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https://www.readbyqxmd.com/read/28918481/fibrinolysis-in-trauma-a-review
#1
REVIEW
M J Madurska, K A Sachse, J O Jansen, T E Rasmussen, J J Morrison
Fibrinolytic dysregulation is an important mechanism in traumatic coagulopathy. It is an incompletely understood process that consists of a spectrum ranging from excessive breakdown (hyperfibrinolysis) and the shutdown of fibrinolysis. Both hyperfibrinolysis and shutdown are associated with excess mortality and post-traumatic organ failure. The pathophysiology appears to relate to endothelial injury and hypoperfusion, with several molecular markers identified in playing a role. Although there are no universally accepted diagnostic tests, viscoelastic studies appear to offer the greatest potential for timely identification of patients presenting with fibrinolytic dysregulation...
September 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28913813/pharmacotherapy-pearls-for-emergency-neurological-life-support
#2
Gretchen M Brophy, Theresa Human
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28910471/evaluation-of-xstat%C3%A2-and-quickclot%C3%A2-combat-gauze%C3%A2-in-a-swine-model-of-lethal-junctional-hemorrhage-in-coagulopathic-swine
#3
Jennifer M Cox, Jason M Rall
BACKGROUND: Hemorrhage is associated with most potentially survivable deaths on the battlefield. Effective and field-tested products are lacking to treat junctional and noncompressible injuries. XSTAT® is a newly developed, U.S. Food and Drug Administration-approved product designed to treat junctional hemorrhage. The Committee on Tactical Combat Casualty Care has recently approved the product for use as part of its treatment guidelines, but data are lacking to assess its efficacy in different wounding patterns and physiologic states...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28880362/cold-platelets-for-trauma-associated-bleeding-regulatory-approval-accreditation-approval-and-practice-implementation-just-the-tip-of-the-iceberg
#4
James R Stubbs, Sheryl A Tran, Richard L Emery, Scott A Hammel, De Anna L Haugen, Martin D Zielinski, Scott P Zietlow, Donald Jenkins
BACKGROUND: Laboratory and clinical evidence suggest that cold-stored platelets (CS-PLTs) might be preferable to room temperature platelets (RT-PLTs) for active bleeding. Ease of prehospital use plus potential hemostatic superiority led our facility to pursue approval of CS-PLTs for actively bleeding trauma patients. STUDY DESIGN AND METHODS: From November 18, 2013, through October 8, 2015, correspondence was exchanged between our facility, the AABB, and the US Food and Drug Administration (FDA)...
September 6, 2017: Transfusion
https://www.readbyqxmd.com/read/28874645/evaluating-effectiveness-of-axiostat-hemostatic-material-in-achieving-hemostasis-and-healing-of-extraction-wounds-in-patients-on-oral-antiplatelet-drugs
#5
Saurabh Sharma, Tejraj P Kale, Lingaraj J Balihallimath, Abhishek Motimath
AIM: The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy. MATERIALS AND METHODS: Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime...
September 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28870210/hemostatic-bioactivity-of-novel-pollen-typhae-carbonisata-derived-carbon-quantum-dots
#6
Xin Yan, Yan Zhao, Juan Luo, Wei Xiong, Xiaoman Liu, Jinjun Cheng, Yongzhi Wang, Meiling Zhang, Huihua Qu
BACKGROUND: Pollen Typhae Carbonisata (PTC) is a type of calcined herb drug that has been used as a hemostatic medicine to promote hemostasis for thousands of years. In this study, we discovered and separated novel water-soluble carbon quantum dots (CQDs, named PTC-CQDs) from aqueous extracts of PTC. These PTC-CDs were characterized using transmission electron microscopy (TEM) and high-resolution TEM, as well as Fourier transform infrared, ultraviolet-visible, and fluorescence spectroscopy...
September 5, 2017: Journal of Nanobiotechnology
https://www.readbyqxmd.com/read/28830606/thrombin-generation-assays-for-global-evaluation-of-the-hemostatic-system-perspectives-and-limitations
#7
Rita Carolina Figueiredo Duarte, Cláudia Natália Ferreira, Danyelle Romana Alves Rios, Helton José Dos Reis, Maria das Graças Carvalho
The existing techniques to evaluate hemostasis in clinical laboratories are not sensitive enough to detect hypercoagulable and mild hypocoagulable states. Under different experimental conditions, the thrombin generation test may meet these requirements. This technique evaluates the overall balance between procoagulant and anticoagulant forces and has provided new insights in our understanding of the coagulation cascade, as well as of the diagnosis of hypocoagulability and hypercoagulability conditions. Thrombin generated in the thrombin generation test can be quantified as platelet-rich or platelet-poor plasma using the calibrated automated thrombogram method, which monitors the cleavage of a fluorogenic substrate that is simultaneously compared to the known thrombin activity in a non-clotting plasma sample...
July 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/28815933/an-%C3%AE-iib-%C3%AE-3-antagonist-prevents-thrombosis-without-causing-fc%C3%AE-riia-mediated-thrombocytopenia
#8
Yu-Ju Kuo, Ying-Ru Chen, Chun-Chieh Hsu, Hui-Chin Peng, Tur-Fu Huang
BACKGROUND: Thrombocytopenia, a common side effect of Arg-Gly-Asp (RGD)-mimetic antiplatelet drugs, is associated with drug-dependent antibodies (DDAbs) that recognize conformation-altered integrin αIIb β3 . OBJECTIVE: To explore the correlation between αIIb β3 binding epitopes and induction of DDAb binding to conformation-altered αIIb β3 , we examined whether two purified disintegrins TMV-2 and TMV-7 with distinct binding motifs that have different effects on induction of αIIb β3 conformational change and platelet aggregation in the presence of AP2, an IgG1 inhibitory monoclonal antibody (mAb) raised against αIIb β3 ...
August 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28815651/peptide-mimetic-drugs-for-modulating-thrombosis-and-hemostasis
#9
Kimberly Nellenbach, Ashley C Brown
Preclinical Research Hemostasis is the complex physiological process that stems bleeding at an injury site while simultaneously maintaining unobstructed circulation in other areas of the body. This system is kept in balance with finely tuned regulation by pro- and antithrombotic agents. When this balance is thrown out of equilibrium, uncontrolled bleeding, or thrombotic complications can occur. Because of the high number of hemostatic disorders, researchers are continually searching for improved technologies for controlling coagulation...
August 16, 2017: Drug Development Research
https://www.readbyqxmd.com/read/28775075/first-selective-12-lox-inhibitor-ml355-impairs-thrombus-formation-and-vessel-occlusion-in-vivo-with-minimal-effects-on-hemostasis
#10
Reheman Adili, Benjamin E Tourdot, Katherine Mast, Jennifer Yeung, John Cody Freedman, Abigail Green, Diane K Luci, Ajit Jadhav, Anton Simeonov, David J Maloney, Theodore R Holman, Michael Holinstat
OBJECTIVE: Adequate platelet reactivity is required for maintaining hemostasis. However, excessive platelet reactivity can also lead to the formation of occlusive thrombi. Platelet 12(S)-lipoxygenase (12-LOX), an oxygenase highly expressed in the platelet, has been demonstrated to regulate platelet function and thrombosis ex vivo, supporting a key role for 12-LOX in the regulation of in vivo thrombosis. However, the ability to pharmacologically target 12-LOX in vivo has not been established to date...
August 3, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28749789/surgical-approach-to-piles-at-risk-of-severe-postoperative-pain-tricks-and-tips
#11
Domenico Tuscano, Linda D'Amore, Fabio Gaj, Paolo Bruzzone, Elena Annesi, Daniele Ceccarelli, Paolox Paolo Negro, Maria Romana Grimaldi, Francesco Gossetti
AIM: Aim of the present study is to propose a clinic-therapeutic course for the treatment of hemorrhoidal disease able to combine radical anatomic surgery with a painless postoperative path. MATERIAL OF STUDY: The present study is based on the evaluation of 20 selected patients who underwent radical hemorrhoidectomy for very high grade hemorrhoidal disease. The clinical course was characterized by careful bowel cleansing, hemorrhoidectomy according to Milligan-Morgan using LigaSure, intraoperative perianal infiltration of Ropivacaine and postoperative use of analgesic drugs...
July 24, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28732897/preparation-and-characterization-of-novel-chitosan-and-%C3%AE-cyclodextrin-polymer-sponges-for-wound-dressing-applications
#12
Claudia Flores, Marco Lopez, Nicolas Tabary, Christel Neut, Feng Chai, Didier Betbeder, Clément Herkt, Frederic Cazaux, Valerie Gaucher, Bernard Martel, Nicolas Blanchemain
Chitosan (CS) presents antibacterial, mucoadhesive and hemostatic properties and is an ideal candidate for wound dressing applications. This work reports the development of sponge-like materials obtained from physical hydrogels after the interaction between CS and a β-cyclodextrin polymer (PCD) in acidic conditions to provoke immediate gelation. Characterization consisted of zeta potential (ZP) measurements, rheology analysis, Fourier transform infrared (FTIR), Raman spectroscopy, wide angle X-ray scattering (WAXS) and scanning electron microscopy (SEM)...
October 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28731874/novel-targets-for-anticoagulants-lacking-bleeding-risk
#13
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...
September 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28707198/platelet-targeted-pharmacologic-treatments-as-anti-cancer-therapy
#14
REVIEW
P Gresele, S Momi, M Malvestiti, M Sebastiano
Platelets act as multifunctional cells participating in immune response, inflammation, allergy, tissue regeneration, and lymphoangiogenesis. Among the best-established aspects of a role of platelets in non-hemostatic or thrombotic disorders, there is their participation in cancer invasion and metastasis. The interaction of many different cancer cells with platelets leads to platelet activation, and on the other hand platelet activation is strongly instrumental to the pro-carcinogenic and pro-metastatic activities of platelets...
July 13, 2017: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/28686242/keratin-dissolution-extraction-and-biomedical-application
#15
REVIEW
Amin Shavandi, Tiago H Silva, Adnan A Bekhit, Alaa El-Din A Bekhit
Keratinous materials such as wool, feathers and hooves are tough unique biological co-products that usually have high sulfur and protein contents. A high cystine content (7-13%) differentiates keratins from other structural proteins, such as collagen and elastin. Dissolution and extraction of keratin is a difficult process compared to other natural polymers, such as chitosan, starch, collagen, and a large-scale use of keratin depends on employing a relatively fast, cost-effective and time efficient extraction method...
August 22, 2017: Biomaterials Science
https://www.readbyqxmd.com/read/28641649/-hemostatic-effect-of-spleen-invigorating-qi-replenishing-and-blood-containing-formula-on-simvastatin-induced-zebrafish-hemorrhage-model
#16
Yu-Ting Chu, Xiao-Yu Zhu, Ya-Yue Zhang, Bo Xia, Li Hou, Ru-Shun Song, Tian-Tian Li, Chun-Qi Li, Qing Dong, Xin-Yi Chen
OBJECTIVE: To investigate the hemostatic effect of spleen-invigorating, qi-replenishing and blood-containing formula on simvastatin-induced zebrafish hemorrhage model, and to compare with the effect of clearing heat and cooling blood formula. METHODS: Zebrafishes from breed A B line were treated with 0.5 µmol/L simvastatin for 24 hours to establish zebrafishes hemorrhage model. Under strict blinded experimental conditions, the above mentioned zebrafishes were then treated with experimental drug of different concentrations at the maximum non-lethal dose...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28634688/acute-variceal-bleeding-risk-stratification-and-management-including-tips
#17
REVIEW
Virginia Hernández-Gea, Claudia Berbel, Anna Baiges, Juan C García-Pagán
Acute variceal bleeding should be suspected in all patients with cirrhosis presenting with upper gastrointestinal bleeding. Vasoactive drugs and prophylactic antibiotics must be started as soon as possible, even before performing the diagnostic endoscopy. Once the patient is hemodynamically stable, upper gastrointestinal endoscopy should be performed in order to confirm the diagnosis and provide endoscopic therapy (preferably banding ligation). After this initial approach, the most appropriate therapy to prevent both early and late rebleeding must be instituted following a risk stratification strategy...
June 20, 2017: Hepatology International
https://www.readbyqxmd.com/read/28616396/management-for-non-variceal-upper-gastrointestinal-bleeding-in-elderly-patients-the-experience-of-a-tertiary-university-hospital
#18
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
BACKGROUND: Peptic ulcer bleeding (PUB) is the main cause of non-variceal upper gastrointestinal bleeding (UGIB). Endoscopic treatment and acid suppression with proton-pump inhibitors (PPIs) are most important in the management of PUB and these treatments have reduced mortality. However, elderly patients sometimes have a poor prognostic outcome due to severe comorbidities. METHODS: A retrospective study was performed on 504 cases with acute non-variceal UGIB who were examined in our hospital, in order to reveal the risk factor of a poor outcome in elderly patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28614427/a-new-era-of-thromboelastometry
#19
Tomaz Crochemore, Felipe Maia de Toledo Piza, Roseny Dos Reis Rodrigues, João Carlos de Campos Guerra, Leonardo José Rolim Ferraz, Thiago Domingos Corrêa
Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients...
June 12, 2017: Einstein
https://www.readbyqxmd.com/read/28608003/transarterial-chemoembolization-for-management-of-hemoptysis-initial-experience-in-advanced-primary-lung-cancer-patients
#20
Akihiko Seki, Chigusa Shimono
PURPOSE: To evaluate the hemostatic effects of transarterial infusion chemotherapy in addition to embolization (chemoembolization) for advanced primary lung cancer with tumor-related hemoptysis. MATERIALS AND METHODS: Ten consecutive patients with stage IIIB/IV or recurrent primary lung cancer (squamous cell carcinoma in six, adenocarcinoma in four) who underwent chemoembolization for control of hemoptysis were enrolled. At enrollment, five patients were considered refractory and five had contraindications to standard therapies...
June 12, 2017: Japanese Journal of Radiology
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