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https://www.readbyqxmd.com/read/29350493/bleeding-and-thrombotic-complications-of-pediatric-liver-transplant
#1
Alexandra J Borst, Debra L Sudan, Laura A Wang, Michael J Neuss, Jennifer A Rothman, Thomas L Ortel
BACKGROUND: Pediatric patients undergoing liver transplant are at significant risk for bleeding and thrombotic complications due to the complex nature of rebalanced hemostasis in patients with liver disease. METHODS/OBJECTIVES: We reviewed records of 92 pediatric liver and multivisceral transplant cases at Duke University Medical Center between January 2009 and December 2015. The goal was to define the nature and incidence of bleeding and thrombotic complications in this cohort and define potential risk factors...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#2
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29318027/diagnostic-performances-of-two-rapid-tests-for-detection-of-feline-leukemia-virus-antigen-in-sera-of-experimentally-feline-leukemia-virus-infected-cats
#3
Matthew R Krecic, Sridhar Velineni, Patrick Meeus, Huihao Fan, Michael Loenser
Objectives: The objective of this study was to compare the diagnostic sensitivities and specificities of WITNESS FeLV-FIV (Zoetis) and SNAP FIV/FeLV Combo Test (IDEXX) for the detection of FeLV p27 antigen in the sera of experimentally feline leukemia virus (FeLV)-infected cats. Methods: Diagnostic sensitivities of WITNESS and SNAP were determined through testing of 47 serum samples collected from cats day 56 post-experimental infection with a virulent FeLV Rickard strain...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29302904/acute-kidney-injury-in-pregnancy-with-special-reference-to-pregnancy-specific-disorders-a-hospital-based-study-2014-2016
#4
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29296762/whole-exome-sequencing-in-evaluation-of-patients-with-venous-thromboembolism
#5
Eun-Ju Lee, Daniel J Dykas, Andrew D Leavitt, Rodney M Camire, Eduard Ebberink, Pablo García de Frutos, Kavitha Gnanasambandan, Sean X Gu, James A Huntington, Steven R Lentz, Koen Mertens, Christopher R Parish, Alireza R Rezaie, Peter P Sayeski, Caroline Cromwell, Noffar Bar, Stephanie Halene, Natalia Neparidze, Terri L Parker, Adrienne J Burns, Anne Dumont, Xiaopan Yao, Cassius Iyad Ochoa Chaar, Jean M Connors, Allen E Bale, Alfred Ian Lee
Genetics play a significant role in venous thromboembolism (VTE), yet current clinical laboratory-based testing identifies a known heritable thrombophilia (factor V Leiden, prothrombin gene mutation G20210A, or a deficiency of protein C, protein S, or antithrombin) in only a minority of VTE patients. We hypothesized that a substantial number of VTE patients could have lesser-known thrombophilia mutations. To test this hypothesis, we performed whole-exome sequencing (WES) in 64 patients with VTE, focusing our analysis on a novel 55-gene extended thrombophilia panel that we compiled...
July 11, 2017: Blood Advances
https://www.readbyqxmd.com/read/29289392/abnormalities-of-laboratory-coagulation-tests-versus-clinically-evident-coagulopathic-bleeding-results-from-the-prehospital-resuscitation-on-helicopters-study-prohs
#6
Ronald Chang, Erin E Fox, Thomas J Greene, Michael D Swartz, Stacia M DeSantis, Deborah M Stein, Eileen M Bulger, Sherry M Melton, Michael D Goodman, Martin A Schreiber, Martin D Zielinski, Terence O'Keeffe, Kenji Inaba, Jeffrey S Tomasek, Jeanette M Podbielski, Savitri Appana, Misung Yi, Pär I Johansson, Hanne H Henriksen, Jakob Stensballe, Jacob Steinmetz, Charles E Wade, John B Holcomb
BACKGROUND: Laboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described. METHODS: Prospective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29286568/utilization-of-frozen-plasma-cryoprecipitate-and-recombinant-factor-viia-for-children-with-hemostatic-impairments-an-audit-of-transfusion-appropriateness
#7
Lani Lieberman, Yulia Lin, Christine Cserti-Gazdewich, Qi Long Yi, Jacob Pendergrast, Wendy Lau, Jeannie Callum
BACKGROUND: Blood transfusions and fractionated products are not without risk and may lead to acute and long-term adverse events. The objective of this study was to evaluate the appropriateness of usage of frozen plasma (FP), cryoprecipitate (CRYO), and recombinant factor VIIa (rVIIa) in a pediatric setting. METHODS: All orders for FP, CRYO, and rVIIa were prospectively audited over 6 weeks. Data collected included demographics, laboratory values, indication, and adverse reactions...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29277620/re-bleeding-and-mortality-after-lower-gastrointestinal-bleeding-in-patients-taking-anti-platelets-or-anti-coagulants
#8
Kathryn Oakland, Michael J Desborough, Mike F Murphy, Mike Schachter, Vipul Jairath
BACKGROUND & AIMS: Patients who develop lower gastrointestinal bleeding (LGIB) while receiving anti-coagulants or anti-platelets have increased severity of bleeding and risk of re-bleeding. We compared outcomes of patients receiving anti-platelets, anti-coagulants, or direct oral anti-coagulants (DOACs) who develop LGIB, as well as the effects of withholding these drugs on their course of bleeding. METHODS: We performed a retrospective study of 2528 consecutive adult patients with LGIB at 143 hospitals in the United Kingdom, from September through December 2015; 917 were taking anti-coagulant or anti-platelet drugs and 1218 were taking neither (unexposed)...
December 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29248372/food-waste-co-digestion-with-slaughterhouse-waste-and-sewage-sludge-digestate-conditioning-and-supernatant-quality
#9
Sebastian Borowski, Paweł Boniecki, Przemysław Kubacki, Agata Czyżowska
In this study, the anaerobic mesophilic co-digestion of food waste (FW) with municipal sewage sludge (MSS) and slaughterhouse waste (SHW) was undertaken in 3-dm3 laboratory reactors as well as in 50-dm3 reactors operated in semi-continuous conditions. The highest methane yield of around 0.63 m3 CH4/kgVSfed was achieved for the mixture of FW and SHW treated in the laboratory digester operated at solids retention time (SRT) of 30 days, whereas the co-digestion of FW with MSS under similar operating conditions produced 0...
December 13, 2017: Waste Management
https://www.readbyqxmd.com/read/29238008/association-between-platelet-count-and-postoperative-blood-loss-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-and-fresh-frozen-plasma-administration-guided-by-thromboelastometry
#10
Junko Ichikawa, Yoshiko Osada, Mitsuharu Kodaka, Keiko Nishiyama, Makiko Komori
BACKGROUND: Coagulopathy after cardiopulmonary bypass (CPB) is caused by multiple factors, including reduced coagulation factors and a low platelet count.Methods and Results:In this study, we undertook a post hoc analysis to identify factors associated with increased postoperative blood loss in 97 patients undergoing cardiac surgery with CPB, with fresh frozen plasma administered according to a ROTEM-guided algorithm. We identified 24 patients for the top quartile of postoperative blood loss, >528 mL and defined as having excessive blood loss...
December 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29226714/-analysis-of-d-dimer-laboratory-findings-and-clinical-evaluation
#11
János Jákó
D-dimer is a product of the enzymatic degradation of the fibrinogen-fibrin molecule, and its existence is demonstrable in circulation. The test based limits may be considered as normal values. It was first thought to be a product of coagulation, then a product of lysis. High-concentration D-dimer in blood detected in thromboembolic diseases is considered to be of diagnostic value. In cases where thromboembolism was ruled out despite elevated titres but heparin (LMWH) or CLOPIDOGREL was given as a cautionary measure, we found that D-dimer values remained elevated...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29226657/short-centrifugation-to-ameliorate-turn-around-time-in-routine-coagulation-testing
#12
Albrecht Pfaefflin, Karen Schuster, Ruediger Braun
BACKGROUND: Fast and timely analysis of coagulation parameters is mandatory in hospital laboratories as the results are decisive for diagnosis and treatment in emergency patients. An important factor in TAT (turn-around time) prolongation is centrifugation of all samples prior to analysis. According to literature and most current SOPs (standard operation protocols) centrifugation time is given with 10 minutes at approximately 2,000 g and cannot be reduced without infringement of standards...
November 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/29224322/-%C3%AE-1-antitrypsin-pittsburg-mutations-report-of-two-cases-in-the-same-family
#13
L J Cao, X Bai, Z Q Yu, W Zhang, J Su, Z Y Wang, C G Ruan
Objective: To analyze the clinical and laboratory abnormalities of two patients with α1-antitrypsin (α1-AT) Pittsburgh in a family and review the literatures. Methods: Both plasma clotting time and factor activities were performed using clotting or substrate methods. Platelet aggregation was evaluated using an optical aggregometer. The serum protein electrophoresis was performed on Sebia HYDRASYS by using Agarose gel. The exons of α1-AT were amplified by using polymerase chain reaction (PCR) and then sequenced and compared with NCBI GenBank records...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29212064/mthfr-a1298c-and-c677t-polymorphisms-are-associated-with-increased-risk-of-venous-thromboembolism-a-retrospective-chart-review-study
#14
Fang Liu, Danuzia Silva, Mariuxi Viteri Malone, Kala Seetharaman
BACKGROUND: Methylene tetrahydrofolate reductase (MTHFR) is a key enzyme in homocysteine metabolism. This study aims to determine the impact of MTHFR polymorphisms on plasma homocysteine levels and risks of venous thromboembolism (VTE). METHODS: This retrospective chart review study included a total of 188 subjects who were tested for MTHFR polymorphisms at Metrowest Coagulation Laboratory between April 2011 and April 2016. Two independent coders were trained to extract relevant clinical data for statistical analysis...
December 7, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/29206934/enzymatic-functional-assays-of-coagulation-using-small-sample-volumes
#15
Sirisha Emani, Lisa T Nelson, Scott Norton, Rajendra Singh, Vamsee Pamula, Sitaram Emani
Current laboratory methods for comprehensive thrombophilia status require large blood volumes and long turn-around times. We demonstrate the feasibility of performing thrombophilia panel testing of enzymatic functional assays on a microfluidic cartridge using low sample volume.Functional assays for Antithrombin III, Protein C, Factor VIII, and plasminogen were adapted on the digital microfluidic platform by developing novel fluorogenic substrates and establishing on-cartridge fluorescence (360/460 nm) detection...
December 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29204476/data-documenting-the-performance-of-the-pt-inr-line-correction-method-for-reconciling-inr-discrepancies-between-central-laboratory-coagulation-analyzers-using-different-thromboplastins-during-the-evaluation-of-a-portable-coagulometer
#16
Wendy S Baker, Kathleen J Albright, Heidi Spratt, Megan Berman, Peggy A Mann, Jaime Unabia, John R Petersen
The data presented here was produced as part of an evaluation of the performance of the CoaguChek XS point-of-care coagulation analyzer, which is discussed in the research article "POCT PT INR - Is it adequate for Patient Care? A Comparison of the Roche Coaguchek XS vs. Stago Star vs. Siemens BCS in Patients Routinely Seen in an Anticoagulation Clinic" (Baker et al., in press) [1]. An effort to reconcile discrepancies in the patient INR result distributions from different central lab instruments (Stago Star and Siemens BCS) with the PT/INR line method is described (Poller et al...
February 2018: Data in Brief
https://www.readbyqxmd.com/read/29196200/incidental-thrombotic-thrombocytopenic-purpura-during-acute-ischemic-stroke-and-thrombolytic-treatment
#17
İbrahim Acır, Hacı Ali Erdoğan, Vildan Yayla, Nilay Taşdemir, Murat Çabalar
BACKGROUND: Intravenous tissue plasminogen activator (IV tPA) was shown to be an effective treatment for acute ischemic stroke (AIS). According to stroke guidelines, there is no need to wait for the complete blood count (CBC) and coagulation test results before application of IV alteplase if there is no suspected coagulation disorder. In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented. CASE: A 33-year-old male patient was admitted at the 2...
November 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29193737/laboratory-testing-in-patients-treated-with-direct-oral-anticoagulants-a-practical-guide-for-clinicians
#18
REVIEW
Jonathan Douxfils, Walter Ageno, Charles-Marc Samama, Sarah Lessire, Hugo Ten Cate, Peter Verhamme, Jean-Michel Dogné, François Mullier
One of the key benefits of the direct oral anticoagulants (DOACs) is that they do not require routine laboratory monitoring. Nevertheless, assessment of DOAC exposure and anticoagulant effects may become useful in various clinical scenarios. The four approved DOACs - apixaban, dabigatran etexilate, edoxaban and rivaroxaban - have different characteristics impacting assay selection and the interpretation of results. This article provides an updated overview on 1) which test to use (and their advantages and limitations), 2) when to assay DOAC levels, 3) how to interpret the results relating to bleeding risk, emergency situations and perioperative management, and 4) what is the impact of DOACs on routine and specialised coagulation assays...
November 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29188749/bleeding-during-veno-venous-ecmo-cannot-reliably-be-predicted-by-rotational-thrombelastometry-rotem%C3%A2
#19
Christina Hellmann, Axel Schmutz, Johannes Kalbhenn
INTRODUCTION: Veno-venous extracorporeal membrane oxygenation (vvECMO) used for respiratory support is associated with clinical bleeding in at least one third of patients. Mechanisms promoting bleeding, like acquired von Willebrand syndrome, cannot be identified by routine coagulation tests. This study was performed to evaluate rotational Thrombelastography (ROTEM™) for specific results predicting bleeding events during vvECMO. METHODS: Five hundred and thirty-four ROTEM™ analyses of 57 patients over 574 days have been evaluated...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29185625/unusual-warfarin-dose-to-achieve-therapeutic-inr-in-a-4-month-old-child-non-genetics-risk-factors-are-still-a-challenge
#20
Lucas Miyake Okumura, Giovanna Webster Negretto, Clarissa Gutiérrez Carvalho
OBJECTIVE: To report a case of a 4-month old girl that required 0.7 mg/kg/day (5 mg) of warfarin and discuss relevant risk factors for requiring higher doses. CASE DESCRIPTION: In November 2015, a 5 kg female infant (36-week preterm) was admitted to the hospital due to status epilepticus and fever. Diazepam, phenytoin and ceftriaxone were prescribed. Cerebrospinal fluid contained 7 leukocytes, 150 mg/dL proteins, 1 mg/dL glucose and gram positive cocci were observed...
October 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
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