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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
Less detail

[Changes of thrombogenic data of blood in the dynamics of pathologic labor under the effect of lactated plasma]

https://arctichealth.org/en/permalink/ahliterature66805
Source
Pediatr Akus Ginekol. 1968;3:47-50
Publication Type
Article
Date
1968

Dosing with recombinant factor viia based on current evidence.

https://arctichealth.org/en/permalink/ahliterature30521
Source
Semin Hematol. 2004 Jan;41(1 Suppl 1):35-9
Publication Type
Article
Date
Jan-2004
Author
Ulla Hedner
Author Affiliation
Research and Development, Novo Nordisk, Denmark.
Source
Semin Hematol. 2004 Jan;41(1 Suppl 1):35-9
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Blood Coagulation - drug effects
Blood Coagulation Disorders - drug therapy - etiology
Blood Platelet Disorders - drug therapy
Child
Dose-Response Relationship, Drug
Factor VII - administration & dosage
Hemophilia A - drug therapy
Hemorrhage - drug therapy - etiology
Humans
Male
Postoperative Hemorrhage - drug therapy
Recombinant Proteins - administration & dosage
Wounds and Injuries - complications - drug therapy
Abstract
Recombinant factor VIIa (rFVIIa; NovoSeven(R), Novo Nordisk, Bagsvaerd, Denmark) induces hemostasis in patients with severe hemophilia and inhibitors, and has been found to control hemorrhage associated with severe trauma and surgery in patients with basically normal hemostatic mechanisms from the start. By enhancing the generation of thrombin on activated platelets, rFVIIa facilitates the formation of a tight, stable fibrin plug that is resistant to premature lysis. Clinical efficacy has been achieved with doses of rFVIIa much lower than originally proposed by in vitro models. Based on early clinical experiences, a dosing schedule of 90 to 120 microg/kg every 2 hours for the first 24 hours was recommended for serious bleeds and surgical cover. This schedule has been shown to induce and maintain hemostasis in 83% to 95% of serious bleeding episodes, and in 90% to 100% of major surgical cases. However, "mega" doses of rFVIIa may demonstrate greater efficacy in the treatment of joint bleeds, as they are more likely to evoke a full thrombin burst. Interpatient variation in recovery rates, clearance rates, and the ability to generate thrombin on the activated platelet surface may influence the efficacy of rFVIIa. Optimal doses may thus vary not only between hemophilia patients, but also between patients treated for other bleeding disorders.
PubMed ID
14872419 View in PubMed
Less detail

[Letter: Cheating the patient and the insurance office. Tricks from the history of anticoagulant therapy].

https://arctichealth.org/en/permalink/ahliterature254106
Source
Tidsskr Nor Laegeforen. 1973 Dec 10;93(34):2508
Publication Type
Article
Date
Dec-10-1973

Management of coagulopathy with recombinant factor VIIa in a neonate with echovirus type 7.

https://arctichealth.org/en/permalink/ahliterature58255
Source
Pediatr Blood Cancer. 2004 Aug;43(2):170-6
Publication Type
Article
Date
Aug-2004
Author
Jakica Tancabelic
Steven Edward Haun
Author Affiliation
University of South Dakota School of Medicine, Department of Pediatrics, Pediatric Critical Care Medicine, Sioux Falls, South Dakota 57117, USA. jtancabe@usd.edu
Source
Pediatr Blood Cancer. 2004 Aug;43(2):170-6
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Blood Coagulation Disorders - drug therapy - pathology - virology
Disseminated Intravascular Coagulation - drug therapy - pathology - virology
Enterovirus B, Human
Enterovirus Infections - complications
Factor VIIa - therapeutic use
Humans
Infant, Newborn
Intracranial Hemorrhages - drug therapy - pathology - virology
Male
Recombinant Proteins
Tomography, X-Ray Computed
Abstract
A 5-day-old newborn presented with neonatal enteroviral infection. The patient's hospital course was complicated by acute liver dysfunction, renal insufficiency, fluid overload, respiratory failure, hypertension, catheter related thrombosis, Klebsiella pneumoniae sepsis, intracerebral and intraventricular hemorrhage, and disseminated intravascular coagulation (DIC). Administration of fresh frozen plasma (FFP) and cryoprecipitate failed to control the patient's hemostasis and led to significant fluid overload. Recombinant activated factor VII (rFVIIa, Novoseven NovoNordisk, Bagsvaerd, Denmark) was given to the neonate as a bolus (rFVIIa at 60-80 microg/kg body weight), followed by a continuous infusion (2.5-16 microg/kg/hr). Recombinant activated factor VII controlled hemostasis, until the patient's liver function recovered. The patient's blood product requirement significantly decreased and his fluid overload resolved. Administration of rFVIIa appears to have stabilized the coagulation process. The patient appears to have fully recovered from the infection's complications.
PubMed ID
15236286 View in PubMed
Less detail

[New preparations for coagulation disorders].

https://arctichealth.org/en/permalink/ahliterature223423
Source
Lakartidningen. 1992 Jul 8;89(28-29):2430
Publication Type
Article
Date
Jul-8-1992
Author
L. Tengborn
L. Stigendal
E. Berntorp
S. Lethagen
H. Johnsson
S. Schulman
Author Affiliation
Koagulationsmottagningen, Malmö allmänna sjukhus.
Source
Lakartidningen. 1992 Jul 8;89(28-29):2430
Date
Jul-8-1992
Language
Swedish
Publication Type
Article
Keywords
Blood Coagulation Disorders - drug therapy
Blood Coagulation Factors
Drug Information Services
Hemostatics - administration & dosage
Humans
Sweden
PubMed ID
1507959 View in PubMed
Less detail

Perioperative use of recombinant activated factor VII in liver transplantation.

https://arctichealth.org/en/permalink/ahliterature56586
Source
Ann Transplant. 2003;8(4):40-2
Publication Type
Article
Date
2003
Author
L. Jureczko
M. Kolacz
J. Trzebicki
G. Szyszko
M. Pacholczyk
B. Lagiewska
A. Chmura
W. Rowinski
E. Mayzner-Zawadzka
Author Affiliation
Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Poland. jureczko@anest.pl
Source
Ann Transplant. 2003;8(4):40-2
Date
2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Blood Coagulation Disorders - drug therapy
Factor VIIa - therapeutic use
Hepatitis C, Chronic - blood - surgery
Hepatolenticular Degeneration - blood - surgery
Humans
Liver Failure - blood - surgery
Liver Transplantation - methods
Male
Middle Aged
Postoperative Hemorrhage - prevention & control
Recombinant Proteins - therapeutic use
Abstract
Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeds in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX). Patients who qualify for liver transplantation may have varying degrees of coagulation impairment, which may adversely impact elective anaesthetic and surgical procedures and elevate the risk of intraoperative bleeds, which require massive blood transfusions and worsen prognosis. Recently, reports have been published on the use of rFVIIa prior to surgical procedures, which are likely to cause severe blood loss as well as for so-called emergency therapy of coagulation disorders during liver transplantation.
PubMed ID
15171005 View in PubMed
Less detail

[The changes of general potential of hemocoagulation in children, suffering an acute hematogenic osteomyelitis]

https://arctichealth.org/en/permalink/ahliterature79761
Source
Klin Khir. 2006 Jul;(7):54-7
Publication Type
Article
Date
Jul-2006
Author
Kazans'kyi A Iu
Bodnar B M
Source
Klin Khir. 2006 Jul;(7):54-7
Date
Jul-2006
Language
Ukrainian
Publication Type
Article
Keywords
Acute Disease
Adolescent
Blood Coagulation Disorders - drug therapy - epidemiology
Child
Child, Preschool
Female
Fibrinolytic Agents - therapeutic use
Hemostatics - therapeutic use
Humans
Male
Osteomyelitis - blood - epidemiology - physiopathology
Thromboplastin - therapeutic use
Abstract
Chronometric hypocoagulation was observed in children, suffering an acute hematogenic ostheomyelitis, witnessed by processes of thrombin formation according to internal (the prolonged time of the blood plasm recalcification and activated partial thromboplastin time) and external (the thrombin time enhancement) ways of the blood coagulation process, as well as changes in fibrinogenesis mechanisms (the thrombin time prolongation). The lowering of anticoagulant capacity of the blood (the antithrombin III activity inhibition by 18.5%) was combined with significant increase of the thrombocytes functional activity (the rising of their adhesive and aggregational properties) in more than two times, which have occurred on the background of constant content of fibrinogen in the blood. Changes in the system of the plasm fibrinolysis in an acute hematogenic ostheomyelitis was characterized by inhibition of cofermental and, mainly, fermental fibrinolytic activity of the blood plasm, in conjunction with Hageman-dependent fibrinolysis intensification and was accompanied by accumulation of soluble complexes of fibrin-monomer in the blood. So far, chronometric hypocoagulation is secondary process, caused by the influence of soluble complexes of fibrin-monomer, which blocks fibrinogenesis. That's why the general potential of the blood coagulation system in children with an acute hematogenic ostheomyelitis must be regarded as a structural hypercoagulation.
PubMed ID
17115601 View in PubMed
Less detail

10 records – page 1 of 1.