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https://www.readbyqxmd.com/read/29778325/tranexamic-acid-for-hyperacute-primary-intracerebral-haemorrhage-tich-2-an-international-randomised-placebo-controlled-phase-3-superiority-trial
#1
Nikola Sprigg, Katie Flaherty, Jason P Appleton, Rustam Al-Shahi Salman, Daniel Bereczki, Maia Beridze, Hanne Christensen, Alfonso Ciccone, Ronan Collins, Anna Czlonkowska, Robert A Dineen, Lelia Duley, Juan Jose Egea-Guerrero, Timothy J England, Kailash Krishnan, Ann Charlotte Laska, Zhe Kang Law, Serefnur Ozturk, Stuart J Pocock, Ian Roberts, Thompson G Robinson, Christine Roffe, David Seiffge, Polly Scutt, Jegan Thanabalan, David Werring, David Whynes, Philip M Bath
BACKGROUND: Tranexamic acid can prevent death due to bleeding after trauma and post-partum haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral haemorrhage. METHODS: We did an international, randomised placebo-controlled trial in adults with intracerebral haemorrhage from acute stroke units at 124 hospital sites in 12 countries. Participants were randomly assigned (1:1) to receive 1 g intravenous tranexamic acid bolus followed by an 8 h infusion of 1 g tranexamic acid or a matching placebo, within 8 h of symptom onset...
May 15, 2018: Lancet
https://www.readbyqxmd.com/read/29772364/pathophysiology-and-non-surgical-treatment-of-chronic-subdural-hematoma-from-past-to-present-to-future
#2
REVIEW
Dana C Holl, Victor Volovici, Clemens M F Dirven, Wilco C Peul, Fop van Kooten, Korné Jellema, Niels A van der Gaag, Ishita P Miah, Kuan H Kho, Heleen M den Hertog, Hester F Lingsma, Ruben Dammers
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the more frequent pathological entities in daily neurosurgical practice. Historically, CSDH was considered a progressive, recurrent bleeding with a traumatic etiology. However, recent evidence suggests a complex intertwined pathway of inflammation, angiogenesis, local coagulopathy, recurrent microbleeds and exudates. The aim of the present review is to collect existing data on pathophysiology of CSDH in order to direct further research questions aiming to optimize treatment for the individual patient...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29765296/peripartum-haemorrhage-haemostatic-aspects-of-the-new-german-pph-guideline
#3
REVIEW
Heiko Lier, Christian von Heymann, Wolfgang Korte, Dietmar Schlembach
Summary Peripartum haemorrhage remains one of the main causes of maternal mortality world-wide. The German, Austrian and Swiss Societies of Gynaecology and Obstetrics have updated the current guidelines for the treatment of peripartum haemorrhage together with the German Society of Anaesthesiology and Intensive Care Medicine and the Society of Thrombosis and Haemostasis Research. The recommendations have been the result of a thorough review of the available scientific literature and a consensus process involving all members of the guideline group...
April 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29759857/multiple-dose-intravenous-tranexamic-acid-further-reduces-hidden-blood-loss-after-total-hip-arthroplasty-a-randomized-controlled-trial
#4
Yiting Lei, Qiang Huang, Zeyu Huang, Jinwei Xie, Guo Chen, Fuxing Pei
BACKGROUND: The most appropriate dose of tranexamic acid in total hip arthroplasty (THA) has not been decided. This study was conducted to evaluate the clinical effects of multiple-dose intravenous tranexamic acid (IV-TXA) in THA. METHODS: One hundred fifty patients were randomized to receive one dose of IV-TXA before incision, followed by 2 doses of IV-TXA (group A), or 3 doses of IV-TXA (group B), or 4 doses of IV-TXA (group C) at 3-hour intervals. The primary outcome was hidden blood loss (HBL)...
April 23, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29758302/plasminogen-binding-inhibitors-demonstrate-unwanted-activities-on-gaba-a-and-glycine-receptors-in-human-ipsc-derived-neurons
#5
Lisbeth Kristensson, Anders Lundin, David Gustafsson, Jan Fryklund, Tomas Fex, Delsing Louise, Erik Ryberg
Plasminogen binding inhibitors (PBIs) reduce the risk of bleeding in hemorrhagic conditions. However, generic PBIs are also associated with an increased risk of seizures, an adverse effect linked to unwanted activities towards inhibitory neuronal receptors. Development of novel PBIs serve to remove compounds with such properties, but progress is limited by a lack of higher throughput methods with human translatability. Herein we apply human induced pluripotent stem cell (hiPSC) derived neurons in combination with dynamic mass redistribution (DMR) technology to demonstrate robust and reproducible modulation of both GABAA and glycine receptors...
May 11, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29758126/abrogating-fibrinolysis-does-not-improve-bleeding-or-rfviia-rfviii-treatment-in-a-non-mucosal-venous-injury-model-in-haemophilic-rodents
#6
Rikke Stagaard, Matthew J Flick, Barbara Bojko, Krzysztof Goryński, Paulina Z Goryńska, Carsten D Ley, Lisbeth H Olsen, Tom Knudsen
BACKGROUND: Fibrinolysis may exacerbate bleeding in haemophilia A (HA). Accordingly, antifibrinolytics have been used to help maintain haemostatic control. While antifibrinolytic drugs have been proven effective in the treatment of mucosal bleeds in the oral cavity, their efficacy in non-mucosal tissues remain an open question of significant clinical interest. OBJECTIVE: To determine whether inhibiting fibrinolysis improves the outcome in non-mucosal haemophilic tail vein transection (TVT) bleeding models, and to determine whether a standard ex vivo clotting/fibrinolysis assay can be used as a predictive surrogate for in vivo efficacy...
May 14, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29757132/safety-and-efficacy-of-tranexamic-acid-for-prevention-of-obstetric-haemorrhage-an-updated-systematic-review-and-meta-analysis
#7
REVIEW
Massimo Franchini, Carlo Mengoli, Mario Cruciani, Valentino Bergamini, Francesca Presti, Giuseppe Marano, Simonetta Pupella, Stefania Vaglio, Francesca Masiello, Eva Veropalumbo, Vanessa Piccinini, Ilaria Pati, Giancarlo M Liumbruno
BACKGROUND: A number of clinical systematic review and meta-analysis have been published on the use of tranexamic in the obstetric setting. The aim of this meta-analysis was to evaluate the safety and effectiveness of tranexamic acid in reducing blood loss when given prior to caesarean delivery. MATERIALS AND METHODS: We searched the Cochrane Wounds Specialized Register, Cochrane Central, MEDLINE (through PUBMED), Embase, and SCOPUS electronic databases. We also searched clinical trials registries for ongoing and unpublished studies, and checked reference lists to identify additional studies...
April 3, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29757130/tranexamic-acid-to-prevent-post-partum-haemorrhage
#8
EDITORIAL
Riana Van Der Linde, Emmanuel J Favaloro
No abstract text is available yet for this article.
May 3, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29756664/patient-blood-management-how-is-implementation-going-a-report-comparing-the-2015-survey-with-the-2013-survey-of-pbm-in-england
#9
L Sherliker, K Pendry, B Hockley
BACKGROUND: Patient blood management (PBM) is an evidence-based approach to optimising the care of patients who might need transfusion. In 2013, all NHS Trusts in England were surveyed about their readiness to implement PBM. National PBM recommendations were launched in 2014. AIMS: The aim of this study was to determine progress of PBM initiatives. METHODS/MATERIALS: A survey was constructed by staff in hospitals and NHS Blood and Transplant (NHSBT)...
April 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#10
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29743045/haematological-and-fibrinolytic-status-of-nigerian-women-with-post-partum-haemorrhage
#11
Ian Roberts, Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Tolulase Olutogun, Beverley J Hunt, Sumaya Huque
BACKGROUND: Early treatment with tranexamic acid reduces deaths due to bleeding after post-partum haemorrhage. We report the prevalence of haematological, coagulation and fibrinolytic abnormalities in Nigerian women with postpartum haemorrhage. METHODS: We performed a secondary analysis of the WOMAN trial to assess laboratory data and rotational thromboelastometry (ROTEM) parameters in 167 women with postpartum haemorrhage treated at University College Hospital, Ibadan, Nigeria...
May 9, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29738877/oral-tranexamic-acid-is-equivalent-to-topical-tranexamic-acid-without-drainage-in-primary-total-hip-arthroplasty-a-double-blind-randomized-clinical-trial
#12
Ze-Yu Luo, Duan Wang, Wei-Kun Meng, Hao-Yang Wang, Hui Pan, Fu-Xing Pei, Zong-Ke Zhou
PURPOSE: To compare the efficacy of multiple doses of oral tranexamic acid (TXA) with topical TXA administration in reducing blood loss following total hip arthroplasty (THA). PATIENTS AND METHODS: In this double-blinded trial, 117 patients undergoing primary THA were randomized to receive 2 g TXA orally 2 h preoperatively, and two doses of 1 g TXA postoperatively (oral group) or 3 g of TXA topical administration in the operating room (topical group). The primary outcome was a reduction in hemoglobin concentration...
May 1, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29738409/reduction-of-blood-loss-by-tranexamic-acid-following-total-hip-and-knee-arthroplasty-a-meta-analysis
#13
Arianna L Gianakos, Eoghan T Hurley, R Sterling Haring, Richard S Yoon, Frank A Liporace
BACKGROUND: This study involved a meta-analysis of 36 published studies to examine the efficacy of intravenous (IV) and intra-articular (IA) tranexamic acid (TXA) in reducing blood loss, drain output, thromboembolic complications, and hospital stay following total hip and total knee arthroplasty. This study also evaluated whether treatment with a combination of both IA and IV TXA has an effect on these outcomes. Lastly, this study attempted to analyze the method and technique of TXA administration in order to establish a best practice for its use in reducing overall blood loss in arthroplasty procedures...
May 1, 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29735227/care-of-the-injured-patients-at-nursing-stations-and-during-air-medical-transport
#14
Brodie Nolan, Alun Ackery, Sol Mamakwa, Shari Glenn, David VanderBurgh, Aaron Orkin, Michael Kirlew, Evelyn Dell, Homer Tien
INTRODUCTION: Nursing stations are the only access point into the health care system for some communities and have limited capabilities and resources. We describe characteristics of patients injured in Northern Ontario who present to nursing stations and require transport by air ambulance. Secondary objectives are to compare interventions performed at nursing stations with those performed by flight paramedics and to identify systemic gaps in trauma care. METHODS: A retrospective cohort study was performed of all injured patients transported by air ambulance from April 1, 2014, to March 31, 2015...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735224/the-tranexamic-acid-conundrum
#15
REVIEW
David J Dries
No abstract text is available yet for this article.
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735174/-tranexamic-acid-as-first-line-emergency-treatment-for-episodes-of-bradykinin-mediated-angioedema-induced-by-ace-inhibitors
#16
C Beauchêne, J Martins-Héricher, D Denis, L Martin, H Maillard
INTRODUCTION: Episodes of acquired bradykinin-mediated angioedema due to angiotensin-converting enzyme (ACE) inhibitors may result in fatal outcomes. There is no consensus regarding emergency pharmacological management of these episodes. Treatment options include icatibant and C1INH concentrate. Tranexamic acid is administered for moderate episodes. Its efficacy in the treatment of ACE inhibitor-induced episodes of angioedema is not established. The aim of this retrospective study is to assess the benefits of emergency tranexamic acid administration in the management of ACE inhibitor-induced episodes of angioedema...
May 4, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29732978/the-effect-of-tranexamic-acid-on-preventing-post-partum-hemorrhage-due-to-uterine-atony-a-triple-blind-randomized-clinical-trial
#17
Mahvash Zargar, Roshan Nikbakht, Mahzad Ahmadi
BACKGROUND: Postpartum haemorrhage (PPH) is an important cause of early maternal death which needs to be controlled. OBJECTIVE: This study was designed to compare the effect of intravenous tranexsmic acid (TXA) and prostaglandin analogue on reducing PPH resulted from uterine atony in women undergoing C section or vaginal delivery. METHOD: A randomized, triple-blind, placebo-controlled study was conducted on 248 pregnant women with PPH due to uterine atony who were randomly assigned into two groups of TXA as the intervention group (n=124) and prostaglandin analogue as the control group (n=124)...
May 6, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29732210/effectiveness-of-tranexamic-acid-for-decreasing-bleeding-in-prostate-surgery-a-systematic-review-and-meta-analysis
#18
REVIEW
Sergio Hernando Mina, Herney Andres Garcia-Perdomo
Introduction: The objective of this study was to determine the effectiveness of tranexamic acid in decreasing bleeding in patients undergoing prostate surgery. Material and methods: All clinical experiments were included without language restrictions. The inclusion criteria were as follows: men over 18 years of age who underwent prostate surgery (transurethral, prostate adenectomy, and radical prostatectomy) and received tranexamic acid prior to prostate surgery as a preventive measure for perioperative hemorrhage...
2018: Central European Journal of Urology
https://www.readbyqxmd.com/read/29729197/excessive-plasmin-compromises-hepatic-sinusoidal-vascular-integrity-after-acetaminophen-overdose
#19
Siqi Gao, Robert Silasi-Mansat, Mandi Behar, Florea Lupu, Courtney T Griffin
The serine protease plasmin degrades extracellular matrix (ECM) components both directly and indirectly through activation of matrix metalloproteinases. Excessive plasmin activity and subsequent ECM degradation causes hepatic sinusoidal fragility and hemorrhage in developing embryos. We report here that excessive plasmin activity in a murine acetaminophen (APAP) overdose model likewise compromises hepatic sinusoidal vascular integrity in adult animals. We found that hepatic plasmin activity is upregulated significantly at 6 hr after APAP overdose...
May 5, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29727870/minimizing-blood-loss-and-transfusions-in-total-knee-arthroplasty
#20
Charles Cody White, Josef K Eichinger, Richard J Friedman
Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination...
May 4, 2018: Journal of Knee Surgery
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