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Heparin in kawasaki

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https://www.readbyqxmd.com/read/27665207/factors-associated-with-resource-utilization-and-coronary-artery-dilation-in-refractory-kawasaki-disease-from-the-pediatric-health-information-system-database
#1
Jennifer Y Lo, L LuAnn Minich, Lloyd Y Tani, Jacob Wilkes, Qian Ding, Shaji C Menon
Management guidelines for refractory Kawasaki disease (KD) are vague. We sought to assess practice variation and identify factors associated with large/complex coronary artery aneurysms (LCAA) and resource utilization in refractory KD. This retrospective cohort study identified patients aged ≤18 years with KD (2004 to 2014) using the Pediatric Health Information System. Refractory KD was defined as receiving >1 dose of intravenous immunoglobulin. Demographics, medications, concomitant infections, length of stay (LOS), and charges were collected...
August 31, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/26635941/kawasaki-disease-and-peripheral-gangrene-in-infancy
#2
Iran Malekzadeh, Vahid Ziaee, Taravat Sadrosadat, Mohammad-Hassan Moardinejad, Keyhan Sayadpour-Zanjani
INTRODUCTION: Early diagnosis and treatment of Kawasaki disease as the most common cause of acquired heart disease in childhood, may significantly improve the prognosis. Diagnosing infantile Kawasaki (younger than a year) is difficult because of obscure symptoms; at the same time they are at the higher risk of coronary abnormalities. CASE PRESENTATION: We report three infants with prolonged (more than 5 days) fever and peripheral gangrene without any other clinical manifestations of Kawasaki disease...
December 2015: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/26171683/strict-management-of-a-pregnant-patient-with-giant-coronary-artery-aneurysm-due-to-kawasaki-disease
#3
Kosuke Taniguchi, Hiroshi Ono, Anna Sato, Satoko Kinomoto, Naomi Tagawa, Nagayoshi Umehara, Hitoshi Kato, Haruhiko Sago
Coronary artery aneurysms (CAA) may occur in Kawasaki disease (KD). Patients with giant CAA (diameter >8 mm), in particular, have higher risk of myocardial infarction. Previous reports have demonstrated the necessity of anticoagulation therapy in such cases. The management of patients with KD complicated by giant CAA later in life, however, remains controversial. Here, we describe the strict management in the case of a 28-year-old pregnant Japanese woman with KD with giant CAA (diameter, 11 mm). Instead of warfarin, the patient was given low-dose aspirin and i...
October 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/25298222/low-dose-antithrombotic-treatment-in-coronary-thrombosis-of-kawasaki-disease
#4
Hua Peng, Zubo Wu, Yalan Liu, Ling Li, Shuangshuang Kong, Jing Wu, Yali Liu
To explore effective and convenient rescue therapy options for coronary artery aneurysms (CAA) with thrombosis in Kawasaki disease (KD). A total of 210 patients with KD between the years 2003 and 2013 were retrospectively reviewed in our institute. 144 of these 210 KD developed CAA, and 10 patients with CAA had associated thrombosis. Thrombosis was confirmed by two-dimensional echocardiograms (2-DE). Laboratory values for CAA were analyzed with and without the thrombus group. The characteristics of CAA were monitored by ultrasound...
March 2015: Pediatric Cardiology
https://www.readbyqxmd.com/read/24495764/-six-kawasaki-disease-patients-with-acute-coronary-artery-thrombosis
#5
Shu-lai Zhou, Jian-ping Luo, Yan-qi Qi, Yu-guang Liang, Wei Wang, Fang-qi Gong
OBJECTIVE: To improve the awareness of acute coronary artery thrombosis in Kawasaki disease (KD). METHOD: Six KD patients with acute coronary artery thrombosis (Jan. 2004 to Jan. 2013) were studied retrospectively. The basic information, clinical manifestations, laboratory data, echocardiography and electrocardiography (ECG), method and consequence of thrombolytic therapy were analyzed. RESULT: The mean age of patients with coronary artery thrombosis (5 males and 1 female) was (17...
December 2013: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/24479564/effect-of-dalteparin-a-low-molecular-weight-heparin-as-adjunctive-therapy-in-patients-with-kawasaki-disease-a-retrospective-study
#6
COMPARATIVE STUDY
Yasuji Inamo, Katsuya Saito, Maki Hasegawa, Rika Hayashi, Takahiro Nakamura, Osamu Abe, Teruaki Ishikawa, Yayoi Yoshino, Koji Hashimoto, Tatsuo Fuchigami
BACKGROUND: Dalteparin, a low-molecular-weight heparin, has anticoagulant and anti-angiogenic activity. This study investigated whether dalteparin reduced coronary artery lesion (CAL) prevalence, and resistance to intravenous immunoglobulin (IVIG) therapy in Kawasaki disease (KD). METHODS: This retrospective study comprised two parts. In the first cohort, 126 patients with KD (68 male, 58 female; median age: 22 months, range: 1-67 months) admitted to Nihon University Nerima-Hikarigaoka Hospital from January 2004 to June 2008, received either dalteparin 75 IU/kg/day, IVIG 400 mg/kg/day for 5 consecutive days, and aspirin 30 mg/kg/day, or dalteparin 75 IU/kg/day and aspirin 30 mg/kg/day, until clinical improvement...
2014: BMC Pediatrics
https://www.readbyqxmd.com/read/23827519/determination-of-galactosamine-impurities-in-heparin-sodium-using-fluorescent-labeling-and-conventional-high-performance-liquid-chromatography
#7
Satsuki Itoh, Yoko Hiruta, Noritaka Hashii, Naho Fujita, Toru Natsuga, Toshiaki Hattori, Aya Bando, Yuko Sekimoto, Kazuyoshi Miyata, Hiroshi Namekawa, Kazunori Mabuchi, Toru Sakai, Hirotoshi Shimahashi, Kenzo Kawai, Hikaru Yoden, Sadatoshi Koyama, Susanne Odgaard Herr, Shunji Natsuka, Teruhide Yamaguchi, Nana Kawasaki
Heparin is a sulfated glycosaminoglycan (GAG), which contains N-acetylated or N-sulfated glucosamine (GlcN). Heparin, which is generally obtained from the healthy porcine intestines, is widely used as an anticoagulant during dialysis and treatments of thrombosis such as disseminated intravascular coagulation. Dermatan sulfate (DS) and chondroitin sulfate (CS), which are galactosamine (GalN)-containing GAGs, are major process-related impurities of heparin products. The varying DS and CS contents between heparin products can be responsible for the different anticoagulant activities of heparin...
November 2013: Biologicals: Journal of the International Association of Biological Standardization
https://www.readbyqxmd.com/read/23200896/antithrombotic-and-anticoagulant-effects-of-direct-factor-xa-inhibitor-darexaban-in-rat-and-rabbit-models-of-venous-thrombosis
#8
COMPARATIVE STUDY
Seiji Kaku, Toshio Uemura, Minori Saitoh, Ken-ichi Suzuki, Yoshiyuki Iwatsuki, Toshiyuki Funatsu, Tomihisa Kawasaki
The oral direct factor Xa inhibitor darexaban administered intraduodenally prevented venous thrombus formation in both rats and rabbits with no effect on bleeding. The indirect parenteral Factor Xa inhibitor fondaparinux exerted similar properties, only prolonging bleeding time at extremely high doses. In contrast, the thrombin inhibitor ximelagatran and low-molecular-weight heparin enoxaparin prolonged bleeding time at antithrombotic doses. Studies using human platelets showed darexaban glucuronide, a darexaban metabolite that predominantly determines darexaban antithrombotic effects in vivo, had no effect on platelet activation and aggregation, while heparin and enoxaparin activated platelets...
January 15, 2013: European Journal of Pharmacology
https://www.readbyqxmd.com/read/22401805/novel-anti-hiv-1-activity-produced-by-conjugating-unsulfated-dextran-with-polyl-lysine
#9
Kosuke Nakamura, Takahiro Ohtsuki, Haruyo Mori, Hiroo Hoshino, Ariful Hoque, Atsushi Oue, Fumie Kano, Hiromi Sakagami, Ken-ichi Tanamoto, Hiroshi Ushijima, Nana Kawasaki, Hiroshi Akiyama, Haruko Ogawa
A conjugate of polyL-lysine (PLL) with unsulfated dextran produced by reductive amination was found to have remarkable anti-HIV-1 activity against both the macrophage-tropic R5 virus Ba-L and T-cell line tropic X4 virus IIIB strains, although neither PLL nor dextran has such activity. The conjugate is a pseudoproteoglycan (pseudoPG) that simulates the structure of a proteoglycan. Conjugation with dextran was found to produce an antiviral effect in three kinds of assay systems including a human CD4(+) T-cell line, and the pseudoPG synthesized using 10 kDa PLL and 10 kDa dextran showed EC(50) 4-40 times lower than that of sulfated dextran or heparin against Ba-L and EC(50) equal to that against IIIB, indicating that PLL-dextran (PLL-Dex) was more effective against R5 virus than sulfated polysaccharides...
April 2012: Antiviral Research
https://www.readbyqxmd.com/read/22396066/establishment-and-clinical-application-of-a-highly-sensitive-enzyme-immunoassay-for-determination-of-n-acetyl-seryl-aspartyl-lysyl-proline
#10
Yosuke Suzuki, Hiroki Itoh, Fumihiko Katagiri, Fuminori Sato, Kanako Kawasaki, Yuhki Sato, Hiromitsu Mimata, Masaharu Takeyama
N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) is a natural inhibitor of pluripotent hematopoietic stem cell proliferation and is normally found in human plasma. Because AcSDKP is hydrolyzed by the N-terminal active site of angiotensin converting enzyme and partially eliminated in urine, its plasma level is a result of a complex balance between its production, hydrolysis by ACE, and renal elimination. In this study, we attempted to establish an enzyme immunoassay (EIA) for quantifying AcSDKP-like immunoreactive substance (IS), which is applicable for monitoring plasma AcSDKP levels in healthy subjects and patients with chronic renal failure...
April 2012: Journal of Peptide Science: An Official Publication of the European Peptide Society
https://www.readbyqxmd.com/read/21206260/anticoagulation-therapy-indications-monitoring-and-complications
#11
REVIEW
Elliot Long, Alexander F Pitfield, Niranjan Kissoon
Anticoagulation for thromboembolic disease and bleeding, the main complication of anticoagulation therapy, are uncommon but are potentially life- or limb-threatening conditions that may present in the pediatric emergency department. Thromboembolic disease in children usually occurs as a complication of vascular access, primarily in children with congenital heart disease or cancer. However, complications of anticoagulation therapy used in the treatment of venous thromboembolism, pulmonary embolism, and blocked central venous catheter; arterial thromboembolism, including arterial ischemic stroke, Kawasaki disease, and after cardiac surgery, may warrant a visit to n the pediatric emergency department...
January 2011: Pediatric Emergency Care
https://www.readbyqxmd.com/read/20452241/heparin-identification-test-and-purity-test-for-oscs-in-heparin-sodium-and-heparin-calcium-by-weak-anion-exchange-high-performance-liquid-chromatography
#12
Noritaka Hashii, Nana Kawasaki, Satsuki Itoh, Yan Qin, Naho Fujita, Toshiaki Hattori, Kazuyoshi Miyata, Aya Bando, Yuko Sekimoto, Takeshi Hama, Masaki Kashimura, Masashi Tatsumi, Kazunori Mabuchi, Hiroshi Namekawa, Toru Sakai, Mio Hirose, Sei Dobashi, Hirotoshi Shimahashi, Sadatoshi Koyama, Susanne Odgaard Herr, Kenzo Kawai, Hikaru Yoden, Teruhide Yamaguchi
Heparin sodium and heparin calcium, which are widely used as anti-coagulants, are known to potentially contain the natural impurity dermatan sulfate (DS). Recently serious adverse events occurred in patients receiving heparin sodium in the US, and a contaminant oversulfated chondroitin sulfate (OSCS) was found to be a cause of the events. To ensure the quality and safety of pharmaceutical heparins, there is need of a physicochemical identification test that can discriminate heparin from the heparin-related substances as well as a sensitive purity test for OSCS...
September 2010: Biologicals: Journal of the International Association of Biological Standardization
https://www.readbyqxmd.com/read/20431996/long-term-anticoagulation-in-kawasaki-disease-initial-use-of-low-molecular-weight-heparin-is-a-viable-option-for-patients-with-severe-coronary-artery-abnormalities
#13
COMPARATIVE STUDY
Cedric Manlhiot, Leonardo R Brandão, Zeeshanefatema Somji, Amy L Chesney, Catherine MacDonald, Rebecca C Gurofsky, Tarun Sabharwal, Nita Chahal, Brian W McCrindle
Patients with severe coronary artery involvement after Kawasaki disease (KD) require long-term systemic anticoagulation. We sought to compare our experience with thrombotic coronary artery occlusions, safety profile, and degree of coronary artery aneurysm regression in KD patients treated with low molecular weight heparin (LMWH) versus warfarin. Medical records of all KD patients diagnosed between January 1990 and April 2007 were reviewed. Of 1374 KD patients, 38 (3%) received systemic anticoagulation, 25 patients received LMWH from diagnosis onward, 12 of whom were subsequently switched to warfarin, and 13 received warfarin from onset...
August 2010: Pediatric Cardiology
https://www.readbyqxmd.com/read/20422172/acute-myocardial-infarction-caused-by-transient-coronary-vasospasm-in-a-child-with-kawasaki-disease-and-no-coronary-aneurysms
#14
Subhashini Subramanian, Winston E Gaum
We report a 15-month old girl with acute myocardial infarction 3 months after treatment for Kawasaki disease (KD); she had no coronary aneurysms. In the first 2 months after KD, she had normal electrocardiograms (ECGs) and echocardiograms that showed mildly dilated coronary arteries. At 3 months, she was asymptomatic but developed ECG changes of anteroseptal MI and increased troponin levels. Echocardiogram showed regional wall-motion abnormalities and decreased left ventricular function. She was admitted and treated with heparin and nitroglycerin drips...
August 2010: Pediatric Cardiology
https://www.readbyqxmd.com/read/19797882/-capillary-electrophoresis-analysis-of-contaminants-in-heparin-sodium-for-the-japanese-pharmacopoeia-purity-test
#15
Naotaka Kakoi, Mitsuhiro Kinoshita, Nana Kawasaki, Teruhide Yamaguchi, Takao Hayakawa, Kazuaki Kakehi
Heparin is widely used as an anticoagulant for the treatment and prevention of thrombotic disorders. Recently, hundreds of cases of anaphylactic reaction as adverse effects were reported by the presence of contaminating oversulfated chondroitin sulfate (OSCS) in some heparin preparations. In addition, these heparin preparations often contaminated dermatan sulfate (DS). Unfortunately, the Japanese Pharmacopoeia (JP) does not include appropriate purity tests. In the present paper, we show that capillary electrophoresis (CE) is a powerful tool for the analysis of OSCS and DS in heparin preparations...
October 2009: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/19763062/hemostatic-effectiveness-of-a-new-application-method-for-fibrin-glue-the-rub-and-spray-method-in-emergency-aortic-surgery-for-acute-aortic-dissection
#16
RANDOMIZED CONTROLLED TRIAL
Naoki Minato, Yuji Katayama, Junji Yunoki, Hiromitsu Kawasaki, Hisashi Satou
PURPOSE: This study was performed to evaluate the clinical hemostatic effectiveness of a new application method for fibrin glue, the rub-and-spray method, in aortic surgery. METHODS: Twenty consecutive patients undergoing emergency ascending aorta or ascending-hemiarch replacement for Stanford type A acute aortic dissection were prospectively randomized into 2 groups, one with the rub-and-spray method (group G, 10 patients) and one without fibrin glue (group C, 10 patients)...
August 2009: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/18930744/tat-conjugation-of-adenovirus-vector-broadens-tropism-and-enhances-transduction-efficiency
#17
Yasuo Yoshioka, Ratima Asavatanabodee, Yusuke Eto, Hikaru Watanabe, Tomohiro Morishige, Xinglei Yao, Shinya Kida, Mitsuko Maeda, Yohei Mukai, Hiroyuki Mizuguchi, Koichi Kawasaki, Naoki Okada, Shinsaku Nakagawa
AIMS: Adenovirus vectors (Advs) have been very useful for basic research and clinical gene therapy because they propagate to high titers and efficiently transduce cells and tissues regardless of the mitotic status. However, poor transduction of cells that lack the coxsackievirus and adenovirus receptor (CAR), the primary receptor for Advs, has limited Adv application. In this study, we attempted to generate novel Tat-Advs (Advs conjugated with the HIV Tat-derived peptide, a protein-transduction domain (PTD)) to broaden Adv tropism and enhance transduction efficiency...
November 21, 2008: Life Sciences
https://www.readbyqxmd.com/read/18685443/safety-and-efficacy-of-lower-dose-unfractionated-heparin-for-prophylaxis-of-deep-vein-thrombosis-and-pulmonary-embolism-in-an-asian-population
#18
Hiromi Ugaki, Takayuki Enomoto, Kazuko Fujiwara, Tadashi Kimura, Tomio Kawasaki
The objective of this study is to analyze the tolerance and efficacy of the subcutaneous administration of a reduced 2,500-unit low-dose unfractionated heparin given for an efficacious, yet Asian population-sensitive, prophylaxis for deep vein thrombosis and fatal pulmonary embolism. Eighty-seven Japanese patients were operated on either for abdominal or pelvic complications or both, as well as for gynecologic conditions including ovarian, cervical, and corpus cancers. Thirty-two of the patients were administered the experimental low dose of unfractionated calcium heparin for prophylaxis...
September 2008: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/18446365/pulse-methylprednisolone-with-gammaglobulin-as-an-initial-treatment-for-acute-kawasaki-disease
#19
Keiko Okada, Junichi Hara, Ichiro Maki, Kazunori Miki, Kouji Matsuzaki, Taro Matsuoka, Takehisa Yamamoto, Toshinori Nishigaki, Syunji Kurotobi, Tetsuya Sano et al.
Approximately 15-20% of patients with Kawasaki disease (KD) are not responsive to high-dose intravenous gammaglobulin (IVIG). We have previously reported a predictive method for identifying IVIG-non-responsive patients (high-risk KD patients). We determined the safety and effectiveness of pulse methylprednisolone with high-dose IVIG (mPSL+IVIG) as a primary treatment for high-risk KD patients. Sixty-two high-risk KD patients were treated with pulse methylprednisolone 30 mg/kg over 2 h, followed by IVIG 2 g/kg over 24 h (mPSL+IVIG group) and were compared with a historical control group of 32 high-risk patients treated with IVIG 2 g/kg alone at the participating hospitals before this study was opened (IVIG group)...
February 2009: European Journal of Pediatrics
https://www.readbyqxmd.com/read/18402791/angiogenesis-tumor-necrosis-factor-alpha-and-procoagulant-factors-in-coronary-artery-giant-aneurysm-of-a-fatal-infantile-kawasaki-disease
#20
Angela Pucci, Silvana Martino, Angela Celeste, Alessandra Linari, Maria Tibaldi, Elisa Camosso, Maruska Muscio, Giacomo Barattia, Caterina Riva, Giovanni Bartoloni
BACKGROUND: Kawasaki disease (KD) is an infantile febrile illness of unknown origin characterized by clinical, laboratory and histopathologic features of systemic vasculitis. METHODS AND RESULTS: We report a 3-month-old female infant with incomplete KD who suddenly died despite intravenous immunoglobulin, aspirin, steroid and heparin treatment. Postmortem examination confirmed the echocardiographically detected giant coronary aneurysms and showed occlusive thrombosis in the giant aneurysm of the left anterior descending coronary artery, associated with neoangiogenesis, macrophage infiltration and immunostaining for tissue factor (a strong initiator of the coagulation cascade), thrombopoietin receptor and tumour necrosis factor-alpha...
May 2008: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
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