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Protamine avoidance

Amir Faravan, Nooredin Mohammadi, Alireza Alizadeh Ghavidel, Mohammad Zia Toutounchi, Ameneh Ghanbari, Mehran Mazloomi
INTRODUCTION: Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology...
2016: Journal of Cardiovascular and Thoracic Research
Sebastian Canovas, Pablo Juan Ross
Fertilization is a very dynamic period of comprehensive chromatin remodeling, from which two specialized cells result in a totipotent zygote. The formation of a totipotent cell requires extensive epigenetic remodeling that, although independent of modifications in the DNA sequence, still entails a profound cell-fate change, supported by transcriptional profile modifications. As a result of finely tuned interactions between numerous mechanisms, the goal of fertilization is to form a full healthy new individual...
July 1, 2016: Theriogenology
Allison Lipitz-Snyderman, Saul N Weingart, Christopher Anderson, Andrew S Epstein, Aileen Killen, David Classen, Camelia S Sima, Elizabeth Fortier, Coral L Atoria, David Pfister, Allison Lipitz-Snyderman, Saul N Weingart, Christopher Anderson, Andrew S Epstein, Aileen Killen, David Classen, Camelia S Sima, Elizabeth Fortier, Coral L Atoria, David Pfister
PURPOSE: Widespread consensus exists about the importance of addressing patient safety issues in oncology, yet our understanding of the frequency, spectrum, and preventability of adverse events (AEs) across cancer care is limited. METHODS: We developed a screening tool to detect AEs across cancer care settings through medical record review. Members of the study team reviewed the scientific literature and obtained structured input from an external multidisciplinary panel of clinicians by using a modified Delphi process...
February 2016: Journal of Oncology Practice
Kamil Rahme, Jianfeng Guo, Justin D Holmes, Caitriona M O'Driscoll
The potential of RNA interference (RNAi)-based therapeutics for cancer has received much attention; however, delivery of RNAi effectors, such as small interfering RNA (siRNA), remains an obstacle to clinical translation. Non-viral delivery vectors have been used extensively to enhance siRNA delivery. Recently, the potential of gold nanoparticles (AuNPs) for transporting drugs, proteins and genetic materials has been demonstrated. Previously, our laboratory synthesised positively charged, surfactant-free AuNPs in water by the reduction of gold (III) chloride (AuCl3) using hydroxylamine hydrochloride (NH2OH·HCl) in the presence of L-cysteine methyl ester hydrochloride (HSCH2CH(NH2)COOCH3·HCl) as a capping agent...
November 1, 2015: Colloids and Surfaces. B, Biointerfaces
Tomohiro Yamamoto, Hans-Gerd Wolf, Nicodème Sinzobahamvya, Boulos Asfour, Victor Hraska, Ehrenfried Schindler
BACKGROUND: In open heart surgery, heparinization is commonly neutralized using an empirical heparin:protamine ratio ranging between 1:1 and 1:1.5. However, these ratios may result in protamine overdose that should be avoided for its negative side effects on the coagulation system. This study aimed to indicate the appropriate treatment for prolonged activated clotting time (ACT) after protamine administration following cardiopulmonary bypass (CPB) in pediatric open heart surgery by investigating the underlying reasons for it...
August 2015: Thoracic and Cardiovascular Surgeon
Marco Ranucci, Ekaterina Baryshnikova, Giulia Beatrice Crapelli, Niels Rahe-Meyer, Lorenzo Menicanti, Alessandro Frigiola
BACKGROUND: Postoperative bleeding after heart operations is still a common finding, leading to allogeneic blood products transfusion. Fibrinogen and coagulation factors deficiency are possible determinants of bleeding. The experimental hypothesis of this study is that a first-line fibrinogen supplementation avoids the need for fresh frozen plasma (FFP) and reduces the need for any kind of transfusions. METHODS AND RESULTS: This was a single-center, prospective, randomized, placebo-controlled, double-blinded study...
June 2015: Journal of the American Heart Association
Andrew H Sparkes, Martha Cannon, David Church, Linda Fleeman, Andrea Harvey, Margarethe Hoenig, Mark E Peterson, Claudia E Reusch, Samantha Taylor, Dan Rosenberg
PRACTICAL RELEVANCE: Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats...
March 2015: Journal of Feline Medicine and Surgery
Weixian Yang, Shubin Qiao, Rong Liu, Fenghuan Hu, Xuewen Qin, Kefei Dou, Lijian Gao, Haibo Liu, Yuan Wu, Jun Zhang, Hong Qiu, Yongjian Wu, Jilin Chen, Yuejin Yang
OBJECTIVE: The clinical features of patients with mediastinal and/or neck hematoma after transradial cardiac catheterization were reviewed and analyzed to help the clinicians to recognize this complication, and try their best to avoid the complication and treat the complication properly. METHODS: A total of 8 patients with mediastinal and/or neck hematoma after right transradial cardiac catheterization in Fuwai hospital from January 1, 2005 to the end of 2012 were included in this study...
May 2014: Zhonghua Xin Xue Guan Bing za Zhi
Yiyang Lin, Robert Chapman, Molly M Stevens
The development of novel assays for protease sensing plays an important role in clinical diagnostics and therapeutics. Herein, we report a supramolecular platform for label-free protease detection, based on protein/dye self-assembly and enzyme-triggered disassembly. In a typical case, coassembly of protamine sulfate and perylene dye via electrostatic attractions and π-π interactions caused significant colorimetric and fluorescent responses. Subsequent addition of trypsin was found to cleave the amide bonds of protein, triggering the dissociation of protein/dye aggregates and the release of perylene dyes...
July 1, 2014: Analytical Chemistry
Laurie Herzig Mallery, Tom Ransom, Brian Steeves, Brenda Cook, Peggy Dunbar, Paige Moorhouse
Clinical practice guidelines specific to the medical care of frail older adults have yet to be widely disseminated. Because of the complex conditions associated with frailty, guidelines for frail older patients should be based on careful consideration of the characteristics of this population, balanced against the benefits and harms associated with treatment. In response to this need, the Diabetes Care Program of Nova Scotia (DCPNS) collaborated with the Palliative and Therapeutic Harmonization (PATH) program to develop and disseminate guidelines for the treatment of frail older adults with type 2 diabetes...
November 2013: Journal of the American Medical Directors Association
Yosi Shamay, Lina Shpirt, Gonen Ashkenasy, Ayelet David
PURPOSE: Cell penetrating peptides (CPPs) can mediate effective delivery of their associated drugs and drug carriers intracellularly, however their lack of cell specificity remains a major obstacle for their clinical development. We aimed at improving the cell specificity and therapeutic efficacy of HPMA copolymer-octaarginine (R8) conjugate (P-R8) in cells at the tumor micro-environment. METHODS: To avoid premature cell-penetration, the positively charged R8 moieties were masked via electrostatic complexation with various polyanionic molecules (heparin sulfate, hyaluronic acid, fucoidan and poly-glutamic acid)...
March 2014: Pharmaceutical Research
Thomas Danne, Areti Philotheou, David Goldman, Xiang Guo, Lin Ping, Anna Cali, Peter Johnston
BACKGROUND: Avoidance of hypoglycemia is a key consideration in treating young children with type 1 diabetes (T1DM). KEY OBJECTIVE: To evaluate hypoglycemia with insulin glargine vs. neutral protamine Hagedorn (NPH) insulin in young children, using continuous glucose monitoring (CGM). SUBJECTS: Children of 1 to <6 yr treated with once-daily glargine vs. once- or twice-daily NPH, with bolus insulin lispro/regular human insulin provided to all...
December 2013: Pediatric Diabetes
Andreas Koster, Jochen Börgermann, Jan Gummert, Markus Rudloff, Armin Zittermann, Uwe Schirmer
BACKGROUND: We assessed the effects of protamine overdosing on thrombelastometry, bleeding, and transfusions in patients after cardiopulmonary bypass (CPB). METHODS: In group 1 (n = 15), representing the clinical standard, the protamine dose was based on the initial heparin dose, and group 2 (n = 15) received protamine based on the heparin concentration measured after CPB. Primary end points were thromboelastometric parameters. Secondary end points were perioperative blood loss and utilization of blood products...
April 2014: Clinical and Applied Thrombosis/hemostasis
Tomas Vymazal, Martin Filaun, Michal Horacek
AIMS: To compare an impact of retransfusion of blood processed in cell-saver (CS) with that of cardiopulmonary bypass (CPB) on blood coagulation in patients undergoing cardiac surgery. METHODS: Prospective observational study using thromboelastography (TEG). RESULTS: TEG samples from 170 patients were analyzed. Cardiopulmonary bypass was used in 100 patients while 70 patients were operated off-pump. In 20 off-pump patients collected blood was processed by cell-saver and returned...
March 2015: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Sook-In Jung, Jonathan S Finkel, Norma V Solis, Siyang Chaili, Aaron P Mitchell, Michael R Yeaman, Scott G Filler
In order to colonize the host and cause disease, Candida albicans must avoid being killed by host defense peptides. Previously, we determined that the regulatory protein Ssd1 governs antimicrobial peptide resistance in C. albicans. Here, we sought to identify additional genes whose products govern susceptibility to antimicrobial peptides. We discovered that a bcr1Δ/Δ mutant, like the ssd1Δ/Δ mutant, had increased susceptibility to the antimicrobial peptides, protamine, RP-1, and human β defensin-2. Homozygous deletion of BCR1 in the ssd1Δ/Δ mutant did not result in a further increase in antimicrobial peptide susceptibility...
March 2013: Eukaryotic Cell
Sam Schulman
Strategies to reduce blood loss and the need for transfusions in surgery include enhancement of coagulation, inhibition of fibrinolysis, and an improved decision algorithm for transfusion based on bedside monitoring of global hemostasis. The synthetic antifibrinolytic drug tranexamic acid has emerged as an effective alternative in this respect for orthopedic and cardiac surgery. Although it seems less effective than aprotinin, it has not been associated with the increased risk of mortality of the latter. Thromboelastography to monitor the global hemostatic capacity and to guide the appropriate use of blood components in cardiac surgery is also effective in reducing the need for transfusion...
2012: Hematology—the Education Program of the American Society of Hematology
T Sivanarayana, Ch Ravi Krishna, G Jaya Prakash, K Murali Krishna, K Madan, B Sireesha Rani, G Sudhakar, G A Rama Raju
PURPOSE: The present study was undertaken to evaluate the effects of morphokinetic abnormalities of human spermatozoa on chromatin packing and DNA integrity and possible beneficial effects of sperm selection in ICSI. METHODS: Semen samples from 1002 patients were analysed for morphology and motility using CASA. Protamine status and DNA fragmentation were analysed by chromomycin A3 staining and sperm chromatin dispersion assay respectively. RESULTS: Sperms with elongated, thin, round, pyri, amorphous, micro and macro forms were significantly higher in teratozoospermic and oligoasthenoteratozoospermic groups...
December 2012: Journal of Assisted Reproduction and Genetics
Christina Gatschelhofer, Agnes Prasch, Michael R Buchmeiser, Andreas Zimmer, Karin Wernig, Martin Griesbacher, Thomas R Pieber, Frank M Sinner
The development of nanomedicines for improved diagnosis and treatment of diseases is pushing current analytical methods to their limits. More efficient, quantitative high-throughput screening methods are needed to guide the optimization of promising nanoparticulate drug delivery formulations. In response to this need, we present herein a novel approach using monolithic separation media. The unique porosity of our capillary monolithic precolumns allows the direct injection and online removal of protamine-oligonucleotide nanoparticles ("proticles") without column clogging, thus avoiding the need for time-consuming off-line sample workup...
September 4, 2012: Analytical Chemistry
F Bassiri, M Tavalaee, A H Shiravi, S Mansouri, M H Nasr-Esfahani
BACKGROUND: Intracytoplasmic sperm injection (ICSI) is the primary treatment for male infertility. However for this procedure, with the exception of visual morphological selection, there is no standardization for sperm selection. Recently, the hypo-osmotic swelling test (HOST) has been proposed to potentially select sperm with intact membranes. The aim of this study is to evaluate the ability of this technique to select functional sperm in terms of apoptosis and morphology, as well as nuclear integrity...
August 2012: Human Reproduction
Marco Ranucci, Ekaterina Baryshnikova, Dionisio Colella
Acutely bleeding patients are commonly found in the trauma and major surgery scenarios. They require prompt and effective treatment to restore an adequate hemostatic pattern, to avoid serious and sometimes life-threatening complications.Different prohemostatic treatments are available, including allogeneic blood derivatives (fresh frozen plasma, platelet concentrates, and cryoprecipitates), prothrombin complex concentrates, specific coagulation factors (fibrinogen, recombinant factor XIII, recombinant activated factor VII), and drugs (protamine for patients under heparin treatment, desmopressin, antifibrinolytics)...
April 2012: Seminars in Thrombosis and Hemostasis
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