[MANAGEMENT RECOMMENDATIONS FOR DIRECT ORAL ANTICOAGULANTS (DOACs) ANTI Xa AND ANTI IIa].

Direct oral anticoagulants have emerged as the drugs that have changed the management of the antithrombotic treatment in the last 15 years. Their advantages, like a more friendly way of anticoagulation and their lower risk of bleeding, especially in the brain, have positioned these new anticoagulants as the first drug of choice in the two most frequent indications of anticoagulation, atrial fibrillation, and the venous thromboembolic disease. However, not all the patients can receive these agents, not all the direct oral anticoagulants have the same characteristics, and most importantly, not all the diseases with an indication of an anticoagulant drug can be treated with them.

[Argentine Consensus in effective management of anticoagulation clinics for the use of vitamin k antagonists].

Treating an anticoagulated patient with vitamin K antagonists (VKA) remains a challenge, especially in areas where dicoumarins are still the first drug of choice due to the cost of other oral anticoagulants. Anticoagulation clinics have proven to be the most efficient and safe way to avoid thrombotic and hemorrhagic complications and to keep patients in optimal treatment range. However, they require adequate infrastructure and trained personnel to work properly.

[Recommendations for the use of thromboprophylaxis in hospitalized patients with COVID-19 in Argentina].

Although the incidence is uncertain, some case reports suggest that COVID 19 infection is associated with an increased risk of venous thromboembolism. We suggest starting prophylactic anticoagulant therapy for all patients hospitalized with a symptomatic infection with COVID-19, unless contraindicated, with enoxaparin 40 mg SC daily if creatinine clearance is greater than 30 ml/min.

[Updated recommendations for venous thromboembolic prophylaxis in Argentina].

Venous thromboembolic disease (VTE) in hospitalized adults has high morbidity and mortality, is the origin of chronic complications and increased cost for the health system. Since the publication of recommendations for thromboprophylaxis in hospitalized patients in 2013, new alternatives and strategies have emerged, which motivated us to update our recommendations. Although there are different consensus and clinical practice guidelines, adherence to them is suboptimal.

[Venous thromboembolic prophylaxis. Guidelines for adults in Argentina].

The venous thromboembolic disease (VTD) in adults has a high morbidity and mortality. It can be also associated to disabling chronic conditions. In spite of this, prophylaxis in healthcare assistance is still underused.

Factors that influence the bleeding phenotype in severe hemophilic patients.

Hemophilia A and B are rare, X-linked bleeding disorders resulting from a partial or total deficiency of functionally active coagulation factor VIII or factor IX, respectively. Endogenous factor levels have traditionally been used to characterize the severity of the disorder, with severe hemophilia considered as circulating levels of factor less than 1% of normal. Identifying patients with severe hemophilia is essential to effective treatment, since these patients are at highest risk of spontaneous life or limb-threatening bleeding and disability resulting from repeated joint bleeding and are most likely to benefit from prophylaxis.

[Bleeding during anti-vitamin K treatment. Incidence, risk factors and comparison with the new oral anticoagulants].

Bleeding is the main complication of oral anticoagulants, anti-vitamin K or new drugs such as anti-factor Xa or anti-thrombin agents. Risk factors associated with bleeding during warfarin therapy are discussed. For the new drugs no published data is available yet.

Decitabine in myelodysplastic syndromes and chronic myelomonocytic leukemia: Argentinian/South Korean multi-institutional clinical experience.

This multicenter, open-label study evaluated the efficacy and safety of decitabine in patients from Argentina and South Korea with myelodysplastic syndromes or chronic myelomonocytic leukemia. Of 106 patients who received decitabine 20 mg/m(2) intravenously over 1 h once daily for 5 days in 4-week cycles, 99 patients were evaluable after receiving at least two cycles. The overall improvement rate was 35% (19% complete response +4% marrow complete response +4% partial response +8% hematologic improvement).

[Thrombotic thrombocytopenic purpura and systemic lupus erythematous. Three cases presenting simultaneously].

Thrombotic thrombocytopenic purpura (TTP) is a clinical syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological symptoms, and renal involvement. The relationship of TTP to systemic lupus erythematosus (SLE) has been recognized in the medical literature since 1939. The differential diagnosis is difficult because both diseases have similar clinical features.

[Prophylaxis of venous thrombosis, yes but...].

Prevention of venous thromboembolism (VTE) can be achieved through mechanic or pharmacological means. For the latter, unfractionated low dose heparin, low molecular weight heparins and oral anticoagulants are successfully and widely employed. Results of controlled and uncontrolled studies favour the use of prophylactic heparin in different clinical and surgical conditions such as myocardial infarction, stroke, orthopedic or prolonged surgery and surgical interventions in patients older than forty.

[Bone marrow granulomas].

Purpose: To evaluate bone marrow granulomatous lesions in order to establish their etiology.

Material And Methods: 2,250 bone marrow biopsies were studied during the period of March 1983-March 1991. Granulomas and/or granulomatous lesions were found in 24 of them (1.

Cost implications of malpractice and adverse events.

The ninth most common allegation against hospitals in 1989 was infection/contamination exposure, with the average claim costing nearly $34,000. Most malpractice claims are associated with inpatient surgery, according to 1990 statistics, and the average cost of a claim for infection and contamination related to surgery was over $64,000 in 1990. Physicians currently pay as much as $50,000 annually for malpractice insurance, and hospitals in some major metropolitan areas pay $8,000 per bed for insurance.