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Hypercoagulability

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https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#1
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing thromboelastography (TEG) to identify those at risk of subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28922103/budd-chiari-syndrome
#2
Tomáš Grus, Lukáš Lambert, Gabriela Grusová, Rohan Banerjee, Andrea Burgetová
Budd-Chiari syndrome (BCS) is a rare disease with an incidence of 0.1 to 10 per million inhabitants a year caused by impaired venous outflow from the liver mostly at the level of hepatic veins and inferior vena cava. Etiological factors include hypercoagulable conditions, myeloprolipherative diseases, anatomical variability of the inferior vena cava, and environmental conditions. Survival rates in treated patients range from 42 to 100% depending on the etiology and the presence of risk factors including parameters of Child-Pugh score, sodium and creatinine plasma levels, and the choice of treatment...
2017: Prague Medical Report
https://www.readbyqxmd.com/read/28920711/rivaroxaban-causes-missed-diagnosis-of-protein-s-deficiency-but-not-of-activated-protein-c-resistance-factor-v-leiden
#3
Elena Maryamchik, Matthew W Rosenbaum, Elizabeth M Van Cott
CONTEXT: - Rivaroxaban causes a false increase in activated protein C resistance (APCR) ratios and protein S activity. OBJECTIVE: - To investigate whether this increase masks a diagnosis of factor V Leiden (FVL) or protein S deficiency in a "real-world" population of patients undergoing rivaroxaban treatment and hypercoagulation testing. DESIGN: - During a 2.5-year period, we compared 4 groups of patients (n = 60): FVL heterozygous (FVL-HET)/taking rivaroxaban, wild-type/taking rivaroxaban, FVL-HET/no rivaroxaban, and normal APCR/no rivaroxaban...
September 18, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#4
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28917273/mechanisms-and-risk-factors-of-thrombosis-in-cancer
#5
REVIEW
Anna Falanga, Laura Russo, Viola Milesi, Alfonso Vignoli
The close relationship between cancer and thrombosis is known since more than a century. Venous thromboembolism (VTE) may be the first manifestation of an occult malignancy in an otherwise healthy individual. Cancer patients commonly present with abnormalities of laboratory coagulation tests, indicating an ongoing subclinical hypercoagulable condition. The results of laboratory tests demonstrate that a process of fibrin formation and removal parallels the development of malignancy, which is of particular interest since fibrin and other clotting products are important for both thrombogenesis and tumor progression...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#6
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28903941/increased-hazard-of-myocardial-infarction-with-insulin-provision-therapy-in-actively-smoking-patients-with-diabetes-mellitus-and-stable-ischemic-heart-disease-the-bari-2d-bypass-angioplasty-revascularization-investigation-2-diabetes-trial
#7
Asrar A Khan, Matthew J Chung, Eric Novak, David L Brown
BACKGROUND: In the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial, randomization of diabetic patients with stable ischemic heart disease to insulin provision (IP) therapy, as opposed to insulin sensitization (IS) therapy, resulted in biochemical evidence of impaired fibrinolysis but no increase in adverse clinical outcomes. We hypothesized that the prothrombotic effect of IP therapy in combination with the hypercoagulable state induced by active smoking would result in an increased risk of myocardial infarction (MI)...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28901563/analysis-of-serum-levels-and-cutaneous-expression-of-lipoprotein-a-in-38-patients-with-livedoid-vasculopathy
#8
Espinel Ds, Di Giacomo Tb, Pincelli Tp, Pereira Nv, Sotto Mn, Kirsner Rs, Criado Pr
BACKGROUND: Coagulation disorders contribute to the development of livedoid vasculopathy (LV). Elevated plasma levels of lipoprotein(a) [Lp(a)] are an independent risk factor for the development of cardiovascular disease and associated with hypercoagulable states. Increased serum Lp(a) levels have been reported in patients with LV and may have an important role in the pathogenesis of LV. OBJECTIVES: To investigate Lp(a) expression in skin lesions and circulating serum Lp(a) levels in patients with LV...
September 13, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28888622/the-utility-of-thromboelastography-and-thrombin-generation-in-assessing-the-prothrombotic-state-of-adults-with-sickle-cell-disease
#9
Marije Wijnberge, Kiran Parmar, Rachel Kesse-Adu, Jo Howard, Alexander T Cohen, Beverley J Hunt
INTRODUCTION: Previous studies have suggested a chronic hypercoagulable state in SCD, and that thrombosis also plays a role in the pathophysiology of sickle cell vaso-occlusive pain crises (VOC). Studies looking at thrombin generation have produced conflicting results. In this study we aimed to assess and compare whole blood thromboelastography (TEG) and plasma Calibrated Automated Thrombogram (CAT) in SCD versus healthy controls and in four different SCD subgroups. MATERIALS AND METHODS: In this prospective observational study, TEG and 1pM TF activated CAT assays were performed in citrated blood samples from 77 adult (18-66years old) SCD patients (HbSS and HbSB) and 22 healthy (HbAA) ethnically-matched controls...
September 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28876625/to-activate-or-not-to-activate-the-controversy-surrounding-tamoxifen-treatment-and-thrombosis
#10
T N Augustine, K Pather, T Dix-Peek, R Duarte
BACKGROUND: Cancer is associated with hypercoagulability, with therapies including chemotherapy, radiation therapy, surgery and hormone-therapy linked to an increased risk of thrombotic complications. Notwithstanding the contribution of other haematological processes and components, platelets are implicated in contributing to a hypercoagulable state, with breast cancer patients receiving Tamoxifen treatment at a greater risk for thrombotic complications. METHOD: MCF-7 and T47D breast cancer cells were cultured under standard conditions, followed by treatment with 2uM Tamoxifen for 24 hours and co-cultured with whole blood (WB) for 2...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870084/comparison-between-thromboelastography-and-conventional-coagulation-tests-in-surgical-patients-with-localized-prostate-cancer
#11
Zhengwei Wang, Jing Li, Qingwei Cao, Lei Wang, Fengzhi Shan, Houyi Zhang
We aimed to examine hypercoagulable and hypocoagulable conditions in patients with prostate cancer using thromboelastography (TEG) and correlate TEG parameters with conventional coagulation test. The t test was used for comparing TEG parameters and routine coagulation results. Spearman rank-order correlation was used to describe the relationship of TEG and conventional tests. Sensitivity, specificity, positive predictive values, and negative predictive values were determined for bleeding and thrombosis. Totally, 20 patients had active bleeding postoperatively, 16 of whom showed hypocoagulation on TEG test and 9 of whom showed hypocoagulation by routine coagulation test ( P = ...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28858139/platelet-derived-microvesicles-a-potential-therapy-for-trauma-induced-coagulopathy
#12
Ernesto Lopez, Amit K Srivastava, Shibani Pati, John B Holcomb, Charles E Wade
Trauma patients are often affected by a hypocoagulable condition referred as trauma-induced coagulopathy (TIC) for which few therapeutic options exist. One available treatment is fresh platelets transfusion, although, It is not efficacious enough and it has a number of limitations; therefore, we reviewed the literature to propose an alternative therapy based on platelet-derived microvesicles (PMVs), which are cellular fragments surrounded by extracellular membrane and filled with cytoplasmic content. This concept is supported by a large number of studies in which the hypercoagulable role of PMVs has been demonstrated and associated with thrombosis-related conditions...
August 29, 2017: Shock
https://www.readbyqxmd.com/read/28856989/from-vulnerable-plaque-to-blood-healthy-therapy
#13
Sun Yuhua, Wang Baoping
Cardiovascular atherosclerotic disease is the leading cause of death in China and in Western nations. People with plaque or stenosis in the coronary artery or the carotid artery are the most susceptible population to suffer from acute events. Current investigations showed that plaque with the characteristics of intra-plaque hemorrhage or a thin cap with a large lipid core was causally associated with vulnerable plaque and plaque rupture. Of the many plaque ruptures occurring in patients with atherosclerotic disease, very few will trigger symptomatic events, rendering it exceedingly difficult to predict adverse outcomes...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28853522/-the-effect-of-vitamin-d-on-the-expression-of-adamts13-in-cultured-endothelial-cells-exposed-to-a-diabetic-like-environment
#14
Keren Cohen-Hagai, Gloria Rashid, Meital Ohana, Sydney Benchetrit, Tali Zitman-Gal
BACKGROUND: Diabetes mellitus (DM) is the leading cause of end-stage kidney disease. Inflammation, fibrosis, coagulability and oxidative stress exacerbate kidney disease. The glycoprotein, Von Willebrand Factor (VWF) has a crucial role in platelet thrombus formation. The enzyme ADAMTS13 is responsible for VWF cleavage. Both are important in the interface between diabetic nephropathy, hypercoagulability and atherosclerotic cardiovascular disease. Vitamin D inhibits endothelial proliferation, blunts angiogenesis and is a cardioprotective agent...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28852324/the-use-of-dielectric-blood-coagulometry-in-the-evaluation-of-coagulability-in-patients-with-peripheral-arterial-disease
#15
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
BACKGROUND: Platelets and coagulation proteins contribute to the development of peripheral arterial disease, especially atherosclerotic disease. Several experimental studies have proven a significant correlation between hypercoagulability and atherosclerosis. We used dielectric blood coagulometry, which was initially designed to evaluate the coagulable status, to examine the coagulability of peripheral arterial disease patients, and investigated the factors that were significantly correlated with the results...
2017: BMC Clinical Pathology
https://www.readbyqxmd.com/read/28851981/lipopolysaccharide-binding-protein-lbp-reverses-the-amyloid-state-of-fibrin-seen-in-plasma-of-type-2-diabetics-with-cardiovascular-co-morbidities
#16
Etheresia Pretorius, Sthembile Mbotwe, Douglas B Kell
Type 2 diabetes (T2D) has many cardiovascular complications, including a thrombotic propensity. Many such chronic, inflammatory diseases are accompanied (and may be exacerbated, and possibly even largely caused) by amyloid fibril formation. Recognising that there are few strong genetic associations underpinning T2D, but that amyloidogenesis of amylin is closely involved, we have been seeking to understand what might trigger the disease. Serum levels of bacterial lipopolysaccharide are raised in T2D, and we recently showed that fibrin(ogen) polymerisation during blood clotting can be affected strongly by LPS...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28844809/-pulmonary-embolism-as-a-presentation-of-nephrotic-syndrome
#17
C Fraisse, M Nouvier, S Lainez, P Nesme, S Ernesto, G Devouassoux
BACKGROUND: Nephrotic syndrome (NS) in adults is defined by proteinuria>3g/24h or 50mg/kg/d, hypoproteinemia<60g/24h and hypoalbuminemia<30g/L. The final diagnosis is guided by the histopathology evidence when a renal biopsy is possible. The consequences of NS are multiple: high blood pressure, undernutrition, infections and a hypercoagulable state. OBSERVATION: We report the case of a patient presenting with thromboembolic disease, occurring in the absence of other thromboembolic risk factors, which revealed NS with spontaneously favorable evolution...
August 24, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28839178/hypercoagulability-progresses-to-hypocoagulability-during-evolution-of-acetaminophen-induced-acute-liver-injury-in-pigs
#18
Karla Chui Luan Lee, Luisa Baker, Susan Mallett, Anne Riddell, Pratima Chowdary, Hatim Alibhai, Yu-Mei Chang, Simon Priestnall, Giacomo Stanzani, Nathan Davies, Rajeshwar Mookerjee, Rajiv Jalan, Banwari Agarwal
Increases in prothrombin time (PT) and international normalised ratio (INR) characterise acute liver injury (ALI) and failure (ALF), yet a wide heterogeneity in clotting abnormalities exists. This study defines evolution of coagulopathy in 10 pigs with acetaminophen (APAP)-induced ALI compared to 3 Controls. APAP administration began at 0 h and continued to 'ALF', defined as INR >3. In APAP pigs, INR was 1.05 ± 0.02 at 0 h, 2.15 ± 0.43 at 16 h and > 3 at 18 ± 1 h. At 12 h thromboelastography (TEG) demonstrated increased clot formation rate, associated with portal vein platelet aggregates and reductions in protein C, protein S, antithrombin and A Disintegrin and Metalloprotease with Thrombospondin type 1 repeats-13 (ADAMTS-13) to 60%, 24%, 47% and 32% normal respectively...
August 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28833583/cell-free-dna-and-dnase-activity-in-dogs-with-immune-mediated-hemolytic-anemia
#19
U Jeffery, L Ruterbories, R Hanel, D N LeVine
BACKGROUND: Immune-mediated hemolytic anemia (IMHA) in dogs has a high risk of thrombosis and is associated with marked neutrophilia and necrosis. Cell death and release of neutrophil extracellular traps contribute to increased serum concentrations of cell-free DNA, and in human autoimmune disease reduced DNase activity further increases cell-free DNA. Free DNA in blood has prothrombotic properties and could contribute to hypercoagulability in IMHA. HYPOTHESIS: Cell-free DNA is elevated and DNase activity reduced in dogs with IMHA compared to healthy dogs...
September 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28830606/thrombin-generation-assays-for-global-evaluation-of-the-hemostatic-system-perspectives-and-limitations
#20
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
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