Garcia, R. (R.)

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    Antiagregación y anticoagulación en síndromes coronarios agudos: niveles de evidencia
    (Ediciones Universidad de Navarra, 2007) Paramo, J.A. (José Antonio); Garcia, R. (R.); Rodriguez, P. (P.); Ruiz-de-Gaona, E. (Estefanía)
    Management of acute coronary syndromes (ACS) has moved rapidly in parallel with our understanding of the pathophysiological basis of the disease. In the eighties, the demonstration of the pivotal role of coronary thrombosis in the etiology of a ACS led to administration of aspirin and unfractionated heparin. In recent years, new medical and invasive therapies have been developed: anti-platelets (thienopyridines and glycoprotein Ilb/IlIa inhibitors), antithrombins (low molecularweight heparins) and most recently, factor Xa inhibitors (pentasaccharides). As new treatments are rapidly added, clinicians are constantly challenged to incorporate new information and guidelines into their practices in a timely fashion.
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    Tratamiento del síndrome antifosfolípido
    (Ediciones Universidad de Navarra, 2007) Paramo, J.A. (José Antonio); Garcia, R. (R.); Lecumberri, E. (E.); Rodriguez, P. (P.); Panizo, E. (Elena)
    The antiphospholipid syndrome (APS) is a disorder of recurrent thrombosis and/or pregnancy loss associated with the presence of antiphospholipid antibodies and persistently positive lupus anticoagulant, anticardiolipin or anti beta2-glycoprotein1. Oral anticoagulants are the best available and most effective treatment for the secondary prevention of recurrent venous or arterial thrombosis. Patients with APS are treated with long-term therapy to prolong the INR to 2.0-3.0. Low-molecular-weight heparin in combination with low-aspirin dose is a reasonable strategy to avoid pregnancy loss in women with this syndrome.
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    Diagnóstico y tratamiento de la trombosis venosa profunda
    (Ediciones Universidad de Navarra, 2007) Paramo, J.A. (José Antonio); Garcia, R. (R.); Rodriguez, P. (P.); Ruiz-de-Gaona, E. (Estefanía); Lecumberri, R. (Ramón)
    Deep-vein thrombosis (DVT) is a common condition that can lead to complications such as postphlebitic syndrome, pulmonary embolism and death. Currently, an algorithm strategy combining pretest probability, D-dimer testing and compression ultrasonography imaging allows for safe and convenient estimation of suspected lower-limb thrombosis. The mainstay of treatment is anticoagulation therapy. The use of low-molecular-weight heparin or pentasaccharide (fondaparinux) allows for outpatient management of most patients with DVT. The duration of anticoagulation depends on whether the primary event was idiopathic or secondary to a transient risk factor. Interventions such as thrombolysis and placement of inferior vena cava filter are reserved for special situations.