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https://www.readbyqxmd.com/read/28432428/tranexamic-acid-for-treatment-and-prophylaxis-of-bleeding-and-hyperfibrinolysis
#1
Ingrid Pabinger, Dietmar Fries, Herbert Schöchl, Werner Streif, Wolfgang Toller
Uncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e...
April 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28422915/enteral-tranexamic-acid-attenuates-vasopressor-resistance-and-changes-in-%C3%AE-1-adrenergic-receptor-expression-in-hemorrhagic-shock
#2
Marco Santamaria, Federico Aletti, Joyce B Li, Aaron Tan, Monica Chang, Jessica Leon, Geert W Schmid-Schönbein, Erik B Kistler
BACKGROUND: Irreversible hemorrhagic shock is characterized by hyporesponsiveness to vasopressor and fluid therapy. Little is known, however, about the mechanisms that contribute to this phenomenon. Previous studies have shown that decreased intestinal perfusion in hemorrhagic shock leads to proteolytically-mediated increases in gut permeability, with subsequent egress of vasoactive substances systemically. Maintenance of blood pressure is achieved in part by α1 receptor modulation, which may be affected by vasoactive factors; we thus hypothesized that decreases in hemodynamic stability and vasopressor response in shock can be prevented by enteral protease inhibition...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28420841/tranexamic-acid-controlled-chronic-disseminated-intravascular-coagulation-associated-with-aortic-dissection-and-patent-false-lumen-for-three-years
#3
Yodo Gatate, Nobuyuki Masaki, Atsushi Sato, Risako Yasuda, Takayuki Namba, Hirotaka Yada, Akio Kawamura, Takeshi Adachi
The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28420413/is-combined-use-of-intravenous-and-intraarticular-tranexamic-acid-superior-to-intravenous-or-intraarticular-tranexamic-acid-alone-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#4
Bobin Mi, Guohui Liu, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: Tranexamic acid (TXA) has been proven to be effective in reducing blood loss and transfusion rate after total knee arthroplasty (TKA) without increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Recently, an increasing number of studies have been interested in applying combined intravenous (IV) with intraarticular (IA) tranexamic acid in total knee arthroplasty. The purpose of this meta-analysis was to compare the blood loss and complications of combined TXA with IV TXA or IA TXA on TKA...
April 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28413832/statistical-analysis-plan-for-the-woman-etaplat-study-effect-of-tranexamic-acid-on-platelet-function-and-thrombin-generation
#5
Kastriot Dallaku, Haleema Shakur, Phil Edwards, Danielle Beaumont, Ian Roberts, Sumaya Huque, Maria Delius, Ulrich Mansmann
Background. Postpartum haemorrhage (PPH) is a potentially life-threatening complication for women, and the leading cause of maternal mortality. Tranexamic acid (TXA) is an antifibrinolytic used worldwide to treat uterine haemorrhage and to reduce blood loss in general surgery. TXA may have effects on thrombin generation, platelet function and coagulation factors as a result of its inhibition on the plasmin. Methods. WOMAN ETAPlaT is a sub-study of the World Maternal Antifibrinolitic trial (WOMAN trial). All adult women clinically diagnosed with PPH after a vaginal delivery or caesarean section, are eligible for inclusion in the study...
December 15, 2016: Wellcome Open Research
https://www.readbyqxmd.com/read/28406854/invited-commentary-related-to-tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#6
https://www.readbyqxmd.com/read/28405671/predictors-of-oral-cavity-bleeding-and-clinical-outcome-after-dental-procedures-in-patients-on-vitamin-k-antagonists-a-cohort-study
#7
Joseph S Biedermann, Willem M H Rademacher, Hendrika C A M Hazendonk, Denise E van Diermen, Frank W G Leebeek, Frederik Rozema, Marieke J H A Kruip
Patients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1-3 elements) and extensive high-risk (e. g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and high-risk dental procedures in patients on VKA...
April 13, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28405037/the-effect-of-different-dose-regimens-of-tranexamic-acid-in-reducing-blood-loss-during-hip-surgery
#8
Anil Kumar Thipparampall, Indira Gurajala, R Gopinath
BACKGROUND AND AIMS: Antifibrinolytics may help bleeding in orthopaedic surgeries. The present study was undertaken to compare two dose regimens of tranexamic acid (TA) on perioperative blood loss in patients undergoing hip surgeries. METHODS: In a prospective, randomised, controlled study, 59 patients scheduled for hip surgery were divided into Group C: receiving normal saline (n - 20), Group B: receiving single dose of TA (10 mg/kg) (n - 21), and Group I: receiving a bolus (10 mg/kg) plus infusion (1 mg/kg/h) of TA up to 4 h postoperatively (n - 18)...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28400658/complication-rate-during-multilevel-lumbar-fusion-in-patients-above-60-years
#9
Bijjawara Mahesh, Bidre Upendra, S Vijay, Gc Arun Kumar, Srinivas Reddy
BACKGROUND: Spine surgery in elderly with comorbidities is reported to have higher complication rates and increased cost. However, the surgical outcome is good irrespective of the complications. Hence, it is essential to identify the factors affecting the complication rates in such patients and the measures to reduce them. This retrospective observational study determines the perioperative complications, their incidence and the measures to reduce complications in the elderly with comorbidities, operated by instrumented multilevel lumbar fusion...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28397672/-successful-treatment-of-severe-dabigatran-intoxication-with-idarucizumab-in-a-patient-with-acute-kidney-injury
#10
Christina Gjerlev Poulsen, Morten Bestle, Lene Boesby
In the course of an uncomplicated sigmoidostomy a 63-year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury. Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Administration of idarucizumab induced immediate clinical and paraclinical improvement. Dabigatran should be carefully administrated in patients who have any degree of renal insufficiency. Idarucizumab may be effective in severe bleeding caused by dabigatran...
February 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28395389/tranexamic-acid-and-computer-assisted-surgery-in-cemented-and-cementless-total-knee-arthroplasty-are-the-effects-additive-for-blood-conservation
#11
Michael Fleischman, Mark Hood, Mary Ziemba-Davis, R Michael Meneghini
INTRODUCTION: Efforts continue to minimize blood loss associated with total knee arthroplasty (TKA). The primary objective of this study was to determine whether computer-assisted surgery (CAS) and tranexamic acid (TXA) were additive in minimizing blood loss in cemented TKA. The secondary objective was to assess the combined effectiveness of CAS and TXA in cementless TKA. MATERIALS AND METHODS: A retrospective study of 393 consecutive primary TKAs with cemented and cementless fixation was performed...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#12
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28395294/treatment-of-persistent-gross-hematuria-with-tranexamic-acid-in-autosomal-dominant-polycystic-kidney-disease
#13
Qing Yao, Ming Wu, Jie Zhou, Meiyang Zhou, Dongping Chen, Lili Fu, Rongrong Bian, Xiaohong Xing, Lijun Sun, Xiaohong Hu, Lin Li, Bing Dai, Rudolf P Wüthrich, Yiyi Ma, Chang-Lin Mei
BACKGROUND/AIMS: In this retrospective study we aimed to compare the effect of tranexamic acid (TXA) vs etamsylate, two hemostatic agents, on hematuria duration in autosomal dominant polycystic kidney disease (ADPKD) patients with persistent gross hematuria. METHODS: This is a retrospective study of 40 patients with ADPKD and macroscopic hematuria. 20 patients receiving TXA and snake venom blood clotting enzyme injection were compared with 20 matched patients receiving etamsylate and snake venom blood clotting enzyme injection...
April 11, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28393053/the-effect-of-topical-tranexamic-acid-on-bleeding-reduction-during-functional-endoscopic-sinus-surgery
#14
Mohammad Hossein Baradaranfar, Mohammad Hossein Dadgarnia, Hossein Mahmoudi, Nasim Behniafard, Saeid Atighechi, Vahid Zand, Amin Baradaranfar, Sedighe Vaziribozorg
INTRODUCTION: Bleeding is a common concern during functional endoscopic sinus surgery (FESS) that can increase the risk of damage to adjacent vital elements by reducing the surgeon's field of view. This study aimed to explore the efficacy of topical tranexamic acid in reducing intraoperative bleeding. MATERIALS AND METHODS: This double-blind, randomized clinical trial was conducted in 60 patients with chronic rhinosinusitis with polyposis (CRSwP) who underwent FESS...
March 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#15
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28381773/a-novel-chemical-enhancer-approach-for-transdermal-drug-delivery-with-c17-monoglycerol-ester-liquid-crystal-forming-lipid
#16
Wesam R Kadhum, Shohei Sekiguchi, Ichiro Hijikuro, Hiroaki Todo, Kenji Sugibayashi
Transdermal administration of drugs represents an excellent alternative to conventional pharmaceutical dosage forms. However, insufficient penetration of the active pharmaceutical substance through the skin is a common problem. Thus, in the present study we evaluated the skin permeation enhancing ability of liquid crystal (LC) topical formulations. A recently developed LC-forming lipid, C17-monoglycerol ester (MGE), was evaluated and compared with glycerol monoolate (GMO), which is considered as the gold standard for LC formulations...
April 4, 2017: Journal of Oleo Science
https://www.readbyqxmd.com/read/28381202/tranexamic-acid-for-acute-intracerebral-hemorrhage-growth-predicted-by-spot-sign-trial-rationale-and-design
#17
Liping Liu, Yilong Wang, Xia Meng, Na Li, Ying Tan, Ximing Nie, Dacheng Liu, Xingquan Zhao
Rationale Acute intracerebral hemorrhage inflicts a high-economic and -health burden. Computed tomography angiography spot sign is a predictor of hematoma expansion, is associated with poor clinical outcome and is an important stratifying variable for patients treated with haemostatic therapy. Aims We aim to compare the effect of treatment with tranexamic acid to placebo for the prevention of hemorrhage growth in patients with high-risk acute intracerebral hemorrhage with a positive spot sign. Design The tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign (TRAIGE) is a prospective, multicenter, placebo-controlled, double-blind, investigator-led, randomized clinical trial that will include an estimated 240 participants...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28378211/intra-articular-versus-intravenous-tranexamic-acid-application-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#18
Bobin Mi, Guohui Liu, Wu Zhou, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). METHODS: A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included...
April 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28376343/oral-contraception-and-menstrual-bleeding-during-treatment-of-venous-thromboembolism-expert-opinion-versus-current-practice-combined-results-of-a-systematic-review-expert-panel-opinion-and-an-international-survey
#19
F A Klok, K Schreiber, K Stach, W Ageno, S Middeldorp, S Eichinger, A Delluc, M Blondon, C Ay
INTRODUCTION: The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. METHODS: 10 international thrombosis experts and 10 abnormal uterine bleeding experts independently completed a questionnaire containing three hypothetical patient cases each with four different scenarios, and additional queries covering different severities of VTE, patient circumstances, hormonal contraceptives and both thrombotic and bleeding complications...
March 20, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28374042/efficacy-and-safety-of-tranexamic-acid-in-melasma-a-meta-analysis-and-systematic-review
#20
Hyun Jung Kim, Seok Hoon Moon, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim
Tranexamic acid is a novel treatment option for melasma; however, there is no consensus on its use. This systematic review searched major databases for relevant publications to March 2016. Eleven studies with 667 participants were included. Pooled data from tranexamic acid-only observational studies with pre- and post-treatment Melasma Area and Severity Index (MASI) showed a decrease of 1.60 in MASI (95% confidence interval (CI), 1.20-2.00; p < 0.001) after treat-ment with tranexamic acid. The addition of tranexamic acid to routine treatment modalities resulted in a further decrease in MASI of 0...
April 4, 2017: Acta Dermato-venereologica
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