the prothrombin time in the control of oral anticoagulation.

The Real Challenge of Plato's Republic

2019 ◽  
Vol 1 (2) ◽  
pp. 149-170
Author(s):  
Russell E. Jones
Keyword(s):  
The Real ◽  
Central Aspect ◽  
Real Challenge

Glaucon's Challenge at the beginning of Book 2 of Plato's Republic has long prompted interpretive difficulties, due to a misunderstanding of its central aspect. The task of this essay is to correct that misunderstanding, at which point The Challenge can be seen to be as simple and powerful as Glaucon seems to think it is. The Challenge is simple, insofar as it requires Socrates to show that justice is always good, that one is always better off cultivating a just character and acting justly than otherwise (and that's all there is to it). And it is powerful, insofar as Glaucon and Adeimantus provide plausible reasons to think not simply that justice is not always good, but that fully developed injustice is always good.

World of van der Waals Species

1993 ◽  
Vol 58 (7) ◽  
pp. 1465-1475
Author(s):  
Pavel Hobza ◽  
Rudolf Zahradník
Keyword(s):  
Chemical Treatment ◽  
Quantum Chemical ◽  
Van Der Waals ◽  
Real Challenge

Van der Waals species (molecules, ions, radicals) attract the attention of chemists, chemical physicists and molecular biologists. Study of these systems presents a real challenge for both experimentalists and theorists. The main features of the contemporary possibilities for quantum chemical treatment are illustrated mostly on systems studied in the authors' laboratory. Prospects in the area are briefly outlined.

Antiplatelet and/or anticoagulant treatment does not increase hemorrhagic adverse events during EUS-guided biliary drainage

2020 ◽  
Vol 92 (3) ◽  
pp. 659-666 ◽  
Author(s):  
Takeshi Ogura ◽  
Nobu Nishioka ◽  
Saori Ueno ◽  
Tadahiro Yamada ◽  
Masanori Yamada ◽  
...  
Keyword(s):  
Adverse Events ◽  
Biliary Drainage ◽  
Anticoagulant Treatment

scholarly journals Preparation of alcohol-based handrub in COVID-19 Alsatian cluster

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Elodie Di-Falco ◽  
Johan Bourbon ◽  
Isalyne Sbaffe ◽  
Jean-Daniel Kaiser
Keyword(s):  
Critical Period ◽  
Hospital Management ◽  
Management Team ◽  
The Other ◽  
Packaging Materials ◽  
Local Production ◽  
Technical Grade ◽  
Hand Sanitizer ◽  
Set Up ◽  
Real Challenge

AbstractAlsace, in particular Haut-Rhin, is one of the main clusters of COVID-19 in France. There has been a shortage of essential supplies in the area, especially alcohol-based hand sanitizer. In this context, and in accordance with the decree dated March 6, 2020, our hospital management team asked us to start local production of alcohol-based handrub. This was a real challenge: In one week, we had to implement the production of handrub to meet the needs of a 1,400-bed hospital. The production had to comply with the French preparation guidelines and take place on specific premises, with qualified and calibrated equipment, by qualified staff, under the supervision of a pharmacist. The other big challenge we faced was the supply of pharmaceutical raw and packaging materials. During this particular critical period, all suppliers were out of stock. Here, we describe the organizational set-up and the decisions made, e. g., to use technical-grade ethanol before the publication of the decrees dated March 13 and March 23, 2020.

Closure of Complex Wounds by a Simple Skin Stretching System Associated With Vacuum Sealing Drainage—Clinical Outcome of 34 Patients

2021 ◽  
pp. 153473462110320
Author(s):  
Yaojun Wu ◽  
Liang Chen ◽  
Xinliang Mao ◽  
Zhengliang Ru ◽  
Liying Yu ◽  
...  
Keyword(s):  
Vacuum Sealing ◽  
Day Range ◽  
Skin Stretching ◽  
Group A ◽  
Group B ◽  
Vacuum Sealing Drainage ◽  
Real Challenge ◽  
Safe Approach ◽  
Large Skin ◽  
Complex Wounds

Management of complex wounds with large skin defects presents a real challenge for orthopedic or reconstructive surgeons. We developed a simple skin stretching system associated with vacuum sealing drainage to examine the efficiency and complication. A total of 34 patients with different types of complex wounds were retrospectively included from January 2015 to March 2021. All patients in the study were underwent the treatment by 2 stages. The method was used to the wounds from 4.71 to 169.65 cm2 with a median defect size of 25.13 cm2. The median time for wound closure was 11.5 days (range: 5-32 days), although the median absolute reduction was 2.08 cm2/day (range: 0.15-25.66 cm2/day). Depending on the site of the wounds, the cause of the wound, and the rate of max-width/max-length ( W/ L), these complex wounds could be separately divided into several groups. There were statistically significant differences in the median value of the above variables ( P < .05 Kruskal–Wallis test). The results showed that different anatomical sites had different viscoelastic properties, the complex wounds caused by trauma were easier to close than caused by diabetic foot and the complex wounds in group A ( W/ L ＞ 0.5) were more difficult to close than in group B ( W/ L ≤ 0.5). No major complications were encountered in this study. In summary, the results of our study showed that the simple skin stretching system associated with vacuum sealing drainage was a safe approach for closure of complex wounds. Nevertheless, more attention should be paid to the viscoelasticity of the wounds to ensure closure and avoid undue complications when applying the method.

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