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Haemostatic agents

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https://www.readbyqxmd.com/read/28218409/development-of-haemostatic-decontaminants-for-treatment-of-wounds-contaminated-with-chemical-warfare-agents-3-evaluation-of-in-vitro-topical-decontamination-efficacy-using-damaged-skin
#1
Helen L Lydon, Charlotte A Hall, Christopher H Dalton, J Kevin Chipman, John S Graham, Robert P Chilcott
Previous studies have demonstrated that haemostatic products with an absorptive mechanism of action retain their clotting efficiency in the presence of toxic materials and are effective in decontaminating chemical warfare (CW) agents when applied to normal, intact skin. The purpose of this in vitro study was to assess three candidate haemostatic products for effectiveness in the decontamination of superficially damaged porcine skin exposed to the radiolabelled CW agents, soman (GD), VX and sulphur mustard (HD)...
February 20, 2017: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/28159767/ticagrelor-reversal-in-vitro-assessment-of-four-haemostatic-agents
#2
Leyla Calmette, Anne-Céline Martin, Bernard Le Bonniec, Diane Zlotnik, Isabelle Gouin-Thibault, Christilla Bachelot-Loza, Pascale Gaussem, Anne Godier
AIM: Management of ticagrelor-induced bleeding is challenging as platelet transfusion is ineffective. An effective strategy is needed. This study aimed to investigate in vitro the efficacy of four haemostatic drugs (HDs), namely recombinant activated factor VII (rFVIIa), fibrinogen concentrate (Fib), tranexamic acid (TXA) and factor XIII concentrate (FXIII) to improve the haemostatic capacity in the presence of ticagrelor. METHODS: Blood was spiked with ticagrelor then supplemented by either HD or control...
February 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28124406/recombinant-porcine-factor-viii-for-high-risk-surgery-in-paediatric-congenital-haemophilia-a-with-high-titre-inhibitor
#3
S E Croteau, Y L Abajas, A S Wolberg, B I Nielsen, G R Marx, C W Baird, E J Neufeld, P E Monahan
INTRODUCTION: High-titre factor VIII (FVIII) inhibitors complicate peri-operative haemostasis. Recombinant porcine FVIII (r-pFVIII) may provide an alternative haemostatic agent for high-risk procedures and allow FVIII activity monitoring. AIM: Devise an effective haemostatic plan for repair of a progressively symptomatic aortic coarctation in a 5-year-old male with immune tolerance induction (ITI) refractory high-titre FVIII inhibitors. METHODS: Preprocedure human FVIII inhibitor titre was 58 Bethesda Units mL(-1) (BU) and cross-reacted to neutralize porcine FVIII at 30 BU...
January 25, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28044953/a-rare-case-of-upper-digestive-hemorrhage-due-to-bleeding-duodenal-tumor
#4
Claudiu Turculeţ, Dragoş Ene, Teodor Florin Georgescu, E Ciucă, A Vlădăşcău, Florin Iordache, Mircea Beuran
We present the case of a 48-year-old patient with no medical history, who presents himself to the emergency room with melena, asthenia and dizziness. The blood tests revealed a severe anemia (Hb = 4,8 g/dL). He is admitted in the Gastroenterology ward, where a first superior digestive endoscopy is performed which shows a duodenal bleeding tumor (second duodenum) of 7 cm in length. After the administration of red blood cell mass, plasma and haemostatic agents the level of the hemoglobin increases. The abdominal CT scan reveals a 3/5 tumor localized in the second and third duodenum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#5
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27799168/fibrinogen-is-it-a-universal-haemostatic-agent
#6
EDITORIAL
D Bolliger, K A Tanaka
No abstract text is available yet for this article.
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27788559/reducing-inflow-occlusion-occlusion-duration-and-blood-loss-during-hepatic-resections
#7
Ya Ruth Huo, Tim Shiraev, Nayef Alzahrani, Francis Chu
BACKGROUND: To assess the changes in blood loss during hepatic resection with improved haemostatic devices such as a bipolar sealing device and a topical haemostatic agent. METHODS: This retrospective clinical study of prospectively collected data will assess hepatic resections performed by a single surgeon between 2005 and 2013, with the introduction of the two haemostatic techniques in 2009. RESULTS: A total of 371 hepatic resections (214 from 2005 to 2008 and 157 from 2009 to 2013) were included in this study...
October 27, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27761964/recombinant-b-domain-deleted-porcine-sequence-factor-viii-r-pfviii-for-the-treatment-of-bleeding-in-patients-with-congenital-haemophilia-a-and-inhibitors
#8
J N Mahlangu, T A Andreeva, D E Macfarlane, C Walsh, N S Key
INTRODUCTION: Development of inhibitors to human FVIII (hFVIII) significantly complicates the control of bleeding events in patients with haemophilia A. AIM: This prospective, multicentre, open-label, non-comparative, Phase II study evaluated the haemostatic activity of a recombinant B-domain-deleted porcine FVIII (r-pFVIII), in the treatment of non-life/non-limb-threatening bleeding in individuals with haemophilia A and FVIII inhibitors. METHODS: Acute bleeding episodes in patients with pFVIII inhibitor titres <0...
October 20, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27752111/structural-and-haemostatic-features-of-pharmaceutical-heparins-from-different-animal-sources-challenges-to-define-thresholds-separating-distinct-drugs
#9
Ana M F Tovar, Gustavo R C Santos, Nina V Capillé, Adriana A Piquet, Bianca F Glauser, Mariana S Pereira, Eduardo Vilanova, Paulo A S Mourão
Heparins extracted from different animal sources have been conventionally considered effective anticoagulant and antithrombotic agents despite of their pharmacological dissimilarities. We performed herein a systematic analysis on the physicochemical properties, disaccharide composition, in vitro anticoagulant potency and in vivo antithrombotic and bleeding effects of several batches of pharmaceutical grade heparins obtained from porcine intestine, bovine intestine and bovine lung. Each of these three heparin types unambiguously presented differences in their chemical structures, physicochemical properties and/or haemostatic effects...
October 18, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27698519/uterotonics-for-non-emergent-caesarean-section-protocol-change-during-uk-licensed-drug-shortage
#10
C Malone, J R Acheson, J D Hinds, M H McComiskey
The aim was to assess the efficacy of Syntometrine (®) (500 micrograms ergometrine with 5 units oxytocin) as an appropriate alternative first-line uterotonic for use in elective caesarean section (CS) during a national shortage of UK-licensed IV oxytocin from April-June 2014. An observational study was performed involving 2 groups of 22 women undergoing elective CS in a UK DGH during this period. Primary endpoints included mean estimated blood loss (EBL), haemoglobin drop post-operatively and transfusion requirement...
September 2016: Ulster Medical Journal
https://www.readbyqxmd.com/read/27650431/alternatives-to-allogeneic-platelet-transfusion
#11
REVIEW
Michael J R Desborough, Peter A Smethurst, Lise J Estcourt, Simon J Stanworth
Allogeneic platelet transfusions are widely used for the prevention and treatment of bleeding in thrombocytopenia. Recent evidence suggests platelet transfusions have limited efficacy and are associated with uncertain immunomodulatory risks and concerns about viral or bacterial transmission. Alternatives to transfusion are a well-recognised tenet of Patient Blood Management, but there has been less focus on different strategies to reduce bleeding risk by comparison to platelet transfusion. Direct alternatives to platelet transfusion include agents to stimulate endogenous platelet production (thrombopoietin mimetics), optimising platelet adhesion to endothelium by treating anaemia or increasing von Willebrand factor levels (desmopressin), increasing formation of cross-linked fibrinogen (activated recombinant factor VII, fibrinogen concentrate or recombinant factor XIII), decreasing fibrinolysis (tranexamic acid or epsilon aminocaproic acid) or using artificial or modified platelets (cryopreserved platelets, lyophilised platelets, haemostatic particles, liposomes, engineered nanoparticles or infusible platelet membranes)...
November 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27630570/role-of-platelet-derived-microvesicles-as-crosstalk-mediators-in-atherothrombosis-and-future-pharmacology-targets-a-link-between-inflammation-atherosclerosis-and-thrombosis
#12
REVIEW
Lina Badimon, Rosa Suades, Eduardo Fuentes, Iván Palomo, Teresa Padró
Reports in the last decade have suggested that the role of platelets in atherosclerosis and its thrombotic complications may be mediated, in part, by local secretion of platelet-derived microvesicles (pMVs), small cell blebs released during the platelet activation process. MVs are the most abundant cell-derived microvesicle subtype in the circulation. High concentrations of circulating MVs have been reported in patients with atherosclerosis, acute vascular syndromes, and/or diabetes mellitus, suggesting a potential correlation between the quantity of microvesicles and the clinical severity of the atherosclerotic disease...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27580747/an-update-on-topical-haemostatic-agents-in-liver-surgery-systematic-review-and-meta-analysis
#13
REVIEW
Raffaele Brustia, Benjamin Granger, Olivier Scatton
Mortality and morbidity in hepatic surgery are affected by blood loss and transfusion. Topical haemostatic agents (THA) are composed by a matrix and/or fibrin sealants, and their association known as "carrier-bound fibrin sealant" (CBFS): despite widely used for secondary haemostasis, the level of evidence remains low. To realize a meta-analysis on the results of CBFS on haemostasis and postoperative complications. Searches in PubMed, PubMed Central, Cochrane and Google Scholar using keywords: "topical_haemostasis" OR "haemostatic_agents" OR "sealant_patch" OR "fibrin_sealant" OR "collagen_sealant" AND "liver_surgery" OR "hepatic_surgery" OR "liver_transplantation"...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27572274/the-use-of-haemostatic-agents-does-not-impact-the-rate-of-hemorrhagic-complications-in-patients-undergoing-partial-nephrectomy-for-renal-masses
#14
Yasmin Abu-Ghanem, Zohar Dotan, Issac Kaver, Dorit E Zilberman, Jacob Ramon
Hemostatic agents(HAs) have gained increasing popularity as interventions to improve perioperative haemostasis and diminish the need for allogeneic red cell transfusion(PBT) despite a paucity of data supporting the practice. The aim of the current study is to examine the efficacy of HAs in reducing the rate of hemorrhagic complications during partial nephrectomy(PN). Data on 657 patients, who underwent elective PN between 2004-2013, were analyzed. The impact of HAs and SURGICEL was evaluated by comparing four sequential groups of patients: Group1 = Sutures alone, Group2 = sutures and HA, Group3 = sutures and SURGICEL, Group4 = both HA and SURGICEL...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27566811/management-of-bleeding-in-vascular-surgery
#15
REVIEW
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27531805/-key-preparation-technique-and-clinical-application-of-frozen-platelets
#16
Guo-Liang Ding, Wei-Sheng Qin, Lin-Yuan Zhao, Lin Zhu, Yu-Fang Bo, Zhen Liu, Jing-Han Liu
OBJECTIVE: To explore the key technique for preparation of the frozen platelet and efficacy of its clinical application. METHODS: The influences of the donators' peripheral platelet count, starting time of freeze, injection rate and evenness of the freeze-protective agent, storage mode, re-melting temperature and the capacity of water-bath etc. on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis...
August 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/27515764/analysis-and-results-of-endoscopic-sinus-surgery-in-chronic-rhinosinusitis-with-polyps
#17
M Soledad Cabrera-Ramírez, M Sandra Domínguez-Sosa, Silvia Andrea Borkoski-Barreiro, Juan Carlos Falcón-González, Ángel Ramos-Macías
INTRODUCTION AND OBJECTIVES: Endoscopic sinus surgery is currently the surgical procedure chosen in cases of sinonasal polyposis refractory to medical treatment. The aim of this study was to show our experience in managing such patients operated using endoscopic sinus surgery. METHOD: A retrospective study of 246 patients with chronic rhinosinusitis and nasal polyps who were operated by endoscopic surgery. We studied the characteristics of the population, symptoms, grade of affectation, complications and recurrences...
August 8, 2016: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/27511890/recombinant-porcine-sequence-factor-viii-rpfviii-for-acquired-haemophilia-a-practical-clinical-experience-of-its-use-in-seven-patients
#18
M D Tarantino, A Cuker, B Hardesty, J C Roberts, M Sholzberg
INTRODUCTION: A recombinant porcine factor VIII B-domain-deleted product (rpFVIII; OBIZUR, Baxalta Incorporated, Deerfield, IL 60015, USA) was recently approved for treatment of bleeding episodes in adults with acquired haemophilia A (AHA) in the United States. To date, no clinical experience outside the registration study has been reported. AIM: To describe early clinical experience using rpFVIII for AHA. METHODS: A retrospective chart review of seven patients with AHA treated with rpFVIII at four institutions from November 2014 to October 2015...
August 10, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27510890/predicting-the-outcomes-of-using-longer-acting-prophylactic-factor-viii-to-treat-people-with-severe-hemophilia-a-a-hypothetical-decision-analysis
#19
A H Miners, S Krishnan, K J Pasi
Essentials No randomized trials have compared long-acting factor VIII (FVIII) with currently used products. A comparison was undertaken using a decision model to predict FVIII use and number of bleeds. In the base case, longer acting FVIII reduced factor use by 17% while resulting in similar bleeds. The value of longer acting FVIII will be largely determined by existing regimens and unit price. Click to hear Prof. Makris's presentation on new treatments in hemophilia SUMMARY: Background Recently, factor VIII (FVIII) products with longer half-lives, such as recombinant FVIII Fc fusion protein (rFVIIIFc), have become available...
November 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27490907/use-of-thrombin-based-haemostatic-matrix-in-head-and-neck-reconstructions-a-potential-risk-factor-for-pulmonary-embolism
#20
Brian Y T Yue, Richard Zinn, Rachael Roberts, Jeremy Wilson
BACKGROUND: Haemostatic agents including thrombin-based haemostatic matrix are widely used in patients undergoing cardiac, vascular and spinal surgery. These agents promote local haemostasis through activation of the clotting cascade. To our knowledge, this case series is the first report of pulmonary embolization associated with FloSeal following head and neck oncology resection and free flap reconstruction. METHODS: We present five patients who were diagnosed with symptomatic pulmonary embolism after oncologic head and neck free flap reconstructions in 2014 and 2015...
August 3, 2016: ANZ Journal of Surgery
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