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Bleeding thrombosis

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https://www.readbyqxmd.com/read/28741138/trans-splenic-access-for-portal-venous-interventions-in-children-do-benefits-outweigh-risks
#1
Sheena Pimpalwar, Ponraj Chinnadurai, Alberto Hernandez, Kamlesh Kukreja, Shakeel Siddiqui, Henri Justino
BACKGROUND: The primary concern of trans-splenic access for portal interventions is the risk of life-threatening intraperitoneal bleeding. OBJECTIVE: To review the clinical indications and efficacy and evaluate the risk factors for intraperitoneal bleeding during trans-splenic portal interventions in children. MATERIALS AND METHODS: A retrospective review of consecutive patients who underwent trans-splenic portal interventions at a tertiary care pediatric institution between March 2011 and April 2017 was performed...
July 24, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28741113/approaches-to-prevent-bleeding-associated-with-anticoagulants-current-status-and-recent-developments
#2
REVIEW
Manu Thomas Kalathottukaren, Charles A Haynes, Jayachandran N Kizhakkedathu
Anticoagulants are widely used for the prophylaxis and treatment of cardiovascular disorders and to prevent blood clotting during surgeries. However, the major limitation associated with anticoagulant therapy is bleeding; all the current anticoagulants do have a bleeding risk. The propensity to bleed is much higher among the elderly population and patients with renal insufficiency. Therefore, there is an utmost and urgent clinical need for a highly efficient, nontoxic antidote with excellent anticoagulant reversal activity...
July 24, 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/28738274/discovery-and-assessment-of-water-soluble-coumarins-as-inhibitors-of-the-coagulation-contact-pathway
#3
Charlotte Bouckaert, Shu Zhu, José W P Govers-Riemslag, Maxime Depoorter, Scott L Diamond, Lionel Pochet
Over the last decade, the coagulation factor XIIa (FXIIa) has seen renewed interest as a therapeutic target. Indeed, its inhibition could offer a protection against thrombosis without increasing the risk of bleeding. Moreover, it could answer the need for a safe prevention of blood-contacting medical devices-related thrombosis. Among the FXII and FXIIa inhibitors already described in literature, organic small-molecular-weight inhibitors are rather left behind. In this study, we were focused on the discovery and assessment of water soluble small molecules...
July 19, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28737834/vitamin-k-antagonists-versus-low-molecular-weight-heparin-for-the-long-term-treatment-of-symptomatic-venous-thromboembolism
#4
REVIEW
Alina Andras, Adriano Sala Tenna, Marlene Stewart
BACKGROUND: People with venous thromboembolism (VTE) generally are treated for five days with intravenous unfractionated heparin or subcutaneous low-molecular-weight heparin (LMWH), followed by three months of vitamin K antagonists (VKAs). Treatment with VKAs requires regular laboratory measurements and carries risk of bleeding; some patients have contraindications to such treatment. Treatment with LMWH has been proposed to minimise the risk of bleeding complications. This is the second update of a review first published in 2001...
July 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28734547/management-of-hemostatic-disorders-in-patients-with-advanced-liver-disease-admitted-to-an-intensive-care-unit
#5
REVIEW
Ton Lisman, William Bernal
Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease...
June 23, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28731874/novel-targets-for-anticoagulants-lacking-bleeding-risk
#6
Julia K Bickmann, Trevor Baglin, Joost C M Meijers, Thomas Renné
PURPOSE OF REVIEW: Arterial and venous thromboembolic diseases are associated with significant morbidity and mortality and present a major medical burden. Currently used anticoagulants for the prevention or treatment of thromboembolic events including heparins, vitamin K-antagonists and inhibitors of thrombin or factor Xa target enzymes of the coagulation cascade that are critical for fibrin formation. However, fibrin is also necessary for hemostatic mechanisms to terminate blood loss at injury sites...
July 20, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28731370/an-evaluation-of-a-factor-xa-based-clotting-time-test-for-enoxaparin-a-proof-of-concept-study
#7
Deborah P J Ng, Stephen B Duffull, James M Faed, Geoffrey K Isbister, Abhishek Gulati
A well-accepted test for monitoring anticoagulation by enoxaparin is not currently available. As inadequate dosing may result in thrombosis or bleeding, a clinical need exists for a suitable test. Previous in silico and in vitro studies have identified factor Xa as an appropriate activating agent, and the phospholipid Actin FS as a cofactor for a Xa clotting time (TenaCT) test. A proof-of-concept study was designed to (1) explore the reproducibility of the TenaCT test and (2) explore factors that could affect the performance of the test...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#8
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28726976/absence-of-transforming-growth-factor-beta-1-in-murine-platelets-reduces-neointima-formation-without-affecting-arterial-thrombosis
#9
Katrin Schaefer, Eva Schütz, Magdalena L Bochenek, Dennis R Riehl, Markus Bosmann, Thomas Münzel, Stavros Konstantinides, Katrin Schäfer
Platelet degranulation at the site of vascular injury prevents bleeding and may affect the chronic vascular wound healing response. Transforming Growth Factor (TGF)-β1 is a major component of platelet α-granules known to accumulating in thrombi. It was our aim to determine the role of TGFβ1 released from activated platelets for neointima formation following arterial injury and thrombosis. Mice with platelet-specific deletion of TGFβ1 (Plt.TGFβ-KO) underwent carotid artery injury. Immunoassays confirmed the absence of active TGFβ1 in platelet releasates and plasma of Plt...
July 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28723807/can-patients-with-femoral-neck-fracture-benefit-from-preoperative-thromboprophylaxis-a-prospective-randomized-controlled-trial
#10
Qiangqiang Li, Bingyang Dai, Jiacheng Xu, Yao Yao, Kai Song, Haojun Zhang, Dongyang Chen, Qing Jiang
BACKGROUND: The effectiveness of preoperative thromboprophylaxis remains obscure in patients with femoral neck fracture. The purpose of the current study was to investigate whether these patients benefit from preoperative thromboprophylaxis. METHODS: In this prospective, randomized controlled trial, a total of 80 patients with femoral neck fracture were randomly assigned to receive either rivaroxaban or conservative treatment before surgery. For all patients, color Doppler ultrasound of both lower extremities was performed immediately after admission...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722151/the-antithrombotic-and-haemostatic-effects-of-lassbio-752-a-synthetic-orally-active-compound-in-an-arterial-and-venous-thrombosis-model-in-rats
#11
Flávia S Frattani, Lidia M Lima, Eliezer J Barreiro, Russolina B Zingali
OBJECTIVES: In this work, we further investigated the effect of the compound LASSBio-752 in thrombosis models in rats. METHODS: Arterial and venous thrombosis model, ex-vivo recalcification time and aPTT and PT. KEY FINDINGS: In the venous thrombosis model, oral administration of LASSBio-752 [48.2 mg (100 μmol)/kg] one hour before the thrombus induction decreased thrombus weight by 37 ± 0.2%. Interestingly, the antithrombotic action of this compound [48...
July 19, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28721927/coagulopathy-and-haemorrhagic-progression-in-traumatic-brain-injury-advances-in-mechanisms-diagnosis-and-management
#12
REVIEW
Marc Maegele, Herbert Schöchl, Tomas Menovsky, Hugues Maréchal, Niklas Marklund, Andras Buki, Simon Stanworth
Normal haemostasis depends on an intricate balance between mechanisms of bleeding and mechanisms of thrombosis, and this balance can be altered after traumatic brain injury (TBI). Impaired haemostasis could exacerbate the primary insult with risk of initiation or aggravation of bleeding; anticoagulant use at the time of injury can also contribute to bleeding risk after TBI. Many patients with TBI have abnormalities on conventional coagulation tests at admission to the emergency department, and the presence of coagulopathy is associated with increased morbidity and mortality...
August 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28719850/tinzaparin-in-cancer-associated-thrombosis-beyond-6months-ticat-study
#13
Luis Jara-Palomares, Aurora Solier-Lopez, Teresa Elias-Hernandez, Maribel Asensio-Cruz, Isabel Blasco-Esquivias, Lucia Marin-Barrera, Maria Rodriguez de la Borbolla-Artacho, Juan Manuel Praena-Fernandez, Emilio Montero-Romero, Silvia Navarro-Herrero, Maria Pilar Serrano-Gotarredona, José María Sánchez-Díaz, Carlos Palacios, Remedios Otero
INTRODUCTION: The safety and efficacy of low-molecular-weight heparin (LMWH) treatment in patients with cancer-associated thrombosis (CAT) beyond 6months are unknown. Our aim was to determine the safety of long-term tinzaparin use in patients with CAT. METHODS: We performed a prospective, open, single arm, multicentre study in patients with CAT receiving treatment with tinzaparin. We evaluated the rate of clinically relevant bleeding events (major and non-major clinically relevant bleeding) and venous thromboembolism (VTE) recurrence...
July 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#14
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28717737/rivaroxaban-an-affordable-and-effective-alternative-in-cancer-related-thrombosis
#15
Flávia Dias Xavier, Paulo Marcelo Gehm Hoff, Maria Ignez Braghiroli, Ana Carolina Carvalho Rocha Paterlini, Karla Teixeira Souza, Luiza Dib Batista Bugiato Faria, Fernando Sergio Blumm Ferreira, Karime Kalil Machado, Gustavo Dos Santos Fernandes
BACKGROUND: Venous thromboembolic events (VTEs) are common and potentially fatal complications in cancer patients, and they are responsible for the second most common cause of death. Low molecular weight heparin (LMWH) is the gold-standard treatment, but the costs involved limit its use, especially in developing countries. Recently, the oral anticoagulant rivaroxaban, which directly inhibits factor Xa, was approved for VTE treatment. METHODS: We conducted a retrospective analysis from January 2009 to February 2014 with patients who had cancer and VTE who were receiving rivaroxaban...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717586/evaluating-platelet-aggregation-dynamics-from-laser-speckle-fluctuations
#16
Zeinab Hajjarian, Diane M Tshikudi, Seemantini K Nadkarni
Platelets are key to maintaining hemostasis and impaired platelet aggregation could lead to hemorrhage or thrombosis. We report a new approach that exploits laser speckle intensity fluctuations, emanated from a drop of platelet-rich-plasma (PRP), to profile aggregation. Speckle fluctuation rate is quantified by the speckle intensity autocorrelation, g2(t), from which the aggregate size is deduced. We first apply this approach to evaluate polystyrene bead aggregation, triggered by salt. Next, we assess dose-dependent platelet aggregation and inhibition in human PRP spiked with adenosine diphosphate and clopidogrel...
July 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28716153/a-nested-mechanistic-sub-study-into-the-effect-of-tranexamic-acid-versus-placebo-on-intracranial-haemorrhage-and-cerebral-ischaemia-in-isolated-traumatic-brain-injury-study-protocol-for-a-randomised-controlled-trial-crash-3-trial-intracranial-bleeding-mechanistic
#17
Abda Mahmood, Ian Roberts, Haleema Shakur
BACKGROUND: Tranexamic acid prevents blood clots from breaking down and reduces bleeding. However, it is uncertain whether tranexamic acid is effective in traumatic brain injury. The CRASH-3 trial is a randomised controlled trial that will examine the effect of tranexamic acid (versus placebo) on death and disability in 13,000 patients with traumatic brain injury. The CRASH-3 trial hypothesizes that tranexamic acid will reduce intracranial haemorrhage, which will reduce the risk of death...
July 17, 2017: Trials
https://www.readbyqxmd.com/read/28709756/postoperative-outcomes-associated-with-neuraxial-vs-general-anesthesia-following-bilateral-total-knee-arthroplasty
#18
Jeffrey B Walker, Patrick L Nguyen, Ulrich H Schmidt, Rodney A Gabriel
BACKGROUND: There is sparse evidence on the benefit of neuraxial (NA) vs general anesthesia (GA) as the primary anesthetic in postoperative outcomes following bilateral total knee arthroplasty. We sought to elucidate differences in outcomes in this surgical population using a national database. METHODS: We used data from the National Surgical Quality Improvement Program from 2007 to 2013 and compared rates of various postoperative outcomes in propensity-matched cohorts (NA vs GA)...
June 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28708213/novel-use-of-low-dose-thalidomide-in-refractory-gastrointestinal-bleeding-in-left-ventricular-assist-device-patients
#19
Benjamin J J Seng, Louis L Y Teo, Laura L Chan, David K L Sim, Ka L Kerk, Jia L Soon, Teing E Tan, Cumaraswamy Sivathasan, Choon P Lim
BACKGROUND: Gastrointestinal bleeding (GIB) is a complication reported in patients post left ventricular assist device (LVAD) implantation that is associated with high mortality rates. Thalidomide is an anti-angiogenic compound that may offer a potential option for management of refractory LVAD-related GIB. METHODS: A single-center, retrospective review was conducted from January 2009 to October 2016 at a tertiary cardiology center. It included LVAD patients initiated on thalidomide for refractory GIB...
July 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28707308/baseline-anemia-in-patients-undergoing-percutaneous-coronary-intervention-after-an-acute-coronary-syndrome-a-paradox-of-high-bleeding-risk-high-ischemic-risk-and-complex-coronary-disease
#20
Khaled Yazji, Fairoz Abdul, Senthil Elangovan, Muhammad Z Ul Haq, Nick Ossei-Gerning, Keith Morris, Richard Anderson, Tim Kinnaird
OBJECTIVES: To define more clearly the associations between baseline anemia, bleeding/ischemia risk, coronary disease severity, and outcomes by revascularization completeness. BACKGROUND: Anemia is associated with adverse outcomes in patients presenting with an acute coronary syndrome (ACS). METHODS AND RESULTS: Data was sourced from hospital databases for patients admitted with an ACS to a single center between 2011 and 2014. Using WHO anemia criteria, 468 (26...
July 13, 2017: Journal of Interventional Cardiology
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