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Seminars in Thrombosis and Hemostasis

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https://www.readbyqxmd.com/read/27923263/microparticles-and-fibrinolysis
#1
Loris Vallier, Sylvie Cointe, Romaric Lacroix, Amandine Bonifay, Coralie Judicone, Françoise Dignat-George, Hau C Kwaan
Microparticles (MPs) are submicronic vesicles which are formed by budding of the cellular membrane of virtually any cell type in response to cell activation or apoptosis. Both circulating MPs and MPs generated within tissues harbor molecules with a large repertoire of biological activities and transfer material to target cells. Depending on their cellular origin, the stimuli triggering their formation, or their localization, they may participate in the maintenance of organ or vascular homeostasis as well as inducing dysfunction...
December 6, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27907937/tranexamic-acid-for-trauma-resuscitation-in-the-united-states-of-america
#2
Mark Walsh, Scott Thomas, Ernest Moore, Hunter Moore, Andres Piscoya, Daniel Hake, Michael Son, Tim Pohlman, Julie Wegner, John Bryant, Alberto Grassetto, Patrick Davis, Nathan Nielsen, Anton Crepinsek, Jacob T Shreve, Francis Castellino
The utilization of tranexamic acid (TXA) for the management of bleeding trauma patients has been a subject of much debate on both sides of the Atlantic and in Australia. As a result of the large randomized controlled study called the Clinical Randomization of an Antifibrinolytic in Severe Hemorrhage (CRASH-2), there was an initial enthusiasm for the use of TXA to treat bleeding patients. However, the adoption of TXA in the United States was delayed by concerns of "knowledge and evidence gaps" of the CRASH-2 study and because of a lack of mechanistic rationale that would explain the survival benefit noted in the study...
December 1, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27825182/practical-aspects-of-monitoring-of-antiplatelet-therapy
#3
Ljubica Jovanovic, Nebojsa Antonijevic, Tina Novakovic, Nebojsa Savic, Branka Terzic, Ivana Zivkovic, Nebojsa Radovanovic, Milika Asanin
Despite the application of new antiplatelet drugs (prasugrel and ticagrelor), dual antiplatelet therapy with clopidogrel and aspirin remains the standard for patients with acute coronary syndrome undergoing percutaneous coronary intervention, especially in countries of low socioeconomic status. Regardless of the proven benefits, numerous studies have shown that certain groups of patients who receive standard doses of clopidogrel and aspirin do not respond adequately, and many of them also exhibit adverse cardiovascular events...
November 8, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27825181/blood-group-o-protects-against-inhibitor-development-in-severe-hemophilia-a-patients
#4
Massimo Franchini, Antonio Coppola, Carlo Mengoli, Gianna Franca Rivolta, Federica Riccardi, Giovanni Di Minno, Annarita Tagliaferri
Increasing evidence supports the link between ABO(H) blood group determinants and hemostasis. In particular, the ABO-related different glycosylation patterns of von Willebrand factor strongly influence its clearance and functional levels, and this may contribute to the inter-individual variations in the half-life of infused Factor VIII (FVIII) in hemophilia A (HA) patients. We investigated the role of ABO blood groups in regulating FVIII immunogenicity by evaluating their distribution in patients with severe (FVIII < 1 IU/dL) HA according to inhibitor development and other known relevant factors...
November 8, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27813042/red-blood-cell-distribution-width-is-an-independent-predictor-of-outcome-in-patients-undergoing-thrombolysis-for-ischemic-stroke
#5
Gianni Turcato, Manuel Cappellari, Luca Follador, Alice Dilda, Antonio Bonora, Massimo Zannoni, Chiara Bovo, Giorgio Ricci, Paolo Bovi, Giuseppe Lippi
An appropriate and timely management, including early diagnosis and accurate prognostication, is the mainstay for managed care of patients with acute ischemic stroke. Since red blood cell distribution width (RDW) was found to be an independent predictor of clinical outcomes in patients with thrombotic disorders, we designed a retrospective observational study to investigate whether the RDW value may also retain predictive significance in stoke patients undergoing thrombolytic therapy. This retrospective study was based on all patients admitted to the Emergency Department (ED) of the University Hospital of Verona (Italy) with a diagnosis of ischemic stroke, who underwent systemic thrombolysis between January 2013 and June 2015...
November 3, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27806384/diagnostic-challenges-in-acquired-von-willebrand-syndrome-a-complex-case-of-prostate-carcinoma-associated-acquired-von-willebrand-syndrome
#6
Paul-Emile Claus, Inge Van Haute, Eline Verhoye, Dries Deeren, Els Moreau
No abstract text is available yet for this article.
November 2, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764883/epidemiology-of-familial-aggregation-of-venous-thromboembolism
#7
Bengt Zöller, Xinjun Li, Henrik Ohlsson, Jianguang Ji, Ashfaque A Memon, Peter J Svensson, Karolina Palmér, Björn Dahlbäck, Jan Sundquist, Kristina Sundquist
Familial aggregation (clustering) of venous thromboembolism (VTE) is the clustering of VTE within a family. Though several genes, such as antithrombin, protein C, protein S, factor V, and prothrombin are associated with the familial clustering of VTE, these loci only partially explain the familial aggregation of VTE. The epidemiology of the familial aggregation of VTE exhibits typical characteristics of complex traits. The family history of VTE in first-degree relatives is associated with a two to three times increased familial relative risk (FRR)...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764882/the-outpatient-treatment-of-venous-thromboembolism-operational-impact-and-the-role-of-novel-anticoagulants
#8
Benjamin White, Rachel Rosovsky, Blair Alden Parry, Christopher Kabrhel
Pulmonary embolism (PE) and venous thromboembolism (VTE) are common diagnoses in the emergency department (ED), with significant potential morbidity and mortality. As a result, historically nearly all patients with PE have been admitted to the hospital for observation and treatment. In recent years, the ability to rapidly and accurately risk stratify patients with VTE according to their risk of short-term clinical deterioration has supported outpatient treatment, and non-vitamin K antagonist oral anticoagulants (NOACs) have further facilitated this approach...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764881/update-on-the-treatment-of-venous-thromboembolism
#9
Sam Schulman
During the past 7 years, results from phase III trials comparing nonvitamin antagonist K oral anticoagulants (NOACs) with vitamin K antagonists (VKAs) or with placebo, including 34,900 patients, have been published. Recent guidelines have been updated and now suggest treatment with NOACs rather than with VKA. Other updates in the guidelines concern the initial thrombolytic treatment for selected patients with deep vein thrombosis or pulmonary embolism as well as the possibility of withholding anticoagulation for minimal venous thromboembolism...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764880/extensive-computed-tomography-versus-limited-screening-for-detection-of-occult-cancer-in-unprovoked-venous-thromboembolism-a-multicenter-controlled-randomized-clinical-trial
#10
Paolo Prandoni, Enrico Bernardi, Fabio Dalla Valle, Adriana Visonà, Pietro F Tropeano, Carlo Bova, Eugenio Bucherini, Md Shahidul Islam, Andrea Piccioli
Patients with unprovoked venous thromboembolism (VTE) may harbor occult cancer. Whether an extensive diagnostic work-up for cancer has additional value over a more limited screening for detection of underlying malignancy in these patients is controversial. We performed a randomized multicenter trial to assess if in patients with unprovoked VTE, a computed tomography (CT)-based diagnostic strategy including thoracic, abdominal, and pelvic CT in combination with fecal occult blood test yields a higher cancer detection rate than a nonstandardized testing approach based on physicians' clinical judgment and patients' preferences...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764879/state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#11
Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764877/venous-thromboembolism-in-patients-undergoing-craniotomy-for-brain-tumors-a-u-s-nationwide-analysis
#12
David J Cote, Heloise M Dubois, Aditya V Karhade, Timothy R Smith
Background Patients who undergo craniotomy for brain tumor have an increased risk of developing venous thromboembolism (VTE). Using the National Surgical Quality Improvement Program (NSQIP) registry, patients undergoing craniotomy for brain tumor from 2006 and 2014 were analyzed to identify risk factors for postoperative VTE. Methods The study population, identified by Current Procedural Terminology codes, included all NSQIP-reported patients who underwent a craniotomy for brain tumor resection. Results There were 629 instances of VTE among 19,409 craniotomies for brain tumor (3...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27743556/pulmonary-infarction-an-often-unrecognized-clinical-entity
#13
Massimo Miniati
Pulmonary infarction occurs in nearly one-third of the patients with acute pulmonary embolism. Infarcts are still often mistaken for pneumonia or lung cancer because of the deeply rooted belief that they ought to be triangular in shape. In reality, the apical portion of an embolized region is spared from infarction thanks to sufficient collateral blood flow. Infarcts are always arranged peripherally along the surface of the visceral pleura (costal, diaphragmatic, mediastinal, or interlobar). Their free margin is sharp and convex toward the hilum, casting a semicircular or cushion-like density on chest radiography or computed tomography (CT)...
October 15, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27706532/optimal-anticoagulation-for-pregnant-women-with-mechanical-heart-valves
#14
Rohan D'Souza, Candice K Silversides, Claire McLintock
The prothrombotic state of pregnancy increases the risk of thromboembolic complications and death in women with mechanical heart valves (MHVs). Although it is accepted that these women must be on therapeutic anticoagulation throughout pregnancy, competing maternal and fetal risks, as well as the lack of high-quality data from prospective studies, make the choice of the optimal method of anticoagulation challenging. Vitamin K antagonists (VKAs) are associated with fewer maternal complications, but conversely also the lowest live birth rates as well as warfarin-related embryopathy and fetopathy...
October 5, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27706531/direct-oral-anticoagulants-and-women
#15
Hannah Cohen, Deepa R J Arachchillage, Jan Beyer-Westendorf, Saskia Middeldorp, Rezan A Kadir
Direct oral anticoagulants (DOACs) provide an effective, safe, and convenient therapeutic alternative to warfarin and other vitamin K antagonists (VKAs), and are now established for a wide range of indications. The use of DOACs in women merits special consideration due to two main situations: first, in relation to fertility, pregnancy, and lactation in women of reproductive age; second, because of their bleeding risk, leading to abnormal uterine and/or other genital tract bleeding. This review focuses on these two clinical situations, including approaches to management in the context of available information...
October 5, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27699730/management-of-coagulopathy-in-postpartum-hemorrhage
#16
Andra H James, Chad Grotegut, Homa Ahmadzia, Cathleen Peterson-Layne, Evelyn Lockhart
The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood bank, the role of massive transfusion protocols, the role of laboratory monitoring, and the role of anesthesia management. Aspects of patient blood management are discussed. The concept refers to an evidence-based, comprehensive, multidisciplinary approach to optimizing the care of patients who might need transfusion and includes measures to avoid or minimize transfusion such as preoperative anemia management, cell salvage, and the use of hemostatic medication to reduce bleeding...
October 3, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27677179/tpa-modulation-of-the-blood-brain-barrier-a-unifying-explanation-for-the-pleiotropic-effects-of-tpa-in-the-cns
#17
Linda Fredriksson, Daniel A Lawrence, Robert L Medcalf
The plasminogen activation (PA) system is best known for its role in fibrinolysis. However, it has also been shown to regulate many nonfibrinolytic functions in the central nervous system (CNS). In particular, tissue-type plasminogen activator (tPA) is reported to have pleiotropic activities in the CNS, regulating events such as neuronal plasticity, excitotoxicity, and cerebrovascular barrier integrity, whereas urokinase-type plasminogen activator is mainly associated with tissue remodeling and cell migration...
September 27, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27677178/plasmin-a-modulator-of-immune-function
#18
Dominik F Draxler, Maithili Sashindranath, Robert L Medcalf
Plasmin is the effector protease of the fibrinolytic system, well known for its involvement in fibrin degradation and clot removal. However, plasmin is also recognized as a potent modulator of immunological processes by directly interacting with various cell types including leukocytes (monocytes, macrophages, and dendritic cells) and cells of the vasculature (endothelial cells, smooth muscle cells) as well as soluble factors of the immune system and components of the extracellular matrix. In fact, the removal of misfolded proteins and maintenance of tissue homeostasis seem to be major physiological functions of plasmin...
September 27, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27677177/laboratory-monitoring-of-oral-vitamin-k-anticoagulation
#19
Karen A Moffat, Clinton W Lewis
Vitamin K antagonists (VKA) have been used for many years as effective anticoagulant therapy. The laboratory plays a crucial role in measuring the prothrombin time (PT) and calculating the international normalized ratio (INR). Each component of the calculation has the potential to increase error in the final result. This article discusses the laboratory aspects of monitoring VKA including sample requirements, PT, determination of the INR, point of care (POC) testing, external quality assurance/proficiency testing, and reversal strategies for VKA therapy...
September 27, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27652600/classic-and-global-hemostasis-testing-in-pregnancy-and-during-pregnancy-complications
#20
Fazoil I Ataullakhanov, Ekaterina M Koltsova, Anna N Balandina, Ilya I Serebriyskiy, Tatiana A Vuimo, Mikhail A Panteleev
Pregnancy is associated with a significant procoagulant shift in the hemostatic system balance as well as other metabolic changes. Pregnancy can thereby provoke manifestation of otherwise dormant disorders of hemostasis (e.g., thrombophilia), or even cause new, pregnancy-specific disorders (e.g., HELLP syndrome). Application and interpretation of laboratory assays of hemostasis in pregnancy is particularly challenging, because normal physiological ranges are no longer applicable, and because the most dangerous and complex changes are not detected by classic routine coagulation/platelet assays...
September 21, 2016: Seminars in Thrombosis and Hemostasis
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