ABSTRACT
Direct oral anticoagulants have demonstrated efficacy and safety in the treatment of venous thromboembolic disease. A review is presented of the results of direct oral anticoagulants in the published clinical trials of extended anticoagulant treatment (after the first 3-6 months of treatment) of venous thromboembolic disease.
Subject(s)
Anticoagulants/administration & dosage , Venous Thromboembolism/drug therapy , Administration, Oral , Anticoagulants/adverse effects , Anticoagulants/pharmacology , Humans , Time Factors , Venous Thromboembolism/physiopathologyABSTRACT
In clinical practice, low-molecular-weight heparins are used relatively frequently in patients with atrial fibrillation to prevent embolic events. In this article, it is revised the available evidence in the following clinical situations: rapid onset of anticoagulation, bridging therapy (replacing long-term oral anticoagulant therapy around an invasive procedure) and transesophageal echocardiography-guided cardioversion.
ABSTRACT
Giant cell arteritis is the most common primary systemic vasculitis in adults. The condition is granulomatous arteritis of large and medium vessels, which occurs almost exclusively in patients aged 50 years or more. This article reviews the diagnosis and treatment of the disease.
ABSTRACT
Rivaroxaban is a direct inhibitor of activated factor X, and dabigatran is a direct inhibitor of thrombin. These new oral anticoagulants have demonstrated to be effective and safe in clinical trials on the treatment of venous thromboembolic disease (deep vein thrombosis and pulmonary thromboembolism).
Subject(s)
Anticoagulants/therapeutic use , Benzimidazoles/therapeutic use , Morpholines/therapeutic use , Thiophenes/therapeutic use , Venous Thromboembolism/drug therapy , beta-Alanine/analogs & derivatives , Clinical Trials as Topic , Dabigatran , Humans , Rivaroxaban , beta-Alanine/therapeutic useABSTRACT
El rivaroxabán es un inhibidor directo de factor X activado y el dabigatrán un inhibidor directo de la trombina. Estos nuevos anticoagulantes orales han demostrado en ensayos clínicos su eficacia y seguridad en el tratamiento de la enfermedad tromboembólica venosa (trombosis venosa profunda y tromboembolia pulmonar) (AU)
Rivaroxaban is a direct inhibitor of activated factor X, and dabigatran is a direct inhibitor of thrombin. These new oral anticoagulants have demonstrated to be effective and safe in clinical trials on the treatment of venous thromboembolic disease (deep vein thrombosis and pulmonary thromboembolism) (AU)
Subject(s)
Humans , Male , Female , Primary Health Care/methods , Primary Health Care/standards , Primary Health Care/trends , Anticoagulants/therapeutic use , Venous Thromboembolism/epidemiology , Venous Thromboembolism/prevention & control , Factor X/therapeutic use , Thrombin/therapeutic use , Thromboembolism/epidemiology , Thromboembolism/prevention & control , Enoxaparin/therapeutic useABSTRACT
El dabigatrán es un nuevo inhibidor directo de la trombina de administración oral. Este artículo revisa los resultados de los principales ensayos clínicos que justifican las indicaciones actuales en la prevención de la enfermedad tromboembólica venosa en cirugía ortopédica de cadera y rodilla, la prevención de embolia en fibrilación auricular y el tratamiento de la enfermedad tromboembólica venosa (AU)
Dabigatran is a new oral direct thrombin inhibitor. This article reviews the results of major clinical trials to justify the present indications in the prevention of venous thromboembolic disease in knee and hip orthopaedic surgery, prevention of embolism in atrial fibrillation and treatment of venous thromboembolic disease (AU)
Subject(s)
Humans , Male , Female , Receptors, Thrombin , Thrombin/therapeutic use , Orthopedics/methods , Embolism/prevention & control , Anticoagulants/therapeutic use , Atrial Fibrillation/prevention & control , Venous Thromboembolism/complications , Venous Thromboembolism/diagnosis , Anticoagulants/administration & dosage , Atrial Fibrillation/complications , Risk Factors , Venous Thromboembolism/prevention & controlABSTRACT
Patients with atrial fibrillation (AF) at risk of stroke are not always anticoagulated with vitamin K antagonists (VKA) despite lack of contraindication. Dabigatran, an oral direct thrombin inhibitor, is a new option with proven safety and effectiveness in these patients. The advantages of dabigatran are its more predictable response, obviating coagulation monitoring and possible lower frequency of bleedings. Its drawbacks are cost, lack of antidote and long-term data, frequency of dyspepsia and the twice daily dosage.
Subject(s)
Acenocoumarol/therapeutic use , Anticoagulants/therapeutic use , Antithrombins/therapeutic use , Atrial Fibrillation/complications , Benzimidazoles/therapeutic use , Stroke/prevention & control , Vitamin K/antagonists & inhibitors , beta-Alanine/analogs & derivatives , Aged, 80 and over , Dabigatran , Female , Humans , Risk Assessment , beta-Alanine/therapeutic useABSTRACT
Los pacientes con fibrilación auricular (FA) en riesgo de ictus no siempre son anticoagulados con antagonistas de la vitamina K (AVK) a pesar de no existir contraindicación. El dabigatrán, un inhibidor directo de la trombina oral, es una nueva opción que ha demostrado su seguridad y eficacia en estos pacientes. Las ventajas del dabigatrán son su respuesta más predecible obviando la necesidad de monitorización anticoagulante y la posible menor frecuencia de hemorragias. Las desventajas del dabigatrán son el coste económico, la ausencia de un antídoto y de datos a largo plazo, la frecuencia de dispepsia y la dosificación en 2 tomas diarias(AU)
Patients with atrial fibrillation (AF) at risk of stroke are not always anticoagulated with vitamin K antagonists (VKA) despite lack of contraindication. Dabigatran, an oral direct thrombin inhibitor, is a new option with proven safety and effectiveness in these patients. The advantages of dabigatran are its more predictable response, obviating coagulation monitoring and possible lower frequency of bleedings. Its drawbacks are cost, lack of antidote and long-term data, frequency of dyspepsia and the twice daily dosage(AU)
Subject(s)
Humans , Female , Aged, 80 and over , Stroke/drug therapy , Stroke/prevention & control , Atrial Fibrillation/drug therapy , Atrial Fibrillation/prevention & control , Vitamin K/antagonists & inhibitors , Thrombin/antagonists & inhibitors , Receptors, Thrombin/antagonists & inhibitors , Acenocoumarol/therapeutic use , Partial Thromboplastin Time/methods , Anticoagulants/therapeutic use , Dyspepsia/prevention & control , Electrocardiography , /methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Hypoglycemia/etiology , Leukocytosis/etiology , Myeloproliferative Disorders/diagnosis , Hypoglycemia/diagnosis , Leukocytosis/diagnosis , Hydroxyurea/therapeutic use , Myeloproliferative Disorders/drug therapySubject(s)
Mesenteric Veins , Point Mutation/genetics , Portal Vein , Prothrombin/genetics , Venous Thrombosis/genetics , Adult , Humans , MaleSubject(s)
Pulmonary Embolism/mortality , Biomarkers , Electrocardiography , Heart Arrest/etiology , Heart Arrest/mortality , Heart Failure/diagnostic imaging , Heart Failure/etiology , Heart Failure/mortality , Humans , Hypertension, Pulmonary/complications , Natriuretic Peptide, Brain/blood , Prognosis , Pulmonary Embolism/blood , Pulmonary Embolism/complications , Pulmonary Embolism/diagnostic imaging , Radionuclide Imaging , Troponin I/blood , Troponin T/blood , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Mesenteric Veins , Point Mutation/genetics , Portal Vein , Prothrombin/genetics , Venous Thrombosis/geneticsABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Phantoms, Imaging , Heart Failure/complications , Pleural Effusion , Heart FailureABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Cerebral Ventricles , Embolism, Air/etiology , Anesthesia, Spinal/adverse effects , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Pulmonary Embolism/diagnosis , Prognosis , Homeopathic Clinical-Dynamic Prognosis/methods , Biomarkers/analysis , Troponin I , Troponin T , Predictive Value of Tests , Natriuretic Peptides , Ventricular Dysfunction, Right/diagnosis , Ventricular Dysfunction, Right/complications , Ventricular Dysfunction, Right/etiologyABSTRACT
INTRODUCCIÓN. La enfermedad tromboembólica venosa (ETV) en la mujer ha sido poco estudiada. En este artículo describimos las características de las mujeres con ETV en nuestra serie. MATERIAL Y MÉTODOS. Estudio observacional prospectivo de todos los pacientes de procedencia ambulatoria diagnosticados mediante métodos objetivos de ETV en el único hospital de un área rural entre noviembre de 2002 y abril de 2005. RESULTADOS. Se diagnosticaron 94 casos de ETV. La edad media fue 71,9 años (rango 35-94 años), y 52 (55,3%) fueron mujeres. El tiempo medio de seguimiento con tratamiento anticoagulante fue 7,1 meses (rango 0-29 meses). La edad de las mujeres fue mayor que la de los varones (74,5 ± 10,5 frente a 68,8 ± 12,5 años, p = 0,01). La frecuencia de enfermedad cardiopulmonar fue menor en las mujeres (11,5 frente a 38,1%, p = 0,002). El tiempo de evolución de la clínica fue mayor en las mujeres, aunque sin alcanzar significación estadística (10,2 ± 19,6 frente a 6,2 ± 7,7 días, p > 0,05). La frecuencia de tromboembolismo pulmonar (TEP) (46,2 frente a 38,1%, p > 0,05) y de eventos adversos (21,1 frente a 16,7%, p > 0,05) fue mayor en las mujeres, aunque sin alcanzar significación estadística. La frecuencia de recurrencia tromboembólica durante el tratamiento anticoagulante fue menor en las mujeres, aunque sin alcanzar significación estadística (1,9 frente a 7,1%, p > 0,05). CONCLUSIONES. Las mujeres con ETV son más ancianas y presentan menos frecuentemente enfermedad cardiopulmonar que los varones. El retraso en el diagnóstico, la frecuencia de TEP y la ocurrencia de eventos adversos pueden ser más frecuentes en las mujeres, y la recurrencia tromboembólica puede ser menos frecuente en las mujeres
INTRODUCTION. Venous thromboembolic disease (VTD) in the woman has been studied little. In this article, we describe the characteristics of women with VTD in our series. MATERIAL AND METHODS. Prospective, observational study of all out-patients diagnosed by objective methods of VTD in the only hospital of a rural area between November 2002 and April 2005. RESULTS. A total of 94 cases of VTD were diagnosed. Mean age was 71.9 years (range 35-94 years) and 52 (55.3%) were women. Mean follow-up time with anticoagulant treatment was 7.1 months (range 0-29 months). The age of the women was greater than that of men (74.5 ± 10.5 vs 68.8 ± 12.5 years, p = 0.01). Frequency of cardiopulmonary disease was lower in women (11.5 vs 38.1%, p = 0.002). Evolution time of the symptoms was greater in women although it did not have statistical significance (10.2 ± 19.6 vs 6.2 ± 7.7 days, p> 0.05). Frequency of pulmonary thromboembolism (PTE) (46.2 vs 38.1%, p> 0.05) and adverse events (21.1 vs 16.7%, p> 0.05) was greater in women although it did not have statistical significance. Frequency of thromboembolic recurrence during anticoagulant treatment was lower in women although without statistical significance (1.9 vs 7.1%, p> 0.05). CONCLUSIONS. Women with VTD are older and have cardiopulmonary disease less frequently than men. Delay in diagnosis, frequency of PTE and occurrence of adverse events may be more frequent in women and thromboembolic recurrence may be less frequent in women
Subject(s)
Humans , Female , Thromboembolism/epidemiology , Prospective Studies , Venous Thrombosis/epidemiology , Recurrence , Anticoagulants/therapeutic use , Thromboembolism/drug therapyABSTRACT
OBJECTIVE: To study the characteristics of patients with venous thromboembolic disease (VTD) and cancer in our area. METHODS: Prospective observational study of all patients diagnosed by objective methods of VTD in the only hospital in a rural area from November 2002 to April 2005. RESULTS: Ninety-four patients were diagnosed of VTD. The median age was 71.9 years (range 35-94 years), and 52 (55.3%) were women. The median follow-up with anticoagulant therapy was 7.1 months (range 0-29 months). Seventeen patients (18.1%) had cancer. Eleven cases (64.7%) had an adenocarcinoma, and 7 (41.2%) had distant metastases. Two (2.5%) of 79 cases without prior cancer were diagnosed of cancer after the diagnosis of VTD. The frequency of adverse events (death, major hemorrhage and thromboembolic recurrence) was higher in patients with cancer (64.7 vs. 9.1%, p < 0.001). CONCLUSIONS: Almost one fifth of patients with VTD in our area had cancer, more frequently an adenocarcinoma. Cancer is infrequently diagnosed after the diagnosis of VTD. Cancer in VTD is associated to a poor prognosis, with a remarkable frequency of adverse events.
Subject(s)
Neoplasms/complications , Venous Thromboembolism/complications , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
In this article we briefly review the evidence on the effect of different "natural" products on cholesterolemia. Plant stanols and sterols reduce cholesterol intestinal absorption and decrease total and LDL cholesterol by approximately 10%. Polycosanol is a mixture of saturated alcohols that seem to inhibit cholesterol hepatic synthesis and decrease total and LDL cholesterol by up to 25%. The effects on the cholestorolemia of soy and soluble fiber are modest.
