Long-term oral treatment with nitrates - what is important?

2000 ◽  
pp. 43-54
Keyword(s):  
Oral Treatment

scholarly journals Hemoglobin level at stabilization is associated with long-term all-cause mortality in patients with left-sided endocarditis, a POET substudy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Pries-Heje ◽  
R.B Hasselbalch ◽  
N Ihleman ◽  
S Gill ◽  
N.E Bruun ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Oral Treatment ◽  
Prosthetic Heart Valve ◽  
Hemoglobin Level ◽  
Common Finding ◽  
Funding Source ◽  
Long Term Outcome ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Left-sided infectious endocarditis (IE) has a high 1-year mortality. Anemia is a common finding in patients with IE, yet little is known about frequency, severity, and associated outcomes in this setting. Purpose To examine the relationship between Hemoglobin (Hgb) level measured at IE stabilization (time of randomization) in the Partial Oral versus intravenous Antibiotic Treatment of Endocarditis (POET) trial - and long-term all-cause mortality. Methods In the POET trial, 400 patients with left-sided IE were randomized, after medical and/or surgical stabilization, to conventional antibiotic treatment or partial oral treatment. Only non-surgically treated patients were considered in this study. Patients were divided by quartiles into four groups based on Hgb level at randomization. Results We examined 248 patients with non-surgically treated IE. Median time from diagnosis of IE to randomization was 14 days (IQ 12–19). At long-term follow-up (median 3.2 years, IQ 2.18–4.60), 71 patients had died (28.6%). Patients in the lowest quantile (Hgb ≤6.0 mmol) had a HR of 4.17 (95% CI 1.81–9.61, p<0.001) for death compared to patients in the highest quantile (Hgb >7.5 mmol/L). This association remained significant after multivariable adjustment for age, sex, renal disease, C-Reactive Protein, and Prosthetic heart valve (HR 2.69, 95% CI 1.11–6.50); p=0.028). Conclusion Low Hemoglobin level at stabilization in patients with IE was associated with an increased risk of long-term mortality. Whether intensified treatment of anemia in patients with IE could improve long-term outcome requires investigation. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The Danish Heart Foundation, The Capital Regions Research Council

scholarly journals Continuing Relief of Pain with Long Term Treatment for Osteoporosis with Intravenous Pamidronate

2018 ◽  
Vol 4 (1) ◽  
pp. 51-58
Author(s):  
Wilson S ◽  
Sharp CA ◽  
Davie MWJ
Keyword(s):  
Bone Mineral Density ◽  
Vertebral Fracture ◽  
Side Effects ◽  
Bone Mineral ◽  
Oral Treatment ◽  
Fracture Incidence ◽  
Mineral Density ◽  
Intravenous Pamidronate ◽  
Vertebral Fracture Incidence

Purpose: Bisphosphonates are valuable in reducing the incidence of fracture. Side effects limit persistence with oral therapy and long term studies of pain relief are difficult to pursue. Intravenous bisphosphonates offer an alternative treatment to oral bisphosphonates and are tolerated over a longer period. The use of Pamidronate, an intravenously administered bisphosphonate, to benefit pain and reduce fracture incidence in the long term has not been extensively investigated. The study aimed to investigate the effect of Pamidronate on pain, vertebral fracture incidence and Bone Mineral Density over 6 or more years.Methods: Patients were offered intravenous Pamidronate if oral treatment with bisphosphonates or Hormone replacement therapy had failed due to side effects, fractures continued on oral treatment or oesophageal reflux led to cessation of oral treatment. Pain was assessed using the Nottingham health profile; radiographs were used to evaluate vertebral fracture and DXA measured bone mineral density.Results: The primary outcome was the pain domain. Median patient follow up was 9 years. Pain had improved significantly (p = 0.03) and in 68% pain had either improved or remained unchanged. Vertebral fractures occurred in 14% of patients in the first 3 years, 9.5% in years 4-6, but increased in years 7-9 to 27%. Bone mineral density increased in the lumbar spine (p < 0.001) but not at the femoral neck.Conclusions: Pamidronate had a beneficial effect on pain over the period of the study. Vertebral fracture incidence increased after 6 years of Pamidronate, although spine BMD increased significantly.

Long-Term Outcomes of Partial Oral Treatment of Endocarditis

2019 ◽  
Vol 380 (14) ◽  
pp. 1373-1374 ◽  
Author(s):  
Henning Bundgaard ◽  
Nikolaj Ihlemann ◽  
Sabine U. Gill ◽  
Niels E. Bruun ◽  
Hanne Elming ◽  
...  
Keyword(s):  
Oral Treatment ◽  
Long Term Outcomes

scholarly journals Use of Edoxaban for the Treatment of Heparin-Induced Thrombocytopenia

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ryo Kanamoto ◽  
Shinichi Hiromatsu ◽  
Tomoyuki Anegawa ◽  
Kanako Sakurai ◽  
Shohei Yoshida ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Esophageal Cancer ◽  
Oral Treatment ◽  
Length Of Hospital Stay ◽  
Heparin Therapy ◽  
Vitamin K Antagonist ◽  
Bleeding Complications ◽  
Heparin Induced Thrombocytopenia ◽  
Life Threatening

Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse drug reaction of heparin therapy, which increases a patient’s risk of developing venous and/or arterial thromboembolism. HIT should be treated through discontinuation of heparin and administration of nonheparin anticoagulants such as argatroban. For long-term anticoagulation, parenteral nonheparin anticoagulants are generally converted to oral treatment with a vitamin K antagonist such as warfarin. Although administration of warfarin is recommended to overlap with a nonheparin anticoagulant for a minimum of 5 days, overlapping with argatroban and warfarin presents high risks of bleeding. We describe a case of HIT treated with edoxaban. A 78-year-old man underwent surgery for esophageal cancer and was administered heparin perioperatively. After surgery, he was diagnosed with HIT and venous thromboembolism. We immediately stopped heparin and initiated parenteral argatroban. The patient was subsequently started on edoxaban without any overlap between the two drugs. The treatment was successful. The treatment of edoxaban following argatroban for HIT could reduce bleeding complications and shorten the length of hospital stay. To the best of our knowledge, this is the first report of the use of edoxaban for HIT treatment.

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