Cancer is the second leading cause of death in the United States. The risk of cancer development and subsequent death from the disease increases sharply in the population over 55 years of age(1). Coagulation problems also increase with age and have been implicated in increasing the metastatic spread of cancer. Although cancer treatment has improved constantly it still remains quite toxic and improvement are needed Mouse mammary tumor is a common form of cancer used for experimental animal study. This investigation was designed to study the nature of leukocytic response to mouse mammary tumor implants in C3H/HeJ mice with and without anticoagulants. The main thrust of the research was in three areas: first, to develop a background in light microscope morphology of spontaneous mouse mammary tumor and its change with first and second passage into normal mice; second, to analyze change in leukocytic response in sham operated, tumor- and liver-implanted mice; and third, to analyze changes in leukocytic response to tumor implants with and without anticoagulation.

Analysis of anticoagulant utilization in the Czech republic in the period from 2007 to 2016 Author: Zuzana Hochelová1 Supervisor: PharmDr. Eva Zimčíková, Ph.D.1 Consultant: PharmDr. Kateřina Malá, Ph.D.1 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Czech Republic Introduction: Anticoagulants are drugs that reduce blood clotting and prevent the formation of blood clots. In the Czech Republic - antagonists of vitamin K-warfarin, direct oral inhibitors of factor Xa-rivaroxaban, apixaban, edoxaban, direct oral inhibitors trombin - dabigatran, parenteral anticoagulants - heparin, low-molecular heparin, fondaparinux, oral and parenteral hirudin are used. Objective: The objective of this diploma thesis was to assess the consumption of oral and parenteral anticoagulants in the Czech Republic from 01. 01. 2007 to 31. 12. 2016, based on the data from the State Institute of Drug Control (SIDC). Methods: ATC/DDD methodology was applied. The research consisted of a retrospective analysis of the SIDC database. All oral and parental anticoagulants approved in the CR were included in the study. Drug utilization was calculated as number of defined daily doses per thousands of inhabitants per day (DID). The data on the number of residents was acquired from...

Atrial fibrillation (AF) is associated with high risk of systemic thromboembolism leading to significant morbidity and mortality. Warfarin, previously the mainstay for stroke prevention in AF, requires close monitoring because of multiple food and drug interactions. In recent years, food and drug administration has approved several direct oral anticoagulants (DOACs) for use in patients with nonvalvular AF. These agents have not been studied in patients with valvular AF who are at an even higher risk of systemic thromboembolism. DOACs do not require frequent blood testing or changes in dosage except when renal function deteriorates, however, the lack of established antidotes for many of these agents remains a challenge. Also, currently there is no head-to-head comparison between these agents to guide clinical choice. This article discusses the advantages and disadvantages of currently approved oral antithrombotics in nonvalvular AF, with a special emphasis on the DOACs and their individual characteristics.

To review the literature on treatment of venous thromboembolism (VTE) and prevention of cardioembolic stroke with direct-acting oral anticoagulants (DOACs) in low- and high-body-weight patients and to make recommendations regarding agent selection and dosing in these patient populations. Summary: The selection and optimal dosing of DOACs in low- and high-body-weight patients has not yet been fully elucidated by clinical trials; however, evidence suggests that issues of both safety and efficacy in patients at the extremes of body weight may warrant careful consideration when selecting a DOAC for such patients. This review provides a thorough discussion of the use of DOACs in the treatment of VTE and prevention of cardioembolic stroke in patients at the extremes of body weight and provides guidance regarding agent selection. Conclusion: While the published evidence on use of DOACs in patients at extremes of body weight is sparse, apixaban and rivaroxaban appear to have the most favorable safety and efficacy profiles. Edoxaban and dabigatran should be avoided.

Atrial fibrillation (AFIB) is the most common heart rhythm abnormality and is associated with significant morbidity and mortality. While the treatment of AFIB involves strategies of rate with or without rhythm control, it is also essential to strategize appropriate therapies to prevent thromboembolic complications arising from AFIB. Previously, anticoagulation was the main treatment option which exposed patients to higher than usual risk of bleeding. However, with the advent of new technology, novel therapeutic options aimed at surgical or percutaneous exclusion or occlusion of the left atrial appendage in preventing thromboembolic complications from AFIB have evolved. This review evaluates recent advances and therapeutic options in treating AFIB with a special focus on both surgical and percutaneous interventions which can reduce and/or eliminate thromboembolic complications of AFIB.

Purpose:This review summarizes the available evidence concerning direct oral anticoagulant (DOAC) use to treat venous thromboembolism (VTE) in patients with cancer as well as pertinent safety data on the use of DOACs in patients with both cancer and atrial fibrillation. Summary:The introduction of DOACs into clinical practice changed the way thrombotic complications are managed and prevented in diverse patient populations, including VTE and atrial fibrillation. Low-molecular-weight heparins have been the standard of care for treating VTE in cancer patients due to superiority over vitamin K antagonists in preventing recurrent VTE. Therefore, widespread DOAC use for VTE in patients with active cancer has not been adopted. Conclusion:Recent randomized clinical trials (SELECT-D, Hokusai VTE Cancer) have provided evidence that DOACs may have a role in treating VTE in cancer patients.

Yes / Health Services Research and Pharmacy Practice Conference Abstracts: Partnerships in Healthcare: Advancing Sustainable Medicines Optimisation 17–18 April 2023 University of Bradford.

Parenteral anticoagulants are vital in the prevention of thrombus formation and thus, are commonly used in a hospital setting. A thrombus can restrict blood flow where formed such is the case with deep vein thrombosis (DVT). They may also become dislodged forming an emboli, which may travel and become lodged in the lungs, causing a pulmonary emboli, or other vessels including those going to the brain, causing a stroke. While anticoagulants are many times necessary, when given subcutaneously, they have been associated with pain, purpura, melena, hematuria, osteoporosis, thrombocytopenia, and hematoma formation. While hematoma formation has not proven to be life threatening, it does lead to increased patient discomfort, distorted body image, and may lead to surgery. Different methods of preventing hematoma formation have been studied with regards to anticoagulant injection technique though no method has been consistently substantiated by the research or adopted by nursing texts.

Patients with mechanical heart valves who present with intracranial haemorrhage are initially treated by reversing their coagulopathy. However, these patients will ultimately require that their oral anticoagulant be restarted. The time at which oral anticoagulants are restarted is critical since restarting too early may increase the risk of recurrent bleeding, while withholding anticoagulants increases the patient’s risk of thromboembolic events. The ideal time to restart patients on their oral anticoagulant medication is defined as the time at which all these risks are minimized. This thesis includes a systematic review and meta-analysis of the literature. The main outcomes were recurrent haematoma, valve thrombosis, stroke and peripheral emboli. Results were stratified by types of intracranial haemorrhage. We also conducted a survey to gain insight into current practices of neurosurgeons and thrombosis experts in Canada and USA when they are faced with deciding on anticoagulant restart times in patients with ICH. Results were stratified by type of intracranial bleed and participants’ characteristics and demographics. The systematic review identified that the ideal time for restarting anticoagulant therapy in patients following an ICH is unknown. Meta-analysis was limited by the heterogeneity of the studies. The survey results indicated that physicians had a wide range of practice and that their practice was dependent on the patient’s clinical features, but many physicians would restart oral anticoagulants between 4 and 14 days after the haemorrhage. For this reason we have proposed a multi centre cohort study to investigate the safety and efficacy of restarting patients on anticoagulation therapy between day 5 and 9 post haemorrhage. A full study protocol is presented in this thesis.

Thesis (Ph.D.)--University of Alabama at Birmingham, 2007. / Title from PDF title page (viewed on Feb. 19, 2010). Includes bibliographical references.