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Ming-Jie Kuang, Chao Han, Jian-Xiong Ma, Fei Li, Jie Zhao, Lin Fu, Xin-Long Ma
PURPOSE: Autologous platelet gel, developed from fresh autologous blood, is a breakthrough in the promotion and acceleration of soft tissue and bone repair. The application of autologous platelet gel has been reported to improve haemostasis and promote function recovery. We screened the randomized controlled trials and controlled clinical trials of high quality to investigate whether autologous platelet gel makes a better performance for postoperative bleeding and functional recovery in patients after total knee arthroplasty...
October 19, 2016: International Journal of Surgery
Yung-Kuan Tsou, Chia-Yuan Liu, Kuang-I Fu, Cheng-Hui Lin, Mu-Shien Lee, Ming-Yao Su, Ken Ohata, Cheng-Tang Chiu
BACKGROUND: Esophageal endoscopic submucosal dissection (ESD) has rarely been reported for the treatment of cirrhotic patients. AIM: To report the results of ESD treatment of superficial esophageal neoplasms (SENs) for cirrhotic patients. METHODS: Forty patients with 50 consecutive SENs undergoing 46 sessions of ESD were retrospectively reviewed. The cirrhotic group included eight patients (11 SENs) with liver cirrhosis consisting of six patients classified as Child-Pugh class A liver cirrhosis and two patients classified as class B liver cirrhosis...
October 21, 2016: Digestive Diseases and Sciences
Gyeung Mi Seon, Mi Hee Lee, Byeong-Ju Kwon, Min Sung Kim, Min-Ah Koo, Dohyun Kim, Young Seomun, Jong-Tak Kim, Jong-Chul Park
: Although a number of natural materials have been used as hemostatic agents, many substances do not act quickly enough. Here, we created a novel dressings using collagen and chitosan with recombinant batroxobin (r-Bat) to promote faster and more effective hemostasis. We hypothesized that r-Bat would promote synergetic blood coagulation because it contains a blood coagulation active site different than those of collagen and chitosan. Our results suggest that each substances can maintain hemostatic properties while in the mixed dressings and that our novel hemostatic dressings promotes potent control of bleeding, as demonstrated by a whole blood assay and rat hemorrhage model...
October 18, 2016: Acta Biomaterialia
Giovanni Milito, Giorgio Lisi, Elena Aronadio, Michela Campanelli, Dario Venditti, Simona Grande, Michele Grande
BACKGROUNDS: Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 haemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study is to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS: Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigaSureTM hemorrhoidectomy for III and IV degree haemorrhoids...
October 21, 2016: Minerva Gastroenterologica e Dietologica
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
Khaled Sinjab, Nouf Zimmo, Guo-Hao Lin, Ming-Pang Chung, Lujain Shaikh, Hom-Lay Wang
BACKGROUND: The use of statins on adult chronic patients showed a positive effect on their periodontal status. However, The effect of locally delivered statins on periodontal treatment has not yet been systematically analyzed. Hence, the present systematic review and meta-analyses aimed to evaluate the efficacy of statins on treating localized periodontal intrabony defects. MATERIAL AND METHODS: An electronic search of 3 databases (1965-2016 March 1(st)), including PubMed, Embase, CINAHL, and a hand search of peer-reviewed journals for relevant articles were performed...
October 21, 2016: Journal of Periodontology
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2016: Journal of the Association of Physicians of India
Naoaki Morihara, Atsuko Hino
Aged garlic extract (AGE), a garlic preparation rich in water-soluble cysteinyl moieties, has been reported to have multiple beneficial effects on cardiovascular disease including inhibition of platelet aggregation. However, the mode of AGE action on platelets has not been clear. In this study, we examined the effect of AGE on the functional property of platelet by administering AGE to rats and evaluating the platelet aggregation in response to collagen in vitro. We found that AGE treatment significantly reduced the ability of platelet to aggregate and this effect of AGE was manifested on the 14 day, but not 7 day of treatment...
October 20, 2016: Journal of Natural Medicines
Carol H Miao
Current treatment of hemophilia A (HemA) patients with repeated infusions of factor VIII (FVIII; abbreviated as F8 in constructs) is costly, inconvenient, and incompletely effective. In addition, approximately 25 % of treated patients develop anti-factor VIII immune responses. Gene therapy that can achieve long-term phenotypic correction without the complication of anti-factor VIII antibody formation is highly desired. Lentiviral vector (LV)-mediated gene transfer into hematopoietic stem cells (HSCs) results in stable integration of FVIII gene into the host genome, leading to persistent therapeutic effect...
2016: Thrombosis Journal
Ming-Ching Shen, Ming Chen, Gwo-Chin Ma, Shun-Ping Chang, Ching-Yeh Lin, Bo-Do Lin, Han-Ni Hsieh
BACKGROUND: Von Willebrand disease (VWD) is not uncommon in Taiwan. In type 2 or type 3 VWD hemorrhagic symptoms are severer and laboratory data relatively more distinctive. De novo mutation and somatic mosaicism of type 2 VWD gene were rarely reported. Therefore clinical, laboratory and genetic studies of only type 2A, 2B and 2M VWD will be presented and issues of de novo mutation and somatic mosaicism will be explored. METHODS: Fifty-four patients belonging to 23 unrelated families from all around the country in whom type 2 VWD exclusive of type 2N has been diagnosed not only by clinical and routine laboratory studies but also by genetic confirmation during 1990-2015 were investigated...
2016: Thrombosis Journal
Xiaohong Ruby Xu, Naadiya Carrim, Miguel Antonio Dias Neves, Thomas McKeown, Tyler W Stratton, Rodrigo Matos Pinto Coelho, Xi Lei, Pingguo Chen, Jianhua Xu, Xiangrong Dai, Benjamin Xiaoyi Li, Heyu Ni
Platelets are central mediators of thrombosis and hemostasis. At the site of vascular injury, platelet accumulation (i.e. adhesion and aggregation) constitutes the first wave of hemostasis. Blood coagulation, initiated by the coagulation cascades, is the second wave of thrombin generation and enhance phosphatidylserine exposure, can markedly potentiate cell-based thrombin generation and enhance blood coagulation. Recently, deposition of plasma fibronectin and other proteins onto the injured vessel wall has been identified as a new "protein wave of hemostasis" that occurs prior to platelet accumulation (i...
2016: Thrombosis Journal
Hui-Ju Tsai, Ching-Ping Tseng
Multiple functions of platelets in various physiological and pathological conditions have prompted considerable attention on understanding how platelets are generated and activated. Of the adaptor proteins that are expressed in megakaryocytes and platelets, Disabled-2 (Dab2) has been demonstrated in the past decades as a key regulator of platelet signaling. Dab2 has two alternative splicing isoforms p82 and p59. However, the mode of Dab2's action remains to be clearly defined. In this review, we highlight the current understanding of Dab2 expression and function in megakaryocytic differentiation, platelet activation and integrin signaling...
2016: Thrombosis Journal
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
April Robinson, Delilah McCarty, Janine Douglas
Acute coronary syndrome (ACS) is a cardiovascular condition with a multifactorial pathophysiology that includes atherosclerotic plaques, platelet activation and thrombin production, among others. Thrombin production and the prothrombotic state of ACS patients have provided a role for anticoagulants to treat patients during the acute event and has led to subsequent research for the post-acute state. Warfarin has an indication for ACS, however, it is restricted to specific patients and many factors limit its use...
October 7, 2016: Therapeutic Advances in Cardiovascular Disease
Mina Alvandipour, Shahram Ala, Hasan Tavakoli, Jamshid Yazdani Cherati, Afshin Shiva
INTRODUCTION: The most frequent problems after anal fistulotomy are pain, bleeding, and delayed or impaired wound healing. Topical Sucralfate preparation has been used to treat a wide variety of wounds. In this study, we investigate effects of 10% sucralfate ointment on wound healing and postoperative pain after fistulotomy. METHODS AND MATERIALS: A total of 41 patients undergoing anorectal fistulotomy were included in this randomized, blinded, controlled trial and were randomly allocated to either sucralfate ointment (every 12 h) or placebo...
October 17, 2016: International Journal of Surgery
Paul J Karanicolas, Yulia Lin, Jordan Tarshis, Calvin H L Law, Natalie G Coburn, Julie Hallet, Barto Nascimento, Janusz Pawliszyn, Stuart A McCluskey
BACKGROUND: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection. METHODS: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery...
October 17, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Jochen Reinöhl, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Manfred Zehender, Constantin von Zur Mühlen, Christoph Bode, Peter Stachon
OBJECTIVES: The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). BACKGROUND: A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. METHODS: In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013...
October 24, 2016: JACC. Cardiovascular Interventions
L Deville, M Konan, A Hij, L Goldwirt, O Peyrony, F Fieux, P Faure, I Madelaine, S Villiers, D Farge-Bancel, C Frère
Direct oral anticoagulants (DAOC) are indicated for the treatment of venous thromboembolism and the prevention of stroke or systemic embolism in patients with non-valvular atrial fibrillation. Given their advantages and friendly use for patient, the prescription of long term DOAC therapy has rapidly increased both as first line treatment while initiating anticoagulation and as a substitute to vitamins K antagonist (VKA) in poorly controlled patients. However, DOAC therapy can also be associated with significant bleeding complications, and in the absence of specific antidote at disposal, treatment of serious hemorrhagic complications under DOAC remains complex...
July 2016: Current Research in Translational Medicine
Sarav S Shah, Alexander M Satin, James R Mullen, Sara Merwin, Mark Goldin, Nicholas A Sgaglione
BACKGROUND: Prior to 2012, the American Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) differed in their recommendations for postoperative pharmacologic venous thromboembolism prophylaxis (VTEP) after total joint arthroplasty. More specifically, aspirin (ASA) monotherapy was not endorsed by the ACCP as an acceptable prophylaxis. In 2012, the ACCP supported ASA monotherapy compared with no prophylaxis. Our aim was to investigate the impact of the convergence of ACCP and AAOS recommendations on surgeon prescribing patterns after knee arthroplasty (KA)...
October 20, 2016: Journal of Orthopaedic Surgery and Research
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