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Hemorrhage and thrombosis

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https://www.readbyqxmd.com/read/28335516/marine-diterpenes-molecular-modeling-of-thrombin-inhibitors-with-potential-biotechnological-application-as-an-antithrombotic
#1
Rebeca Cristina Costa Pereira, André Luiz Lourenço, Luciana Terra, Paula Alvarez Abreu, Valéria Laneuville Teixeira, Helena Carla Castro
Thrombosis related diseases are among the main causes of death and incapacity in the world. Despite the existence of antithrombotic agents available for therapy, they still present adverse effects like hemorrhagic risks which justify the search for new options. Recently, pachydictyol A, isopachydictyol A, and dichotomanol, three diterpenes isolated from Brazilian marine brown alga Dictyota menstrualis were identified as potent antithrombotic molecules through inhibition of thrombin, a key enzyme of coagulation cascade and a platelet agonist...
March 20, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28334263/pathogenesis-of-meningococcal-purpura-fulminans
#2
H Lécuyer, D Borgel, X Nassif, M Coureuil
Purpura fulminans (PF) is a dreadful and frequent complication of Neisseria meningitidis invasive infection, and is associated with a high mortality rate. This syndrome begins with dermal microvessels thrombosis that rapidly lead to hemorrhagic skin necrosis. In this review, we discuss the prothrombotic events occurring during meningococcal infection. Moreover, recent data from an experimental mouse model have highlighted the critical role of the meningococcus adhesion to the endothelium in the development of PF lesions, thus opening new therapeutic perspectives...
March 9, 2017: Pathogens and Disease
https://www.readbyqxmd.com/read/28331857/thrombosis-neuroinflammation-and-poststroke-infection-the-multifaceted-role-of-neutrophils-in-stroke
#3
REVIEW
Johanna Ruhnau, Juliane Schulze, Alexander Dressel, Antje Vogelgesang
Immune cells can significantly predict and affect the clinical outcome of stroke. In particular, the neutrophil-to-lymphocyte ratio was shown to predict hemorrhagic transformation and the clinical outcome of stroke; however, the immunological mechanisms underlying these effects are poorly understood. Neutrophils are the first cells to invade injured tissue following focal brain ischemia. In these conditions, their proinflammatory properties enhance tissue damage and may promote ischemic incidences by inducing thrombus formation...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28331452/balloon-occlusion-technique-for-managing-portal-vein-hemorrhage-in-liver-transplantation
#4
John B Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S Bruce, Ian C Carmody, Ari J Cohen, George E Loss
BACKGROUND: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. CASE REPORT: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28328784/direct-xa-inhibitors-in-addition-to-antiplatelet-therapy-in-acute-coronary-syndrome-meta-analysis-of-randomized-trials
#5
Pedro A Villablanca, David Holmes, Divyanshu Mohananey, David F Briceno, Ivan J Núñez Gil, Faraj Kargoli, Tanush Gupta, Jorge R Kizer, Anna E Bortnick, Jose Wiley, Mark A Menegus, Robert Pyo, Mario García, Harish Ramakrishna, Farouk Mookadam
OBJECTIVE: We carried out a meta-analysis summarizing the efficacy and safety of direct factor Xa inhibitor (DXI) in patients receiving guideline-based antiplatelet therapy (GBAT) after an acute coronary syndrome. BACKGROUND: Randomized-controlled trials have shown that the addition of a DXI to GBAT after acute coronary syndrome can reduce ischemic events, the trade-off being an increase in major bleeding complications. METHODS: PubMed, Central, Embase, The Cochrane Register, Google Scholar databases, and the scientific session abstracts were searched for eligible randomized trials from 1 January 1990 through 31 December 2016...
March 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28328595/hemorrhage-and-infarction-of-the-conjunctiva-and-orbit-in-essential-thrombocythemia
#6
Jaehoon Na, Soo Youn Choi, Sehyun Baek, Hwa Lee
An 82-year-old woman who had a history of essential thrombocythemia presented with ocular pain, bleeding, and decreased visual acuity of the left eye. Orbital computed tomography revealed a relatively well-defined homogenous mass-like lesion in the left subconjunctival and intraconal space. Conjunctival biopsy showed acute inflammation with necrosis, vascular ectasia with thrombosis and hemorrhage. After the treatment with hydroxyurea and anagrelide, her symptom and lesion were markedly improved. Hematologic disorders like essential thrombocythemia should be considered in patients with severe spontaneous bleeding around the eye...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#7
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28316323/a-rare-cause-of-upper-gastrointestinal-hemorrhage-chronic-thrombosis-of-the-splenic-artery
#8
Sevtap Arslan, Mehmet Ruhi Onur, Erhan Akpınar
Upper gastrointestinal bleeding (UGIB) represents one of the most serious conditions of the gastrointestinal tract with a mortality rate of 10%. The main cause of UGIB is peptic ulcer, accounting for 28%-59% of cases. A rare cause of UGIB is submucosal arterial collaterals, which develop after splenic artery thrombosis. UGIB secondary to gastric submucosal collateral arteries should be considered in patients with endoscopic appearance of varicose veins in the absence of portal hypertension. Computed tomography angiography (CTA) is the only fast and noninvasive definitive imaging technique for such patients...
March 17, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28314978/can-developmental-venous-anomalies-cause-seizures
#9
Claire Dussaule, Pascal Masnou, Ghaïdaa Nasser, Frédérique Archambaud, Cécile Cauquil-Michon, Jean-Paul Gagnepain, Viviane Bouilleret, Christian Denier
Developmental venous anomalies (DVAs) are congenital anatomical variants of normal venous drainage of normal brain. Although DVAs are often discovered on the occasion of a seizure, their involvement in epilepsy is poorly studied. Our objective was to determine whether DVA can cause seizures, in the cases where there is no associated lesion, including no cavernoma or dysplasia. Based on clinical history, cerebral MRI, EEG recording, and (18)F-FDG PET, we report 4 patients with DVA revealed by seizures. The first patient had a convulsive seizure caused by a hemorrhagic infarction due to thrombosis of her DVA...
March 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28314136/platelet-microparticle-inspired-clot-responsive-nanomedicine-for-targeted-fibrinolysis
#10
Christa L Pawlowski, Wei Li, Michael Sun, Kavya Ravichandran, DaShawn Hickman, Clarissa Kos, Gurbani Kaur, Anirban Sen Gupta
Intravascular administration of plasminogen activators is a clinically important thrombolytic strategy to treat occlusive vascular conditions. A major issue with this strategy is the systemic off-target drug action, which affects hemostatic capabilities and causes substantial hemorrhagic risks. This issue can be potentially resolved by designing technologies that allow thrombus-targeted delivery and site-specific action of thrombolytic drugs. To this end, leveraging a liposomal platform, we have developed platelet microparticle (PMP)-inspired nanovesicles (PMINs), that can protect encapsulated thrombolytic drugs in circulation to prevent off-target uptake and action, anchor actively onto thrombus via PMP-relevant molecular mechanisms and allow drug release via thrombus-relevant enzymatic trigger...
March 14, 2017: Biomaterials
https://www.readbyqxmd.com/read/28306544/acute-ischemic-stroke-mimicking-subarachnoid-hemorrhage-after-coronary-angioplasty
#11
Ana Pršić, Tomislav Šipić, Krešimr Štambuk, Hrvoje Budinčević
Use of non-ionic contrast media (CM) in coronary arteriography has been reported to cause transient cortical blindness, confusion, amnesia and very rare focal deficits. We report a 69-year old patient with stabile angina pectoris who underwent coronary angioplasty with stent placement due to in-stent thrombosis of the right coronary artery who developed stroke symptoms with radiological suspicion of subarachnoid hemorrhage. No vascular malformations were detected on CT cerebral angiography. Dual antiplatelet treatment was continued...
March 16, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#12
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28285286/necrotizing-polyarteritis-nodosa-like-vasculitis-in-a-child-with-systemic-lupus-erythematosus
#13
Ritambhra Nada, Joseph L Matthews, Sagar Bhattad, Anju Gupta, Surjit Singh
A 10-year-old child presented with prolonged fever, lymphadenopathy, weight loss, oral ulcers, alopecia and parotitis. She later developed arterial thrombosis, poly-serositis, nephritis, myocarditis, sacro-ilitis, autoimmune hemolytic anemia and refractory thrombocytopenia. Though anti-dsDNA was negative, she was diagnosed to have systemic lupus erythematosus (SLE). Terminally, she had pulmonary symptoms and succumbed to her illness. The autopsy showed lupus nephritis-Class II, polyserositis, myocarditis, inflammatory myositis, immune mediated vasculitis involving renal, coronary, pancreatic, adrenal, dermal and intramuscular arteries, and pulmonary hemorrhages and edema...
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28284499/the-optimal-discontinuation-of-dual-antiplatelet-therapy-in-patients-undergoing-percutaneous-coronary-intervention-with-drug-eluting-stents-a-meta-analysis-of-randomized-trials
#14
Wei Wang, Jing Liu, Jingxue Fang, Yang Liu, Tong An, Meijuan Zou, Gang Cheng
BACKGROUND: Current guidelines recommend prolonged dual antiplatelet therapy (DAPT) for patients with drug-eluting stents (DES) implantation. Nevertheless, optimal discontinuation of DAPT remains a controversy. We performed a meta-analysis of all randomized controlled trials (RCTs) that evaluate optimal discontinuation of DAPT in patients undergoing percutaneous coronary intervention (PCI) with DES. METHODS: We searched electronic databases including PubMed, Cochrane Library, EMBASE and ClinicalTrials...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28274641/pathways-for-neuroimaging-of-childhood-stroke
#15
REVIEW
David M Mirsky, Lauren A Beslow, Catherine Amlie-Lefond, Pradeep Krishnan, Suzanne Laughlin, Sarah Lee, Laura Lehman, Mubeen Rafay, Dennis Shaw, Michael J Rivkin, Max Wintermark
BACKGROUND: The purpose of this article is to aid practitioners in choosing appropriate neuroimaging for children who present with symptoms that could be caused by stroke. METHODS: The Writing Group members participated in one or more pediatric stroke neuroimaging symposiums hosted by the Stroke Imaging Laboratory for Children housed at the Hospital for Sick Children in Toronto, Ontario, Canada. Through collaboration, literature review, and discussion among child neurologists with expertise diagnosing and treating childhood stroke and pediatric neuroradiologists and neuroradiologists with expertise in pediatric neurovascular disease, suggested imaging protocols are presented for children with suspected stroke syndromes including arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke...
January 25, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28271663/vascular-complications-following-prophylactic-balloon-occlusion-of-the-internal-iliac-arteries-resolved-by-successful-interventional-thrombolysis-in-a-patient-with-morbidly-adherent-placenta
#16
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jia-Ning Fu, Yun-Yan Chen, Zhi-Guo Zhuang, Jian-Hua Lin
The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28265133/the-future-of-nanoparticle-directed-venous-therapy
#17
REVIEW
Benjamin Jacobs, Chandu Vemuri
Nanoparticles, structures of less than 200 nm capable of delivering pharmacotherapeutics to sites of disease, have shown great promise for the treatment of many disease states. While no nanoparticle therapies for deep vein thrombosis are currently approved by the Food and Drug Administration, many of the unique features of these therapies have the potential to treat both deep vein thrombosis and its most significant sequela, postthrombotic syndrome, while limiting the hemorrhagic complications of current antithrombotic therapies...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28265010/venous-collateral-drainage-patterns-predict-clinical-worsening-in-dural-venous-sinus-thrombosis
#18
Sunil A Sheth, Harry Trieu, David S Liebeskind, Jeffrey L Saver, Viktor Szeder, Reza Jahan, Satoshi Tateshima, Gary Duckwiler
BACKGROUND: Dural venous sinus thrombosis (DVST) is an increasingly recognized cause of a wide array of neurological symptoms, with outcomes that range from complete recovery to death. The condition of approximately 23% of patients with DVST will worsen after initial presentation, as a result of restricted venous outflow and venous hypertension, but early identification of this subset is challenging. A venous collateral scale (VCS) that grades alternative drainage routes may improve prediction of clinical deterioration...
March 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28263921/the-impact-of-splenectomy-in-myelofibrosis-patients-prior-to-allogeneic-hematopoietic-stem-cell-transplantation
#19
Marie Robin, Maryem Zine, Sylvie Chevret, Véronique Meignin, Nicolas Munoz-Bongrand, Hannah Moatti, Aliénor Xhaard, Flore Sicre de Fontbrune, Régis Peffault de Latour, Emile Sarfati, Gérard Socié
Performing a pre-transplant splenectomy in patients with myelofibrosis (MF) is a matter of debate, as while the procedure improves hematological recovery it may lead to severe morbidities. We retrospectively analyzed data from 85 patients consecutively transplanted in our center for MF, including 39 patients who underwent splenectomy before their transplant. A majority of them had primary MF (78%), were considered high risk patients (84% DIPSS intermediate-2 or higher), and were transplanted from HLA-matched sibling donors (56%) after a reduced-intensity conditioning regimen (82%)...
March 2, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28262550/pathways-for-neuroimaging-of-neonatal-stroke
#20
REVIEW
Sarah Lee, David M Mirsky, Lauren A Beslow, Catherine Amlie-Lefond, Amy R Danehy, Laura Lehman, Nicholas V Stence, Arastoo Vossough, Max Wintermark, Michael J Rivkin
PURPOSE: To provide consensus-based, suggested imaging protocols to facilitate the accurate and timely diagnosis of a neonate with symptoms concerning for stroke. METHODS: The Writing Group, an international collaboration of pediatric neurologists and neuroradiologists with expertise in perinatal and childhood stroke, participated in a series of pediatric stroke neuroimaging symposia. These discussions, in conjunction with extensive literature review, led to a consensus for imaging protocols to guide practitioners in the diagnosis of neonatal stroke subtypes as defined by the National Institute of Neurological Disorders and Stroke Common Data Elements...
January 26, 2017: Pediatric Neurology
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