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treatment bleeding diathesis

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https://www.readbyqxmd.com/read/28594466/bleeding-is-not-the-main-clinical-issue-in-many-patients-with-inherited-thrombocytopaenias
#1
REVIEW
F Melazzini, C Zaninetti, C L Balduini
Bleeding diathesis has been considered for a long time the main clinical issue impacting the lives of patients affected by inherited thrombocytopaenias. However, the number of known inherited thrombocytopaenias greatly increased in recent years, and careful evaluation of hundreds of patients affected by these 'new' disorders revealed that most of them are at risk of developing additional life-threatening disorders during childhood or adult life. These additional disorders are usually more serious and dangerous than low platelet count...
June 8, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28484587/reducing-error-in-anticoagulant-dosing-via-multidisciplinary-team-rounding-at-point-of-care
#2
Munish Sharma, Mahesh Krishnamurthy, Richard Snyder, James Mauro
The incorporation of a clinical pharmacist in daily rounding can help identify and correct errors related to anticoagulation dosing. Inappropriate anticoagulant dosing increases the risk of developing significant bleeding diathesis. Conversely, inappropriate dosing may also fail to produce a therapeutic response. We retrospectively reviewed electronic medical records of 41 patients to confirm and analyze the errors related to various anticoagulants. A clinical pharmacist in an integrated rounding between the period of February 2016 and April 2016 collected this data...
April 6, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28480552/hyperfibrinolysis-and-hypofibrinogenemia-diagnosed-with-rotational-thromboelastometry-in-dogs-naturally-infected-with-angiostrongylus-vasorum
#3
N E Sigrist, N Hofer-Inteeworn, R Jud Schefer, C Kuemmerle-Fraune, M Schnyder, A P N Kutter
BACKGROUND: The pathomechanism of Angiostrongylus vasorum infection-associated bleeding diathesis in dogs is not fully understood. OBJECTIVE: To describe rotational thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum and to compare ROTEM parameters between infected dogs with and without clinical signs of bleeding. ANIMALS: A total of 21 dogs presented between 2013 and 2016. METHODS: Dogs with A...
May 7, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28359132/point-of-care-testing-in-liver-disease-and-liver-surgery
#4
Lasitha Abeysundara, Susan V Mallett, Ben Clevenger
The alterations in coagulation and hemostasis that accompany liver disease are complex, and while patients with this disease have traditionally been perceived as having a bleeding diathesis, it is now understood that in stable patients hemostasis is "re-balanced." Hepatic surgery, and particularly liver transplantation, can be associated with large fluid shifts, massive bleeding, and coagulopathy, as well as postoperative thrombosis. Point-of-care tests (POCTs) of coagulation facilitate goal-directed treatments and hemostatic monitoring in dynamic environments where the coagulation status can alter rapidly and often unpredictably...
March 30, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28352011/biopsy-of-small-kidneys-a-safe-and-a-useful-guide-to-potentially-treatable-kidney-disease
#5
Kamel El-Reshaid, Wael El-Reshaid, Dalal Al-Bader, Jozsef Varro, John Madda, Hosameldin Tawfik Sallam
Over the past four years, all patients with unexplained rapid progression of their renal disease were subjected to kidney biopsy, despite their small size (<9 cm), to define its etiology. Children, pregnant women, morbidly obese patients, and those with an unstable cardiovascular state, septicemia, bleeding diathesis as well as those kidney size with size <6 cm were excluded from the study. Doppler ultrasound was used to exclude renovascular/ischemic nephropathy. The procedure was performed by an interventional radiologist using a biopsy gun technique and under ultrasound guidance...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27909619/the-role-of-ultra-mini-percutaneous-nephrolithotomy-in-the-treatment-of-kidney-stones
#6
Abdulkadir Tepeler, İsmail Başıbüyük, Muhammed Tosun, Abdullah Armağan
OBJECTIVE: In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones. MATERIAL AND METHODS: Between October 2014 and September 2015, a single surgeon performed UMP on a total of 49 consecutive patients with symptomatic kidney stones at our center. Pregnants, anticogulant users, patients with bleeding diathesis pyonephrosis, and partial/complete staghorn stones were excluded from the study...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27866582/bleeding-diatheses-approach-to-the-patient-who-bleeds-or-has-abnormal-coagulation
#7
REVIEW
Marcia Paddock, John Chapin
Many complex elements contribute to normal hemostasis, and an imbalance of these elements may lead to abnormal bleeding. In addition to evaluating medication effects, the hematologist must evaluate for congenital or acquired deficiencies in coagulation factors and platelet disorders. This evaluation should include a thorough bleeding history with careful attention to prior hemostatic challenges and common laboratory testing, including coagulation studies and/or functional platelet assays. An accurate diagnosis of a bleeding diathesis and selection of appropriate treatment are greatly aided by a basic understanding of the mechanisms of disease and the tests used to diagnose them...
December 2016: Primary Care
https://www.readbyqxmd.com/read/27780690/risk-of-atrial-fibrillation-and-bleeding-diathesis-associated-with-ibrutinib-treatment-a-systematic-review-and-pooled-analysis-of-four-randomized-controlled-trials
#8
Seongseok Yun, Nicole D Vincelette, Utkarsh Acharya, Ivo Abraham
BACKGROUND: Clinical trials raised concern that ibrutinib may increase the risk of atrial fibrillation/flutter (Afib/Aflutter) and major bleeding. However, the association has not been statistically validated, and there is no consensus regarding optimal management of anticoagulation among patients receiving ibrutinib who develop Afib/Aflutter. We performed a systematic review and pooled analysis to precisely assess the risk of Afib/Aflutter and bleeding associated with ibrutinib treatment in patients with hematologic malignancies...
January 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/27615056/hemophilic-pseudotumor-in-a-non-hemophilic-patient-treated-with-a-hybrid-procedure-of-preoperative-embolization-of-the-feeding-arteries-followed-by-surgical-resection-a-case-report
#9
Sorcha Allen, Craig B Reeder, Mark J Kransdorf, Christopher P Beauchamp, Matthew A Zarka, Farouk Mookadam
INTRODUCTION: Hemophilic pseudotumor is a rare but well documented complication seen in approximately 1-2% of patients with hemophilia. The incidence continues to decrease, likely because of increasingly sophisticated techniques in managing factor deficiency. We present a case of hemophilic pseudotumor in a patient without hemophilia, an exceptionally rare entity, and outline a hybrid approach to treatment. PRESENTATION OF CASE: The patient presented with a left sided iliopsoas mass and associated radiculopathy, with a history of a poorly characterized bleeding diathesis and Noonan's syndrome...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27609734/life-threatening-hemorrhage-from-acquired-hemophilia-a-as-a-presenting-manifestation-of-prostate-cancer
#10
Chirag Sheth, Amandeep Gill, Sumeet Sekhon
Acquired factor VIII deficiency (acquired hemophilia A) is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII). The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with autoimmune diseases, pregnancy, postpartum period, drugs, and malignancy. Management of this condition begins with attempts to arrest an acute bleed based on the site and severity of bleeding and inhibitor titer. The next priority is eradication of the fVIII antibodies using immunosuppressive therapies...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27599665/transcatheter-closure-of-pda-in-premature-babies-less-than-2-kg
#11
Nazmi Narin, Özge Pamukçu, Ali Baykan, Mustafa Argun, Abdullah Özyurt, Adnan Bayram, Kazım Üzüm
OBJECTIVE: Our hypothesis was that percutaneous PDA closure in babies less than 2 kg was a safe and effective method. The aim of this study is to share our experience in transcatheter PDA closure in infants whose body weight is less than 2 kg in order to support our hypothesis. METHODS: Between July 1997 and October 2014, 382 percutaneous PDA closures were done in our center. Nineteen patients who weighed less than 2 kg were included in this retrospectively study...
September 2, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27597910/intraperitoneal-hemorrhage-in-a-pregnant-woman-with-hyperemesis-gravidarum-vitamin-k-deficiency-as-a-possible-cause
#12
Yosuke Baba, Hiroyuki Morisawa, Koyomi Saito, Hironori Takahashi, Kazuma Rifu, Shigeki Matsubara
Hyperemesis gravidarum can cause various vitamin deficiencies. Vitamin K deficiency can lead to coagulopathy or hemorrhagic diathesis. A nulliparous Japanese woman with hyperemesis gravidarum at 10(5/7) weeks was admitted with giant myoma, intestinal obstruction, and abdominal pain. Treatment for a degenerative myoma was instituted with intravenous antibiotics. The abdominal pain ameliorated, but intestinal obstruction persisted. At 16(6/7) weeks, we performed laparotomy for release of intestinal obstruction, when intraabdominal bleeding of 110 mL existed...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27529121/pulmonary-fibrosis-in-hermansky-pudlak-syndrome
#13
Glenn W Vicary, Yeidyly Vergne, Alberto Santiago-Cornier, Lisa R Young, Jesse Roman
Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive genetic disorder characterized by oculocutaneous albinism and a bleeding diathesis due to platelet dysfunction. More than 50% of cases worldwide are diagnosed on the Caribbean island of Puerto Rico. Genetic testing plays a growing role in diagnosis; however, not all patients with HPS have identified genetic mutations. In Puerto Rico, patients with HPS are often identified shortly after birth by their albinism, although the degree of hypopigmentation is highly variable...
October 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27214810/use-of-recombinant-factor-viia-in-surgery-in-factor-vii-deficient-patients
#14
J Ingerslev, L Knudsen, I Hvid, M R Tange, U Fredberg, O Sneppen
Patients suffering from severe factor VII deficiency may present with serious bleeding problems. No clear guidelines exist regarding therapy in such patients in case of a large bleeding or surgery. Indeed, it has been postulated that some patients with severe factor VII deficiency may never present with overt bleeding problems. However, in factor-VII-deficient patients who have previously demonstrated a clinical tendency to bleed, surgery is expected to cause excessive bleeding. We present two females suffering from a severe factor VII deficiency (FVII:C < 0...
July 1997: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27136426/towards-personalised-therapy-for-von-willebrand-disease-a-future-role-for-recombinant-products
#15
REVIEW
Emmanuel J Favaloro
von Willebrand disease (VWD) is reportedly the most common bleeding disorder and is caused by deficiencies and/or defects in the adhesive plasma protein von Willebrand factor (VWF). Functionally, normal VWF prevents bleeding by promoting both primary and secondary haemostasis. In respect to primary haemostasis, VWF binds to both platelets and sub-endothelial matrix components, especially collagen, to anchor platelets to damaged vascular tissue and promote thrombus formation. VWF also stabilises and protects factor VIII in the circulation, delivering FVIII to the site of injury, which then facilitates secondary haemostasis and fibrin formation/thrombus stabilisation...
2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/26948766/warfarin-anticoagulation-and-spontaneous-pectoral-haematomas
#16
Ji Can Yang, Amgad N Makaryus
Warfarin is the oldest and most commonly used anticoagulant in the outpatient setting. Major bleeding events remain as the most life threatening complication of this medication. Bleeding into enclosed structures and body cavities can be fatal in acute scenarios or cause continuous exsanguination if left unnoticed. Pectoral haematomas are an unusual presentation of bleeding diathesis, and are also seldom reported in the literature. We present three cases of patients with development of spontaneous pectoral haematoma during therapy with warfarin alone or with heparin bridging in the treatment of atrial fibrillation and thromboembolism...
July 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/26920716/prognostic-factors-in-acute-promyelocytic-leukemia-strategies-to-define-high-risk-patients
#17
REVIEW
Ugo Testa, Francesco Lo-Coco
All trans retinoic acid (ATRA) has revolutionized the therapy of acute promyelocytic leukemia (APL). Treatment of this leukemia with ATRA in combination with chemotherapy has resulted in complete remission rates >90 % and long-term remission rates above 80 %. Furthermore, the combination of ATRA and arsenic trioxide (ATO) was shown to be safe and effective in frontline treatment and, for patients with low and intermediate risk disease, possibly superior to the standard ATRA and anthracycline-based regimen...
April 2016: Annals of Hematology
https://www.readbyqxmd.com/read/26760586/what-s-new-in-the-pathogenesis-of-the-coagulopathy-in-acute-promyelocytic-leukemia
#18
REVIEW
Simon Mantha, Martin S Tallman, Gerald A Soff
PURPOSE OF REVIEW: Acute promyelocytic leukemia (APL) is associated with a complex coagulopathy. In spite of substantial recent improvements in treatment regimens, hemorrhagic death remains the main cause of induction failure. In this review, we delineate recent understanding of the pathophysiology and management of the hemorrhagic diathesis of APL. RECENT FINDINGS: Laboratory and clinical data suggest that the malignant leukocytes mediate the hemorrhagic diathesis associated with APL through multiple mechanisms which lead to a combination of consumptive coagulopathy and primary hyperfibrinolysis...
March 2016: Current Opinion in Hematology
https://www.readbyqxmd.com/read/26752909/mononeuritis-multiplex-in-acquired-amegakaryocytic-thrombocytopenia
#19
Firosh Khan, Abdulkhader Shehna, Lekha Mukundan
Mononeuritis multiplex involves inflammation of two or more nerves, typically in unrelated parts of the body. It has been well described in bleeding disorders like idiopathic thrombocytopenic purpura (ITP) and Hemophilia. Acquired amegakaryocytic thrombocytopenia (AAT) is a bleeding diathesis characterized by thrombocytopenia but with reduced number of megakaryocytes in the bone marrow, as against ITP. Though AAT is a well described entity, peripheral nervous system manifestations have not been described so far...
October 2015: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/26645263/comparison-of-uninterrupted-warfarin-and-bridging-therapy-using-low-molecular-weight-heparin-with-respect-to-the-severity-of-bleeding-after-dental-extractions-in-patients-with-prosthetic-valves
#20
İsmail Erden, Emine Çakcak Erden, Tolga Aksu, Şükriye Ebru Gölcük, Burak Turan, Ayhan Erkol, Mustafa Akçakoyun, Tülin Sayın
OBJECTIVE: The management of anticoagulated patients with warfarin during dental extraction is an intricate issue. We carefully designed the current study so that the amount of bleeding was measured with objective methods and the data from the same patient in different dental extraction appointments could be compared, eliminating the bleeding diathesis differences of patients. METHODS: This prospective and controlled study was conducted in 36 adult patients with prosthetic valve requiring multiple tooth extractions...
September 15, 2015: Anatolian Journal of Cardiology
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