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Safety and Efficacy of Sodium-glucose Cotransporter 2 Inhibitors in Kidney Transplant Recipients With Pretransplant Type 2 Diabetes Mellitus: A Retrospective, Single-center, Inverse Probability of Treatment Weighting Analysis of 85 Transplant Patients.

Transplant Direct 2021 Nov 6;7(11):e772. Epub 2021 Oct 6.

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Whether sodium-glucose cotransporter 2 (SGLT2) inhibitors can be used effectively and safely in kidney transplant (KT) recipients with pretransplant type 2 diabetes as the primary cause of end-stage renal disease (ESRD) remains unclear. In this study, we retrospectively analyzed the efficacy and safety of SGLT2 inhibitors compared with other oral hypoglycemic agents (OHAs) in KT recipients with pretransplant type 2 diabetes as the primary cause of ESRD.

Methods: In this retrospective, observational, single-center, inverse probability of treatment weighting (IPTW) analysis study, we compared the outcomes of SGLT2 inhibitors (SGLT2 group) and other OHAs (control group) following KT. Read More

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November 2021

Case Report: Oral Cimetidine Administration Causes Drug-Induced Immune Hemolytic Anemia by Eliciting the Production of Cimetidine-Dependent Antibodies and Drug-Independent Non-specific Antibodies.

Front Med (Lausanne) 2021 24;8:723167. Epub 2021 Sep 24.

Department of Blood Transfusion, Dongguan Tungwah Hospital, Dongguan, China.

Previously, it was reported that multiple patients had hemolytic anemia associated with cimetidine administration, while only one patient who had received intravenous cimetidine was serologically diagnosed with drug-induced immune hemolytic anemia (DIIHA) caused by cimetidine-dependent antibodies. However, the ability of oral cimetidine intake to induce the production of antibodies has not been examined. In this study, we report a 44-year-old male patient in whom oral cimetidine administration resulted in cimetidine-dependent antibodies and drug-independent non-specific antibodies, leading to the development of DIIHA. Read More

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September 2021

Effectiveness and Safety of Direct Oral Anticoagulants vs. Warfarin and Recurrence After Discontinuation in Patients With Acute Venous Thromboembolism in the Real World.

Circ J 2021 Oct 12. Epub 2021 Oct 12.

Department of Cardiology, Japanese Red Cross Musashino Hospital.

Background: The efficacy of direct oral anticoagulants (DOACs) compared with warfarin for the treatment of venous thromboembolism (VTE), and the recurrence of VTE after discontinuation of anticoagulation therapy in research are limited.Methods and Results:This retrospective study enrolled 893 patients with acute VTE between 2011 and 2019. The cohort was divided into the transient risk, unprovoked, continued cancer treatment, and cancer remission groups. Read More

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October 2021

Anticoagulant prescribing for atrial fibrillation and risk of incident dementia.

Heart 2021 Oct 13. Epub 2021 Oct 13.

Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK

Objective: The aim of this study was to investigate the association between oral anticoagulant type (direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs)) and incident dementia or mild cognitive impairment (MCI) among patients with newly diagnosed atrial fibrillation (AF).

Methods: Using linked electronic health record (EHR) data from the Clinical Practice Research Datalink in the UK, we conducted a historical cohort study among first-time oral anticoagulant users with incident non-valvular AF diagnosed from 2012 to 2018. We compared the incidence of (1) clinically coded dementia and (2) MCI between patients prescribed VKAs and DOACs using Cox proportional hazards regression models, with age as the underlying timescale, accounting for calendar time and time on treatment, sociodemographic and lifestyle factors, clinical comorbidities and medications. Read More

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October 2021

Clearing the cognitive cloud: direct oral anticoagulants or vitamin K antagonists for reducing dementia risk in patients with atrial fibrillation?

Authors:
Winnie Chua

Heart 2021 Oct 13. Epub 2021 Oct 13.

Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK

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October 2021

Ultrasound-guided post-pyloric feeding tube insertion in peri-operative cardiac infants.

Cardiol Young 2021 Oct 14:1-4. Epub 2021 Oct 14.

Section of Pediatric Cardiac ICU, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia.

Delivery of enteral nutrition in critical infants post-paediatric cardiac surgery is sometimes hampered, necessitating direct feeding into the small intestine. This study is highlighting the role of ultrasound-guided post-pyloric feeding tube insertion performed by the paediatric cardiac ICU intensivist in critically ill infants.

Methods: We carried out a prospective pilot observational experimental study in peri-operative cardiac infants with feeding intolerance between 2019 and 2021. Read More

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October 2021

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial.

Trials 2021 Oct 13;22(1):697. Epub 2021 Oct 13.

Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China.

Background: Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps.

Methods: Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. Read More

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October 2021

Tissue-resident M2 macrophages directly contact primary sensory neurons in the sensory ganglia after nerve injury.

J Neuroinflammation 2021 Oct 13;18(1):227. Epub 2021 Oct 13.

Department of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima, 890-8544, Japan.

Background: Macrophages in the peripheral nervous system are key players in the repair of nerve tissue and the development of neuropathic pain due to peripheral nerve injury. However, there is a lack of information on the origin and morphological features of macrophages in sensory ganglia after peripheral nerve injury, unlike those in the brain and spinal cord. We analyzed the origin and morphological features of sensory ganglionic macrophages after nerve ligation or transection using wild-type mice and mice with bone-marrow cell transplants. Read More

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October 2021

Altered production of reproductive neuropeptides in rats subjected to chronic intermittent hypoxia.

J Integr Neurosci 2021 Sep;20(3):651-657

Cátedra de Fisiología, Facultad de Odontología, Universidad de Buenos Aires, 1122 Buenos Aires, Argentina.

Hypobaric hypoxia is a stressful condition known to decrease fertility both in humans and animals. However, the mechanism by which the hypothalamus-pituitary-gonad axis is altered remains unknown. The aim of the present study was to analyze the effects of chronic intermittent and continuous exposure to hypoxia on hypothalamic-pituitary-gonadal axis regulation in male rats. Read More

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September 2021

Paraneoplastic pemphigus in a dog.

Vet Dermatol 1998 Jun;9(2):127-134

Institut für Tierpathologie der Universität Bern, Switzerland.

This report presents a case of paraneoplastic pemphigus in a 7-year-old female Bouvier. The dog initially showed extensive oral ulcerations that exacerbated upon treatment with trimethoprim-sulfadiazine. Subsequently, the dog developed vesiculobullous and ulcerative lesions on the ear margins, the nose, periocular, and at the nail beds. Read More

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A Systematic Review and Meta-analysis on the Efficacy and Safety of Direct Oral Anticoagulants in Patients with Peripheral Artery Disease.

Ann Vasc Surg 2021 Oct 10. Epub 2021 Oct 10.

Division of Vascular Surgery and Endovascular Therapy, University of Colorado, Anschutz Medical Center, Aurora, CO. Electronic address:

Background-objective: PAD is a significant cause of morbidity and mortality affecting over 200 million people worldwide. Current guidelines recommend at least a single antiplatelet or anticoagulant agent in symptomatic PAD and lifelong antithrombotic treatment after a revascularization procedure. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of direct oral anticoagulants (DOACs) in patients with peripheral artery disease (PAD). Read More

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October 2021

Side-by-Side Comparison of uPAR-Targeting Optical Imaging Antibodies and Antibody Fragments for Fluorescence-Guided Surgery of Solid Tumors.

Mol Imaging Biol 2021 Oct 12. Epub 2021 Oct 12.

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Purpose: Radical resection is paramount for curative oncological surgery. Fluorescence-guided surgery (FGS) aids in intraoperative identification of tumor-positive resection margins. This study aims to assess the feasibility of urokinase plasminogen activator receptor (uPAR) targeting antibody fragments for FGS in a direct comparison with their parent IgG in various relevant in vivo models. Read More

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October 2021

Direct endoscopic placement of percutaneous endoscopic gastrostomies with jejunal extension tubes (PEG-J) using ultra-thin endoscopes - long-term outcomes from a U.S. tertiary referral center.

Surg Endosc 2021 Oct 12. Epub 2021 Oct 12.

Department of Internal Medicine, Division of Gastroenterology & Hepatology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA, 52240, USA.

Introduction: Several techniques for PEG-J tube placement have been described, commonly requiring fluoroscopic guidance and/or fixation of the jejunostomy tube (J-tube) into the small intestine. We describe a modified technique for placing jejunostomy tubes under direct visualization through a PEG with the use of ultra-thin endoscopes and steel guidewire.

Methods: A retrospective study at a single tertiary academic center evaluating patients who underwent PEG-J placement between 2010 and 2020. Read More

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October 2021

A costing analysis of B-GAP: index-linked HIV testing for children and adolescents in Zimbabwe.

BMC Health Serv Res 2021 Oct 12;21(1):1082. Epub 2021 Oct 12.

London School of Hygiene and Tropical Medicine, London, UK.

Background: By testing children and adolescents of HIV positive caretakers, index-linked HIV testing, a targeted HIV testing strategy, has the ability to identify high risk children and adolescents earlier and more efficiently, compared to blanket testing. We evaluated the incremental cost of integrating index-linked HIV testing via three modalities into HIV services in Zimbabwe.

Methods: A mixture of bottom-up and top-down costing was employed to estimate the provider cost per test and per HIV diagnosis for 2-18 year olds, through standard of care testing, and the incremental cost of index-linked HIV testing via three modalities: facility-based testing, home-based testing by a healthcare worker, and testing at home by the caregiver using an oral mucosal transudate test. Read More

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October 2021

High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients-A Cross-Sectional Study.

J Clin Med 2021 Sep 28;10(19). Epub 2021 Sep 28.

Oral Rehabilitation Department, Faculty of Dentistry, "Iuliu Haţieganu" University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania.

Background: Exogenous factors (such as sun exposure, smoking habits, and diet) and endogenous (inflammatory status, general diseases) have a direct influence on skin and soft tissue characteristics. The study's objective was to assess the impact of metabolic syndrome (MS) on characteristics of skin layers in sun-exposed and non-exposed maxillofacial tissues evaluated by high-frequency ultrasound (HFU), as a potential diagnosis and monitoring tool for the aging process.

Material And Methods: The present study included 102 subjects (24 with MS; 78 without MS). Read More

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September 2021

Minimal Dentinal Tubule Penetration of Endodontic Sealers in Warm Vertical Compaction by Direct Detection via SEM Analysis.

J Clin Med 2021 Sep 27;10(19). Epub 2021 Sep 27.

Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany.

Sealer staining using rhodamine B dye to investigate the penetration depth of endodontic sealers was proven unsuitable for this purpose. This study aimed to investigate the sealer penetration depth into dentinal tubules by scanning electron microscopy (SEM). Root canals of 52 human upper central incisors were instrumented using the ProTaper Gold NiTi system (Dentsply Sirona, York, PA, USA) up to size F3. Read More

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September 2021

Conservative Management of Uterine Fibroid-Related Heavy Menstrual Bleeding and Infertility: Time for a Deeper Mechanistic Understanding and an Individualized Approach.

J Clin Med 2021 Sep 26;10(19). Epub 2021 Sep 26.

Université Catholique de Louvain, 1200 Brussels, Belgium.

(1) Background: Uterine fibroids are the most common form of benign uterine tumors, causing heavy menstrual bleeding (HMB), pelvic pain, infertility and pressure symptoms. Almost a third of women with uterine fibroids seek treatment. The objective of this review is to understand the mechanisms linking fibroids to these symptoms and evaluate different options for their management, particularly the place of gonadotropin-releasing hormone (GnRH) antagonist. Read More

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September 2021

A Review of Current and Future Antithrombotic Strategies in Surgical Patients-Leaving the Graduated Compression Stockings Behind?

J Clin Med 2021 Sep 22;10(19). Epub 2021 Sep 22.

Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London W6 8RF, UK.

Venous thromboembolism (VTE) remains an important consideration within surgery, with recent evidence looking to refine clinical guidance. This review provides a contemporary update of existing clinical evidence for antithrombotic regimens for surgical patients, providing future directions for prophylaxis regimens and research. For moderate to high VTE risk patients, existing evidence supports the use of heparins for prophylaxis. Read More

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September 2021

Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review.

Int J Environ Res Public Health 2021 Sep 26;18(19). Epub 2021 Sep 26.

College of Nursing, Ewha Womans University, Seoul 03760, Korea.

This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Read More

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September 2021

Impact of centrifugation time and pneumatic tube transport on plasma concentrations of direct oral anticoagulants.

Int J Lab Hematol 2021 Oct 12. Epub 2021 Oct 12.

Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Introduction: Rapid results are needed when plasma concentrations of direct oral anticoagulants (DOACs) are required in acute clinical settings. We evaluated the impact of centrifugation time and pneumatic tube transport on DOAC plasma concentrations with the overall aim of reducing turnaround time.

Methods: Blood samples were spiked with rivaroxaban, apixaban or dabigatran in a low and a high concentration prior to centrifugation for 25 minutes (3163 g) or 5 minutes (3000 g) (n = 20 for each DOAC). Read More

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October 2021

Bioequivalence and Food Effect Assessment of 2 Rivaroxaban Formulations in Healthy Chinese Volunteers: An Open, Randomized, Single-Dose, and 4-Period Crossover Study.

Clin Pharmacol Drug Dev 2021 Oct 12. Epub 2021 Oct 12.

Phase I Clinical Research Center, the Affiliated Hospital of Qingdao University, Qingdao, China.

Rivaroxaban is a direct factor Xa inhibitor used for the management of thromboembolic disorders. The aim of this study was to evaluate the safety, pharmacokinetic profile, and bioequivalence of a generic and a branded rivaroxaban formulation (Xarelto) under fasted and fed conditions in healthy Chinese volunteers. An open-label, randomized, single-dose, 4-period complete, and replicate crossover study in healthy Chinese volunteers was performed. Read More

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October 2021

Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews.

J Dent Res 2021 Oct 12:220345211042795. Epub 2021 Oct 12.

Department of Health Sciences, University of Leicester, Leicester, UK.

Detection and diagnosis of caries-typically undertaken through a visual-tactile examination, often with supporting radiographic investigations-is commonly regarded as being broadly effective at detecting caries that has progressed into dentine and reached a threshold where restoration is necessary. With earlier detection comes an opportunity to stabilize disease or even remineralize the tooth surface, maximizing retention of tooth tissue and preventing a lifelong cycle of restoration. We undertook a formal comparative analysis of the diagnostic accuracy of different technologies to detect and inform the diagnosis of early caries using published Cochrane systematic reviews. Read More

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October 2021

Targeting-YAP/TAZ therapies for head and neck cancer, directly or indirectly?

Authors:
Xiao-Dong Feng

Hua Xi Kou Qiang Yi Xue Za Zhi 2021 Oct;39(5):493-500

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.

YAP/TAZ are wild over-activated in head and neck squamous cell carcinoma (HNSCC) with high potential as a direct therapy target for HNSCC treatments. However, the efforts on the directly targeting-YAP/TAZ therapies over the past decade, have very limited impacts, mainly caused by: 1. There is still none effective and specific YAP/TAZ inhibitor with clinical potential; 2. Read More

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October 2021

NUDT15 polymorphism and NT5C2 and PRPS1 mutations influence thiopurine sensitivity in acute lymphoblastic leukaemia cells.

J Cell Mol Med 2021 Oct 12. Epub 2021 Oct 12.

Department of Pediatrics, University of Yamanashi, Yamanashi, Japan.

In chemotherapy for childhood acute lymphoblastic leukaemia (ALL), maintenance therapy consisting of oral daily mercaptopurine and weekly methotrexate is important. NUDT15 variant genotype is reportedly highly associated with severe myelosuppression during maintenance therapy, particularly in Asian and Hispanic populations. It has also been demonstrated that acquired somatic mutations of the NT5C2 and PRPS1 genes, which are involved in thiopurine metabolism, are detectable in a portion of relapsed childhood ALL. Read More

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October 2021

Economic Benefit from Improvements in Quality of Life with Upadacitinib: Comparisons with Tofacitinib and Methotrexate in Patients with Rheumatoid Arthritis.

Adv Ther 2021 Oct 12. Epub 2021 Oct 12.

Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA.

Introduction: To compare the economic benefit of upadacitinib combination therapy versus tofacitinib combination therapy and upadacitinib monotherapy versus methotrexate monotherapy from improvements in health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA).

Methods: Data were analyzed from two trials of upadacitinib (SELECT-NEXT and SELECT-MONOTHERAPY) and one trial of tofacitinib (ORAL-Standard) that collected HRQOL measurements using the Short Form 36 (SF-36) Health Survey in patients with RA. Direct medical costs per patient per month (PPPM) for patients receiving upadacitinib 15 mg once daily and methotrexate were derived from observed SF-36 Physical (PCS) and Mental Component Summary (MCS) scores in the SELECT trials using a regression algorithm. Read More

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October 2021

Early versus late start of direct oral anticoagulants after acute ischaemic stroke linked to atrial fibrillation: an observational study and individual patient data pooled analysis.

J Neurol Neurosurg Psychiatry 2021 Oct 11. Epub 2021 Oct 11.

Stroke Research Center, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.

Objective: The optimal timing to start direct oral anticoagulants (DOACs) after an acute ischaemic stroke (AIS) related to atrial fibrillation (AF) remains unclear. We aimed to compare early (≤5 days of AIS) versus late (>5 days of AIS) DOAC-start.

Methods: This is an individual patient data pooled analysis of eight prospective European and Japanese cohort studies. Read More

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October 2021

Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis.

BMJ Evid Based Med 2021 Oct 11. Epub 2021 Oct 11.

Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.

Objectives: To assess cost-effectiveness of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF) by pooling incremental net benefits (INBs).

Design: Systematic review and meta-analysis.

Setting: We searched PubMed, Scopus and Centre for Evaluation of Value and Risks in Health Registry from inception to December 2019. Read More

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October 2021

Coral growth bands recorded trace elements associated with the Fundão dam collapse.

Sci Total Environ 2021 Oct 8:150880. Epub 2021 Oct 8.

Programa de Pós-Graduação em Ecologia and Núcleo Professor Rogério Vale de Produção Sustentável-SAGE/COPPE, Universidade Federal do Rio de Janeiro, 21941-900 Rio de Janeiro, RJ, Brazil. Electronic address:

In November 2015, the collapse of the Fundão dam (Minas Gerais, Brazil) carried over 40 × 10 m of iron ore tailings into the Doce river and caused massive environmental and socioeconomic impacts across the watershed. The downstream mudslide scavenged contaminants deposited in the riverbed, and several potentially toxic elements were further released through reduction and solubilization of Fe oxy-hydroxides under estuarine conditions. A turbidity plume was formed off the river mouth, but the detection of contaminants' dispersion in the ocean remains poorly assessed. Read More

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October 2021

Rivaroxaban Is Associated With Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants : A Nationwide Propensity Score-Weighted Study.

Ann Intern Med 2021 Oct 12. Epub 2021 Oct 12.

Faculty of Medicine, University of Iceland and Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland (A.B.I., A.S.Á., P.T.Ö., E.S.B.).

Background: Gastrointestinal bleeding (GIB) rates for direct oral anticoagulants (DOACs) and warfarin have been extensively compared. However, population-based studies comparing GIB rates among different DOACs are limited.

Objective: To compare rates of GIB among apixaban, dabigatran, and rivaroxaban. Read More

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October 2021

Direct Oral Anticoagulants and Warfarin for Atrial Fibrillation Treatment: Rural and Urban Trends in Medicare Beneficiaries.

Am J Cardiovasc Drugs 2021 Oct 11. Epub 2021 Oct 11.

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

Background: Data are needed on the use of oral anticoagulation in patients with atrial fibrillation (AF) in rural versus urban areas, including the initiation of direct oral anticoagulants (DOACs).

Objective: We used Medicare data to examine rural/urban differences in anticoagulation use in patients with AF.

Methods: We identified incident AF in a 20% sample of fee-for-service Medicare beneficiaries (aged ≥ 65 years) from 2011 to 2016 and collected ZIP code and covariates at the time of AF. Read More

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October 2021