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Pierre-Antoine Moulin, Anne Dutour, Patricia Ancel, Pierre-Emmanuel Morange, Thierry Bege, Olivier Ziegler, Stéphane Berdah, Corinne Frère, Bénédicte Gaborit
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of death in obese patients undergoing bariatric surgery (BS), but there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. OBJECTIVE: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices. SETTING: French obesity specialized care centers (CSO), which are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey (11 opened, 15 closed questions) investigating their prophylactic schemes of anticoagulation (molecule, dose, weight-adjustment, duration, associated measures, follow-up) was sent to the 37 CSO...
September 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mouna Sassi, Taher Chakroun, Elisabeth Mbemba, Patrick Van Dreden, Ismail Elalamy, Annette K Larsen, Grigoris T Gerotziafas
BACKGROUND: A documented relationship between ovarian cancer and thrombosis does exist. Low-molecular-weight heparins (LMWHs) are cornerstone drugs in the primary prevention and treatment of venous thromboembolic events in patients with cancer. However, cancer cells may alter the efficiency of these antithrombotic agents. OBJECTIVE: We aimed to characterize the procoagulant phenotype of human epithelial ovarian adenocarcinoma cells, IGROV1, and to compare the capacity of tinzaparin and enoxaparin to inhibit thrombin generation triggered by these cells...
September 7, 2016: Clinical and Applied Thrombosis/hemostasis
Lukas Goertz, Stefan Werner Schneider, Anna Desch, Frank Thomas Mayer, Julian Koett, Kai Nowak, Ioannis Karampinis, Michael K Bohlmann, Viktor Umansky, Alexander Thomas Bauer
Von Willebrand factor (VWF) serves as a nidus for platelet aggregation and thrombosis. We hypothesize that VWF fibers contribute to the development of venous thromboembolism (VTE) and to metastasis formation. Here, we show that vascular and lymphatic endothelial cells (ECs) express VWF in vitro and release VWF fibers after activation by tumor cell supernatants. In contrast, an ex vivo analysis of primary mouse tumors revealed the presence of VWF fibers in the blood microvasculature but not in lymphatic vessels...
September 2, 2016: Oncotarget
Omar M Shaaban, Ahmed M Abbas, Kamal M Zahran, Mohamed M Fathalla, Mohamed A Anan, Safwat A Salman
BACKGROUND: Recurrent miscarriage (RM) is one of the most common clinical problems in reproduction with no definite cause in about 50% of the cases. The study aims to evaluate the effect of low-molecular-weight heparin (LMWH) in the treatment of women with RM negatively tested for antiphospholipid antibodies (APAs). METHODS: An open-labeled registered randomized controlled study (NCT 01608347) included women who attended the outpatient clinic in Assiut Women Health Hospital and Nag-Hamady Central Hospital, Egypt, with 3 or more unexplained RM...
August 29, 2016: Clinical and Applied Thrombosis/hemostasis
Marilyn J Telen, Milena Batchvarova, Siqing Shan, Petra H Bovee-Geurts, Rahima Zennadi, Anna Leitgeb, Roland Brock, Maria Lindgren
Sevuparin is a novel drug candidate in phase II development as a treatment for vaso-occlusive crises (VOC) in patients with sickle cell disease (SCD). As a heparin-derived polysaccharide, sevuparin has been designed to retain anti-adhesive properties, while the antithrombin-binding domains have been eliminated, substantially diminishing its anticoagulant activity. Here, we demonstrate that sevuparin inhibits the adhesion of human sickle red blood cells (SS-RBCs) to stimulated cultured endothelial cells in vitro...
August 23, 2016: British Journal of Haematology
Damien Balestrino, Mercédès Quintana, Nicolas Charbonnel, Christiane Forestier, Claire Lartigue, Bertrand Souweine
BACKGROUND AND OBJECTIVES: Interdialytic lock solutions should maintain catheter patency and prevent catheter infections. We aimed to determine in which conditions injectable anticoagulant agents (IAAs) combined with ethanol are compatible and to assess the antibiofilm activity of the selected combination and its effects on dialysis catheters (DC). METHODS: The solubility and compatibility of unfractionated heparin (UFH), low molecular weight heparins (LMWHs), heparinoids and fondaparinux (50 to 2,500 U/mL) in 30 to 70% ethanol were determined by visual observation...
2016: PloS One
Hans Gamperl, Corinna Plattfaut, Annika Freund, Tabea Quecke, Friederike Theophil, Frank Gieseler
Elevated levels of extracellular vesicles (EVs) have been correlated with inflammatory diseases as well as progressive and metastatic cancer. By presenting tissue factor (TF) on their membrane surface, cellular microparticles (MPs) activate both the coagulation system and cell-signaling pathways such as the PAR/ERK pathway. We have shown before that malignant effusions are a rich source of tumor cell-derived EVs. Here, we used EVs from malignant effusions from three different patients after serial low-speed centrifugation steps as recommended by the ISTH (lsEV)...
October 2016: Cell Biology International
L Panicot-Dubois, S Mezouar, L Plantureux, L Crescence, C Frère, C Dubois
INTRODUCTION: In clinical studies, thromboprophylaxis with low-molecular-weight heparins (LMWHs) has been demonstrated to reduce the risk of venous thromboembolism and to improve outcomes in cancer patients. Moreover, preclinical models have previously suggested that LMWHs may also offer additional benefits through direct antitumor properties. However, the optimal doses of LMWHs that may prevent both cancer-related thrombosis and tumor development are yet unknown. AIM: The goal of this study was to determine the optimal doses of tinzaparin that may prevent both cancer-related thrombosis and tumor development in a syngeneic ectopic model of pancreatic cancer...
April 2016: Thrombosis Research
C I Piatek, S T Tagawa, D Wei-Tsai, D Hanna, I C Weitz, C O'Connell, L Rochanda, S Groshen, H A Liebman
INTRODUCTION: VTE is a major complication in cancer patients. Despite treatment with low molecular weight heparin (LMWH), 9% will have recurrent VTE within 6 months. Measurement of plasma biomarkers in cancer patients receiving LMWH may be predictive of recurrent VTE or overall survival (OS). AIM: We conducted a single arm phase 2 study to evaluate the efficacy and safety of once daily tinzaparin for the initial treatment and extended prophylaxis of VTE in cancer patients...
April 2016: Thrombosis Research
Julia Spratte, Frauke Bornkessel, Florian Schütz, Marek Zygmunt, Herbert Fluhr
PURPOSE: The aim of this paper is to study the impact of heparin on the response of human endometrial stromal cells (ESCs) to interleukin (IL)-1β during decidualization in vitro. METHODS: ESCs were isolated from hysterectomy specimens of premenopausal women undergoing hysterectomy for benign reasons; decidualized in vitro and incubated in parallel with unfractionated heparin or tinzaparin; and stimulated with IL-1β at days 0, 3, 6, and 9 during decidualization...
July 2016: Journal of Assisted Reproduction and Genetics
Peter P Roeleveld, Alieke van der Hoeven, Rob B P de Wilde, Jeroen Eikenboom, Frans J Smiers, Heleen E Bunker-Wiersma
OBJECTIVES: This study was conducted to evaluate tinzaparin dosing and therapeutic drug monitoring. DESIGN: Retrospective study. SETTING: Single tertiary-level PICU. PATIENTS: Tinzaparin doses and anti-Xa levels from all children admitted to a PICU (from October 1, 2010, to December 31, 2013) were retrospectively analyzed. Thirty-nine children, median age of 13 months (interquartile range, 73 mo), with 46 episodes of newly started therapeutic tinzaparin were identified...
March 2016: Pediatric Critical Care Medicine
Esther J van Zuuren, Zbys Fedorowicz
BACKGROUND: Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be broadly divided into two distinct clinical phenotypes characterized by either haemolysis or vaso-occlusion. Pain is the most prominent symptom of vaso-occlusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Low-molecular-weight heparins might control this hypercoagulable state through their anticoagulant effect. This is an update of a previously published version of this review...
2015: Cochrane Database of Systematic Reviews
Owain Thomas, Anna Larsson, Nahreen Tynngård, Ulf Schött
BACKGROUND: Monitoring low molecular weight heparins (LMWH's) in the perioperative period is prudent in patients at high risk of coagulative complications, especially when the patient has an epidural catheter requiring withdrawal, which is associated with the risk of spinal haematoma. The aim of this study was to evaluate the in vitro dose-responses of two different LMWH's on two different viscoelastic haemostatic tests, using blood sampled from patients with normal routine coagulation parameters, on the day after major surgery when their epidural catheters were due to be withdrawn...
2015: BMC Anesthesiology
A J W M Anita Brouns, K S G Asiong Jie
BACKGROUND: Heparin-induced skin lesions are common. The majority are delayed-type hypersensitivity reactions to heparin or other components of the injection fluid. Differentiation from heparin-induced thrombocytopenia (HIT) skin lesions is important. The Warkentin 4T's score is helpful for assessment of the risk of HIT. CASE DESCRIPTION: A 36-year old female was treated with injections of tinzaparin for a deep vein thrombosis. After 16 days, she developed progressive thrombocytopenia and a skin lesion at one of the injection sites...
2015: Nederlands Tijdschrift Voor Geneeskunde
Thomas Wilke, Martin Wehling, Steffen Amann, Rupert M Bauersachs, Björn Böttger
BACKGROUND AND STUDY OBJECTIVES: The assessment of the renal function of patients with a deep vein thrombosis/pulmonary embolism (VTE patients) is of utmost importance for the selection/dosage of an agent in the initial anticoagulation management of these patients because the majority of available anticoagulants are cleared renally. Specifically, there is a high risk of drug accumulation and subsequent bleedings in patients with severe renal insufficiency. Consequently, specific recommendations have been made for the initial anticoagulation management of these patients in both product labels and AWMF treatment recommendations: some drugs should not be used in these patients, for other drugs a careful use, intensified screening (anti-Xa), or, in the case of enoxaparin, a dose-adjustment are recommended...
August 2015: Deutsche Medizinische Wochenschrift
Norris E Igbineweka, Gillian A Horne, Mark B Jackson, Timothy J Chevassut
An asymptomatic 81-year-old woman was referred by her general practitioner regarding a pulse-oximetry oxygen saturation (SpO2) of 74%. An arterial blood gas analysis (ABG) on air showed PaO2 12.9 kPa, oxygen saturation 80%, with normal pH, PaCO2, methaemoglobin and carboxyhaemoglobin levels. After a normal chest x-ray, tinzaparin was administered empirically for possible occult pulmonary embolus. This diagnosis was subsequently excluded with an unremarkable computed tomography pulmonary angiogram (CTPA). She was further investigated as an out patient...
2015: Acute Medicine
Agnes Y Y Lee, Pieter W Kamphuisen, Guy Meyer, Rupert Bauersachs, Mette S Janas, Mikala F Jarner, Alok A Khorana
IMPORTANCE: Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism (VTE) in patients with active cancer largely based on results of a single, large trial. OBJECTIVE: To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer. DESIGN, SETTINGS, AND PARTICIPANTS: A randomized, open-label study with blinded central adjudication of study outcomes enrolled patients in 164 centers in Asia, Africa, Europe, and North, Central, and South America between August 2010 and November 2013...
August 18, 2015: JAMA: the Journal of the American Medical Association
Daniel Bastian Pfankuchen, Daniel Philipp Stölting, Martin Schlesinger, Hans-Dieter Royer, Gerd Bendas
Low molecular weight heparin (LMWH) is routinely used for antithrombotic treatment of cancer patients. Preclinical- and clinical data suggest that LMWH has beneficial effects for cancer patients beyond the prevention of thrombosis, i.e. by inhibiting metastasis. It is, however, unclear whether heparin has an impact on the efficiency of chemotherapy in cancer patients. Here we show that a therapeutic dosage of LMWH tinzaparin reverses cisplatin resistance of A2780cis human ovarian cancer cells to the level of sensitive cells...
September 15, 2015: Biochemical Pharmacology
Annemieke Dhondt, Ruben Pauwels, Katrien Devreese, Sunny Eloot, Griet Glorieux, Raymond Vanholder
BACKGROUND AND OBJECTIVE: Low molecular weight heparins (LMWHs) are small enough to pass large pore dialysis membranes. Removal of LMWH if injected before the start of the session is possible during high-flux dialysis and hemodiafiltration. The aim of this study was to determine the optimal mode (place and time) of tinzaparin administration during postdilution hemodiafiltration. STUDY DESIGN, SETTING, PATIENTS: In 13 chronic hemodiafiltration patients, 3 approaches of injection were compared in a randomised cross over trial: i) before the start of the session at the inlet blood line filled with rinsing solution (IN0), ii) 5 min after the start at the inlet line filled with blood (IN5) and iii) before the start of the session at the outlet blood line (OUT0)...
2015: PloS One
Ferdows Atiq, Patricia M L A van den Bemt, Frank W G Leebeek, Teun van Gelder, Jorie Versmissen
PURPOSE: Although therapeutic dosages of most low-molecular-weight heparins (LMWHs) are known to accumulate in patients with renal insufficiency, for the lower prophylactic dosages this has not been clearly proven. Nevertheless, dose reduction is often recommended. We conducted a systematic review to investigate whether prophylactic dosages of LMWH accumulate in renal insufficient patients. METHODS: A comprehensive search was conducted on 17 February 2015 using Embase, Medline, Web of Science, Scopus, Cochrane, PubMed publisher, and Google scholar...
August 2015: European Journal of Clinical Pharmacology
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