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Samuel Hall, Eleanor Walshe, Claudia Ajayi, Kevin Boyle, Colin Griffith
Background: Herbal supplements are commonly used, however, their side-effect profiles are poorly understood and not subject to the same scrutiny as prescribed medications. Some herbal supplements such as St Johns' Wort are accepted to interfere with clotting pathways, however others, including Red Clover have theoretical bleeding risks based on coumarin content with very little underlying evidence. Case Description: This case reports a 65-year-old woman who suffered a spontaneous acute-on-chronic subdural hemorrhage with a significant postoperative re-hemorrhage...
2018: Surgical Neurology International
Kathryn L Perrin, Anne K Krogh, Mads Kjelgaard-Hansen, Lauren Howard, Louise Bochsen, Wendy K Kiso, Dennis Schmitt, Annemarie T Kristensen, Mads F Bertelsen
Hemorrhagic disease associated with elephant endotheliotropic herpesvirus infection is the most-frequent cause of mortality in captive Asian elephants ( Elephas maximus). Survival relies on intensive monitoring of hemostatic status. Thromboelastography (TEG) utilizes whole blood samples containing all the blood components of hemostasis and is therefore a sensitive indicator of the clinical status in the patient. This study was performed to assess the practicability of TEG in Asian elephants in a zoo environment...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Sarina Levy-Mendelovich, Assaf Arie Barg, Nurit Rosenberg, Einat Avishai, Jacob Luboshitz, Mudi Misgav, Gili Kenet, Tami Livnat
INTRODUCTION: Congenital factor V deficiency (FVD) is a rare bleeding disorder with an estimated incidence of 1 in 1000,000 in the general population. Since the common coagulation tests do not correlate with the bleeding tendency there is an unmet need to predict FVD patients' bleeding hazard prior to surgical interventions. AIM: To optimize treatment prior to surgical interventions, using global coagulation assays, thrombin generation (TG) and rotating thromboelastogram (ROTEM)...
February 2, 2018: Blood Cells, Molecules & Diseases
Christine M Leeper, Matthew D Neal, Christine McKenna, Timothy Billiar, Barbara A Gaines
BACKGROUND: Trauma-induced coagulopathy is common and associated with poor outcome in injured children. Our aim is to identify patterns of coagulation dysregulation after injury and associate these phenotypes with relevant clinical outcomes. METHODS: We performed principal components analysis on prospectively collected data from children with the highest-level trauma activation June 2015-June 2016. Parameters included admission international normalized ratio, platelet count and thromboelastograms...
December 13, 2017: Surgery
Danyan Chen, Xiaolong Huang, Hua Gan, Xiaogang Du, Song Lu, Rongxi Huang, Ke Liu, Binghan Zhang
In the present study, we evaluated the curative effect of dipeptidyl peptidase-IV (DPP-IV) inhibitor alogliptin combined with motor imagery under hyperbaric oxygen in diabetic nephropathy (DN) with silent cerebral infarction (SCI). Two-hundred newly diagnosed DN patients with and without SCI were included. The SCI patients were divided into two treatment groups: Alogliptin (A group, n=50) and alogliptin combined with motor imagery under hyperbaric oxygen (B group, n=50). The degrees of neurocognitive dysfunction were evaluated at baseline and after 6 months of treatment...
November 2017: Biomedical Reports
Brandon Tanner, Steven Lu, Guston Zervoudakis, Alyssa Woodwyk, Gitonga Munene
BACKGROUND: Thromboelastography has called into question the coagulopathy seen following partial hepatectomy. However the coagulation profile in cirrhotic livers has not been studied. Our objective was to determine the coagulation profile following partial hepatectomy in normal and cirrhotic livers. METHODS: Patients undergoing liver resection were prospectively enrolled in the study. The prothrombin time and international normalized ratio, as well as the thromboelastogram, were obtained preoperatively, post-operatively, and on post-operative days 1, 3, and 5...
November 11, 2017: American Journal of Surgery
Antònia Bonet, Zoilo Madrazo, Maylin Koo, Israel Otero, Montserrat Mallol, Irene Macia, Luciano Ramirez, Antoni Sabaté
INTRODUCTION: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM(®)) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. METHODS: Single-center, observational, prospective study in polytraumatic patients...
October 27, 2017: Cirugía Española
Yoni Cohen, Togas Tulandi, Benny Almog, Eyal Zohav, Varda Deutsch, Ariel Many, Ami Amit, Aviad Cohen
OBJECTIVE: To investigate coagulation system changes during an in-vitro fertilization (IVF) cycle using Thromboelastogram (TEG) that enables analysis of the elastic properties of whole blood samples and provides a global assessment of the hemostatic function. STUDY DESIGN: A prospective study. TEG indices were evaluated in 23 women who underwent controlled ovarian stimulation for IVF at four points in time: 1. At the beginning of the cycle (corresponding to the lowest levels of E2), 2...
September 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cara A Rabik, Meredith A Atkinson, Sangeeta Sule, John J Strouse
BACKGROUND: Factor (F)XIII deficiency is a rare inherited bleeding disorder, but can also be acquired due to the development of inhibitors. CASE REPORT: A 17-year-old female with systemic lupus erythematosus and end-stage kidney disease secondary to Class IV lupus nephritis developed spontaneous subcutaneous and muscular hematomas and delayed major bleeding after invasive procedures. She had abnormal kaolin thromboelastography (kTEG; decreased maximal amplitude, representative of clot strength) initially attributed to thrombocytopenia and uremic platelet dysfunction, but her FXIII activity was undetectable, and a high-titer antibody against FXIII was identified...
September 2017: Transfusion
Katie Moynihan, Kerry Johnson, Lahn Straney, Christian Stocker, Ben Anderson, Prem Venugopal, John Roy
OBJECTIVES: Extracorporeal Life Support (ECLS) risks thrombotic and hemorrhagic complications. Optimal anti-coagulation monitoring is controversial. We compared coagulation tests evaluating the heparin effect in pediatric ECLS. METHODS: A retrospective study of children (<18yrs) undergoing ECLS over 12 months in a tertiary pediatric intensive care unit (PICU). Variables included anti-Factor Xa activity (anti-Xa), activated partial thromboplastin time (aPTT), activated clotting time (ACT) and thromboelastogram (TEG(®)6s) parameters: ratio and delta reaction (R) times (the ratio and difference, respectively, between R times in kaolin assays with and without heparinase)...
July 1, 2017: Perfusion
Chandra K Pandey, Vandana Saluja, Kumar Gaurav, Manish Tandon, Vijay K Pandey, Ajeet S Bhadoria
BACKGROUND & OBJECTIVES: Coagulation and haemostasis are dynamic processes. The haemostatic changes in liver disease affect all aspects of coagulation. The prothrombin time (PT)/ international normalized ratio (INR) was developed to monitor oral anticoagulant therapy and the activated partial thromboplastin time to investigate inheritable single factor deficiencies. Viscoelastic tests such as thromboelastogram (TEG) give information about dynamics of clot formation (coagulation factor and anticoagulant activity), clot strength (platelets and fibrinogen) and clot stability (finbrinolysis and factor XIII)...
January 2017: Indian Journal of Medical Research
Anaar Siletz, Sigrid Burruss, Terry Gruber, Alyssa Ziman, Victor Marder, Henry Magill Cryer
BACKGROUND: Whole blood (WB) transfusion is a promising alternative to component therapy in hemostatic resuscitation. Use of banked WB requires filtration of white blood cells (leukoreduction) and an established shelf life during which WB retains coagulant capacities. The goal of this study was to define the time course of coagulation stability in leukoreduced compared to unfiltered WB under standard refrigeration conditions. METHODS: Twelve WB units were donated by healthy volunteers after routine screening...
September 2017: Journal of Trauma and Acute Care Surgery
Indre Zostautiene, Kristina Zvinienė, Darius Trepenaitis, Rolandas Gerbutavičius, Antanas Mickevičius, Rima Gerbutavičienė, Mindaugas Kiudelis
INTRODUCTION: Thromboelastography (TEG) is a technique that measures coagulation processes and surveys the properties of a viscoelastic blood clot, from its formation to lysis. AIM: To determine the possible hypercoagulability state and the effect of antithrombotic prophylaxis on thromboelastogram results and development of venous thrombosis during laparoscopic fundoplication. MATERIAL AND METHODS: The study was performed on 106 patients who were randomized into two groups...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Raffael Pereira Cezar Zamper, Thiago Chaves Amorim, Luiz Guilherme Villares da Costa, Flávio Takaoka, Ary Serpa
Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37°C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy...
April 2017: Einstein
Myriam Defontis, Serge Côté, David Ledieu
Early detection of drug-induced alterations of hemostasis is challenging. Drugs can affect different components of the Virchow's triad and measurement of plasmatic coagulation times lacks sensitivity. New techniques for a more global assessment of the hemostasis are now available: the impedance platelet aggregometry, the thromboelastography and the thrombin generation measurement. The aim of this study was to evaluate three techniques (i.e.: Multiplate(®), TEG(®) and CAT) for the in vitro detection of the effect of a drug known to induce hemostatic alterations in a preclinical safety environment...
February 9, 2017: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
Shu-Wu Zhao, Yu-Ping Wang, Lin-Dong Xu, Wei Gang
BACKGROUND: This study aims to explore the application value of thromboelastogram (TEG) in antiplatelet therapy in coronary artery intervention. METHODS: A retrospective analysis of 90 cases of coronary interventional treatment was conducted in our hospital from January 2010 to January 2012. Cases were divided into three groups, according to the kind of coronary heart disease: angina pectoris (AP) group (30 cases), unstable angina pectoris (UAP) group (30 cases) and acute myocardial infarction (AMI) group (30 cases)...
December 2016: Journal of Thoracic Disease
Jawad T Ali, Mitchell J Daley, Nina Vadiei, Zachary Enright, Joseph Nguyen, Sadia Ali, Jayson D Aydelotte, Pedro G Teixeira, Thomas B Coopwood, Carlos Vr Brown
PURPOSE: Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC. METHODS: This retrospective chart review evaluated all trauma patients admitted to an urban, level one trauma center from February 2011 to September 2014 who received a TEG within the first 24h...
April 2017: American Journal of Emergency Medicine
Z Y Wang, Y Wang, A H Sui, Y Dong
Objective: To investigate the relationship of single nucleotide polymorphisms of Multi-drug resistance (ABCB1/MDR1) gene with Aspirin resistance (AR) in patients with ischemic stroke. Methods: Three hundred ischemic stroke patients from Department of Neurology, Affiliated Hospital of Qingdao University were collected from September 2014 to May 2016. According to the results of Thromboelastogram (TEG), the patients were divided into aspirin resistance (AR) group and aspirin sensitive (AS) group. The genotypes of ABCB1 gene (C1236T, G2677T/A, C3435T) were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct sequencing...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
A Yu Bryushkov, P V Ershov, N A Sergeeva, V Yu Bogachev
The study was aimed at evaluating a possibility of correcting endothelial dysfunction by means of angioprotective therapy with natural-origin bioflavonoids in patients presenting with acute venous thromboses. Ours was an open comparative prospective study including a total of thirty 34-to-60-year-old patients suffering from lower limb deep vein thrombosis. The patients were subdivided into two groups. The Study Group was composed of 15 patients receiving on the background of anticoagulant therapy with direct thrombin inhibitors (dabigatran etexilate at a daily dose of 300 mg) natural-origin angioprotectors (red grape leaf extract)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Patrick Bosch, Tanya S Kenkre, Joanne A Londino, Antonio Cassara, Charles Yang, Jonathan H Waters
BACKGROUND: Blood loss and transfusion requirements during posterior spinal fusion for adolescent idiopathic scoliosis remain a concern. The mechanism of bleeding in these patients is poorly characterized. Thromboelastography is a comprehensive test of a patient's coagulation system commonly used in cardiac surgical procedures. It has not been well studied for use in patients with adolescent idiopathic scoliosis. METHODS: A prospective, observational study of the coagulation profile of patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion is presented...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
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