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Nathan Goodyear

Overview of the coagulation system - 0 views

www.ncbi.nlm.nih.gov/...PMC4260295

Coagulation

shared by Nathan Goodyear on 07 Nov 18 - No Cached
  • Nathan Goodyear on 07 Nov 18
     
    Good updated review of coagulation cascade
Nathan Goodyear

Disseminated Intravascular Coagulation (DIC) - Hematology and Oncology - Merck Manuals ... - 0 views

www.merckmanuals.com/...-intravascular-coagulation-dic

DIC disseminated intravascular coagulation oncology

shared by Nathan Goodyear on 09 May 18 - No Cached
  • Nathan Goodyear on 09 May 18
     
    good review of DIC
Nathan Goodyear

Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA)... - 0 views

eje-online.org/...285.long

Testosterone therapy low T cardiovascular risk men male hormone hormones disease coagulation fibrinogen PAI-1 tPA

shared by Nathan Goodyear on 29 Jul 14 - No Cached
  • Nathan Goodyear on 29 Jul 14
     
    Thrombosis and cardiovascular risk is a hot topic in Testosterone therapy in men.  This study showed that topical "physiologic" Testosterone therapy provided no negative effects on the coagulation system.  No changes were documented in tPA, PAI-1, and fibrinogen levels in men with chronic stable angina.  This stands in contrast to supra-physiologic therapy of Testosterone that leads to hypofibrinogenemia.
Nathan Goodyear

High D-dimer levels are associated with poor prognosis in cancer patients - 0 views

www.ncbi.nlm.nih.gov/...PMC3409812

cancer D-dimer

shared by Nathan Goodyear on 10 Jul 18 - No Cached
  • a systemic activation of blood coagulation and procoagulant changes in the hemostatic system have frequently been observed in cancer patients, even in the absence of venous thromboembolism
  • Thrombin is a pivotal enzyme in the process of blood coagulation and leads to the conversion of fibrinogen to fibrin, which is the end product of blood coagulation and finally results in the formation of a fibrin clot
  • deposition of fibrin, which has an important role in the formation of tumor stroma and hematogenous spread of tumor cells.
  • ...5 more annotations...
  • The interaction of fibrin, platelets and tumor cells leads to the formation of platelet-fibrin-tumor-cell aggregates that promote endothelial adhesion and metastatic spread, as well as tumor cell growth and tumor cell survival
  • fibrin degradation products have been shown to display strong angiogenic properties
  • D-dimer is a biomarker that globally indicates the activation of hemostasis and fibrinolysis
  • It is a degradation product of fibrin
  • high D-dimer levels were reported to be predictive of the occurrence of VTE in cancer patients
  • Nathan Goodyear on 10 Jul 18
     
    elevated D-Dimer associated with poor prognosis in cancer. Good review of cancer and ehmostasis.
Nathan Goodyear

Testosterone treatment and risk of venous thromboembolism: population based case-contro... - 0 views

www.bmj.com/bmj.i5968

low T low Testosterone Testosterone Testosterone therapy VTE venous thromboembolism thromboembolism

shared by Nathan Goodyear on 07 Dec 16 - No Cached
  • Nathan Goodyear on 07 Dec 16
     
    Testosterone is great when needed, not doped; but Testosterone is not without risks.  Population case-control study finds increased blood clot risk in first 6 months of Testosterone therapy.  To many variables left unanswered by this study.  
Nathan Goodyear

Intensive Lifestyle Intervention or Metformin on Inflammation and Coagulation in Partic... - 0 views

diabetes.diabetesjournals.org/...1566

CRP metformin type II diabetes DM IGT insulin resistance inflammation inflammatory markers lifestyle intervention glucose tolerance

shared by Nathan Goodyear on 20 Dec 11 - No Cached
  • Nathan Goodyear on 20 Dec 11
     
    Large study of over 3,000 adults shows lifestyle changes are more effective, than metformin, in reducing development of type II diabetes.  CRP, inflammatory marker, reduced at 1 year more in lifestyle (29%) versus metformin (14%).     And don't forget all the nutritional deficiencies that metformin creates.
Nathan Goodyear

Testosterone, thrombophilia, throm... [Blood Coagul Fibrinolysis. 2014] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...24732175

Testosterone therapy men male hormones hormone thrombophilia thrombosis clotting

shared by Nathan Goodyear on 16 Apr 14 - No Cached
  • Nathan Goodyear on 16 Apr 14
     
    This study's conclusion is to evaluate clotting factor i.e. factor V leiden, Factor VIII, and prothrombin prior to giving Testosterone.  This small study found increased clotting in some men on Testosterone. The problem here is the dosing of Testosterone in these men was 50-160 mg.  Physiologic dosing is 5-10 mg.  The problem is doping.  One wonders if physiologic dosing was undertaken if any of the men in this study would develop clotting problems, even though they had undiagnosed hypercoagulabitliy.
Nathan Goodyear

Effects of Oral and Transdermal Estrogen/Progesterone Regimens on Blood Coagulation and... - 0 views

atvb.ahajournals.org/...3071.short

transdermal bioidentical estrogen progesterone estradiol thromboembolism DVT

shared by Nathan Goodyear on 09 Aug 11 - No Cached
  • Nathan Goodyear on 09 Aug 11
     
    transdermal estrogen/progesterone therapy does not increase thrombotic risk
Nathan Goodyear

Adherence to the Mediterranean diet attenuates inflammation and coagulation process in ... - 0 views

www.ncbi.nlm.nih.gov/...15234425

mediterranean diet CVD cardiovascular disease nutrition diet inflammation CRP IL-6 homocysteine fibrinogen

shared by Nathan Goodyear on 27 Oct 15 - No Cached
  • Nathan Goodyear on 27 Oct 15
     
    Mediterranean diet reduced IL-6, homocysteine and CRP; as well as WBCs and fibrinogen.
Nathan Goodyear

Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metab... - 0 views

www.ncbi.nlm.nih.gov/...PMC4029282

IV fluids lactated ringers normal saline LR NS

shared by Nathan Goodyear on 03 Jul 18 - No Cached
  • NS contains 154 mM Na+ and Cl-, with an average pH of 5.0 and osmolarity of 308 mOsm/L.
  • LR solution has an average pH of 6.5, is hypo-osmolar (272 mOsm/L), and has similar electrolytes (130 mM Na+, 109 mM Cl-, 28 mM lactate, etc.) to plasma
  • hyperchloremic acidosis
  • ...26 more annotations...
  • LR’s acid base balance is superior to that of NS’s
  • There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count
  • Total protein dropped
  • no significant differences in Hct (Table  1) or total protein between LR and NS groups
  • Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation
  • Na+ was increased after NS resuscitation
  • No changes in Na+ or K+ were observed
  • K+ did not change initially after NS resuscitation but was elevated at 6 h afterwards
  • Ca++ was similarly decreased
  • Cl- was elevated for 6 h after NS resuscitation, with no changes shown after LR resuscitation
  • PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS
  • Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS
  • NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt
  • NS had better tissue perfusion and oxygen metabolism than LR
  • LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation
  • current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR
  • LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion
  • PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states
  • potential thrombotic risk from LR resuscitation is unlikely.
  • we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects
  • NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model
  • NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation
  • These differences are possibly due to the vasodilator effects from NS
  • an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation
  • The mechanism for the increase of K+ from NS is not fully known
  • NS is associated with vasodilator effects and the risks of metabolic acidosis and hyperkalemia
  • Nathan Goodyear on 03 Jul 18
     
    LR vs NS crystalloid.
Nathan Goodyear

Advanced Gastric Cancer Associated with Disseminated Intravascular Coagulation Successf... - 0 views

www.ncbi.nlm.nih.gov/...PMC3705133

DIC cancer

shared by Nathan Goodyear on 03 Jul 18 - No Cached
  • Nathan Goodyear on 03 Jul 18
     
    Case study of DIC in patient with gastric cancer successfully treated with 5-fu and oxaliplatin.
Nathan Goodyear

Management of cancer‐associated disseminated intravascular coagulation: guida... - 0 views

onlinelibrary.wiley.com/...jth.12838

DIC cancer

shared by Nathan Goodyear on 03 Jul 18 - No Cached
  • Nathan Goodyear on 03 Jul 18
     
    Treatment of DIC discussion in cancer
Nathan Goodyear

The Pharmacokinetics and Interactions of Ivermectin in Humans-A Mini-review - 0 views

www.ncbi.nlm.nih.gov/...PMC2751445

Ivermectin

shared by Nathan Goodyear on 19 Mar 18 - No Cached
  • This drug is extensively metabolized by human liver microsomes by cytochrome P450
  • cytochrome P-4503A4, converting the drug to at least 10 metabolites
  • its elimination half-life is around a day
  • ...12 more annotations...
  • second rise in plasma levels (mostly occurring between 6 and 12 h after the dose) suggesting an enterohepatic recycling of the drug
  • Ivermectin is exceptionally potent, with effective dosages levels that are unusually low.
  • the optimal dose of ivermectin is 150 μg/kg, but the frequency of administration is still controversial, ranging from 150 μg/kg once to three times yearly.
  • high lipid solubility of ivermectin, this compound is widely distributed within the body.
  • To interrupt the transmission of onchocerciasis in humans, the combination of ivermectin and doxycycline is highly effective as, in infested patients, the ingestion of the anthelmintic (200 μg/kg, single dose) and the antibacterial (100 mg/kg, daily for 6 weeks)
  • ivermectin interactions with another concurrently administered drugs can occur.
  • This issue becames important, as combination chemotherapy is being used with increasing frequency as resistance to antiparasitic agents is becoming more widespread.
  • haematomatous swellings
  • prothrombin times were significantly above baseline by one week to one month after drug ingestion, suggesting an antagonist effect against vitamin K
  • bleeding disorders were not found in 15,000 patients treated with ivermectin (150 μg/kg)
  • prolonged prothrombin ratios were observed in 148 subjects given ivermectin orally. Although no patients suffered bleeding complications, factor II and VII levels were reduced in most of them, suggesting interference with vitamin K metabolism
  • Ivermectin has a minimal effect on coagulation and concern about mass treatment for this reason appears to be unjustified
  • Nathan Goodyear on 19 Mar 18
     
    Review of Ivermectin as an anti-parasitic.
Nathan Goodyear

Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Clinical... - 0 views

ascopubs.org/...JCO.19.01461

DVT pulmonary embolus deep venous thrombosis PE pulmonary emboli anti-coagulant cancer

shared by Nathan Goodyear on 04 Jul 21 - No Cached
  • Nathan Goodyear on 04 Jul 21
     
    Updated recommendations
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