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Gurhan Erturan, Borna Guevel, Abtin Alvand, Nicholas J Goddard
Patients with haemophilia who have developed inhibitors against factor VIII (FVIII) or factor IX present a significant concern to those surgeons who operate on them. The evidence base for bypassing agents such as recombinant factor VIIa and activated prothrombin complex concentrate has amassed over several decades. The literature is open to positive interpretation on the successful use of these agents in the treatment of inhibitor-positive patients. However, there are equally persistent concerns amongst surgeons, in particular orthopaedic surgeons, regarding the high complication rate of bleeding...
December 3, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Serena Staglianò, Felice D'Arco, Ai Peng Tan, Owase Jeelani, Giovanni Morana, Kshitij Mankad
No abstract text is available yet for this article.
October 2018: Quantitative Imaging in Medicine and Surgery
Afisu A Oladega, Olutayo James, Wasiu L Adeyemo
AIM: The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture. METHODS: Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated...
November 12, 2018: Journal of Cranio-maxillo-facial Surgery
Rüdiger E Scharf
Platelet signal transduction is the focus of this review. While 'classic' platelet signaling through G protein-coupled receptors in response to fluid-phase agonists has been extensively studied, signaling mechanisms linking platelet adhesion receptors such as GPIb-IX-V, GPVI and α2β1 to the activation of αIIbβ3 are less well established. Moreover, 'non-haemostatic' pathways can also activate platelets in various settings, including platelet-immune or platelet-tumour cell interactions, platelet responses to neutrophil extracellular traps, or stimulation by microbial pathogens...
November 2018: Hämostaseologie
Lacey Johnson, Mathew Cameron, Lauren Waters, Matthew P Padula, Denese C Marks
BACKGROUND AND OBJECTIVES: Refrigeration (cold-storage) of pathogen inactivated (PI) platelet components may increase the shelf-life and safety profile of platelet components, compared to conventional room-temperature (RT) storage. Whilst there is substantial knowledge regarding the impact of these individual treatments on platelets, the combined effect has not been assessed. MATERIALS AND METHODS: Using a pool-and-split study design, paired buffy-coat derived platelets in 70% platelet additive solution (SSP+; MacoPharma) were left untreated or PI-treated using the THERAFLEX UV-Platelets System (UVC; MacoPharma)...
November 30, 2018: Vox Sanguinis
Nurfatin Mohd Shah, Soon Eu Chong, Syahirah Mohamed Yusoff, Mohd Zulfakar Mazlan, Khairul Bariah Johan, Nizuwan Azman, Jo Anne Lim, Siti Mardhiana Mohamad, Siti Salmah Noordin, Zainab Abdul Ghaffar, Mohd Hasyizan Hassan, Muhammad Azrul Zabidi, Nur Arzuar Abdul Rahim
Background: Massive bleeding is one of the commonest salvageable causes of death. The search for an ideal haemostatic agent during massive bleeding is still ongoing. One of the novel haemostatic medications is recombinant activated factor VII (rFVIIa). To date, the usage of rFVIIa during massive haemorrhage among non-haemophiliac patients remains off-label. The aim of this study is to report our experience in using rFVIIa to treat refractory bleeding. Methods: Medical records of all patients treated with rFVIIa for massive bleeding over an eleven-year period in a single institution were recorded...
2018: BMC Hematology
H Fogarty, M Byrne, N M O’Connell, K Ryan, B White, J S O’Donnell, M Lavin
Factor XIII (FXIII) is a plasma clotting protein involved in clot stabilization. Severe FXIII deficiency may present with severe, even fatal bleeding. Critically however, routine coagulation assays may be normal and only specific FXIII assays will detect the abnormality. Herein we discuss a case report of a patient with acquired FXIII deficiency in order to highlight the clinical challenges associated with establishing the diagnosis and discuss the treatment approach. A 70-year-old man presented with a gluteal haematoma despite no preceding personal history of bleeding...
May 10, 2018: Irish Medical Journal
Matthew K H Tan, Sarah Onida, Michael Laffan, Alun H Davies
Chronic venous disease (CVD) represents a significant healthcare burden. Thrombophilia is proposed as a risk factor, particularly for post-thrombotic CVD. A systematic review was performed to determine the relationship between thrombophilia and non-thrombotic CVD. MEDLINE® and Embase® databases were searched from 1946 up to March 2018. Case-control studies, cohort studies or randomised clinical trials reporting on thrombophilias in non-thrombotic lower limb CVD in adult patients were included. Non-English and post-thrombotic syndrome studies were excluded...
December 2018: British Journal of Haematology
G A Morrison, J Koch, M Royds, D McGee, R T A Chalmers, J Anderson, A F Nimmo
Major vascular surgery is frequently associated with significant blood loss and coagulopathy. Existing evidence suggests hypofibrinogenaemia develops earlier than other haemostatic deficiencies during major blood loss. The purpose of this study was to assess whether the use of an infusion of fibrinogen concentrate to prevent and treat hypofibrinogenaemia during surgery resulted in satisfactory haemostasis, removing or reducing the need for blood component transfusion. Twenty patients undergoing elective extent-4 thoraco-abdominal aortic aneurysm repair were randomly allocated to receive either fresh frozen plasma or fibrinogen concentrate to treat hypofibrinogenaemia during surgery...
November 23, 2018: Anaesthesia
Sandra Le Quellec, Nathalie Enjolras, Eloïse Perot, Jonathan Girard, Claude Negrier, Yesim Dargaud
Prophylaxis is currently considered the optimal care for severe haemophilia. For patients and their families one of the major difficulties with prophylaxis is the need for frequent venipunctures. The half-life of standard factor IX (FIX) concentrates is approximately 18 hours, which requires 2 or 3 intravenous infusions per week to achieve bleeding prevention in patients with severe haemophilia B. Prolonging the half-life of FIX can therefore reduce the frequency of infusions. Recently, extended half-life recombinant FIX (rFIX) concentrates have been developed...
November 19, 2018: Thrombosis and Haemostasis
Kerstin Jurk, Ulrich Walter
As circulating sentinels of vascular integrity, platelets act as crucial haemostatic cells as well as important inflammatory and immune cells, whereas under pathological conditions platelets drive thrombotic as well as non-thrombotic diseases related to chronic inflammation. In addition, platelets serve as an important cellular model to study the biology and pharmacology of signal transduction pathways. Platelet inhibition and activation responses are mediated by multiple signalling networks, which are tightly regulated by balanced catalysis of protein phosphorylation and dephosphorylation through protein kinases and protein phosphatases, respectively...
November 19, 2018: Hämostaseologie
T Fontana, V Silvestri, N Falco, P Venturelli, L Licari, P De Marco, E Gulotta, L Gulotta, G Cocorullo
BACKGROUND: The success of every surgical procedure depends on an appropriate hemostatis. Topical haemostatic agents, like fibrin sealants, are an option for providing haemostasis and may be particularly useful for complex injuries. AIM: The aim of the study is to evaluate the use of TachoSil® in abdominal surgery and its benefits to prevent bleedings, and to establish its fields of use. METHODS: A retrospective observational study was performed on 308 patients underwent to emergency surgery with TachoSil®'s application into our department between January 2012 and March 2018...
September 2018: Il Giornale di Chirurgia
Lene Russell, Nicolai Haase, Anders Perner
: ICU patients with haematological malignancy have an increased risk of bleeding. Recently, global haemostatic methods such as thromboelastography (TEG) have gained impact in evaluating coagulation. The aim of this study was to observe whether TEG could predict bleeding in haematological ICU patients with severe sepsis. Post-hoc single-centre analysis of patients with haematological malignancy included in the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial. Clinical characteristics, TEG measurements and details regarding bleeding complications were retrieved from the 6S database...
December 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Ziwei Sun, Fang Lu, Jinjun Cheng, Meiling Zhang, Yue Zhang, Wei Xiong, Yan Zhao, Huihua Qu
Schizonepetae Spica Carbonisata (SSC) has pronounced haemostatic effects for hundreds of years and has been acknowledged in the 2015 Pharmacopoeia of the People's Republic of China (PPRC) as a haemostatic charcoal drug. However, after years of efforts, the underlying mechanism and the material basis is still less defined. In this research, we developed a novel CDs derived from SSC (SSC-CDs) with an average diameter of 1.29-6.87 nm and a quantum yield of 6.31%. SSC was prepared using a modified pyrolysis method and no further modification and external surface passivation agent is required...
November 15, 2018: Artificial Cells, Nanomedicine, and Biotechnology
Giuseppe Baldino, Federica Persi, Paolo Mortola, Amerigo Gori
Introduction: Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) using the Perclose ProGlide suture mediated closure device is currently performed on a global scale. A safe, effective, and cheap technique for achieving haemostasis during PEVAR is described that allows the reversible downsizing of the arteriotomy, without using any other devices. Technique: The procedure consists of pulling the blue thread of the pre-implanted ProGlide, advancing the knot close to the arterial wall by pushing it with the dilator of a small introducer sheath, and maintaining the system under tension by grasping the end of the blue thread with a haemostat until bleeding control is achieved...
2018: EJVES Short Reports
Katharina Seif, Lejla Alidzanovic, Barbara Tischler, Nahla Ibrahim, Branislav Zagrapan, Sabine Rauscher, Manuel Salzmann, Lena Hell, Lisa-Marie Mauracher, Ulrich Budde, Johannes A Schmid, Bernd Jilma, Ingrid Pabinger, Alice Assinger, Patrick Starlinger, Christine Brostjan
Thrombospondin-1 (TSP-1) is primarily expressed by platelets and endothelial cells (ECs) and rapidly released upon their activation. It functions in haemostasis as a bridging molecule in platelet aggregation, by promoting platelet adhesion to collagen and by protecting von Willebrand factor strings from degradation. In blood of patients undergoing surgery and in co-cultures of neutrophils with platelets or ECs, we observed proteolysis of the 185 kDa full-length TSP-1 to a 160-kDa isoform. We hypothesized that TSP-1 processing may alter its haemostatic properties...
November 12, 2018: Thrombosis and Haemostasis
Jelena Dzudovic, Boris Dzudovic, Vesna Subota, Marko Antunovic, Milena Stavric, Bojana Subotic, Slobodan Obradovic
WHAT IS KNOWN AND OBJECTIVE: Direct oral anticoagulants (DOACs) are frequently used for the treatment of pulmonary embolism (PE), but both clinical and laboratory data comparing their efficacy and safety are conflicting. This study investigated and compared the impact of three DOACs (apixaban, rivaroxaban and dabigatran) on coagulation cascade in acute PE patients. METHODS: After the initial treatment, acute PE patients were randomly allocated to one of three groups, and treatment continued using one of the three DOACs...
November 8, 2018: Journal of Clinical Pharmacy and Therapeutics
Eleonora Petito, Richard T Amison, Elisa Piselli, Sajeel A Shah, Stefania Momi, Simon C Pitchford, Paolo Gresele, Clive P Page
INTRODUCTION: Platelets participate in inflammatory disorders through a variety of different functional responses, including chemotaxis, platelet-leukocyte complex formation and facilitation of leukocyte recruitment that are thought to be distinct from platelet aggregation. This may account for why classical anti-platelet drugs have failed to ameliorate inflammatory disorders where platelets are known to participate, suggesting that distinct pathways may control inflammatory and haemostatic functions of platelets...
October 25, 2018: Thrombosis Research
Steven R Lentz, Dragana Janic, Kaan Kavakli, Predrag Miljic, Johannes Oldenburg, Margareth C Ozelo, Elena Santagostino, Takashi Suzuki, Silva Zupancic Šalek, Lars Korsholm, Irina Matytsina, Andreas Tiede
INTRODUCTION: Turoctocog alfa is a recombinant factor VIII (FVIII) molecule, approved for treatment and prophylaxis of bleeding in patients with haemophilia A. In the guardian 1 (adolescents/adults) and guardian 3 (children) phase 3 trials, turoctocog alfa demonstrated a favourable efficacy and safety profile. Guardian 1 or 3 completers could enrol in the guardian 2 extension. Final guardian 2 results are reported here. AIM: Investigate long-term safety and efficacy of turoctocog alfa administered for prophylaxis and treatment of bleeds...
November 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Navideh Mirzakhani, Amir Abbas Farshid, Esmaeal Tamaddonfard, Mehdi Imani, Amir Erfanparast, Farahnaz Noroozinia
AIMS: Peripheral nerve injury represents a substantial clinical problem with insufficient or unsatisfactory treatment options. Current researches have extensively focused on the new approaches for the treatment of peripheral nerve injuries. Carnosine is a naturally occurring pleotropic dipeptide and has many biological functions such as antioxidant property. In the present study, we examined the regenerative ability of carnosine after sciatic nerve crush injury using behavioral, biochemical, histological and ultrastructural evaluations...
October 31, 2018: Life Sciences
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