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Coagulation & Hemostasis

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https://www.readbyqxmd.com/read/29790188/coagulation-failure-in-patients-with-acute-on-chronic-liver-failure-aclf-and-decompensated-cirrhosis-beyond-inr
#1
Annabel Blasi, Andrea Calvo, Verónica Prado, Enric Reverter, Juan Carlos Reverter, María Hernández-Tejero, Fátima Aziz, Alex Amoros, Andres Cardenas, Javier Fernández
Balanced hemostasis with hypo and hypercoagulable features may occur in acute-on-chronic liver failure. Characteristics and prognostic impact of the coagulation profile in acute-on-chronic liver failure are unknown. METHODS: Consecutive patients with acute-on-chronic liver failure (n=36) and acute decompensation (n=24) were included. Blood samples for thromboelastometry (ROTEM®) were obtained at admission and 72h thereafter. Coagulation profile was evaluated in patients with and without acute-on-chronic liver failure and in those with and without systemic inflammatory response syndrome...
May 23, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29787319/usefulness-of-multiple-electrode-aggregometry-as-a-screening-tool-for-bleeding-disorders-in-a-pediatric-hospital
#2
Thorsten Haas, Melissa M Cushing, Stephanie Varga, Séverine Gilloz, Markus Schmugge
Platelet function testing is a cornerstone in the diagnostic investigation of patients with a bleeding history. Multiple electrode aggregometry (MEA) has been shown to detect von Willebrand disease (VWD), platelet function disorders, and drug-induced bleeding disorders. However, there are few studies supporting its successful use in children. We have implemented and used MEA over 3 years in our hemostasis laboratory in order to study its usefulness to supplement and expedite diagnosis. This is a retrospective, single-center, cohort study of 109 hospitalized children who underwent a laboratory investigation of hemostasis and either had a reported bleeding history or an abnormal bleeding episode...
May 22, 2018: Platelets
https://www.readbyqxmd.com/read/29772593/-coagulation-monitoring-and-bleeding-management-in-cardiac-surgery
#3
Berthold Bein, Robert Schiewe
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29769447/aquaporin-1-regulates-platelet-procoagulant-membrane-dynamics-and-in-vivo-thrombosis
#4
Ejaife O Agbani, Christopher M Williams, Yong Li, Marion Tj van den Bosch, Samantha F Moore, Adele Mauroux, Lorna Hodgson, Alan S Verkman, Ingeborg Hers, Alastair W Poole
In response to collagen stimulation, platelets use a coordinated system of fluid entry to undergo membrane ballooning, procoagulant spreading, and microvesiculation. We hypothesized that water entry was mediated by the water channel aquaporin-1 (AQP1) and aimed to determine its role in the platelet procoagulant response and thrombosis. We established that human and mouse platelets express AQP1 and localize to internal tubular membrane structures. However, deletion of AQP1 had minimal effects on collagen-induced platelet granule secretion, aggregation, or membrane ballooning...
May 17, 2018: JCI Insight
https://www.readbyqxmd.com/read/29769259/novel-therapeutics-for-hemophilia-and-other-bleeding-disorders
#5
Michael U Callaghan, Robert Sidonio, Steven W Pipe
Hemophilia and von Willebrand disease are the most common congenital bleeding disorders. Treatment for these disorders has focused on replacement of the missing coagulation factor to prevent or treat bleeding. New technologies and insights into hemostasis have driven the development of many promising new therapies for hemophilia and von Willebrand disease. Emerging bypass agents including zymogen-like factor IXa and Xa molecules are in development and a bispecific antibody, emicizumab, demonstrated efficacy in a phase III trial in people with hemophilia A and inhibitors...
May 16, 2018: Blood
https://www.readbyqxmd.com/read/29768939/higher-preoperative-plasma-thrombin-potential-in-patients-undergoing-surgery-for-aortic-stenosis-compared-to-surgery-for-stable-coronary-artery-disease
#6
Axel Dimberg, Ulrica Alström, Elisabeth Ståhle, Christina Christersson
Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29761104/platelets-in-immune-response-to-virus-and-immunopathology-of-viral-infections
#7
REVIEW
Eugenio D Hottz, Fernando A Bozza, Patrícia T Bozza
Platelets are essential effector cells in hemostasis. Aside from their role in coagulation, platelets are now recognized as major inflammatory cells with key roles in the innate and adaptive arms of the immune system. Activated platelets have key thromboinflammatory functions linking coagulation to immune responses in various infections, including in response to virus. Recent studies have revealed that platelets exhibit several pattern recognition receptors (PRR) including those from the toll-like receptor, NOD-like receptor, and C-type lectin receptor family and are first-line sentinels in detecting and responding to pathogens in the vasculature...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#8
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29749651/effects-of-immunosuppressive-agents-on-the-hemostatic-system-in-normal-dogs
#9
John M Thomason, Todd M Archer, Robert W Wills, Andrew J Mackin
BACKGROUND: In dogs, the effects of immunosuppressive medications on hemostasis are not well known. HYPOTHESIS/OBJECTIVES: The objective was to determine the effects of immunosuppressive medications on primary and secondary hemostasis. Our hypothesis was that cyclosporine and prednisone would increase markers of hypercoagulability and thromboxane synthesis, while azathioprine, mycophenolate mofetil, and leflunomide would have minimal effects on hemostasis. ANIMALS: Eight healthy dogs...
May 10, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29749244/influence-of-perioperative-hypothermia-on-blood-clotting-in-children
#10
A Trckova, P Stourac
OBJECTIVES: The decrease of body temperature is one of the causes of blood clotting disorders. BACKGROUND: Accidental hypothermia during anesthesia is a common condition and children, especially newborns, are the most sensitive patients to the side effects of hypothermia. METHODS: Web of Science, SCOPUS and PubMed search was performed to retrieve both original and review articles addressing both, hypothermia during surgery and coagulation disorder in pediatric patients...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29748826/the-invention-of-microwave-surgical-scissors-for-seamless-coagulation-and-cutting
#11
Tohru Tani, Shigeyuki Naka, Soichiro Tani, Hisanori Shiomi, Koichiro Murakami, Atsushi Yamada, Dang Tran Khiem
PURPOSE: We developed a microwave energy-based scissors device (MWCX) that is capable of performing cutting and coagulation using 2.45 GHz microwave energy. This paper aims to present the concept of the device and assess the basic functions including the hemostasis, cutting, and sealing abilities. METHODS: Seven beagle dogs were used in our experiments. In six dogs, we measured the coagulation time (CT), lateral thermal injury (LTI), bursting pressure (BP). The dogs were then subjected to re-laparotomy 1 week later to allow us to investigate the results...
May 10, 2018: Surgery Today
https://www.readbyqxmd.com/read/29741463/influence-of-needle-gauge-used-for-venipuncture-on-measures-of-hemostasis-in-cats
#12
Susanna Solbak, Steven E Epstein, Kate Hopper
Objectives The objective of this study was to evaluate the effect of different needle sizes used to obtain blood via jugular venipuncture in cats on routine measures of hemostasis. Methods This was a prospective, observational, randomized, clinical study carried out at a university teaching hospital. Twenty healthy, client-owned cats were used. Results Each cat had blood collected via direct venipuncture from both jugular veins. Sampling of the right and left jugular vein was randomized to be collected with either a 22 G or a 25 G needle, respectively, and routine coagulation variables and platelet count were performed on all samples...
May 1, 2018: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29739232/comparison-of-the-coagulation-effect-achieved-by-octaplaslg-versus-fresh-frozen-plasma-in-pediatric-cardiac-surgical-patients
#13
Amanpreet S Kalsi, Omar Al-Azzawi, Ravi Gill
OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have beneficial effects when considering the transmission of enveloped viruses. Additionally, it has the potential for fewer adverse reactions, reduced disease transmission, and a more homogenous coagulation factor composition. However, its efficacy and safety have not yet been evaluated in the pediatric population...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29731231/structural-properties-of-the-human-protease-activated-receptor-1-changing-by-a-strong-antagonist
#14
Patrizia M Spoerri, Hideaki E Kato, Moritz Pfreundschuh, Stefania A Mari, Tetiana Serdiuk, Johannes Thoma, K Tanuj Sapra, Cheng Zhang, Brian K Kobilka, Daniel J Müller
The protease-activated receptor 1 (PAR1), a G protein-coupled receptor (GPCR) involved in hemostasis, thrombosis, and inflammation, is activated by thrombin or other coagulation proteases. This activation is inhibited by the irreversible antagonist vorapaxar used for anti-platelet therapy. Despite detailed structural and functional information, how vorapaxar binding alters the structural properties of PAR1 to prevent activation is hardly known. Here we apply dynamic single-molecule force spectroscopy to characterize how vorapaxar binding changes the mechanical, kinetic, and energetic properties of human PAR1 under physiologically relevant conditions...
April 17, 2018: Structure
https://www.readbyqxmd.com/read/29730103/value-of-routine-preoperative-tests-for-coagulation-before-elective-cranial-surgery-results-of-an-institutional-audit-and-a-nationwide-survey-of-neurosurgical-centers-in-pakistan
#15
Naveed Zaman Akhunzada, Muhammad Bilal Tariq, Saad Akhtar Khan, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar Dogar
Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. MATERIAL AND METHODS: This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29727892/hemostasis-during-extreme-exertion
#16
Cécile Hélène Kicken, Adam Miszta, Hilde Kelchtermans, Bas De Laat
Exercise is protective against cardiovascular disease, but can also provoke sudden cardiac death, a phenomenon referred to as "the exercise paradox." Extreme exertion is known to induce a rebalanced hemostatic state by causing hypercoagulability and concomitantly enhanced fibrinolysis. Over the past decade, novel techniques for quantifying hemostasis have been introduced, which may provide new insights into this process. This review summarizes recent literature on the effect of extreme exertion of both short and long duration on coagulation, fibrinolysis, and recovery of hemostatic balance...
May 4, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29727017/recent-advances-in-the-discovery-and-development-of-factor-xi-xia-inhibitors
#17
REVIEW
Rami A Al-Horani, Daniel K Afosah
Factor XIa (FXIa) is a serine protease homodimer that belongs to the intrinsic coagulation pathway. FXIa primarily catalyzes factor IX activation to factor IXa, which subsequently activates factor X to factor Xa in the common coagulation pathway. Growing evidence suggests that FXIa plays an important role in thrombosis with a relatively limited contribution to hemostasis. Therefore, inhibitors targeting factor XI (FXI)/FXIa system have emerged as a paradigm-shifting strategy so as to develop a new generation of anticoagulants to effectively prevent and/or treat thromboembolic diseases without the life-threatening risk of internal bleeding...
May 4, 2018: Medicinal Research Reviews
https://www.readbyqxmd.com/read/29724628/the-rare-coexistence-of-high-titer-inhibitor-development-and-gastrointestinal-stromal-tumor-in-a-patient-with-severe-hemophilia-a-case-report
#18
Abdulkerim Yıldız, Osman Şahin, Okan Yayar, Çiğdem Pala Öztürk, Hacer Berna Afacan Öztürk, Senem Maral, Harika Okutan, Murat Albayrak
Hemophilia is a hereditary disease with impaired blood coagulation due to a genetic deficiency of blood coagulation factors. The development of inhibitors further complicates the course of the disease and management. The case is here reported of a haemophilia patient who presented with coexisting development of high titer inhibitor with Gastrointestinal Stromal Tumor (GIST) diagnosis and was admitted with upper gastrointestinal system bleeding. The patient had no prior history of inhibitor presence. During all procedures including surgery, excellent hemostasis was achieved with rFVIIa treatment and no hemorrhagic complication was observed...
April 26, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29718819/understanding-diabetic-induction-of-cellular-senescence-a-concise-review
#19
Matthew Regulski
OBJECTIVE: This study examines the healing dynamics of in vivo porcine muscle tissue wounds hemostatically treated with a saline-coupled bipolar tissue sealer (SCBS) compared with traditional electrosurgical (ES) coagulation. MATERIALS AND METHODS: Six cutaneous incisions were created on the dorsum of 28 adult male Yorkshire swine. The underlying muscle tissue was incised with a cold scalpel then treated with either SCBS (at 170 W) or traditional ES (at Coag 45 W)...
April 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29704268/characteristics-of-hemostasis-during-experimental-ehrlichia-canis-infection
#20
Sarah Shropshire, Christine Olver, Michael Lappin
BACKGROUND: Ehrlichia canis infection in dogs can cause thrombocytopenia and clinical evidence of bleeding. It is unknown why some dogs show signs of bleeding whereas others do not despite clinically relevant thrombocytopenia. HYPOTHESIS/OBJECTIVES: Activated platelets, decreased fibrinolysis or both mitigate bleeding tendency. Assess standard hemostatic variables, platelet dynamics, and specialized coagulation testing in dogs experimentally infected with E. canis to evaluate this clinical discrepancy...
April 27, 2018: Journal of Veterinary Internal Medicine
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