The Experts below are selected from a list of 3276552 Experts worldwide ranked by ideXlab platform
Domenico Prisco - One of the best experts on this subject based on the ideXlab platform.
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standardized low molecular weight heparin bridging regimen in outpatients on oral anticoagulants undergoing invasive procedure or surgery an inception cohort Management Study
Circulation, 2009Co-Authors: Vittorio Pengo, Sophie Testa, Umberto Cucchini, Gentian Denas, Nicoletta Erba, Giuliana Guazzaloca, L La Rosa, V De Micheli, R Frontoni, Domenico PriscoAbstract:Background— Bridging therapy with low–molecular-weight heparin is usually recommended in patients who must stop oral anticoagulants before surgical or invasive procedures. To date, there is no universally accepted bridging regimen tailored to the patient’s thromboembolic risk. This prospective inception cohort Management Study was designed to assess the efficacy and safety of an individualized bridging protocol applied to outpatients. Methods and Results— Oral anticoagulants were stopped 5 days before the procedure. Low–molecular-weight heparin was started 3 to 4 days before surgery and continued for 6 days after surgery at 70 anti–factor Xa U/kg twice daily in high-thromboembolic-risk patients and prophylactic once-daily doses in moderate- to low-risk patients. Oral anticoagulation was resumed the day after the procedure with a boost dose of 50% for 2 days and maintenance doses afterward. The patients were followed up for 30 days. Of the 1262 patients included in the Study (only 15% had mechanical valves...
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standardized low molecular weight heparin bridging regimen in outpatients on oral anticoagulants undergoing invasive procedure or surgery an inception cohort Management Study
Circulation, 2009Co-Authors: Vittorio Pengo, Sophie Testa, Umberto Cucchini, Gentian Denas, Nicoletta Erba, Giuliana Guazzaloca, L La Rosa, V De Micheli, R Frontoni, Domenico PriscoAbstract:BACKGROUND: Bridging therapy with low-molecular-weight heparin is usually recommended in patients who must stop oral anticoagulants before surgical or invasive procedures. To date, there is no universally accepted bridging regimen tailored to the patient's thromboembolic risk. This prospective inception cohort Management Study was designed to assess the efficacy and safety of an individualized bridging protocol applied to outpatients. METHODS AND RESULTS: Oral anticoagulants were stopped 5 days before the procedure. Low-molecular-weight heparin was started 3 to 4 days before surgery and continued for 6 days after surgery at 70 anti-factor Xa U/kg twice daily in high-thromboembolic-risk patients and prophylactic once-daily doses in moderate- to low-risk patients. Oral anticoagulation was resumed the day after the procedure with a boost dose of 50% for 2 days and maintenance doses afterward. The patients were followed up for 30 days. Of the 1262 patients included in the Study (only 15% had mechanical valves), 295 (23.4%) were high-thromboembolic-risk patients and 967 (76.6%) were moderate- to low-risk patients. In the intention-to-treat analysis, there were 5 thromboembolic events (0.4%; 95% confidence interval, 0.1 to 0.9), all in high-thromboembolic-risk patients. There were 15 major (1.2%; 95% confidence interval, 0.7 to 2.0) and 53 minor (4.2%; 95% confidence interval, 3.2 to 5.5) bleeding episodes. Major bleeding was associated with twice-daily low-molecular-weight heparin administration (high-risk patients) but not with the bleeding risk of the procedure. CONCLUSIONS: This Management bridging protocol, tailored to patients' thromboembolic risk, appears to be feasible, effective, and safe for many patients, but safety in patients with mechanical prosthetic valves has not been conclusively established.
Emilio Carretero - One of the best experts on this subject based on the ideXlab platform.
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vermiculture and waste Management Study of action of earthworms elsinia foetida eudrilus euginae and perionyx excavatus on biodegradation of some community wastes in india and australia
The Environmentalist, 2002Co-Authors: Rajiv Kumar Sinha, Sunil Herat, Sunita Agarwal, Ravi Kumar Asadi, Emilio CarreteroAbstract:The practice of vermiculture is at least a century old but it is now being revived worldwide with diverse ecological objectives such as waste Management, soil detoxification and regeneration and sustainable agriculture. Earthworms act in the soil as aerators, grinders, crushers, chemical degraders and biological stimulators. They secrete enzymes, proteases, lipases, amylases, cellulases and chitinases which bring about rapid biochemical conversion of the cellulosic and the proteinaceous materials in the variety of organic wastes which originate from homes, gardens, dairies and farms. The process is odour free because earthworms release coelomic fluids in the decaying waste biomass which has anti-bacterial properties which kills pathogens. The species used in India were Indian blue (Perionyx excavatus), African night crawler (Eudrilus euginae) and the Tiger worm (Elsinia foetida). E. foetida was used in Australia. E. euginae was found to have higher feeding, growth and biodegradation capacity compared to other two species.
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vermiculture and waste Management Study of action of earthworms elsinia foetida eudrilus euginae and perionyx excavatus on biodegradation of some community wastes in india and australia
The Environmentalist, 2002Co-Authors: Rajiv Kumar Sinha, Sunil Herat, Sunita Agarwal, Ravi Kumar Asadi, Emilio CarreteroAbstract:The practice of vermiculture is at least a century old but it is now being revived worldwide with diverse ecological objectives such as waste Management, soil detoxification and regeneration and sustainable agriculture. Earthworms act in the soil as aerators, grinders, crushers, chemical degraders and biological stimulators. They secrete enzymes, proteases, lipases, amylases, cellulases and chitinases which bring about rapid biochemical conversion of the cellulosic and the proteinaceous materials in the variety of organic wastes which originate from homes, gardens, dairies and farms. The process is odour free because earthworms release coelomic fluids in the decaying waste biomass which has anti-bacterial properties which kills pathogens. The species used in India were Indian blue (Perionyx excavatus), African night crawler (Eudrilus euginae) and the Tiger worm (Elsinia foetida). E. foetida was used in Australia. E. euginae was found to have higher feeding, growth and biodegradation capacity compared to other two species.
Vittorio Pengo - One of the best experts on this subject based on the ideXlab platform.
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d dimer to guide the duration of anticoagulation in patients with venous thromboembolism a Management Study
Blood, 2014Co-Authors: Gualtiero Palareti, Sophie Testa, Cristina Legnani, Alberto Tosetto, Benilde Cosmi, Angelo Ghirarduzzi, Emilia Antonucci, Valeria De Micheli, Daniela Poli, Vittorio PengoAbstract:The optimal duration of anticoagulation in patients with venous thromboembolism (VTE) is uncertain. We investigated whether persistently negative D-dimers in patients with vein recanalization or stable thrombotic burden can identify subjects at low recurrence risk. Outpatients with a first VTE (unprovoked or associated with weak risk factors) were eligible after at least 3 months (12 in those with residual thrombosis) of anticoagulation. They received serial D-dimer measurements using commercial assays with predefined age/sex-specific cutoffs and were followed for up to 2 years. Of 1010 patients, anticoagulation was stopped in 528 (52.3%) with persistently negative D-dimer who subsequently experienced 25 recurrences (3.0% pt-y; 95% confidence interval [CI], 2.0-4.4%). Of the remaining 482 patients, 373 resumed anticoagulation and 109 refused it. Recurrent VTE developed in 15 patients (8.8% pt-y; 95% CI, 5.0-14.1) of the latter group and in 4 of the former (0.7% pt-y; 95% CI, 0.2-1.7; hazard ratio = 2.92; 95% CI, 1.87-9.72; P = .0006). Major bleeding occurred in 14 patients (2.3% pt-y; 95% CI, 1.3-3.9) who resumed anticoagulation. Serial D-dimer measurement is suitable in clinical practice for the identification of VTE patients in whom anticoagulation can be safely discontinued. This Study was registered at clinicaltrials.gov as #NCT00954395.
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standardized low molecular weight heparin bridging regimen in outpatients on oral anticoagulants undergoing invasive procedure or surgery an inception cohort Management Study
Circulation, 2009Co-Authors: Vittorio Pengo, Sophie Testa, Umberto Cucchini, Gentian Denas, Nicoletta Erba, Giuliana Guazzaloca, L La Rosa, V De Micheli, R Frontoni, Domenico PriscoAbstract:Background— Bridging therapy with low–molecular-weight heparin is usually recommended in patients who must stop oral anticoagulants before surgical or invasive procedures. To date, there is no universally accepted bridging regimen tailored to the patient’s thromboembolic risk. This prospective inception cohort Management Study was designed to assess the efficacy and safety of an individualized bridging protocol applied to outpatients. Methods and Results— Oral anticoagulants were stopped 5 days before the procedure. Low–molecular-weight heparin was started 3 to 4 days before surgery and continued for 6 days after surgery at 70 anti–factor Xa U/kg twice daily in high-thromboembolic-risk patients and prophylactic once-daily doses in moderate- to low-risk patients. Oral anticoagulation was resumed the day after the procedure with a boost dose of 50% for 2 days and maintenance doses afterward. The patients were followed up for 30 days. Of the 1262 patients included in the Study (only 15% had mechanical valves...
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standardized low molecular weight heparin bridging regimen in outpatients on oral anticoagulants undergoing invasive procedure or surgery an inception cohort Management Study
Circulation, 2009Co-Authors: Vittorio Pengo, Sophie Testa, Umberto Cucchini, Gentian Denas, Nicoletta Erba, Giuliana Guazzaloca, L La Rosa, V De Micheli, R Frontoni, Domenico PriscoAbstract:BACKGROUND: Bridging therapy with low-molecular-weight heparin is usually recommended in patients who must stop oral anticoagulants before surgical or invasive procedures. To date, there is no universally accepted bridging regimen tailored to the patient's thromboembolic risk. This prospective inception cohort Management Study was designed to assess the efficacy and safety of an individualized bridging protocol applied to outpatients. METHODS AND RESULTS: Oral anticoagulants were stopped 5 days before the procedure. Low-molecular-weight heparin was started 3 to 4 days before surgery and continued for 6 days after surgery at 70 anti-factor Xa U/kg twice daily in high-thromboembolic-risk patients and prophylactic once-daily doses in moderate- to low-risk patients. Oral anticoagulation was resumed the day after the procedure with a boost dose of 50% for 2 days and maintenance doses afterward. The patients were followed up for 30 days. Of the 1262 patients included in the Study (only 15% had mechanical valves), 295 (23.4%) were high-thromboembolic-risk patients and 967 (76.6%) were moderate- to low-risk patients. In the intention-to-treat analysis, there were 5 thromboembolic events (0.4%; 95% confidence interval, 0.1 to 0.9), all in high-thromboembolic-risk patients. There were 15 major (1.2%; 95% confidence interval, 0.7 to 2.0) and 53 minor (4.2%; 95% confidence interval, 3.2 to 5.5) bleeding episodes. Major bleeding was associated with twice-daily low-molecular-weight heparin administration (high-risk patients) but not with the bleeding risk of the procedure. CONCLUSIONS: This Management bridging protocol, tailored to patients' thromboembolic risk, appears to be feasible, effective, and safe for many patients, but safety in patients with mechanical prosthetic valves has not been conclusively established.
Rosanne Van Maanen - One of the best experts on this subject based on the ideXlab platform.
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validation and impact of a simplified clinical decision rule for diagnosing pulmonary embolism in primary care design of the pecan prospective diagnostic cohort Management Study
BMJ Open, 2019Co-Authors: Menno V Huisman, Rosanne Van Maanen, Frans H Rutten, Frederikus A Klok, Jeanet W Blom, Karel G M Moons, Geertjan GeersingAbstract:Introduction Combined with patient history and physical examination, a negative D-dimer can safely rule-out pulmonary embolism (PE). However, the D-dimer test is frequently false positive, leading to many (with hindsight) ‘unneeded’ referrals to secondary care. Recently, the novel YEARS algorithm, incorporating flexible D-dimer thresholds depending on pretest risk, was developed and validated, showing its ability to safely exclude PE in the hospital environment. Importantly, this was accompanied with 14% fewer computed tomographic pulmonary angiography than the standard, fixed D-dimer threshold. Although promising, in primary care this algorithm has not been validated yet. Methods and analysis The PECAN (Diagnosing Pulmonary Embolism in the context of Common Alternative diagNoses in primary care) Study is a prospective diagnostic Study performed in Dutch primary care. Included patients with suspected acute PE will be managed by their general practitioner according to the YEARS diagnostic algorithm and followed up in primary care for 3 months to establish the final diagnosis. To Study the impact of the use of the YEARS algorithm, the primary endpoints are the safety and efficiency of the YEARS algorithm in primary care. Safety is defined as the proportion of false-negative test results in those not referred. Efficiency denotes the proportion of patients classified in this non-referred category. Additionally, we quantify whether C reactive protein measurement has added diagnostic value to the YEARS algorithm, using multivariable logistic and polytomous regression modelling. Furthermore, we will investigate which factors contribute to the subjective YEARS item ‘PE most likely diagnosis’. Ethics and dissemination The Study protocol was approved by the Medical Ethical Committee Utrecht, the Netherlands. Patients eligible for inclusion will be asked for their consent. Results will be disseminated by publication in peer-reviewed journals and presented at (inter)national meetings and congresses. Trial registration NTR 7431.
Rajiv Kumar Sinha - One of the best experts on this subject based on the ideXlab platform.
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vermiculture and waste Management Study of action of earthworms elsinia foetida eudrilus euginae and perionyx excavatus on biodegradation of some community wastes in india and australia
The Environmentalist, 2002Co-Authors: Rajiv Kumar Sinha, Sunil Herat, Sunita Agarwal, Ravi Kumar Asadi, Emilio CarreteroAbstract:The practice of vermiculture is at least a century old but it is now being revived worldwide with diverse ecological objectives such as waste Management, soil detoxification and regeneration and sustainable agriculture. Earthworms act in the soil as aerators, grinders, crushers, chemical degraders and biological stimulators. They secrete enzymes, proteases, lipases, amylases, cellulases and chitinases which bring about rapid biochemical conversion of the cellulosic and the proteinaceous materials in the variety of organic wastes which originate from homes, gardens, dairies and farms. The process is odour free because earthworms release coelomic fluids in the decaying waste biomass which has anti-bacterial properties which kills pathogens. The species used in India were Indian blue (Perionyx excavatus), African night crawler (Eudrilus euginae) and the Tiger worm (Elsinia foetida). E. foetida was used in Australia. E. euginae was found to have higher feeding, growth and biodegradation capacity compared to other two species.
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vermiculture and waste Management Study of action of earthworms elsinia foetida eudrilus euginae and perionyx excavatus on biodegradation of some community wastes in india and australia
The Environmentalist, 2002Co-Authors: Rajiv Kumar Sinha, Sunil Herat, Sunita Agarwal, Ravi Kumar Asadi, Emilio CarreteroAbstract:The practice of vermiculture is at least a century old but it is now being revived worldwide with diverse ecological objectives such as waste Management, soil detoxification and regeneration and sustainable agriculture. Earthworms act in the soil as aerators, grinders, crushers, chemical degraders and biological stimulators. They secrete enzymes, proteases, lipases, amylases, cellulases and chitinases which bring about rapid biochemical conversion of the cellulosic and the proteinaceous materials in the variety of organic wastes which originate from homes, gardens, dairies and farms. The process is odour free because earthworms release coelomic fluids in the decaying waste biomass which has anti-bacterial properties which kills pathogens. The species used in India were Indian blue (Perionyx excavatus), African night crawler (Eudrilus euginae) and the Tiger worm (Elsinia foetida). E. foetida was used in Australia. E. euginae was found to have higher feeding, growth and biodegradation capacity compared to other two species.