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MELD score for prediction of survival after emergent TIPS for acute variceal hemorrhage: derivation and validation in a 101-patient cohort.

UNLABELLED: BACKGROUND AND RATIONALE FOR THE STUDY: The Model for End Stage Liver Disease (MELD) score has not been derived and validated fo … multivariate Cox regression: baseline bilirubin (regression coefficient 0.366), creatinine (0.621), international normalized ratio (1.111), and liver disease etiology (0.808), validating the MELD system for emergent cases. No other significant predictive parameters were identified. MELD was an excellent predictor of 90-day mortality in the emergent TIPS population (AUROC = 0.84 …

Serum Ferritin in Patients With Cirrhosis is Associated With Markers of Liver Insufficiency and Circulatory Dysfunction, but Not of Portal Hypertension.

BACKGROUND/AIMS: Iron overload is an increasingly recognized phenomenon in nonhemochromatosis cirrhosis. To evaluate the relationship betwee … and serum sodium: r=-0.419, P=0.002). In contrast, associations to markers of liver failure such as international normalized ratio (r=0.333, P=0.005), bilirubin (r=0.378, P=0.007), albumin (r=-0.265, P=0.082), model for end-stage liver disease (r=0.293, P=0.041), and Child-Pugh score (r=0.392, P=0.009) were observed. No differences in survival according to ferritin was detected …

Perioperative management of and recommendations for antithrombotic medications in dermatological surgery.

With the ever-increasing number of patients on anticoagulant or antiplatelet medications presenting for a dermatological surgical procedure, … reatening nature of a likely thrombosis. For patients on warfarin, surgery should be avoided if the international normalized ratio is > 3·5; aspirin should not be stopped prior to dermatological surgery and in most other circumstances patients taking long-term antithrombotic medication should not stop this prior to dermatological surgery. In more complicated cases liaison with …

Paroxysmal atrial fibrillation and the hazards of under-treatment.

BACKGROUND AND PURPOSE: Oral anticoagulants are highly efficacious for the prevention of stroke in atrial fibrillation, and are the preferre … th warfarin and aspirin, 294 (39%) aspirin alone, and 189 (25%) no antithrombotic therapy. The mean international normalized ratio was 1.6. Among patients with paroxysmal atrial fibrillation, one in five was taking warfarin. Although increasing stroke risk was associated with a greater likelihood of warfarin use, only 39% of highest risk CHADS2 3-6 were taking warfarin at the t …

Central venous catheter placement in children with thrombocytopenia.

BACKGROUND: The use of central venous catheter (CVC) is essential in the management of chronically ill children. Thrombocytopenia is a commo … d. Age, gender, diagnosis, type of CVC, hematological values (hemoglobin and PLT count, prothrombin international normalized ratio, active partial thromboplastin time) and post-operative bleeding complications were compared between patients with PLT count below (group A) and above 50×109/L (group B). RESULTS: Seventy-two CVC procedures were performed in 67 patients, with a med …

Up-regulation of A20 gene expression in peripheral blood mononuclear cells is associated with acute-on-chronic hepatitis B liver failure.

Aberrant immunity contributes to the pathogenesis of acute-on-chronic hepatitis B liver failure (ACHBLF), and A20 is a newly identified nega … ith CHB and HCs. In ACHBLF patients, A20 mRNA was closely associated with total bilirubin, albumin, international normalized ratio, prothrombin time activity and model for end-stage liver disease. Furthermore, A20 mRNA was significantly correlated with IL-6 and IL-10. An optimal cut-off value of 12.32 for A20 mRNA had significant power in discriminating survival or death in ACH …

Rationale and design of VENTURE-AF: a randomized, open-label, active-controlled multicenter study to evaluate the safety of rivaroxaban and vitamin K antagonists in subjects undergoing catheter ablation for atrial fibrillation.

PURPOSE: To evaluate the safety of uninterrupted rivaroxaban, a novel oral anticoagulant that directly inhibits factor Xa, and a vitamin K a … be randomized 1:1 to rivaroxaban 20 mg orally once daily or to dose-adjusted oral VKA (recommended international normalized ratio (INR) 2.0-3.0) and stabilized on anticoagulation therapy for 1-7 days (if no intracardiac thrombus on transesophageal echocardiogram (TEE) immediately prerandomization/post-randomization or if 3 weeks of sufficient anticoagulation is documented) or …

Survival after 131I-labeled lipiodol therapy for hepatocellular carcinoma. A single-center study based on a long-term follow-up.

UNLABELLED: This study investigated the efficacy of 131iodine-labeled lipiodol (131I-lipiodol) as a palliative therapy, evaluated overall su … sence of ascites, PVO, or extrahepatic disease; largest lesion size; favourable treatment response; international normalized ratio, baseline albumin and alpha-fetoprotein levels. Patients with a Child-Pugh A liver disease had a longer OS. CONCLUSION: Currently, different treatment modalities for HCC include radioembolization, transarterial chemoembolization, and systemic thera …

Опыт лечения ламивудинами острого гепатита В.

ВВЕДЕНИЕ: Опыт лечения ламивудинами острого острого гепатита В ограничен. У 1% иммунокомпетентных пациентов, страдающих острым гепатитом В, развивается мягкий гепатит. ЦЕЛЬ: Цель этого исследования заключалась в оценке эффективности ламивудина в лечении острого острого гепатита В (SAHB) у иммунокомпетентных взрослых пациентов. В период с января 2006 года по май 2013 года в клинике по инфекционным заболеваниям Баня-Лука 13 пациентов, больных SAHB, прошли курс лечения ламивудина при дозе 100 мг в день. Все 13 пациентов удовлетворяли по крайней мере двум из трех стандартных критериев: 1. энцефало

Совпадение в аннотации оригинала
INTRODUCTION: Experience with lamivudine treatment for acute severe hepatitis B is limited. Fulminant hepatitis develops in 1% of immunocomp … 1. hepatic encephalopathy; 2. total bilirubin greater than 210 μmol/L; and 3. severe coagulopathy (international normalized ratio--INR ≥1.5 or prothrombin time--PT <40%). The criteria were defined according to the experiences reported in the study of Schmilovitz-Weiss et al. "Lamivudine treatment for severe acute hepatitis B". Nine patients had a rapid rise in the total biliru …

Clinical presentation of hepatitis D in Pakistani children.

BACKGROUND: There are limited data on hepatitis D in children. The aim of this study was to assess the clinical presentation of hepatitis D … artate aminotransferase and γ-glutamyl transferase levels (P<0.001 each), platelet count (P=0.015), international normalized ratio (P<0.001), severity of inflammation on liver biopsy (P=0.007), and advanced fibrosis (P=0.016) in the two groups, indicating more severe disease in the HDV group. In the HDV group, six patients had normal ALT, of whom three were positive for hepatit …

Intravenous warfarin and heparin-induced thrombocytopenia: making the diagnosis, management, modern monitoring, and multidisciplinary care.

OBJECTIVE: To describe the diagnosis, management, and monitoring of a patient with heparin-induced thrombocytopenia (HIT) with thrombosis an … ICU team transitioned the patient from argatroban to IV warfarin for long-term anticoagulation. The international normalized ratio was monitored and remained therapeutic throughout his admission without further thrombotic complications. DISCUSSION: HIT occurs when antibodies develop to heparin-platelet factor 4 complexes, causing simultaneous hypercoagulability and thrombocyto …

Altered mental status in cirrhosis: etiologies and outcomes.

BACKGROUND: Cirrhotic patients admitted with altered mental status (AMS) represent a clinical challenge, as many potentially life-threatenin … s, or psychiatric abnormalities). RESULTS: Patients with AMS had higher levels of serum bilirubin, international normalized ratio, blood urea nitrogen, creatinine, and lower levels of albumin and platelets than those with normal mental status (NMS) (P = < 0.001). The most common cause of AMS was HE, accounting for nearly half of all patients. Other causes of AMS included the f …

[Realities and perspectives of stroke prevention in atrial fibrillation: physician's opinions analysis].

The purpose is to study the opinions of general practitioners and cardiologists on the issue of stroke prevention and the prospects of new o … with stroke risk. 85.0% of respondents believe the complexity of controlling and instability of the international normalized ratio to be the barrier to warfarin prescription. We revealed the differences in the approaches to antithrombotic drugs choice between general practitioners and cardiologists, as well as between subgroups of doctors who use or don't use the stroke risk sc …

The unappreciated importance of blood pressure in recent and older atrial fibrillation trials.

Atrial fibrillation and arterial hypertension represent two common clinical conditions that frequently coexist, especially in older individu … ED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs/alcohol concomitantly) scores (risk for bleeding) and the presence of hypertension alone is an indication to initiate antithrombotic treatment. However, blood pressure remains remarkably unappreciated in previous and recent atrial fi …

I smell a rat: a case report and literature review of paradoxical thrombosis and hemorrhage in a patient with brodifacoum toxicity.

Brodifacoum poisoning occurs as a result of ingestion of rodenticide compounds. It acts as a superwarfarin, inhibiting vitamin K epoxide red … ormal. Prothrombin time (PT) was above 100 s, partial thromboplastin time (PTT) was above 200 s and international normalized ratio was reported as above 12.0. Urinalysis revealed hematuria. Venous Doppler ultrasound of lower extremities demonstrated left popliteal vein thrombosis. Computed tomography scan of the abdomen demonstrated transmural hematoma, and fecal occult blood t …

A case of atypical hemolytic uremic syndrome successfully treated with eculizumab.

Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathy (TMA) characterized by the triad of hemolytic anemia, thrombo … head revealed a right-sided subdural hematoma due to coagulopathy resulting from a supratherapeutic international normalized ratio (INR). Following treatment with prothrombin complex concentrate to reverse the INR, urine output dropped and his serum creatinine subsequently increased to 247.52 μmol/l from the admission value of 70.72 μmol/l. Laboratory evaluation was remarkable …

Pretreatment viral DNA stratifies mortality risk in patients receiving antiviral therapy for severe acute exacerbation of chronic hepatitis B.

BACKGROUND: Prognostic factors have not been elucidated for severe acute exacerbation of chronic hepatitis B treated with antiviral therapy. … tality was associated with baseline viral DNA level (HR 1.49 per log copies/ml, 95% CI 1.13, 1.96), international normalized ratio for prothrombin time (HR 2.68 per unit, 95% CI 1.81, 3.98), platelet count (HR 0.87 per 10(4) cells/μl, 95% CI 0.78, 0.98) and age (HR 1.10 per year, 95% CI 1.05, 1.15). A significant interaction existed between viral DNA and prolonged prothrombin t …

Basic hemostatic parameters in patients with long-term oral anticoagulation undergoing cholecystectomy.

BACKGROUND: The current hemostatic data in relation to laparoscopic cholecystectomy (LC) is limited particularly for patients receiving chro … erved in the OAC group when compared with the control group (P<.05). Although within normal ranges, international normalized ratio values and the tissue plasminogen activator activity were significantly higher, whereas factor II, VII, IX, and X levels were significantly lower in the OAC group when compared with the control group (P<.05). CONCLUSION: Patients receiving oral ant …

Catheter ablation of atrial fibrillation in patients with therapeutic oral anticoagulation treatment.

AIMS: Current guidelines recommend discontinuation of oral anticoagulation treatment (OAT) and switch to heparin 2-5 days before catheter ablation of atrial fibrillation (AF). However, increasing evidence leans against the 'bridge therapy' and support continuation of OAT during the procedure. METHODS AND RESULTS: We evaluated the safety of AF ablation among patients with therapeutic OAT. The study population comprised 193 consecutive patients who underwent 228 AF ablation procedures guided by electroanatomical mapping. Periprocedural international normalized ratio was <2 (1.6 ± 0.3) in 103 ca…

A method for anticoagulation of children on mechanical circulatory support.

Anticoagulation of children on mechanical circulatory support presents a challenge. We implanted 28 devices in children and infants using a consistent anticoagulation protocol. We performed a retrospective review of all children implanted in our program with mechanical assist devices since 1997. Heparin, dipyridamole, and aspirin were used for anticoagulation and antiaggregation. Coagulation monitoring included thromboelastography (TEG), platelet aggregration studies, international normalized ratio, partial thromboplastin time, and platelet count. Twenty-eight children, ages 1 month to 16 year…