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Yusuke Ito, Kengo Noguchi, Yoshiyuki Morishima, Kyoji Yamaguchi
: No rodent models are currently available for evaluating inhibitors of the activated form of thrombin-activatable fibrinolysis inhibitor (TAFIa) without exogenous supplementation of tissue-type plasminogen activator (tPA). Characterization of tPA transgenic rats as a tool for the nonclinical evaluation of TAFIa inhibitors is the objective of the current study. tPA transgenic rats were subjected to rat models of tissue-factor-induced thromboembolism, FeCl3-induced deep vein thrombosis (DVT) and arterial thrombosis, and tail bleeding...
March 13, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Marc Righini, Helia Robert-Ebadi
During the last three decades, considerable advances in the management of patients with suspected pulmonary embolism (PE) have improved diagnostic accuracy and made management algorithms safer, easier to use and well standardized. These diagnostic algorithms are mainly based on the assessment of clinical pretest probability, D-Dimer measurement and imaging tests, mainly computed tomography pulmonary angiography (CTPA). These diagnostic algorithms allow a safe and cost-effective diagnosis for most patients with suspected PE...
February 2018: Hämostaseologie
Alauddin Kochai, Meric Enercan, Sinan Kahraman, Cagatay Ozturk, Azmi Hamzaoglu
PURPOSE: The aim of this study is to compare the efficacy of the mechanical aspiration technique just prior to cement application in the standard vertebroplasty (VP). METHODS: Forty patients were included in the study. In group A, mechanical aspiration of the cavity was done just before the cement injection and in group B aspiration of vertebral body did not perform, VP was done with the same size cannula, same injection force, same injection speed and same cement viscosity...
January 2018: Journal of Orthopaedic Surgery
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
Yang Yu, Yuying Wei, Xiangrong Zhang, Xinyu Li
OBJECTIVE: To explore the effects of early intervention with heparin on function of coagulopathy, liver and kidney as well as the prognosis in rats with exertional heatstroke (EHS) under the ambient air of high temperature and low humidity. METHODS: 108 healthy SPF male Sprague-Dawley (SD) rats were randomly divided into normal temperature control group, EHS + normal saline (NS) group and EHS + heparin group. Of which 54 rats were collected for survival analysis (18 rats in each group), the weight change and 8-hour survival rate were observed, and Kaplan-Meier survival curves were drawn...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Hiral N Golakiya, Viren N Naik, Hiren N Hirapara, Kalpanaben H Mody, Alpesh P Goswami, Chandrabhanu Tripathi
Our aim of the present study was to evaluate the anticoagulant effect of sulfated polysaccharides (SPS) from Codium dwarkense Bergesen in ic-carrageenan induced hypercoagulable state in Wistar albino rats. 48 Wistar albino rats of either sex were randomly divided into 6 groups - disease control, active control, treatment lowmand high dose and preventive low and high dose. K-Carrageenan (3 mg/kg) single dose intravenously was given in rat tail vein at pre-decided time to produce hypercoagulable state. Baseline, 24, 48 and 72 hours duration blood samples were collected for PT, INR, aPTT, platelet count and fibrinogen level, FDP and D-Dimer measurements...
May 2017: Acta Poloniae Pharmaceutica
Gianni Belcaro, Umberto Cornelli, Mark Dugall, Morio Hosoi, Roberto Cotellese, Beatrice Feragalli
BACKGROUND: This registry study evaluated the effects of Pycnogenol® on edema and thrombotic complications in long-haul flights; jet lag was also evaluated. METHODS: Four hundred and fifty subjects at different risk levels for thrombosis, flying in economy class twice a week for more than 8 hours, were included; 295 completed the registry study and were subdivided in 3 groups according to their risk level - low, moderate, or high. The high-risk group also received Aspirin®...
April 2018: Minerva Cardioangiologica
Lianlian Pan, Yali Ye, Mingyi Wo, Danni Bao, Fengjiao Zhu, Maoliang Cheng, Xiuwen Ni, Xianming Fei
It would be important to predict type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). This study was aimed at evaluating the predicting significance of hemostatic parameters for T2DM and DN. Plasma coagulation and hematologic parameters before treatment were measured in 297 T2DM patients. The risk factors and their predicting power were evaluated. T2DM patients without complications exhibited significantly different activated partial thromboplastin time (aPTT), platelet (PLT), and D-dimer (D-D) levels compared with controls ( P < 0...
2018: Disease Markers
Maria Farm, Anwar J Siddiqui, Liselotte Onelöv, Ingela Järnberg, Jaak Eintrei, Filip Maskovic, Anders Kallner, Margareta Holmström, Jovan P Antovic
BACKGROUND: The study compares different D-dimer assays and age-adjusted cutoffs in outpatients with suspected venous thromboembolism (VTE). The plasma concentration of this sensitive biomarker is increased by activated coagulation, but also by several conditions that are linked to an increased risk of VTE. One such condition is old age, which poses a common clinical problem where many prefer not to analyze D-dimer in elderly patients. Age-adjusted cutoffs have been validated for both deep venous thrombosis (DVT) and pulmonary embolism, aiming to increase specificity without notably decreasing sensitivity...
March 5, 2018: Journal of Thrombosis and Haemostasis: JTH
Hyun Choi, Dinesh Krishnamoorthy
BACKGROUND: Pulmonary embolism (PE) during pregnancy remains one of the leading causes of maternal morbidity and mortality in the developed world. However, there is a paucity of high-quality evidence resulting in a lack of consensus in managing this group of patients. The aims of the study were to address the diagnostic utility of D-dimer for suspected PE in pregnant and post-partum patients and to identify any clinical presentation variables that are predictors of PE in this group of patients...
March 5, 2018: International Journal of Emergency Medicine
Kazuhiro Shimizu, Takuo Iiduka, Shuji Sato, Hajime Kiyokawa, Takahiro Nakagami, Hiroshi Mikamo, Masayo Kawazoe, Mao Takahashi, Mahito Noro
Background: For the management of venous thromboembolism (VTE), providing anticoagulant therapy within the therapeutic range has been a major challenge, as conventional therapy with unfractionated heparin (UFH) and vitamin K antagonist (VKA) requires frequent laboratory monitoring and dose adjustment. Recently, fondaparinux and edoxaban are being used as beneficial alternatives to UFH and VKA. Methods: We evaluated the clinical course of symptomatic deep vein thrombosis (DVT) in patients who received the 3-month anticoagulation therapy with fondaparinux/edoxaban (Group A; n=40) in comparison with the findings from our previous experience of patients who received the fondaparinux/VKA combination (Group B; n=33)...
2018: Therapeutics and Clinical Risk Management
Sho Takeshita, Toshiyasu Ogata, Hidekazu Mera, Jun Tsugawa, Mikiko Aoki, Morishige Takeshita, Yoshio Tsuboi
A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases...
March 1, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Nancy Glober, Christopher R Tainter, Jesse Brennan, Mark Darocki, Morgan Klingfus, Michelle Choi, Brenna Derksen, Frances Rudolf, Gabriel Wardi, Edward Castillo, Theodore Chan
BACKGROUND: Assessment for pulmonary embolism (PE) in the emergency department (ED) remains complex, involving clinical decision tools, blood tests, and imaging. OBJECTIVE: Our objective was to examine the test characteristics of the high-sensitivity d-dimer for the diagnosis of PE at our institution and evaluate use of the d-dimer and factors associated with a falsely elevated d-dimer. METHODS: We retrospectively collected data on adult patients evaluated with a d-dimer and computed tomography (CT) pulmonary angiogram or ventilation perfusion scan at two EDs between June 4, 2012 and March 30, 2016...
March 1, 2018: Journal of Emergency Medicine
Albeir Y Mousa, Mike Broce, David De Wit, Mina Baskarioun, Shadi AbuHalema, Michael Yacoub, Mark C Bates
BACKGROUND: The D-Dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude Deep Venous Thrombosis (DVT). The objective for this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VDU remains over utilized in low-risk patients with negative DD and that higher DD levels may correlate with thrombus burden and location. METHODS: Patients who presented to a high volume tertiary care center with lower limb swelling with or without associated pain were retrospectively examined through June and July for four consecutive years (2012 to 2015)...
March 1, 2018: Annals of Vascular Surgery
Satoshi Kawatsu, Konosuke Sasaki, Ko Sakatsume, Shingo Takahara, Katsuhiro Hosoyama, Naoki Masaki, Yusuke Suzuki, Yukihiro Hayatsu, Ichiro Yoshioka, Kei Sakuma, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Naotaka Motoyoshi, Shunsuke Kawamoto, Yoshikatsu Saiki
BACKGROUND: Heparin resistance is often encountered during cardiovascular surgery using cardiopulmonary bypass. Clinical risk factors and the mechanism underlying heparin resistance are yet to be determined. The aim of this study was to elucidate the clinically valid preoperative predictors related to heparin resistance. METHODS: A total of 489 patients undergoing cardiovascular surgery were evaluated. Of these, 25 patients presented with heparin resistance (HR) and received antithrombin III administration for the initiation of cardiopulmonary bypass with an effective activated coagulation time...
March 1, 2018: Annals of Thoracic Surgery
Xin-Liang Gao, Si-Si Wang, Dian-Bo Cao, Wei Liu
Introduction Elevated plasma D-dimer levels have been suggested as a predictor of poor prognosis in NSCLC. But rare study showed the relationship between d-dimer levels and lymph node involvement. Objectives To evaluate the role of plasma D-dimer levels in predicting lymph node and mediastinal lymph node involvement in NSCLC. Methods Preoperative plasma D-dimer levels were quantified in 253 NSCLC patients that underwent radical lung resection with systemic lymph node dissection. Patients were classified as lymph node negative (N0) vs...
March 2, 2018: Clinical Respiratory Journal
Jonas Munch Nielsen, Jann Mortensen
The diagnosis of pulmonary embolism (PE) relies on clinical assessment, D-dimer test and diagnostic imaging. Modern CT pulmonary angiography (CTPA), ventilation/perfusion  single-photon emission computed tomography (SPECT) and SPECT/CT are rather equal in terms of sensitivity, specificity and inconclusive results for the diagnosis of PE, outper-forming planar lung scintigraphy. Furthermore, SPECT/CT and CTPA can both provide important information regarding differential diagnoses. Thus, the choice of primary diag-nostic modality relies on local expertise, availability and special circumstances like radiation dose, contraindications and the clinical urgency...
February 19, 2018: Ugeskrift for Laeger
Clive Kearon, Sameer Parpia, Fredrick A Spencer, Trevor Baglin, Scott M Stevens, Kenneth A Bauer, Steven R Lentz, Craig M Kessler, James D Douketis, Stephan Moll, Scott Kaatz, Sam Schulman, Jean M Connors, Jeffrey S Ginsberg, Luciana Spadafora, Vinai Bhagirath, Patricia C Liaw, Jeffrey I Weitz, Jim A Julian
It is uncertain whether antiphospholipid antibodies (APA) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti-β2 glycoprotein I antibodies and lupus anticoagulant on two occasions about six months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APA were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results...
February 28, 2018: Blood
Wenhan Li, Yao Tang, Yongchun Song, Szu Hao Chen, Navard Sisliyan, Ming Ni, Hao Zhang, Qingnuo Zeng, Bin Hou, Xin Xie, Dongmin Chang
BACKGROUND/AIMS: Elevated pretreatment plasma D-dimer level has been reported as an unfavorable prognostic indicator in several malignancies. The aim of this meta-analysis was to evaluate the prognostic value of elevated D-dimer level in solid tumors. METHODS: A comprehensive search of electronic databases up to June 10, 2017 was carried out by two independent reviewers. We included studies exploring the association between pretreatment plasma D-dimer level and patients' survival outcomes in solid tumors...
February 22, 2018: Cellular Physiology and Biochemistry
I Ródenas Quiñonero, J M Plasencia Martínez, J M García Santos
When the probability of pulmonary embolism is low, the decision to do a computed tomography angiography (CTA) of the pulmonary vessels is based on the D-dimer concentration. However, excessive dependence on this parameter can result in unnecessary imaging studies, inappropriate treatment, or an inappropriate increase in the estimated probability of venous thromboembolism developing. The main objective of this study was to determine when CTA of pulmonary vessels could be avoided in patients with low clinical probability of pulmonary embolism through an efficient literature search of studies published about this question...
February 24, 2018: Radiología
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