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An Overview of COVID-19 Treatment
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Saffora Riaz, Farkhanda Manzoor, Dou Deqiang, Najmur Rahman
Coagulation markers such as D-dimer, prothrombin detected in the COVID-19 patients’ blood undergo coagulation. Venous thromboembolism and anticoagulant treatment are common in COVID-19 patients. Patients were prescribed to get thromboprophylaxis. Enoxaparin is a blood thinner medicine that is used to treat the circulatory issue as anticoagulation. Heparin is also preferred for anticoagulation as a prophylactic dose for all patients with COVID [74].
Thromboembolic disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
LMWH is the standard management of VTE in pregnancy. Doses are based on the woman's weight, but higher doses are required in pregnancy for some LMWHs (e.g. enoxaparin [Clexane®] 1 mg/kg b.d. as opposed to the non-pregnant dose of 1.5 mg/kg o.d.). Once daily enoxaparin may suffice for treatment in pregnancy but most clinicians use a twice daily regime at least initially. Prophylactic and treatment doses in pregnancy of the different LMWHs are shown in Table 3.4.
Current status of fibrinolytic therapy
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Saubhik Kanjilal, Soumitra Kumar
In the EXTRACT-TIMI 25 trial, enoxaparin was found to reduce death and reinfarction at 30 days when compared with weight adjusted UFH [15]. A reduced dose of enoxaparin was used for patients >75 years and those with impaired renal function. However, major non-cerebral bleeding occurred more with enoxaparin, shown in the ASSENT-3 trial. Still, the net clinical benefit suggested the use of LMWH over UFH.
Acute spontaneous non-hemorrhagic adrenal infarction in pregnancy: case-report and literature review
Published in Gynecological Endocrinology, 2023
Sara Ornaghi, Federica Fernicola, Elisabetta Marelli, Mario Perotti, Filiberto Di Gennaro, Irene Cameroni, Eloisa M. Mariani, Angela I. Pincelli, Elisabetta Colciago, Irene Cetin, Patrizia Vergani
In addition, anticoagulation should always be considered to avoid ischemic events in the contralateral gland [2]. However, awareness of an increased risk for adrenal hemorrhage as well as hemorrhage at childbirth for pregnant women has to be maintained, especially with therapeutic doses of anticoagulants. Since no standard anticoagulation protocol is currently available for NHAI, hematology consultation is mandatory. Our review identified two pregnant patients not receiving anticoagulation who experienced complete remission and an uncomplicated perinatal outcome[1]; however, in a third case, a contralateral NHAI occurred 18 weeks after the first event [2]. Also, 27 of the 31 published cases were treated with therapeutic doses of anticoagulant, with only one woman receiving prophylactic dosage. The hematologist consulted for our case suggested a prophylactic dosage of enoxaparin, to be continued till delivery and for 6 weeks afterwards. Of note, there is also a lack of consensus on the appropriate duration of anticoagulation after delivery, with published data ranging from two weeks to 11 months.
A review of emerging factor XI inhibitors
Published in Expert Opinion on Emerging Drugs, 2023
Sandra Elsheikh, Nicola Tidbury, Gregory Y.H. Lip
The first phase II study investigated IONIS-FXI-Rx (200 mg or 300 mg SC) vs enoxaparin (40 mg once daily) in patients undergoing total knee arthroplasty. Participants in the IONIS-FXI-Rx group began treatment 36 days prior to surgery. In the first week they received three doses on days 1, 3 and 5 then doses weekly on days 8, 15, 22 and 29. On the day of surgery (day 36), participants received a dose 6 hours post-operatively and on day 39. The enoxaparin was administered for at least 8 days, starting with the evening before or 6–8 hours post-operatively. The primary efficacy outcome of VTE occurred in 27% and 4% of those receiving 200 mg and 300 mg of IONIS-FXI-Rx, respectively, and in 30% of those receiving enoxaparin. Bleeding occurred in 3% of both the IONIS-FXI-Rx groups and in 8% of those receiving enoxaparin, demonstrating that IONIS-FXI-Rx has the potential to reduce post-operative thrombo-embolism without increasing the risk of bleeding when compared to enoxaparin [50].
The clinical course and short-term health outcomes of multisystem inflammatory syndrome in children in the single pediatric rheumatology center
Published in Postgraduate Medicine, 2021
Betül Sözeri, Şengül Çağlayan, Vildan Atasayan, Kadir Ulu, Taner Coşkuner, Özge Pelin Akbay, Canan Hasbal Akkuş, Gürkan Atay, Enes Salı, Mehmet Karacan, Taliha Öner, Seher Erdoğan, Ferhat Demir
The mean duration of hospitalization was 11.8 ± 7.07 days (min-max: 1–37 days). Fifty- seven patients (85%) received intravenous immunoglobulin (IVIG) and 45 (67%) received corticosteroids (median 23 days). The first IVIG dose (2 g/kg) was administered in 24 hours to 70% of the patients, and 20 of these patients were given concurrent steroids. 17 (25.3%) patients received anakinra (median 8 days), and one (1.5%) received tocilizumab (10 mg/kg). The median (IQR) dose of anakinra was 3 mg/kg/day (IQR, 2–4 mg/kg/day). Seven of the patients (10.4%) underwent therapeutic plasma exchange (TPE). Vasoactive medications mostly used norepinephrine were used in 14 patients (21%). The median duration of vasopressor use was 5 days (IQR,1–6 days). Prophylactic dosing with enoxaparin was used in 42 (63%) patients. The median duration of anticoagulant use was 7.5 days (IQR, 3.75–11).