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A Mysterious Cause of Coagulopathy With Bleeding Diathesis.
Cureus
December 2024
Department of Internal Medicine IV, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.
Vitamin K is essential to produce functional vitamin K-dependent coagulation factors (prothrombin, factors VII, IX, and X). Vitamin K antagonists inhibit the normal activation of these factors, leading to bleeding manifestations of variable severity. Long-acting vitamin K antagonists or superwarfarins were developed as rodenticides and have a significantly longer half-life and greater potency when compared to warfarin.
View Article and Find Full Text PDFVitamin K Antagonist Use and Level of Anticoagulation Control Among Patients at a Tertiary Hospital in Northern Tanzania.
J Cardiovasc Pharmacol Ther
January 2025
Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Background: Vitamin K antagonists (VKA) continue to be the principal anticoagulants for both the treatment and prevention of venous thromboembolism. The use of VKA often requires regular monitoring to avoid over-anticoagulation and prevent thromboembolic complications. The aim was to determine the indication for VKA use and factors associated with suboptimal anticoagulation control among patients in northern Tanzania.
View Article and Find Full Text PDFEvaluating remyelination compounds for new applications in opioid use disorder management.
J Addict Dis
January 2025
Departments of Anesthesiology and Perioperative Medicine and Pharmacology, Penn State College of Medicine, Hershey, PA, USA.
Opioid use disorder (OUD) is associated with a reduction in brain white matter, affecting critical areas involved in decision-making, impulse control, and reward processing. The FDA has approved several drugs and natural compounds that enhance myelination, targeting oligodendrocyte progenitor cells (OPCs), directly enhancing oligodendrocyte (OL) function, or acting as cofactors for myelin production. This retrospective case study aimed to assess whether current clinical evidence supports the use of myelin-enhancing agents to promote remission in OUD.
View Article and Find Full Text PDFAims: This study aimed to determine the robustness, reproducibility and representativeness of the landmark Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (AF) (ARISTOTLE) and Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in AF (ROCKET AF) randomised trials through replication in an observational AF patient registry.
Methods And Results: Patients from the Global Anticoagulant Registry in the FIELD (GARFIELD)-AF registry treated with apixaban, rivaroxaban or vitamin K antagonist (VKA) were assessed for eligibility for the ARISTOTLE and ROCKET AF trials. HRs of apixaban and rivaroxaban versus comparator for stroke/systemic embolism, major bleeding and all-cause mortality within 2 years follow-up were calculated using propensity score overlap-weighted Cox models.
Intravenous thrombolysis for patients with acute ischemic stroke while receiving a direct oral anticoagulant: A systematic review and meta-analysis.
Pharmacotherapy
January 2025
Auburn University Harrison College of Pharmacy, Auburn, Alabama, USA.
Recent guidelines for acute ischemic stroke (AIS) indicate administration of intravenous thrombolysis (IVT) in patients receiving direct oral anticoagulants (DOAC) is not firmly established and may be harmful unless certain potential parameters are met. This systematic review and meta-analysis explores safety outcomes and other clinical parameters from the growing number of publications describing patients taking a DOAC who experience an AIS that is treated acutely with IVT alone. Embase, International Pharmaceutical Abstracts, and PubMed were searched up to January 9, 2024 for studies including adult patients taking a DOAC who experienced an AIS treated with IVT and did not undergo endovascular therapy (EVT), regardless of the use of an anticoagulation reversal agent.
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