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Christina Gjerlev Poulsen, Morten Bestle, Lene Boesby
In the course of an uncomplicated sigmoidostomy a 63-year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury. Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Administration of idarucizumab induced immediate clinical and paraclinical improvement. Dabigatran should be carefully administrated in patients who have any degree of renal insufficiency. Idarucizumab may be effective in severe bleeding caused by dabigatran...
February 13, 2017: Ugeskrift for Laeger
Haijun Cao, Qian Tian, Yun Huang, Shengliang Ye, Ye Xin, Fangzhao Lin, Changqing Li
Despite increasing use of prothrombin complex concentrates (PCCs), there is little knowledge about the biochemical characterization of Chinese PCCs. Six Chinese PCCs were investigated and compared with PCCs (Octaplex®) from Europe. The levels of coagulation factors and inhibitors were detected. The presence of activated coagulation factors was assessed. Furthermore, their thrombin inhibitory capacities, specific activity and purity were assayed. All above parameters of biochemical properties were statistically analyzed...
March 2015: Biologicals: Journal of the International Association of Biological Standardization
David John Card, Sebastian Francis, Krutika Deuchande, Dominic Jon Harrington
Difenacoum is a long-acting superwarfarin-type anticoagulant that exerts its effect through inhibiting vitamin K 2,3-epoxide reductase. Inhibition of this enzyme leads to reduced bioavailability of the metabolically active form of vitamin K resulting in decreased production of vitamin K-dependent proteins including coagulation factors II, VII, IX and X. A 45-year-old woman with psychiatric illness presented with haematuria. Laboratory test results indicated she had been exposed to a vitamin K antagonist which was subsequently identified as difenacoum...
October 13, 2014: BMJ Case Reports
H M Hirri, P J Green
INTRODUCTION: Prothrombin Complex Concentrate (PCC) is increasingly used for the emergency reversal of the effects of Vitamin K antagonists due to the increased use of the latter. There is no consensus on dosage protocols for its use. There is evidence that small fixed doses are effective. We report the result of the use of a simple three dose level protocol i.e. 2000 IU for CNS bleeds, 1500 IU for other bleeds and 1000 IU for non bleeders. METHODS: Data was prospectively collected over a 6 month period on all patients receiving PCC (Octaplex)...
October 2014: Transfusion and Apheresis Science
Joanne van Ryn, Johanna Schurer, Monika Kink-Eiband, Andreas Clemens
BACKGROUND: Dabigatran is a potent oral anticoagulant. Like any anticoagulant, there is an increased risk of bleeding associated with its use, and reversal may be needed in cases of severe bleeding. METHODS: In this study, six coagulation factor concentrates (CFCs) were tested for their ability to reduce bleeding induced by oral dabigatran etexilate (30 mg/kg) in a rat-tail bleeding model (n = 5 to 8 per group): three-factor (Profilnine [Grifols Biologicals Inc...
June 2014: Anesthesiology
Stephen McCain, Sadaf Gull, Jawad Ahmad, Declan Carey
A 71-year-old man presented to the emergency department with his first episode of hematemesis. He was anemic and coagulopathic on admission, and became hemodynamically unstable requiring surgical intervention to control the bleeding. Prior to surgery, he required 100% plasma exchange with human plasma derived prothrombin complex concentrate (Octaplex) as the exchange fluid. At induction of anesthesia, he received tranexamic acid, prothrombin complex concentrate, and platelets. At the time of knife to skin, he was given coagulation factor VIIa intravenously as a bolus...
February 5, 2014: BMJ Case Reports
Michael Hickey, Mathieu Gatien, Monica Taljaard, Amiirah Aujnarain, Antonio Giulivi, Jeffrey J Perry
BACKGROUND: Physicians reverse patients' warfarin anticoagulation with frozen plasma or prothrombin complex concentrate. Our objective was to determine adverse event frequency after urgent reversal with frozen plasma versus the prothrombin complex concentrate Octaplex. METHODS AND RESULTS: This natural before-after retrospective cohort study in 2 tertiary care emergency departments compared anticoagulation reversal with frozen plasma (September 2006-August 2008) and with Octaplex (September 2008-August 2010), without other system changes...
July 23, 2013: Circulation
Ori J Lieberman, Jeffrey J DeStefano, Vincent T Lee
Bacterial signaling networks control a wide variety of cellular processes including growth, metabolism, and pathogenesis. Bis-(3'-5')-cyclic dimeric guanosine monophosphate (cdiGMP) is a secondary signaling nucleotide that controls cellulose synthesis, biofilm formation, motility and virulence in a wide range of gram-negative bacterial species. CdiGMP is a dynamic molecule that forms different tertiary structures in vitro, including a trans-monomer, cis-monomer, cis-dimer and G-octaplex (G8). Although the monomer and dimer have been shown to be physiologically relevant in modulating protein activity and transcription, the biological effects of the cdiGMP G8 has not yet been described...
2013: PloS One
Thibaut Desmettre, Emilie Dehours, Charles-Marc Samama, Suchin Jhundoo, Frédéric Pujeau, Christian Guillaudin, Claudine Hecquart, Pierre Clerson, Jean Charles Crave, Roland Jaussaud
INTRODUCTION: Prothrombin Complex Concentrate (PCC) is a key treatment in the management of bleeding related to Vitamin K antagonists (VKA). This study aimed to evaluate prospectively PCC use in patients with VKA-related bleeding in view of the French guidelines published in 2008. METHODS: All consecutive patients with VKA-related bleeding treated with a 4-factor PCC (Octaplex®) were selected in 33 French hospitals. Collected data included demographics, site and severity of bleeding, modalities of PCC administration, International Normalized Ratio (INR) values before and after PCC administration, outcomes and survival rate 15 days after infusion...
October 4, 2012: Critical Care: the Official Journal of the Critical Care Forum
Uffe Vest Schneider, Nikolaj Dam Mikkelsen, Anja Lindqvist, Limei Meng Okkels, Nina Jøhnk, Gorm Lisby
We introduce quantitative polymerase chain reaction (qPCR) primers and multiplex end-point PCR primers modified by the addition of a single ortho-Twisted Intercalating Nucleic Acid (o-TINA) molecule at the 5'-end. In qPCR, the 5'-o-TINA modified primers allow for a qPCR efficiency of 100% at significantly stressed reaction conditions, increasing the robustness of qPCR assays compared to unmodified primers. In samples spiked with genomic DNA, 5'-o-TINA modified primers improve the robustness by increased sensitivity and specificity compared to unmodified DNA primers...
2012: PloS One
Miranda Wozniak, Adrian Kruit, Ruth Padmore, Antonio Giulivi, Janis Bormanis
BACKGROUND: Octaplex®, a six factor prothrombin complex concentrate (PCC), has recently been approved for use in Canada. The optimal dose of Octaplex has yet to be established and our study was designed to monitor the efficacy of a low standard dose. STUDY DESIGN AND METHODS: Patients on warfarin treatment in need of urgent reversal for bleeding, invasive procedures or surgery were given a standard dose of 40 ml (1000 IU FIX, 14 IU/kg). We conducted a retrospective chart review of 231 patients...
June 2012: Transfusion and Apheresis Science
Manuela C Carvalho, Anabela G Rodrigues, Luísa M Conceição, Miguel L Galvão, Luis C Ribeiro
In emergency/clinical practice it is often necessary to restore the balance of blood coagulation: the rapid reversal of oral anticoagulant therapy (OAT) is crucial in cases of serious acute bleeding and emergency surgery in patients with high international normalized ratios (INRs). Coagulation can be normalized via the application of haemostatic products, including fresh frozen plasma (FFP) or prothrombin complex concentrates (PCCs). Guidelines recommend PCCs for the reversal of OAT in preference to FFP in patients with major/life-threatening bleeding and high INRs...
April 2012: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Christopher J Patriquin, Ian H Chin-Yee, Michael J Kovacs, Alejandro Lazo-Langner, Michael Keeney, Cyrus C Hsia
Prothrombin complex concentrates (PCC) are recommended for urgent warfarin reversal. However, disagreement exists regarding the proper dosing strategy (i.e. fixed vs. weight-based). We measured the in vitro effect of PCC dosing on international normalised ratio (INR) and factor activity. Plasma from warfarin-anticoagulated patients with stable INRs was collected. PCC doses of 1,000, 2,000 and 3,000 IU were added to the samples, and INR and factor activity were analysed before and after PCC. Twenty-three of thirty subjects enrolled had complete data for analysis...
February 2012: Thrombosis and Haemostasis
Takahito Oki, Tokutaro Hayashi, Masao Ota, Hideki Asamura
We selected 16 new X chromosomal SNPs (rs4827155, rs471205, rs7884160, rs16982419, rs985251, rs3813932, rs6630351, rs4132871, rs5966270, rs7471388, rs6641116, rs6521038, rs5990560, rs5959408, rs414960, and rs3006142) and developed the two X chromosomal SNPs Octaplex systems using multiplex single base extension reactions. To make the systems more useful for analyzing degraded DNA samples, we designed primers to render amplicons of 100 bp or shorter (shorter PCR products). Statistical analyses of the 16 SNPs indicated a high usefulness for the Japanese forensic practice...
January 2012: Legal Medicine
James A Robblee, Peter R H Wilkes, Sean J Dickie, Fraser D Rubens, Janis Bormanis
PURPOSE: This is a case report involving a middle-aged Jehovah's Witness patient who underwent a redo aortic valve replacement, coronary artery bypass graft, and Maze procedure facilitated by cardiopulmonary bypass. The consent process included a discussion of the management of bleeding and hemostasis in the perioperative period in the context of the patients' religious choice and the possible consequences of avoiding transfusion in massive bleeding. The medical team agreed to abide by the patient's wishes with respect to the blood and blood products deemed unacceptable by the patient irrespective of the consequences...
March 2012: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Erik Berntorp, Sandra Figueiredo, Lucimara Futema, Katharina Pock, Sigurd Knaub, Olaf Walter, Laurenz Trawnicek, Jürgen Römisch
The nonactivated prothrombin complex concentrate (PCC) Octaplex (Octapharma PPGmbH, Vienna, Austria) has been used successfully for the treatment of congenital and acquired coagulation factor deficiencies and associated bleeding. The aims of this study were to assess retrospectively whether Octaplex is an effective treatment option for haemophilia A patients with high-titre inhibitors of factor VIII (FVIII) and to investigate the impact of Octaplex on thrombin generation in vitro and ex vivo. Retrospective data were collected from 15 haemophilia A patients with FVIII inhibitors who had been treated with Octaplex...
September 2010: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Yasutaka Nakamura, Kiyoshi Minaguchi
X-chromosome short tandem repeat (STR) polymorphisms are a useful tool in the fields of human population genetics and personal identification and are indispensable in investigating complex kinship or deficiency cases in circumstances where information on mtDNA or Y-chromosome polymorphisms is unavailable. The purpose of this study was to construct a multiplex polymerase chain reaction (PCR) system capable of analyzing a large number of X-STR loci and establish a 16-X-STR database in the Japanese population We developed two octaplex X-STR systems, one including the DXS7424, GATA172D05, HPRTB, DXS8377, GATA31E08, DXS9895, DXS7423, and DXS981 loci and the other the DXS6803, DXS6789, DXS6800, DXS6809, DXS7133, DXS7132, DXS101, and DXS6807 loci, and conducted a population study in 512 Japanese individuals comprising 339 men and 173 women...
September 2010: International Journal of Legal Medicine
Chistine Grobler, Jeannie Callum, Stuart A McCluskey
PURPOSE: The purpose of this article is to review the effective options for the reversal of vitamin K antagonists (warfarin and it coumarin analogues) and to help identify the option best suited for the patient requiring urgent surgery. PRINCIPAL FINDINGS: Vitamin K antagonists, the mainstay in long-term anticoagulation therapy, can be reversed with the administration of vitamin K, frozen plasma (FP), recombinant factor VIIa (rFVIIa), or the recently approved four-factor prothrombin complex concentrate (PCC), Octaplex...
May 2010: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
U Kalina, H Bickhard, S Schulte
AIMS: A number of prothrombin complex concentrates (PCCs) are commercially available but they differ in terms of composition. We performed a series of studies to compare the biochemical properties of seven PCCs. METHODS: The following products were investigated: Beriplex P/N, Octaplex, S-TIM 4, PPSB Solvent Detergent, Uman Complex DI, Kaskadil and Cofact. Assays were performed to investigate levels of coagulation factors and their inhibitors, activated coagulation factors and heparin...
October 2008: International Journal of Clinical Practice
Hanno B Riess, Andreas Meier-Hellmann, Johann Motsch, Mazen Elias, Friedrich W Kursten, Carl-Erik Dempfle
INTRODUCTION: Rapid reversal of anticoagulant effect from the use of vitamin K antagonists (VKA) is essential when acute bleeding or emergency surgery occurs. Prothrombin complex concentrates (PCCs) produce a more rapid effect with a better clinical outcome, and do not cause volume overload as compared with fresh-frozen plasma (FFP). Octaplex is a modern, double virus safeguarded PCC with balanced content of vitamin K-dependent coagulation factors, which ensures fast onset of action and efficacious treatment, i...
2007: Thrombosis Research
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