/library/oar/handle/123456789/485 2025-11-08T13:37:20Z 2025-11-08T13:37:20Z Delluc, Aurélien Carrier, Marc Lauw, Mandy Cuker, Adam Bertoletti, Laurent Beyer-Westendorf, Jan Di Nisio, Marcello Simard, Camille Roberge, Guillaume Harrigan, Amye Shivakumar, Sudeep Skeith, Leslie Ageno, Walter Riva, Nicoletta /library/oar/handle/123456789/140347 2025-10-20T15:17:29Z 2025-01-01T00:00:00Z

Title: Indefinite anticoagulation with reduced-intensity direct oral anticoagulants in patients with splanchnic vein thrombosis. An international practice survey Authors: Delluc, Aurélien; Carrier, Marc; Lauw, Mandy; Cuker, Adam; Bertoletti, Laurent; Beyer-Westendorf, Jan; Di Nisio, Marcello; Simard, Camille; Roberge, Guillaume; Harrigan, Amye; Shivakumar, Sudeep; Skeith, Leslie; Ageno, Walter; Riva, Nicoletta Abstract: Introduction: Low-dose direct oral anticoagulants (DOACs) could be beneficial for secondary prevention of splanchnic vein thrombosis (SVT) in subgroups of patients at high risk for recurrence. In the absence of direct evidence, we aimed to identify the practice preferences of physicians managing patients with SVT in an international web-based survey. Methods and results: An anonymous questionnaire was sent via E-Mail between April and July 2023 to members of 14 national and international scientific societies. We received 236 responses of which 175 were complete responses. After an initial 3-6 months of SVT treatment, more than 80% of respondents would continue anticoagulation in the presence of cancer, myeloproliferative neoplasms, or in case of unprovoked SVT. If anticoagulation is continued, 45.8-68.6% would use reduced-intensity dosing of DOACs. In case of compensated cirrhosis or controlled inflammatory bowel disease (IBD), 54.3% and 44.4% of respondents would continue anticoagulation and 68.8% and 73.3% would opt for reduced-intensity DOAC dosing, respectively. Gastroenterologists were more likely to discontinue anticoagulation in SVT associated with cancer, controlled IBD, or unprovoked event, and more likely to continue anticoagulation in compensated cirrhosis compared to other specialists. Overall, 96% of respondents supported prospective evaluation of low-dose DOACs for the secondary prevention of SVT. Conclusion: This survey showed that physicians adapt duration and intensity of anticoagulation therapy depending on the patient's specific condition and risk factors even in the absence of high-quality evidence. Prospective evaluation is awaited.

2025-01-01T00:00:00Z Krasniqi, Valon Bahtiri, Elton Pasha, Flaka Zeqiri, Vjollca Uka, Sami Zarb, Peter Raka, Lul Qorraj Bytyqi, Hasime Krasniqi, Blana /library/oar/handle/123456789/139009 2025-09-15T10:44:05Z 2024-01-01T00:00:00Z

Title: Prevalence of antibiotic prescription in primary healthcare settings in the municipality of Prishtina, Kosovo Authors: Krasniqi, Valon; Bahtiri, Elton; Pasha, Flaka; Zeqiri, Vjollca; Uka, Sami; Zarb, Peter; Raka, Lul; Qorraj Bytyqi, Hasime; Krasniqi, Blana Abstract: Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributing to increased antibiotic resistance in the community and prevailing as an emerging global health concern. We aimed to quantify the prevalence and quality of antibiotic prescription in primary healthcare settings in the Municipality of Prishtina to identify targets for quality improvement.; Methods and Results: This study represents a population-based, retrospective cohort, including data from eight randomly selected family medical centers in the Municipality of Prishtina. Each 150th patient on medical records was assessed for demographic data, diagnosis (ICD-10), antibiotic prescription, antibiotic class, and antibiotic form. In total, the study included 1614 cases reviewed. The antibiotic prescription rate was 16%. The health condition for which most of the cases received antibiotics was J18 - Pneumonia, unspecified organism (67%), followed by J03 - Acute tonsillitis (54%), J42 - Unspecified chronic bronchitis (46%), and N39 - Other disorders of the urinary system (43%). Broad-spectrum antibiotics, such as co-amoxiclav (17.7%), amoxicillin (16.5%), and ceftriaxone (12.6%), featured among the most routinely prescribed antibiotics. The antibiotic prescription rate was the highest for cases in the 3-5 age group, of whom 27% received an antibiotic prescription. In 73% of cases, oral antibiotics were prescribed, 69% of which belong to the WHO AWaRe (Access, Watch, Reserve) essential medicines list. Only 18% of antibiotics were prescribed with their generic names.; Conclusion: The prevalence of antibiotic prescription in primary healthcare settings in Prishtina is moderately low. These data cannot be extrapolated to other municipalities in Kosovo or other countries due to different organizational levels. High antibiotic prescription rates for young age groups, prescription of broad-spectrum antibiotics, and high rates of parenteral antibiotics were identified as targets for quality improvement.(International Journal of Biomedicine. 2024;14(1):134-140.)

2024-01-01T00:00:00Z Zhang, Jinjin Zhang, Shuo Xu, Shanhu Zhu, Zhiying Li, Jiang Wang, Zengjin Wada, Youichiro Gatt, Alexander Liu, Ju /library/oar/handle/123456789/138612 2025-09-02T09:35:53Z 2023-01-01T00:00:00Z

Title: Oxidative stress induces e-selectin expression through repression of endothelial transcription factor ERG Authors: Zhang, Jinjin; Zhang, Shuo; Xu, Shanhu; Zhu, Zhiying; Li, Jiang; Wang, Zengjin; Wada, Youichiro; Gatt, Alexander; Liu, Ju Abstract: Oxidative stress induces a prothrombotic state through enhancement of adhesion properties of the endothelium. E-selectin, an endothelial cell adhesion molecule, becomes a therapeutic target for venous thrombosis, whereas the regulatory mechanisms of its expression have not been fully understood. In the present study, we report that H2O2 treatment increases expression of E-selectin but decreases expression of the endothelial transcription factor ETS-related gene (ERG) in HUVECs in a dose- and time-dependent manner. In BALB/c mice treated with hypochlorous acid, E-selectin expression is increased and ERG expression is decreased in endothelial cells of the brain and lung. RNA interference of ERG upregulates E-selectin expression, whereas transfection of ERG-expressing plasmid downregulates E-selectin expression in HUVECs. Knockdown or overexpression of ERG comprises H2O2-induced E-selectin expression in HUVECs. Deletion of the Erg gene in mice results in embryonic lethality at embryonic days 10.5–12.5, and E-selectin expression is increased in the Erg−/− embryos. No chromatin loop was found on the E-selectin gene or its promoter region by capture high-throughput chromosome conformation capture. Chromatin immunoprecipitation and luciferase reporter assay determined that the −127 ERG binding motif mediates ERG-repressed E-selectin promoter activity. In addition, ERG decreases H2O2-induced monocyte adhesion. Together, ERG represses the E-selectin gene transcription and inhibits oxidative stress–induced endothelial cell adhesion.

2023-01-01T00:00:00Z Carlin, Stephanie Cuker, Adam Gatt, Alexander Gendron, Nicolas Hernández-Gea, Virginia Meijer, Karina Siegal, Deborah M. Stanworth, Simon Lisman, Ton Roberts, Lara N. /library/oar/handle/123456789/137750 2025-07-30T07:28:24Z 2024-01-01T00:00:00Z

Title: Anticoagulation for stroke prevention in atrial fibrillation and treatment of venous thromboembolism and portal vein thrombosis in cirrhosis : guidance from the SSC of the ISTH Authors: Carlin, Stephanie; Cuker, Adam; Gatt, Alexander; Gendron, Nicolas; Hernández-Gea, Virginia; Meijer, Karina; Siegal, Deborah M.; Stanworth, Simon; Lisman, Ton; Roberts, Lara N. Abstract: While advanced liver disease was previously considered to be an acquired bleeding disorder, there is increasing recognition of an associated prothrombotic state with patients being at higher risk of atrial fibrillation (AF) and stroke and venous thromboembolism (VTE) including portal vein thrombosis (PVT). We review the available literature on epidemiology, pathophysiology, and risk factors and provide guidance on anticoagulant management of these conditions in adults with cirrhosis. In patients with Child–Pugh A or B cirrhosis and AF, we recommend anticoagulation with standard-dose direct oral anticoagulants (DOACs) in accordance with cardiology guideline recommendations for patients without liver disease. In those with Child–Pugh C cirrhosis, there is inadequate evidence with respect to the benefit and risk of anticoagulation for stroke prevention in AF. In patients with cirrhosis and acute deep vein thrombosis or pulmonary embolism, we recommend anticoagulation and suggest use of either a DOAC or low-molecular-weight heparin (LMWH)/vitamin K antagonist (VKA) in Child-Pugh A or B cirrhosis and LMWH alone (or as a bridge to VKA in patients with a normal baseline international normalized ratio) in Child-Pugh C cirrhosis. We recommend anticoagulation for patients with cirrhosis and symptomatic PVT. We suggest anticoagulation for those with asymptomatic, progressing PVT and recommend continuing extended anticoagulation for liver transplant candidates with PVT.

2024-01-01T00:00:00Z