keyword
https://read.qxmd.com/read/33489568/rectus-sheath-hematoma-a-rare-surgical-emergency
#21
Kyle Drinnon, Sean S Simpson, Yana Puckett, Catherine A Ronaghan, Robyn E Richmond
A rectus sheath hematoma (RSH) is a rare medical condition that consists of blood accumulating in the rectus abdominis muscle sheath. RSH is most frequently due to a hemorrhage from the superior or inferior epigastric artery. RSH has many specific risk factors, such as anticoagulant use. As the use of anticoagulants increases, the incidence of RSH has also increased. This condition can present with the infrequent complication of abdominal compartment syndrome (ACS), which can require surgical decompression of the abdomen to avoid high morbidity and mortality...
December 18, 2020: Curēus
https://read.qxmd.com/read/33425507/effectiveness-of-tranexamic-acid-in-reducing-postoperative-blood-loss-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#22
JOURNAL ARTICLE
Prashant Khadanga, Muralidhar Kanchi, Pallavi Gaur
Background Off-pump coronary artery bypass grafting (OP-CABG) is an accepted surgical option in treating ischemic heart disease and has proven safer than traditional on-pump CABG in terms of reducing perioperative bleeding, coagulopathy, avoiding cardiopulmonary bypass machine and its related morbidity. However, there is evidence that shows the risk of bleeding in OP-CABG due to surgical trauma, heart manipulations, and heparin-protamine exposure. We aim to evaluate the effectiveness of tranexamic acid (TxA) in reducing blood loss and related perioperative complications in patients undergoing OP-CABG...
December 5, 2020: Curēus
https://read.qxmd.com/read/33251719/managing-the-coagulopathy-associated-with-cardiopulmonary-bypass
#23
REVIEW
Justyna Bartoszko, Keyvan Karkouti
Cardiopulmonary bypass (CPB) has allowed for significant surgical advancements, but accompanying risks can be significant and must be expertly managed. One of the foremost risks is coagulopathic bleeding. Increasing levels of bleeding in cardiac surgical patients at the time of separation from CPB are associated with poor outcomes and mortality. CPB-associated coagulopathy is typically multifactorial and rarely due to inadequate reversal of systemic heparin alone. The components of the bypass circuit induce systemic inflammation and multiple disturbances of the coagulation and fibrinolytic systems...
March 2021: Journal of Thrombosis and Haemostasis: JTH
https://read.qxmd.com/read/33132429/heparin-concentration-in-cell-salvage-during-heparinization-a-pilot-study
#24
JOURNAL ARTICLE
Takahiro Tamura, Jonathan H Waters, Kimitosi Nishiwaki
Cell salvage is frequently used to avoid unnecessary allogeneic blood transfusions, which results in a reduction in blood transfusion volume and cost. The aspirated blood is washed with normal saline and centrifuged to recover only blood cells, salvaged blood is then made. In cardiovascular surgery, heparin is used to maintain activated clotting time over 400 seconds. Some practitioners believe that heparin remains in the salvaged blood. Therefore, we hypothesized that salvaged blood during cardiovascular surgery includes heparin...
August 2020: Nagoya Journal of Medical Science
https://read.qxmd.com/read/32919446/risk-factors-associated-with-difficult-reversal-of-heparin-by-protamine-sulfate-in-cardiopulmonary-bypass-an-ignored-issue
#25
JOURNAL ARTICLE
Min Jung Ku, Su Wan Kim, Seogjae Lee, Jee Won Chang, Jonggeun Lee
Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31)...
September 4, 2020: Korean Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/32037946/extracorporeal-membrane-oxygenation-without-therapeutic-anticoagulation-in-adults-a-systematic-review-of-the-current-literature
#26
JOURNAL ARTICLE
Dario Fina, Matteo Matteucci, Federica Jiritano, Paolo Meani, Valeria Lo Coco, Mariusz Kowalewski, Jos Maessen, Marco Guazzi, Andrea Ballotta, Marco Ranucci, Roberto Lorusso
Extracorporeal membrane oxygenation is essential for the treatment of refractory cardiopulmonary failure. Its use may be complicated by worse haemorrhagic complications exacerbated by extracorporeal membrane oxygenation-related therapeutic anticoagulation. Progressive technological advancements have made extracorporeal membrane oxygenation components less thrombogenic, potentially allowing its application with temporary avoidance of systemic anticoagulants. A systematic review of all the available experiences, reporting the use of extracorporeal membrane oxygenation without systemic anticoagulation in the published literature was performed...
September 2020: International Journal of Artificial Organs
https://read.qxmd.com/read/31853428/combined-coronary-artery-bypass-grafting-and-extra-anatomic-ascending-aorta-to-bifemoral-grafting-through-median-sternotomy
#27
Mohammed Al-Musawi, Michelle M Dugan, Levonti Ohanisian, David Rubay, Ali N Abed
A high proportion of patients with severe systemic atherosclerotic disease present with the involvement of both the coronary and aortoiliac arteries. For these patients with multiple comorbidities and high surgical risk, it is critical to minimize the overall physiologic burden of the operation when possible. Furthermore, with severe or complete occlusion of vascular supply to the lower extremities, it is beneficial to avoid two-stage surgeries because of the high risk of irreversible ischemia necessitating amputation...
November 5, 2019: Curēus
https://read.qxmd.com/read/31659537/radial-artery-perforation-when-a-friend-turns-against-you
#28
JOURNAL ARTICLE
Mostafa Elwany, Roberto Adriano Latini, Gaetano Di Palma, Bernardo Cortese
BACKGROUND: Radial artery approach is currently the most common access site for coronary angiography and percutaneous coronary intervention. It rarely results in complications, improves patient comfort, and reduces the duration of hospitalization. CASE PRESENTATION: A 91-year-old woman presented to our institution with ST-segment elevation myocardial infarction (STEMI). The right radial access was chosen for the performance of percutaneous coronary intervention...
September 11, 2019: Egyptian Heart Journal: EHJ
https://read.qxmd.com/read/31488301/insights-from-a-multidisciplinary-introduction-of-the-manta-vascular-closure-device
#29
JOURNAL ARTICLE
Federico Moccetti, Miriam Brinkert, Robert Seelos, Stefan Ockert, Matthias Bossard, Florim Cuculi, Richard Kobza, Stefan Toggweiler
OBJECTIVES: The aim of this paper is to report insights from the first 100 consecutive cardiovascular procedures with MANTA closure. BACKGROUND: The collagen-based MANTA vascular closure device (Teleflex, Wayne, Pennsylvania) has recently been approved for the closure of large-bore femoral access. METHODS: Procedural and access site-related complications were analyzed according to Valve Academic Research Consortium-2 criteria. Duration of bleeding after device closure was recorded...
September 9, 2019: JACC. Cardiovascular Interventions
https://read.qxmd.com/read/31257632/bdnf-overexpressing-human-mesenchymal-stem-cells-mediate-increased-neuronal-protection-in-vitro
#30
JOURNAL ARTICLE
Verena Scheper, Jana Schwieger, Anika Hamm, Thomas Lenarz, Andrea Hoffmann
The use of neurotrophic factors as therapeutic agents for neurodegenerative diseases is considered as an approach aimed at restoring and maintaining neuronal function in the peripheral and central nervous system. Since the neuroprotective effect is depending on chronic delivery of the neurotrophic factors a sustained application, e.g., via cell-based delivery is necessary. Human mesenchymal stem cells (hMSCs) were lentivirally modified to overexpress brain-derived neurotrophic factor (BDNF) and to express fluorescent marker genes for easy visualization...
November 2019: Journal of Neuroscience Research
https://read.qxmd.com/read/30924387/advances-in-pharmacological-treatment-of-type-1-diabetes-during-pregnancy
#31
REVIEW
Angelo Maria Patti, Rosaria Vincenza Giglio, Kalliopi Pafili, Manfredi Rizzo, Nikolaos Papanas
INTRODUCTION: In women with type 1 diabetes mellitus (T1DM), pregnancy is associated with a potential risk of maternal, foetal and neonatal outcomes. Stringent metabolic control is required to improve these outcomes. AREAS COVERED: In this review, the authors summarise the current evidence from studies on the pharmacological therapy and on monitoring of T1DM during pregnancy. The authors also discuss the use of new technologies to improve therapeutic management and patient compliance...
June 2019: Expert Opinion on Pharmacotherapy
https://read.qxmd.com/read/30916009/anaesthetic-management-of-patients-with-pre-existing-allergic-conditions-a-narrative-review
#32
REVIEW
Pascale Dewachter, Peter Kopac, Jose Julio Laguna, Paul Michel Mertes, Vito Sabato, Gerald W Volcheck, Peter J Cooke
This narrative review seeks to distinguish the clinical patterns of pre-existing allergic conditions from other confounding non-allergic clinical entities, and to identify the potential related risks and facilitate their perioperative management. Follow-up investigation should be performed after a perioperative immediate hypersensitivity to establish a diagnosis and provide advice for subsequent anaesthetics, the main risk factor for perioperative immunoglobulin E (IgE)-mediated anaphylaxis being a previous uninvestigated perioperative immediate hypersensitivity reaction...
July 2019: British Journal of Anaesthesia
https://read.qxmd.com/read/30579056/carrier-particle-mediated-stabilization-and-isolation-of-valsartan-nanoparticles
#33
JOURNAL ARTICLE
Ajay Kumar, Peter Davern, Benjamin K Hodnett, Sarah P Hudson
Drug nanoparticles are a promising solution to the challenging issues of low dissolution rates and erratic bioavailability due to their greater surface/volume ratio. The central purpose of this study is to prepare, stabilize and isolate nanoparticles of poorly water-soluble active pharmaceutical ingredients (APIs) into a dried form with the help of clay carrier particles. Isolation of nanoparticles from suspension into the dried state is crucial to avoid the problems of aggregation and Ostwald ripening. In this study nanoparticles of the API valsartan were generated via a reverse antisolvent process at high supersaturations...
December 12, 2018: Colloids and Surfaces. B, Biointerfaces
https://read.qxmd.com/read/29448503/construction-and-characterization-of-cell-penetrating-peptide-fused-fibroblast-growth-factor-and-vascular-endothelial-growth-factor-for-an-enhanced-percutaneous-delivery-system
#34
JOURNAL ARTICLE
Sang Won Choi, Rudra Pangeni, Dai Hyun Jung, Su Jung Kim, Jin Woo Park
The exogenous administration of growth factors has been examined for treating wounds and such factors serve as cosmetic agents for skin regeneration. However, the topical application of growth factors is hampered by their limited percutaneous absorption. In this study, we genetically modified basic fibroblast growth factor (bFGF) and vascular endothelial growth factor-A (VEGF-A) using a cell-penetrating peptide to facilitate their permeation into skin and to avoid multiple steps in the chemical or physical modification of biomaterials...
February 1, 2018: Journal of Nanoscience and Nanotechnology
https://read.qxmd.com/read/28420481/safety-and-feasibility-of-subcutaneous-purse-string-suture-of-the-femoral-vein-after-electrophysiological-procedures-on-uninterrupted-oral-anticoagulation
#35
COMPARATIVE STUDY
Marc Kottmaier, Felix Bourier, Tilko Reents, Alina Reiter, Marielouise Kornmayer, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Michael Deiss, Stephanie Brooks, Christian Grebmer, Carsten Lennerz, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer
The aim of this study was to compare safety and feasibility of a subcutaneous purse-string suture (PSS) with manual compression (MC) to gain hemostasis in patients after multiple femoral venous punctures undergoing electrophysiological procedures on uninterrupted oral anticoagulation (OAK). A total of 784 patients who underwent catheter ablation for atrial fibrillation (n = 564) or (a)typical atrial flutter (n = 220) were assessed. Four hundred sixty-two patients received PSS (58.9%) and 322 patients (41...
June 1, 2017: American Journal of Cardiology
https://read.qxmd.com/read/28345968/relationship-between-phospholipase-c-zeta-semen-parameters-and-chromatin-status
#36
JOURNAL ARTICLE
Marziyeh Tavalaee, Abbas Kiani-Esfahani, Mohammad H Nasr-Esfahani
The need for additional tests to complement basic sperm analysis in clinics is well appreciated. In this regard, a number of tests such as sperm DNA integrity test as a tool in diagnosis and treatment of infertility are suggested. But recent studies have focused on main sperm factors involved in oocyte activation such as phospholipase C-zeta (PLCζ) that initiate intracellular Ca2+ signaling and embryogenesis. Therefore, this study aimed to investigate the relationship between PLCζ, basic semen parameters, sperm DNA fragmentation (SDF), and protamine deficiency in men with normal (n=32) and abnormal (n=23) semen parameters...
August 2017: Systems Biology in Reproductive Medicine
https://read.qxmd.com/read/28034889/alteration-of-blood-clotting-and-lung-damage-by-protamine-are-avoided-using-the-heparin-and-polyphosphate-inhibitor-uhra
#37
JOURNAL ARTICLE
Manu Thomas Kalathottukaren, Libin Abraham, Piyushkumar R Kapopara, Benjamin F L Lai, Rajesh A Shenoi, Federico I Rosell, Edward M Conway, Edward L G Pryzdial, James H Morrissey, Charles A Haynes, Jayachandran N Kizhakkedathu
Anticoagulant therapy-associated bleeding and pathological thrombosis pose serious risks to hospitalized patients. Both complications could be mitigated by developing new therapeutics that safely neutralize anticoagulant activity and inhibit activators of the intrinsic blood clotting pathway, such as polyphosphate (polyP) and extracellular nucleic acids. The latter strategy could reduce the use of anticoagulants, potentially decreasing bleeding events. However, previously described cationic inhibitors of polyP and extracellular nucleic acids exhibit both nonspecific binding and adverse effects on blood clotting that limit their use...
March 9, 2017: Blood
https://read.qxmd.com/read/28025988/charge-based-precipitation-of-extracellular-vesicles
#38
JOURNAL ARTICLE
Maria Chiara Deregibus, Federico Figliolini, Sergio D'Antico, Paola Maria Manzini, Chiara Pasquino, Michela De Lena, Ciro Tetta, Maria Felice Brizzi, Giovanni Camussi
Vesicular-mediated communication between cells appears critical in many biological processes. Extracellular vesicles (EVs) released from healthy and diseased cells are involved in a network of exchange of biologically active molecules. Since EVs present in biological fluids carry the signature of the cell of origin, they are potential biomarkers for ongoing physiological or pathological processes. Despite the knowledge on EV biology accrued in recent years, techniques of EV purification remain a challenge and all the described methods have some advantages and disadvantages...
November 2016: International Journal of Molecular Medicine
https://read.qxmd.com/read/27987984/biological-and-structural-analyses-of-bovine-heparin-fractions-of-intermediate-and-high-molecular-weight
#39
JOURNAL ARTICLE
Alexsandro V Nogueira, Daiana L Drehmer, Marcello Iacomini, Guilherme L Sassaki, Thales R Cipriani
Low molecular weight heparin, which is generally obtained by chemical and enzymatic depolymerization of unfractionated heparin, has high bioavailability and can be subcutaneously injected. The aim of the present investigation was to fractionate bovine heparin using a physical method (ultrafiltration through a 10kDa cut-off membrane), avoiding structural modifications that can be caused by chemical or enzymatic treatments. Two fractions with different molecular weights were obtained: the first had an intermediate molecular weight (B-IMWH; Mn=9587Da) and the other had a high molecular weight (B-HMWH; 22,396Da)...
February 10, 2017: Carbohydrate Polymers
https://read.qxmd.com/read/27914270/surface-mediated-transfection-of-a-pdna-vector-encoding-short-hairpin-rna-to-downregulate-tgf-%C3%AE-1-expression-for-the-prevention-of-in-stent-restenosis
#40
JOURNAL ARTICLE
He Zhang, Ke-Feng Ren, Hao Chang, Jin-Lei Wang, Jian Ji
In-stent restenosis is one of the most serious modes of failure of cardiovascular stent implant. Although drug-eluting stents have been proven to reduce in-stent restenosis, the nonspecific inhibitory effects of anti-proliferative drugs, such as rapamycin, result in delayed re-endothelialization and fatal late stent thrombosis. Although many studies have focused on promoting rapid re-endothelialization, a feasible method of reducing excessive extracellular matrix (ECM) production and cell proliferation might provide a promising way to efficiently inhibit the restenosis in vivo...
February 2017: Biomaterials
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