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https://www.readbyqxmd.com/read/29772593/-coagulation-monitoring-and-bleeding-management-in-cardiac-surgery
#1
Berthold Bein, Robert Schiewe
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29771328/association-of-preoperative-plasma-fibrinogen-level-with-postoperative-bleeding-after-on-pump-coronary-bypass-surgery-does-plasma-fibrinogen-level-affect-the-amount-of-postoperative-bleeding
#2
Sameh Alagha, Murat Songur, Tugba Avci, Kerem Vural, Sadi Kaplan
OBJECTIVES: Our primary aim was to investigate the association between the preoperative concentration of plasma fibrinogen and the volume of postoperative bleeding. Our secondary aim was to identify whether there is a possible correlation between the patients' different characteristics and haemostatic laboratory variables and the postoperative amount of bleeding after on-pump coronary artery bypass grafting procedures. METHODS: A total of 550 adult patients undergoing isolated coronary artery bypass grafting on cardiopulmonary bypass in our hospital were enrolled and investigated retrospectively...
May 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29770422/biodegradable-toughened-nanohybrid-shape-memory-polymer-for-smart-biomedical-applications
#3
Arpan Biswas, Akhand Pratap Singh, Dipak Rana, Vinod K Aswal, Pralay Maiti
A polyurethane nanohybrid has been prepared through the in situ polymerization of an aliphatic diisocyanate, ester polyol and a chain extender in the presence of two-dimensional platelets. Polymerization within the platelet galleries helps to intercalate, generate diverse nanostructure and improve the nano to macro scale self-assembly, which leads to a significant enhancement in the toughness and thermal stability of the nanohybrid in comparison to pure polyurethane. The extensive interactions, the reason for property enhancement, between nanoplatelets and polymer chains are revealed through spectroscopic measurements and thermal studies...
May 17, 2018: Nanoscale
https://www.readbyqxmd.com/read/29768939/higher-preoperative-plasma-thrombin-potential-in-patients-undergoing-surgery-for-aortic-stenosis-compared-to-surgery-for-stable-coronary-artery-disease
#4
Axel Dimberg, Ulrica Alström, Elisabeth Ståhle, Christina Christersson
Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29768524/evaluation-of-the-effect-of-dose-dependent-platelet-rich-fibrin-membrane-on-treatment-of-gingival-recession-a-randomized-controlled-clinical-trial
#5
Rana Culhaoglu, Levent Taner, Berceste Guler
Miller's class I gingival recessions (GR) have been treated using coronally advanced flap (CAF) with platelet-rich fibrin membrane (PRF membrane) or connective tissue graft (CTG). The aim of this study was to evaluate the effect of different multiple layers of PRF membranes for the treatment of GR compared with the CTG procedure. Sixty-three Miller class I GR were treated in this study. Twenty-one GR selected randomly were treated with two layers of PRF membranes+CAF in 2PRF+CAF (test group-1), four layers of PRF membranes+CAF in 4PRF+CAF (test group-2), and CTG+CAF in the control group...
May 14, 2018: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/29767837/romiplostim-for-the-management-of-perioperative-thrombocytopenia
#6
Hanny Al-Samkari, Ariela L Marshall, Katayoon Goodarzi, David J Kuter
Thrombocytopenic patients requiring invasive surgery have few options to improve their platelet count preoperatively. This is a single-centre, retrospective review of thrombocytopenic patients receiving the thrombopoietin receptor agonist romiplostim perioperatively to allow for surgical interventions. Patient characteristics, romiplostim use, and surgical and safety outcomes (bleeding, thrombosis, transfusions) were collected and analysed. Forty-seven patients underwent 51 surgical procedures (ranging from total hip arthroplasty to open cardiac surgery) with romiplostim support...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29765248/preoperative-neutrophil-to-lymphocyte-ratio-as-a-prognostic-predictor-after-curative-intent-surgery-for-hepatocellular-carcinoma-experience-from-a-developing-country
#7
Danijel Galun, Aleksandar Bogdanovic, Jelena Djokic Kovac, Predrag Bulajic, Zlatibor Loncar, Marinko Zuvela
Purpose: The aim of the study was to evaluate a prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) on long-term survival of cirrhotic and noncirrhotic hepatocellular cancer (HCC) patients managed by a curative-intent liver surgery in a developing country. Patients and methods: During the study period between November 1, 2001, and December 31, 2012, 109 patients underwent potentially curative hepatectomy for HCC. Data were retrospectively reviewed from the prospectively collected database...
2018: Cancer Management and Research
https://www.readbyqxmd.com/read/29764885/compliance-with-current-vte-prophylaxis-guidelines-and-risk-factors-linked-to-complications-of-vte-prophylaxis-in-medical-inpatients-a-prospective-cohort-study-in-a-spanish-internal-medicine-department
#8
Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Alba Costa-Grille, Javier Suárez-Dono, Fernando Ferrón-Vidan, Antonio Pose-Reino
OBJECTIVES: To evaluate the degree of compliance with the current guidelines regarding venous thromboembolism (VTE) prophylaxis in medical patients during admission and to identify risk factors linked to complications of VTE prophylaxis. DESIGN: Prospective cohort study. SETTING: The Internal Medicine Department of the University Hospital of Santiago de Compostela (tertiary referral hospital). PARTICIPANTS: A total of 396 hospitalised, elderly patients who did not undergo surgery and had no active or previous oral anticoagulation or low molecular weight heparin (LMWH) treatment (during the previous year) and who received VTE prophylaxis during admission...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29762775/combination-superficial-temporal-artery-middle-cerebral-artery-bypass-and-m2-m2-reanastomosis-with-trapping-of-a-stented-distal-middle-cerebral-artery-aneurysm-3-dimensional-operative-video
#9
Jan-Karl Burkhardt, Sonia Yousef, Halima Tabani, Arnau Benet, Roberto Rodriguez Rubio, Michael T Lawton
Distal middle cerebral artery (MCA) aneurysms often have non-saccular morphology and cannot be clipped, requiring revascularization and trapping instead. Combination bypasses are needed when 2 arteries exit the aneurysm, and extracranial-intracranial and intracranial-intracranial bypasses can be used. This video demonstrates a combination bypass used to treat a previously stented distal MCA aneurysm with both a superficial temporal artery (STA)-to-MCA bypass and an M2-to-M2 reanastomosis. This 56-yr-old man presented with distal left-sided MCA aneurysm 2 years earlier and attempted stent-assisted coiling was aborted after the aneurysm was perforated with stenting alone...
May 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29756161/risk-factors-for-failure-of-systemic-to-pulmonary-artery-shunts-in-biventricular-circulation
#10
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease, but it is associated with high morbidity and mortality. Data of all patients with biventricular circulation who underwent systemic-to-pulmonary artery shunt implantation between 2000 and 2016 were reviewed. Endpoints of the study were shunt failure and shunt-related mortality. Shunt failure was defined as any shunt dysfunction requiring intervention or reoperation. Shunt-related mortality was defined as death due to shunt dysfunction...
May 14, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29755531/adjunctive-platelet-rich-plasma-prp-in-infrabony-regenerative-treatment-a-systematic-review-and-rct-s-meta-analysis
#11
REVIEW
Mubashir Saleem, Flavio Pisani, Faisal Maqbool Zahid, Ioannis Georgakopoulos, Teuta Pustina-Krasniqi, Edit Xhajanka, Maher Almasri
Background and Objective: The purpose of this study was to highlight the clinical performance of platelet-rich plasma (PRP) used as an adjunctive tool for regeneration in infrabony periodontal defects using different biomaterials or performing different surgical flap approaches. Comparative evaluation of main clinical outcomes as probing pocket depth reduction, clinical attachment gain, and recession reduction with and without the use of PRP has been analysed. Materials and Methods: According to the focused question, an electronic and hand searching has been performed up to December 2016...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29754149/the-role-of-dipyrone-in-the-high-development-of-on-treatment-platelet-reactivity-in-acetylsalicylic-acid-treated-patients-undergoing-peripheral-artery-revascularization
#12
Jan Hartinger, Robert Novotny, Jana Bilkova, Tomas Kvasnicka, Petr Mitas, Martin Sima, Jaroslav Hlubocky, Jan Kvasnicka, Ondrej Slanar, Jaroslav Lindner
OBJECTIVE: To evaluate the effects of dipyrone on sensitivity to Aspirin [acetyl salicylic acid, (ASA)] in patients who underwent peripheral artery vascular reconstruction. SUBJECTS AND METHODS: Impedance aggregometry and light transmission aggregometry were used to determine the effects of dipyrone on ASA treatment in 21 patients. Blood samples were drawn in a 7-day period after the surgery. The cut-off value for high on-treatment platelet reactivity (HTPR) was set at < 65% of aggregation inhibition for impedance aggregometry...
May 13, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#13
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753820/association-of-pre-operative-cell-counts-with-outcomes-after-surgery-for-congenital-heart-disease
#14
Shannon Jones, Courtney McCracken, Bahaaldin Alsoufi, William T Mahle, Matthew E Oster
BACKGROUND: We examined the association of pre-operative cell count abnormalities, which have been shown to be associated with outcomes in adult cardiac patients, with morbidity and mortality following surgery for congenital heart disease (CHD) in children. METHODS: We performed a retrospective cohort study on 4865 children undergoing cardiac surgery from 2004- 2014. Our exposures of interest were presence of pre-operative lymphopenia (lymphocyte count ≤ 3000 cells/μL), thrombocytopenia (platelet count < 150 x103 / μL), and neutrophilia (neutrophil count ≥ 7000 cells/ μL)...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#15
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29742582/changes-in-microrna-expression-level-of-circulating-platelets-contribute-to-platelet-defect-after-cardiopulmonary-bypass
#16
Nobuhiro Mukai, Yoshinobu Nakayama, Sachiyo Ishi, Satoru Ogawa, Sachiko Maeda, Natuki Anada, Satoshi Murakami, Toshiki Mizobe, Teiji Sawa, Yasufumi Nakajima
OBJECTIVES: Platelet defect mechanisms after cardiopulmonary bypass remain unclear. Our hypothesis microRNA expressions in circulating platelets significantly change between pre and post cardiopulmonary bypass, and consequent messenger RNA and protein expression level alterations cause postcardiopulmonary bypass platelet defect. DESIGN: Single-center prospective observational study. SETTING: Operating room of Kyoto Prefectural University of Medicine...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29741923/effect-of-intraoperative-platelet-rich-plasma-treatment-on-postoperative-donor-site-knee-pain-in-patellar-tendon-autograft-anterior-cruciate-ligament-reconstruction-a-double-blind-randomized-controlled-trial
#17
Brian L Walters, David A Porter, Sarah J Hobart, Benjamin B Bedford, Daniel E Hogan, Malachy M McHugh, Devon A Klein, Kendall Harousseau, Stephen J Nicholas
BACKGROUND: Donor site morbidity in the form of anterior knee pain is a frequent complication after bone-patellar tendon-bone (BPTB) autograft anterior cruciate ligament (ACL) reconstruction. Hypothesis/Purpose: The purpose was to examine the effect of the intraoperative administration of platelet-rich plasma (PRP) on postoperative kneeling pain. It was hypothesized that PRP treatment would reduce knee pain. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29741735/widespread-epigenomic-transcriptomic-and-proteomic-differences-between-hip-osteophytic-and-articular-chondrocytes-in-osteoarthritis
#18
Julia Steinberg, Roger A Brooks, Lorraine Southam, Sahir Bhatnagar, Theodoros I Roumeliotis, Konstantinos Hatzikotoulas, Eleni Zengini, J Mark Wilkinson, Jyoti S Choudhary, Andrew W McCaskie, Eleftheria Zeggini
Objectives: To identify molecular differences between chondrocytes from osteophytic and articular cartilage tissue from OA patients. Methods: We investigated genes and pathways by combining genome-wide DNA methylation, RNA sequencing and quantitative proteomics in isolated primary chondrocytes from the cartilaginous layer of osteophytes and matched areas of low- and high-grade articular cartilage across nine patients with OA undergoing hip replacement surgery. Results: Chondrocytes from osteophytic cartilage showed widespread differences to low-grade articular cartilage chondrocytes...
May 8, 2018: Rheumatology
https://www.readbyqxmd.com/read/29736572/hyaluronic-acid
#19
Hélder Pereira, Duarte Andre Sousa, António Cunha, Renato Andrade, J Espregueira-Mendes, J Miguel Oliveira, Rui L Reis
In recent times, the field of tissue engineering and regenerative medicine (TERM) has considerably increased the extent of therapeutic strategies for clinical application in orthopedics. However, TERM approaches have its rules and requirements, in the respect of the biologic response of each tissue and bioactive agents which need to be considered, respected, and subject of ongoing studies. Different medical devices/products have been prematurely available on the market and used in clinics with limited success...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29731075/association-of-platelet-count-and-platelet-transfusion-with-serotonin-level-during-living-donor-liver-transplantation-possible-connection-to-graft-regeneration
#20
S Han, J S Ko, M S Gwak, G S Kim
BACKGROUND: We recently showed that platelet counts and the amount of platelet transfusion during liver transplantation are positively associated with early graft regeneration. It was hypothesized that platelet-derived serotonin mediates liver regeneration. OBJECTIVES: This study aimed to evaluate the association between intraoperative platelet count, platelet transfusion, and serum serotonin level. METHODS: Thirty-two recipients undergoing living-donor liver transplantation were enrolled into this prospective observational study...
May 2018: Transplantation Proceedings
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