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2B or not to be--the 45-year saga of the Montreal Platelet Syndrome.

https://arctichealth.org/en/permalink/ahliterature140851
Source
Thromb Haemost. 2010 Nov;104(5):903-10
Publication Type
Article
Date
Nov-2010
Author
Man-Chiu Poon
Margaret L Rand
Shannon C Jackson
Author Affiliation
Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. mcpoon@ucalgary.ca
Source
Thromb Haemost. 2010 Nov;104(5):903-10
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Blood Coagulation - genetics
Blood Coagulation Tests - history
Blood Platelet Disorders - blood - genetics - history
Blood Platelets - metabolism - pathology
Canada
Genetic Predisposition to Disease
History, 20th Century
Humans
Mutation
Pedigree
Phenotype
Platelet Function Tests - history
Syndrome
von Willebrand Disease, Type 2 - blood - genetics - history
von Willebrand Factor - genetics - history
Abstract
Over 45 years ago, Montreal Platelet Syndrome was first described as a rare inherited platelet disorder characterised by macrothrombocytopenia with spontaneous platelet clumping, abnormal platelet shape change upon stimulation and a defect in platelet calpain. This syndrome has now been reclassified as type 2B von Willebrand disease with the V1316M VWF mutation in the only kindred ever reported. We herein revisit the historical platelet characteristics originally described in Montreal Platelet Syndrome in light of the new diagnosis. This paper will review the 45-year saga of Montreal Platelet Syndrome, a story that highlights the value of revisiting a rare diagnosis to look for a more common explanation.
PubMed ID
20838735 View in PubMed
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[Activated protein C resistance as a cause of thrombophilia]

https://arctichealth.org/en/permalink/ahliterature64478
Source
Rev Invest Clin. 1996 May-Jun;48(3):223-9
Publication Type
Article
Author
G J Ruiz-Argüelles
Author Affiliation
Laboratorios Clínicos de Puebla, México.
Source
Rev Invest Clin. 1996 May-Jun;48(3):223-9
Language
Spanish
Publication Type
Article
Keywords
Antithrombin III - analysis
Blood Coagulation Factors - analysis - physiology
DNA Mutational Analysis
English Abstract
Enzyme Activation
Factor V - genetics
Factor V Deficiency - complications - epidemiology
Female
Humans
Male
Mexico - epidemiology
Partial Thromboplastin Time
Phenotype
Pregnancy
Pregnancy Complications, Hematologic - epidemiology - etiology
Prevalence
Protein C - physiology
Protein S - analysis
Thrombosis - blood - genetics
Abstract
The proportion of identifiable causes of familial thrombophilia has increased from 5-10% to 60-70% since the identification of activated protein C resistance (aPCR) in February 1993 by Dahlbäck et al. A mutation in the factor V gene (G-->A, 1691) leads to the so called Leiden mutation (R 506 Q) that produces a mutated factor V resistant to the catalytic action of activated protein C (aPC), yet normal in its procoagulant properties. This recently identified aPCR is in Nordic populations the most prevalent and well defined genetic defect associated with disease so far described. Its prevalence in the general population ranges from 0% to up to 15% and suggests that a positive genetic selection pressure has been involved. The aPCR phenotype can be assessed in vitro by measurement of the prolongation of the activated partial thromboplastin time in the presence of aPC, whereas the aPCR genotype is studied using polymerase chain reaction searching for the Arg to Gln mutation in the coagulation factor V gene. Some acquired conditions such as the presence of lupus anticoagulants, antiphospholipid antibodies, pregnancy, liver disease and contraceptives may lead into the aPCR phenotype. The aPCR search must be the initial step in the study of a patient with thrombophilia, either inherited or acquired aPCR together with protein C, protein S and antithrombin III explain 60 to 70% of cases of familial thrombophilia.
PubMed ID
8966383 View in PubMed
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An Adjusted Calculation Model Allows for Reduced Protamine Doses without Increasing Blood Loss in Cardiac Surgery.

https://arctichealth.org/en/permalink/ahliterature284260
Source
Thorac Cardiovasc Surg. 2016 Sep;64(6):487-93
Publication Type
Article
Date
Sep-2016
Author
Gunilla Kjellberg
Ulrik Sartipy
Jan van der Linden
Emelie Nissborg
Gabriella Lindvall
Source
Thorac Cardiovasc Surg. 2016 Sep;64(6):487-93
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - administration & dosage - adverse effects
Blood Coagulation - drug effects
Blood Coagulation Tests
Blood Loss, Surgical - prevention & control
Body Height
Body Weight
Cardiac Surgical Procedures - adverse effects
Cardiopulmonary Bypass - adverse effects
Computer simulation
Drug Dosage Calculations
Female
Heparin - administration & dosage - adverse effects
Heparin Antagonists - administration & dosage - adverse effects
Humans
Male
Middle Aged
Models, Biological
Postoperative Hemorrhage - etiology - prevention & control
Protamines - administration & dosage - adverse effects
Sweden
Time Factors
Treatment Outcome
Abstract
Background Heparin dosage for anticoagulation during cardiopulmonary bypass (CPB) is commonly calculated based on the patient's body weight. The protamine-heparin ratio used for heparin reversal varies widely among institutions (0.7-1.3?mg protamine/100 IU heparin). Excess protamine may impair coagulation. With an empirically developed algorithm, the HeProCalc program, heparin, and protamine doses are calculated during the procedure. The primary aim was to investigate whether HeProCalc-based dosage of heparin could reduce protamine use compared with traditional dosages. The secondary aim was to investigate whether HeProCalc-based dosage of protamine affected postoperative bleeding. Patients and Methods We consecutively randomized 40 patients into two groups. In the control group, traditional heparin and protamine doses, based on body weight alone, were given. In the treatment group, the HeProCalc program was used, which calculated the initial heparin bolus dose from weight, height, and baseline activated clotting time and the protamine dose at termination of CPB. Results We analyzed the results from 37 patients, after exclusion of three patients. Equal doses of heparin were given in both groups, whereas significantly lower mean doses of protamine were given in the treatment group versus control group (211?±?56 vs. 330?±?61?mg, p?
PubMed ID
26270199 View in PubMed
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Antenatal drugs affecting vitamin K status of the fetus and the newborn.

https://arctichealth.org/en/permalink/ahliterature23368
Source
Semin Thromb Hemost. 1995;21(4):364-70
Publication Type
Article
Date
1995
Author
B. Astedt
Author Affiliation
Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.
Source
Semin Thromb Hemost. 1995;21(4):364-70
Date
1995
Language
English
Publication Type
Article
Keywords
Abnormalities, Drug-Induced - etiology
Anticoagulants - adverse effects - pharmacokinetics
Anticonvulsants - adverse effects - pharmacokinetics
Blood Coagulation Factors - metabolism
Child
Cohort Studies
Coumarins - adverse effects - pharmacokinetics
Epilepsy - drug therapy
Female
Fetal Diseases - chemically induced
Great Britain - epidemiology
Hemorrhage - chemically induced
Humans
Infant, Newborn
Maternal-Fetal Exchange
Neoplasms - chemically induced - epidemiology
Pregnancy
Pregnancy Complications - drug therapy
Prenatal Exposure Delayed Effects
Protein Processing, Post-Translational
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Thrombosis - drug therapy
Vitamin K - adverse effects - physiology - therapeutic use
Vitamin K Deficiency - chemically induced - embryology - prevention & control
Abstract
Coumarin derivatives and anticonvulsants administered during pregnancy enter the fetal circulation, interfering with the action of vitamin K. Vitamin K plays a crucial part in the gamma-carboxylation of glutamic acid residues of the vitamin K-dependent coagulation factors prothrombin, FVII, FIX, and FX. Other vitamin K-dependent proteins in the coagulation cascade are protein C and protein S. Vitamin K-dependent bone proteins are osteocalcin and gamma-carboxyglutamate matrix protein. Administration of coumarol derivatives results in under carboxylation of the vitamin K-dependent proteins. Anticoagulation therapy with warfarin is followed by an increased risk of embryopathy, which has been shown to be greatest between gestational weeks 6 and 12. Administration of warfarin is also followed by an increased risk both of fetal intraventricular hemorrhage, and of cerebral microbleedings, which may result in microencephaly and mental retardation. Treatment with coumarol derivatives should therefore be avoided during pregnancy, even in pregnant women with artificial heart valves, and replaced by heparin. Hemorrhage in the newborn related to the use of anticonvulsant drugs during pregnancy occurs very early within the first 24 hours, probably due to increased degradation of vitamin K. Transplacental administration of vitamin K has been shown to prevent neonatal hemorrhage induced by maternal anticonvulsant therapy. Prophylactic administration of vitamin K, especially by intramuscular injection, has been reported to be associated with an increased risk of childhood cancer. However, subsequent extensive studies have yielded no evidence of any relationship between prophylactic vitamin K administration and the occurrence of childhood cancer.
PubMed ID
8747699 View in PubMed
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Anticoagulant activity of fucoidan from brown algae Fucus evanescens of the Okhotsk Sea.

https://arctichealth.org/en/permalink/ahliterature181491
Source
Bull Exp Biol Med. 2003 Nov;136(5):471-3
Publication Type
Article
Date
Nov-2003
Author
T A Kuznetsova
N N Besednova
A N Mamaev
A P Momot
N M Shevchenko
T N Zvyagintseva
Author Affiliation
Institute of Epidemiology and Microbiology, Siberian Division of the Russian Academy of Medical Sciences, Vladivostok, Russia. kuznetsov@stl.ru.
Source
Bull Exp Biol Med. 2003 Nov;136(5):471-3
Date
Nov-2003
Language
English
Publication Type
Article
Keywords
Animals
Anticoagulants - chemistry - pharmacology
Blood Coagulation Tests
Dose-Response Relationship, Drug
Fucus - chemistry
Heparin - pharmacology
Humans
Mice
Mice, Inbred BALB C
Oceans and Seas
Polysaccharides - chemistry - pharmacology
Russia
Time Factors
Abstract
In vitro and in vivo experiments showed that anticoagulant activity of sulfated polysaccharide from Fucus evanescens (brown algae of the Okhotsk Sea) was similar to that of heparin. Anticoagulant properties of fucoidan are determined by thrombin inhibition mediated via plasma antithrombin III.
PubMed ID
14968163 View in PubMed
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Anticoagulant medication at time of needle biopsy for breast cancer in relation to risk of lymph node metastasis.

https://arctichealth.org/en/permalink/ahliterature103076
Source
Int J Cancer. 2014 Jul 1;135(1):238-41
Publication Type
Article
Date
Jul-1-2014
Author
Rickard Ljung
Roland Sennerstam
Fredrik Mattsson
Gert Auer
Jesper Lagergren
Author Affiliation
Upper Gastrointestinal Surgery Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Source
Int J Cancer. 2014 Jul 1;135(1):238-41
Date
Jul-1-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - adverse effects
Aspirin - administration & dosage - adverse effects
Biopsy, Needle
Blood Coagulation - drug effects
Blood Platelets - drug effects - pathology
Breast Neoplasms - complications - diagnosis - pathology
Early Detection of Cancer
European Continental Ancestry Group
Female
Humans
Lymphatic Metastasis - pathology - prevention & control
Mammography
Middle Aged
Sweden
Abstract
Anticoagulant treatment might enhance the natural defense against tumor cell dissemination caused by diagnostic needle biopsy by counteracting thrombocyte coating of such cells. To clarify whether women using anticoagulant treatment at the time of biopsy have a lower occurrence of lymph node metastasis, we conducted a nationwide Swedish cohort study of 26,528 female incident breast cancer patients in 2006-2011. Point risk ratio (RR) of risk of lymph node metastasis among users of anticoagulant treatment adjusted for age, T-stage, socioeconomic factors, and concomitant medication was RR?=?0.94, (95% CI: 0.87-1.03), and lower in younger women (RR?=?0.80, 95% CI 0.50-1.29). Although nonsignificant, these associations may underestimate a true negative association since women using anticoagulant treatment are likely to have more concomitant diseases, lead an unhealthier lifestyle, and have lower participation in mammography screening. These findings provide some support for the hypothesis that anticoagulant medications might counteract breast cancer spread caused by needle biopsy.
PubMed ID
24346771 View in PubMed
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Source
Journal of the American Medical Association. 1951 Jul 14;146(11):992-5.
Publication Type
Article
Date
1951
Author
Theis FV
O'Connor WR
Wahl FJ
Source
Journal of the American Medical Association. 1951 Jul 14;146(11):992-5.
Date
1951
Language
English
Publication Type
Article
Keywords
Anticoagulants
Blood Coagulation
Frostbite
Humans
PubMed ID
14841065 View in PubMed
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Anticoagulation management in remote primary care.

https://arctichealth.org/en/permalink/ahliterature167798
Source
Can Fam Physician. 2005 Mar;51:384-5
Publication Type
Article
Date
Mar-2005
Author
Shauna L Nast
Martin J Tierney
Ray McIlwain
Author Affiliation
University of British Columbia, Vancouver.
Source
Can Fam Physician. 2005 Mar;51:384-5
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - therapeutic use
Blood Coagulation Disorders - drug therapy
British Columbia
Female
Humans
International Normalized Ratio
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Primary Health Care - statistics & numerical data
Rural Health Services - statistics & numerical data
Warfarin - therapeutic use
Abstract
To examine anticoagulation management at the Bella Coola Medical Clinic in British Columbia.
Charts of all patients in the Bella Coola Valley receiving warfarin were assessed. Data were analyzed using Microsoft Excel.
Bella Coola Medical Clinic on the remote central coast of British Columbia.
Twenty-one patients at the Bella Coola Medical Clinic who were receiving warfarin.
All international normalized ratio (INR) tests over the preceding 12 months were examined for results, time elapsed since previous test, and interval until next scheduled test.
An in-range INR rate of 60% is considered acceptable for anticoagulation services. The clinic had performed 406 INR tests on these 21 patients over the last 12 months. We found that 53% of all INR results fell strictly within the recommended therapeutic range. The relative success of anticoagulation management in Bella Coola probably results from several factors. For instance, physicians usually responded to out-of-range INR results with close monitoring: in 71% of cases, follow-up tests were scheduled within 1 week. On average, patients attended 77% of these visits on schedule; 58% of all out-of-range INR results were followed up with retesting within 1 week.
Our results suggest that primary care physicians can manage anticoagulation adequately, even in remote settings.
Notes
Cites: Arch Intern Med. 2000 Apr 10;160(7):967-7310761962
Cites: Br J Gen Pract. 2000 Oct;50(459):779-8011127164
Cites: Can Fam Physician. 2003 Feb;49:181-412619741
Cites: Circulation. 2003 Aug 12;108(6):711-612885749
Cites: CMAJ. 2003 Aug 19;169(4):293-812925422
Cites: Chest. 1998 Nov;114(5 Suppl):445S-469S9822057
Cites: CMAJ. 1999 Sep 7;161(5):493-710497604
PubMed ID
16926932 View in PubMed
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Anticoagulation management pre- and post atrial fibrillation ablation: a survey of canadian centres.

https://arctichealth.org/en/permalink/ahliterature122177
Source
Can J Cardiol. 2013 Feb;29(2):219-23
Publication Type
Article
Date
Feb-2013
Author
Vartan Mardigyan
Atul Verma
David Birnie
Peter Guerra
Damian Redfearn
Giuliano Becker
Jean Champagne
John Sapp
Lorne Gula
Ratika Parkash
Laurent Macle
Eugene Crystal
Gilles O'Hara
Yaariv Khaykin
Marcio Sturmer
George D Veenhuyzen
Isabelle Greiss
Jean-Francois Sarrazin
Iqwal Mangat
Paul Novak
Allan Skanes
Jean-Francois Roux
Vijay Chauhan
Tom Hadjis
Carlos A Morillo
Vidal Essebag
Author Affiliation
McGill University Health Centre, Montreal, Québec, Canada.
Source
Can J Cardiol. 2013 Feb;29(2):219-23
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Atrial Fibrillation - blood - complications - surgery
Blood Coagulation
Canada - epidemiology
Catheter Ablation - adverse effects - methods
Follow-Up Studies
Humans
Incidence
Retrospective Studies
Risk Assessment - methods
Risk factors
Thromboembolism - epidemiology - etiology - prevention & control
Treatment Outcome
Abstract
Anticoagulation in patients undergoing atrial fibrillation (AF) ablation is crucial to minimize the risk of thromboembolic complications. There are broad ranges of approaches to anticoagulation management pre and post AF ablation procedures. The purpose of this study was to determine the anticoagulation strategies currently in use in patients peri- and post AF ablation in Canada.
A Web-based national survey of electrophysiologists performing AF ablation in Canada collected data regarding anticoagulation practice prior to ablation, periprocedural bridging, and duration of postablation anticoagulation.
The survey was completed by 36 (97%) of the 37 electrophysiologists performing AF ablation across Canada. Prior to AF ablation, 58% of electrophysiologists started anticoagulation for patients with paroxysmal AF CHADS(2) scores of 0 to 1, 92% for paroxysmal AF CHADS(2) scores = 2, 83% for persistent AF CHADS(2) scores of 0 to 1, and 97% for persistent AF CHADS(2) scores = 2. For patients with CHADS(2) 0 to 1, warfarin was continued for at least 3 months by most physicians (89% for paroxysmal and 94% for persistent AF). For patients with CHADS(2) = 2 and with no recurrence of AF at 1 year post ablation, 89% of physicians continued warfarin.
Although guidelines recommend long-term anticoagulation in patients with CHADS(2) = 2, 11% of physicians would discontinue warfarin in patients with no evidence of recurrent AF 1 year post successful ablation. Significant heterogeneity exists regarding periprocedural anticoagulation management in clinical practice. Clinical trial evidence is required to guide optimal periprocedural anticoagulation and therapeutic decisions regarding long-term anticoagulation after an apparently successful catheter ablation for AF.
Notes
Comment In: Can J Cardiol. 2013 Feb;29(2):139-4122819445
PubMed ID
22840300 View in PubMed
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379 records – page 1 of 38.