Sangramento durante a anticoagulação oral: alerta sobre um mal maior

Lavitola, Paulo de Lara; Spina, Guilherme Sobreira; Sampaio, Roney Orismar; Tarasoutchi, Flávio; Grinberg, Max

doi:10.1590/s0066-782x2009000800017

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…It is noteworthy that most patients that presented bleeding with an INR value within the therapeutic range also had some type of predisposing pathology -as previously observed 21 .…”

Section: Discussionsupporting

confidence: 59%

Varfarina ou Aspirina na prevenção de fenômenos embólicos na valvopatia mitral com fibrilação atrial

Lavitola¹,

Sampaio²,

Oliveira³

et al. 2010

Arq. Bras. Cardiol.

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“…It is noteworthy that most patients that presented bleeding with an INR value within the therapeutic range also had some type of predisposing pathology -as previously observed 21 .…”

Section: Discussionsupporting

confidence: 59%

Varfarina ou Aspirina na prevenção de fenômenos embólicos na valvopatia mitral com fibrilação atrial

Lavitola¹,

Sampaio²,

Oliveira³

et al. 2010

Arq. Bras. Cardiol.

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“…The female genital tract is the location with the most frequent episodes of bleeding in the presence of pathologies predisposing to hemorrhage in patients undergoing OAT [54]. Bleeding is also more common in patients with latent pathology [55].…”

Section: Discussionmentioning

confidence: 99%

Risk of More Advanced Lesions at Hysterectomy after Initial Diagnosis of Non-Atypical Endometrial Hyperplasia in Patients with Postmenopausal Bleeding and Oral Anticoagulant Treatment

et al. 2021

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Background and Objectives: Endometrial hyperplasia (EH) is a precursor lesion to endometrial cancer (EC), and when cellular atypia is present, in 40% of cases, they are diagnosed with EC on hysterectomy. Usually, EH is clinically manifested by uterine bleeding. In patients with oral anticoagulant therapy (OAT), the uterus is the second most common source of bleeding. The aim of the study was to show that uterine bleeding in postmenopausal patients undergoing OAT may reveal precancerous endometrial lesions with atypia, or neoplastic lesions in patients with an initial diagnosis of endometrial hyperplasia without atypia (non-atypical endometrial hyperplasia, NAEH) on dilation and curettage (D&C). We will be able to estimate the risk of a postmenopausal female patient with uterine bleeding during an OAT to have a precancerous endometrial lesion. Materials and Methods: The subjects of the study were 173 female patients with uterine bleeding, who have had total hysterectomy with bilateral salpingoovarectomy, of whom 99 underwent an OAT. There were 101 female patients initially diagnosed with NAEH, of which 60 did not have anticoagulant treatment (mean age 57.36 ± 6.51) and 41 had anticoagulant treatment (mean age 60.39 ± 7.35) (p = 0.006). From the pathology diagnosis moment, the surgery was performed at 42.09 ± 14.54 days in patients without OAT and after 35.39 ± 11.29 days in those who received such treatment (p = 0.724). Results: Initial diagnosis of NAEH established at D&C was changed at the final diagnosis after hysterectomy in EH with cellular atypia (atypical endometrial hyperplasia AEH) or EC in 18.18% of patients without OAT, and in 40.54% of patients who received this treatment. Conclusions: Based on a logistic regression model, it is estimated that female patients with an initial histopathological diagnosis of NAEH and who underwent OAT have, on average, 4.85 times greater odds (OR = 4.85, 95% CI 1.79–14.06) than the others of being identified postoperatively with more advanced lesions.

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“…O exame de escolha para monitorização dos anticoagulantes cumarínicos (sendo a varfarina o principal medicamento dessa classe) é o tempo de protrombina (TP), já que, dos cinco fatores que influenciam o TP, três são dependentes da vitamina K (II, VII, X). Para que ocorra padronização e o TP possa ser comparável em qualquer laboratório do mundo, seu valor é expresso em INR, critério proposto pela Organização Mundial de Saúde (OMS) desde 1982 [24][25][26] . O valor de INR para indivíduos normais é de aproximadamente 1.…”

Section: Discussionunclassified

Protocolo de atendimento odontológico a pacientes usuários de terapia antitrombótica

Pesse

Macedo

Mestriner

et al. 2018

Rev. da Fac. de Odontologia, UPF

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Muitos pacientes que necessitam de intervenção odontológica, atualmente, são usuários de terapia medicamentosa antitrombótica. Essa condição se mostra prevalente, considerando que problemas cardiovasculares afetam grande parte da população. Objetivo: construir um protocolo clínico para o Serviço de Odontologia e Estomatologia do Hospital das Clínicas de Ribeirão Preto da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, a partir de evidências científicas. Revisão de literatura: foi realizada uma pesquisa bibliográfica nas bases de dados eletrônicas Scientific Eletronic Library Online (SciELO) e Public MedLine (PubMed), nos idiomas português e inglês, do período entre 2013 e 2017. Após obtenção dos periódicos, foram selecionados os que se tratavam de estudos clínicos e seguiu-se com tradução, leitura e análise dos artigos. Com base nas evidências científicas, optou-se por construir o protocolo a partir da classe de medicamento utilizada pelos usuários de terapia antitrombótica (antiagregantes plaquetários, anticoagulantes orais e novos anticoagulantes orais) e orientações (pré, intra e pós-operatórias) para cada procedimento odontológico. Considerações finais: o protocolo clínico estabeleceu parâmetros para condutas clínicas e cirúrgicas em atendimento ambulatorial e hospitalar, possibilitando o cuidado integral aos usuários de terapia antitrombótica. Futuros estudos clínicos são necessários para validação e adequação para seu uso em diferentes serviços.

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Sangramento durante a anticoagulação oral: alerta sobre um mal maior

Abstract: Background: Bleeding is one of the main concerns in patients undergoing oral anticoagulation therapy.

Cited by 11 publications

References 12 publications

Varfarina ou Aspirina na prevenção de fenômenos embólicos na valvopatia mitral com fibrilação atrial

Varfarina ou Aspirina na prevenção de fenômenos embólicos na valvopatia mitral com fibrilação atrial

Risk of More Advanced Lesions at Hysterectomy after Initial Diagnosis of Non-Atypical Endometrial Hyperplasia in Patients with Postmenopausal Bleeding and Oral Anticoagulant Treatment

Protocolo de atendimento odontológico a pacientes usuários de terapia antitrombótica

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