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Hemorrhage and thrombosis

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https://www.readbyqxmd.com/read/28731874/novel-targets-for-anticoagulants-lacking-bleeding-risk
#1
Julia K Bickmann, Trevor Baglin, Joost C M Meijers, Thomas Renné
PURPOSE OF REVIEW: Arterial and venous thromboembolic diseases are associated with significant morbidity and mortality and present a major medical burden. Currently used anticoagulants for the prevention or treatment of thromboembolic events including heparins, vitamin K-antagonists and inhibitors of thrombin or factor Xa target enzymes of the coagulation cascade that are critical for fibrin formation. However, fibrin is also necessary for hemostatic mechanisms to terminate blood loss at injury sites...
July 20, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28720743/-usefulness-of-edoxaban-for-deep-cerebral-venous-sinus-thrombosis-with-hemorrhagic-infarction-a-case-report
#2
Takeo Amemiya, Toshio Uesaka, Katsuharu Kameda, Junji Uno, Shintaro Nagaoka, Yoshiaki Ikai, Hidefuku Gi
We describe a case of deep cerebral venous sinus thrombosis(DCVST)that was successfully treated by oral administration of the Xa inhibitor edoxaban. A 53-year-old man was admitted to our hospital because of a headache and undifferentiated dizziness. Computed tomography(CT)demonstrated a low-density area in the bilateral thalamus and high-density lesions in the internal cerebral veins(ICVs)and vein of Galen. Magnetic resonance imaging with diffusion-weighted images detected areas of hyperintensity in the bilateral thalamus...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28717586/evaluating-platelet-aggregation-dynamics-from-laser-speckle-fluctuations
#3
Zeinab Hajjarian, Diane M Tshikudi, Seemantini K Nadkarni
Platelets are key to maintaining hemostasis and impaired platelet aggregation could lead to hemorrhage or thrombosis. We report a new approach that exploits laser speckle intensity fluctuations, emanated from a drop of platelet-rich-plasma (PRP), to profile aggregation. Speckle fluctuation rate is quantified by the speckle intensity autocorrelation, g2(t), from which the aggregate size is deduced. We first apply this approach to evaluate polystyrene bead aggregation, triggered by salt. Next, we assess dose-dependent platelet aggregation and inhibition in human PRP spiked with adenosine diphosphate and clopidogrel...
July 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#4
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28711538/cerebral-venous-sinus-thrombosis-secondary-to-idiopathic-hypertrophic-cranial-pachymeningitis-a-case-report-and-review-of-the-literature
#5
Kaiyuan Huang, Qingsheng Xu, Yuankun Ma, Renya Zhan, Jian Shen, Jianwei Pan
BACKGOUND AND IMPORTANCE: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare fibrosing inflammatory process involving the dura mater. Currently, there is no consensus on the treatments for IHCP, and the usefulness of immunosuppressive agents as a first-line option remains controversial. Cerebral venous sinus occlusion (CVSO) and cerebral venous sinus thrombosis (CVST) secondary to IHCP, which may cause progressive intracranial hypertension and venous obstructive parenchymal lesions, make the diagnosis and treatment of IHCP more complicated...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706620/adams-oliver-syndrome-with-unusual-central-nervous-system-findings-and-an-extrahepatic-portosystemic-shunt
#6
Carlos Pérez-García, Yolanda Ruíz Martín, Alejandra Aguado Del Hoyo, Carlos Marín Rodríguez, Minia Campos Domínguez
We report a case of a premature neonate girl with scalp and skull defects and brachydactyly of the feet consistent with an Adams-Oliver syndrome (AOS). The patient had central nervous system abnormalities, such as periventricular calcifications, hypoplastic corpus callosum, and bilateral hemispheric corticosubcortical hemorrhagic lesions. A muscular ventricular septal defect and a portosystemic shunt were diagnosed. To our knowledge, this is the first report of congenital supratentorial grey-white matter junction lesions without dural sinus thrombosis in association with AOS...
June 26, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28705401/-are-general-practitioners-in-paris-and-surrounding-areas-reticent-about-direct-oral-anticoagulants
#7
C Caucanas, D Sfeir, C Blas-Châtelain, P Priollet
OBJECTIVE: Determine how familiar general practitioners (GPs) working in Paris and surrounding areas are with prescriptions for direct oral anticoagulants (DOACs). MATERIAL AND METHOD: A questionnaire sent to 189 GP working in Paris and surrounding areas yielded 100 responses. Data collected included a brief summary of sociodemographic items, comparative knowledge about DOACs and vitamin K antagonists (VKAs), and responses to two clinical situations for DOAC prescriptions (renewal of a first prescription)...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28704875/sonographic-and-doppler-sonographic-diagnosis-of%C3%A2-neonatal-ischemic-stroke
#8
Karl-Heinz Deeg
Children are particularly at risk for stroke in the neonatal period. 1/3 of all strokes in children occur during the perinatal period. The incidence of perinatal stroke is 1:4000. A differentiation is made between ischemic stroke and hemorrhagic stroke. Ischemic strokes are caused by arterial occlusion due to thrombosis or embolism. As a result of the nonspecific clinical symptoms in this age group, diagnosis is usually made too late. The only relatively specific symptom is focal cerebral seizure during the first week of life...
July 13, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28704111/incomplete-dabigatran-reversal-with-idarucizumab
#9
Aaron P Steele, Jin A Lee, William E Dager
CONTEXT: With increasing use of direct oral anticoagulants (DOACs), urgent reversal of these agents becomes a growing concern. Idarucizumab is a humanized monoclonal antibody fragment that specifically binds to dabigatran with higher affinity than thrombin, rapidly neutralizing its anticoagulant effect without increased risk of thrombosis. CASE DETAILS: We describe two cases in which the recommended dose of idarucizumab was unsuccessful in completely reversing the anticoagulant effects of dabigatran...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28697027/impact-of-venous-thromboembolism-chemoprophylaxis-on-postoperative-hemorrhage-following-operative-stabilization-of-spine-fractures
#10
John P Sharpe, Wade C Gobbell, Maranda Pahlkotter, Michael S Muhlbauer, Francis X Camillo, Timothy C Fabian, Martin A Croce, Louis J Magnotti
BACKGROUND: Prophylactic anticoagulation may decrease the risk of venous thromboembolism (VTE) in patients with spine fractures following blunt trauma, but comes with the threat of postoperative bleeding in patients requiring stabilization of these fractures. The purpose of this study was to evaluate the impact of preoperative anticoagulation on VTE and bleeding complications in patients with blunt spine fractures requiring operative stabilization. METHODS: All patients with blunt spine fractures requiring operative stabilization over a 6-year period were identified...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#11
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28694001/safety-and-effectiveness-of-argatroban-versus-heparin-for-preventing-venous-thromboembolism-after-lumbar-decompressive-surgery
#12
Ying Guo, Zhongwen Zou, Lianshun Jia, Zhi Huang, Xiong Yun, Guo Xing
BACKGROUND: To evaluate the safety and effectiveness of argatroban for the prevention of venous thromboembolism (VTE) after posterior lumbar decompressive surgery. METHODS: Included in this retrospective study were 556 patients who underwent posterior lumbar decompressive surgery for trauma and degenerative diseases. They were divided into two groups: argatroban group (n = 274), and low molecular weight heparin (LMWH) group (n = 282). The occurrence of postoperative venous thrombosis and complications including hemorrhage and allergic reaction was compared between the two groups...
July 8, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28693359/coagulation-monitoring-correlation-with-heparin-dose-in-pediatric-extracorporeal-life-support
#13
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
https://www.readbyqxmd.com/read/28678644/the-pathology-of-eclampsia-an-autopsy-series
#14
Jonathan L Hecht, Jaume Ordi, Carla Carrilho, Mamudo R Ismail, Zsuzsanna K Zsengeller, S Ananth Karumanchi, Seymour Rosen
OBJECTIVE: We describe the main lesions in the liver, brain, and kidney from autopsies of women who died of eclampsia and characterize the endothelial injury. METHODS: Cases were identified from a study involving 317 maternal deaths (2003-2006) conducted at the Maputo Central Hospital (Maputo, Mozambique) in association with ISGlobal (Barcelona, Spain). Histology slides along with stains for endothelial, histiocyte, and platelet markers (CD31, CD34, CD68, CD42B) were reviewed to identify the relevant lesions...
July 5, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28672052/direct-acting-oral-anticoagulants-for-the-treatment-of-suspected-heparin-induced-thrombocytopenia
#15
Kyle A Davis, Daphne O Davis
OBJECTIVE: To evaluate the efficacy and safety of direct oral anticoagulant (DOAC) therapy in hospitalized patients with suspected heparin induced thrombocytopenia (HIT). METHODS: Retrospective cohort study of adult patients prescribed apixaban, dabigatran, or rivaroxaban for the treatment of acute HIT from January 1 2013 to January 1 2017. Eligibility requirements included an intermediate or high pretest probability for HIT (4T score ≥ 4) and a positive IgG-specific anti-PF4/ heparin complex assay...
July 3, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28668628/effectiveness-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-for-atrial-fibrillation-and-venous-thromboembolism-a-systematic-review-and-meta-analyses
#16
REVIEW
Abdulaali R Almutairi, Lili Zhou, Walid F Gellad, Jeannie K Lee, Marion K Slack, Jennifer R Martin, Wei-Hsuan Lo-Ciganic
PURPOSE: The findings from the observational studies comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) for atrial fibrillation (AF) and venous thromboembolism (VTE) are inconsistent. We conducted separate meta-analyses examining the efficacy/effectiveness and safety of NOACs versus VKAs by disease (AF vs VTE), study design (randomized controlled trials [RCTs] vs observational studies), and NOAC (dabigatran, rivaroxaban, apixaban, and edoxaban)...
June 28, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28651554/validation-of-an-international-classification-of-disease-ninth-revision-coding-algorithm-to-identify-decompressive-craniectomy-for-stroke
#17
Hormuzdiyar H Dasenbrock, David J Cote, Yuri Pompeu, Viren S Vasudeva, Timothy R Smith, William B Gormley
BACKGROUND: Although International Classification of Disease, Ninth Revision, Clinical Modification (ICD9-CM) coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial infarction. METHODS: Patients who underwent decompressive craniectomy for stroke at our institution were retrospectively identified and their associated ICD9-CM codes were extracted from billing data...
June 26, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#18
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28646118/direct-oral-anticoagulants-for-treatment-of-hit-update-of-hamilton-experience-and-literature-review
#19
Theodore E Warkentin, Menaka Pai, Lori-Ann Linkins
Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, Canada, since January 1, 2015 (when we completed our prospective rivaroxaban for HIT study) using rivaroxaban for serologically-confirmed HIT (4Ts score ≥4 points, PF4/heparin immunoassay-positive, serotonin-release assay positive). We also performed a literature review of HIT treatment using a DOAC (rivaroxaban, apixaban, dabigatran, edoxaban)...
June 23, 2017: Blood
https://www.readbyqxmd.com/read/28642178/neurological-outcome-after-decompressive-craniectomy-predictors-of-outcome-in-different-pathologies
#20
Taco Goedemans, Dagmar Verbaan, Bert A Coert, Bertjan Kerklaan, René van den Berg, Jonathan M Coutinho, Tessa van Middelaar, Paul J Nederkoorn, W Peter Vandertop, Pepijn van den Munckhof
OBJECTIVE: Decompressive craniectomy (DC) has been proposed as lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching favorable neurological outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologies. METHODS: This retrospective study included all patients undergoing DC from 2006-2014. One-year outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS 4-5) and unfavorable (GOS 1-3) outcome...
June 19, 2017: World Neurosurgery
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