Spontaneous retrobulbar hemorrhage in the setting of warfarin therapy and latent scurvy diagnosis

Orbit ◽  
2021 ◽  
pp. 1-3
Author(s):  
Brian W. Chou ◽  
Quinn N. Rivera ◽  
Courtney E. Francis
Keyword(s):  
Warfarin Therapy ◽  
Retrobulbar Hemorrhage

Lack of Agreement of Chromogenic and Glotting Assays for Factor X and Protein C in Warfarinised Plasma

1991 ◽  
Vol 65 (04) ◽  
pp. 360-363 ◽  
Author(s):  
P Han ◽  
K P Fung ◽  
U Rahdakrishnan
Keyword(s):  
Serine Proteases ◽  
Protein C ◽  
Warfarin Therapy ◽  
Intraclass Correlation ◽  
Chromogenic Substrate ◽  
Factor X ◽  
Laboratory Automation ◽  
Quantitative Results ◽  
Assay Methods

SummaryCoagulation serine proteases can be measured with either a chromogenic substrate assay or a clotting assay using deficient plasmas. It is a concern whether both assays give similar quantitative results, in particular in plasma obtained fiom patients on long term warfarin therapy. If these two assay methods were interchangeable, then the chromogenic substrate assay has the advantages of precision as well as laboratory automation. We used the intraclass correlation coefficient (r1) to assess the agreement between the two methods in measuring factor X and protein C levels in warfarinised plasma. The results indicate that the extent and pattern of agreement of the two methods for the measurement of the two variables in warfarinised plasma are poor, despite high Pearson product moment coefficients of correlation.

A Rare Case Report of Dabigatran Induced Oral Ulcers

2020 ◽  
Vol 15 (2) ◽  
pp. 160-162
Author(s):  
Ajeet Singh ◽  
Neel Prabha ◽  
Hitesh Yadav
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Warfarin Therapy ◽  
Systemic Embolism ◽  
Vein Thrombosis ◽  
Oral Ulcers ◽  
Retrosternal Pain ◽  
Novel Oral Anticoagulant ◽  
Rare Case Report ◽  
Deep Vein

Background: Dabigatran is a novel oral anticoagulant molecule which is a direct thrombin (Factor IIa) inhibitor and is used for prevention of stroke and systemic embolism. It is easy to administer as compared to warfarin therapy as it does not require routine laboratory monitoring and has fewer drug interactions. Objective: To present a rare case of oral ulcers secondary to dabigatran in a patient with deep vein thrombosis. Case report: A 68-year-old female presented with painful oral ulcers, retrosternal pain and difficulty in swallowing. She had been taking capsule Dabigatran for the prevention of systemic embolism for 2 months. She had experienced symptoms of onset taking dabigatran for 7 days. Clinical examination revealed three tender, well-defined, clean looking ulcers of various sizes present over the dorsum of the tongue. Dabigatran was withdrawn and the patient was on oral proton pump inhibitors. Patient showed remarkable improvement in oral ulcers after 2 weeks. Conclusion: Patient education and counseling should be done regarding this side effect of dabigatran and proper intake of this medicine.

scholarly journals Pharmacist-physician collaborative care for outpatients with left ventricular assist devices using a cloud-based home medical management information-sharing system: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoshiki Katada ◽  
Atsushi Yonezawa ◽  
Momoe Utsumi ◽  
Noriaki Kitada ◽  
Yu-ki Sato ◽  
...  
Keyword(s):  
Information Sharing ◽  
Warfarin Therapy ◽  
Anticoagulation Therapy ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Care Providers ◽  
Left Ventricular Assist Devices ◽  
Management Information ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Abstract Background The standard anticoagulation therapy for patients implanted with left ventricular assist devices (LVADs) includes warfarin therapy. We developed a cloud-based home medical management information-sharing system named as LVAD@home. The LVAD@home system is an application designed to be used on iPad tablet computers. This system enables the sharing of daily information between a patient and care providers in real time. In this study, we reported cases of outpatients with LVADs using this system to manage anticoagulation therapy. Case presentation The patient, a man in his 40s with end-stage heart failure owing to non-ischemic dilated cardiomyopathy, underwent LVAD implantation and warfarin was started on postoperative day 1. He started to use LVAD@home to manage warfarin therapy after discharge (postoperative day 47). He sent his data to care providers daily. By using this system, the pharmacist observed his signs of reduced dietary intake 179 days after discharge, and after consulting the physician, told the patient to change the timing of the next measurement earlier than usual. On the next day, the prothrombin time-international normalized ratio increased from 2.0 to 3.0, and thus the dose was decreased by 0.5 mg. Four patients used this system to monitor warfarin therapy from October 2015 to March 2018. In these patients, the time in therapeutic range was 90.1 ± 1.3, which was higher than that observed in previous studies. Additionally, there were no thromboembolic events or bleeding events. Conclusions The cloud-based home management system can be applied to share real-time patient information of factors, including dietary intake that interact with warfarin. It can help to improve long-term anticoagulation outcomes in patients implanted with LVAD.

scholarly journals Incidence and management of retrobulbar hemorrhage after blowout fracture repair

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Hwi Park ◽  
Inhye Kim ◽  
Jun Hyuk Son
Keyword(s):  
Medical Center ◽  
Rare Complication ◽  
Fracture Repair ◽  
Control Group ◽  
Orbital Decompression ◽  
Secondary Surgery ◽  
Orbital Surgery ◽  
Exact Test ◽  
Blowout Fracture ◽  
Retrobulbar Hemorrhage

Abstract Background Retrobulbar hemorrhage (RBH) is a rare complication after orbital surgery but associated with ocular complications including blindness. The aim of this study was to identify clinical characteristics of patients with RBH requiring emergent orbital decompression after blowout fracture repair. Method A retrospective review of 426 blowout fracture patients at a tertiary oculoplastic clinic provided data regarding demographics, physical examination findings, and computed tomography (CT) images. Extraocular motility had been recorded in patient charts on a scale from 0 to − 4. Patients requiring emergent orbital decompression due to RBH after surgery (RBH group) were compared with those who did not (Control group), using the Mann-Whitney U-test. Incidences of RBH according to primary or secondary surgery were also investigated, using Fisher’s exact test. Result Five (1.2%) of the 426 patients who underwent blowout fracture repair developed RBH requiring emergent intervention. All RBH patients fully recovered after the decompression procedure or conservative treatment. Number of days to surgery was significantly longer in the RBH group (97.0 ± 80.1) than in the Control group (29.0 ± 253.0) (p = 0.05). Preoperative enophthalmos was also significantly greater in the RBH group (RBH vs. Control group, 3.6 ± 1.7 mm versus 1.2 ± 1.3 mm (p = 0.003)). The incidence of RBH was significantly higher in patients that underwent secondary surgery (odds ratio = 92.9 [95% confidence interval, 11.16–773.23], p = 0.001). Conclusions Surgeons should pay more attention to hemostasis and postoperative care in patients with a large preoperative enophthalmic eye, when time from injury to surgery is long and in revision cases. When RBH occurs, time to intervention and surgical decompression is critical for visual recovery and preventing blindness. Trial registration The institutional review board of the Yeungnam University Medical Center approved this study (YUMC 2018-11-010), which was conducted in accord with the Declaration of Helsinki.

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