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Tranexamic Acid

Claudio Rostetter, Tim Finkenstädt, Martin Rücker, Heinz-Theo Lübbers
This manuscript provides an overview of therapeutic options for the problem of bleeding in a dentist’s office. Bleeding after tooth extraction is a very common finding in dental medicine and persistent blood in the mouth is obviously uncomfortable and sometimes terrifying for the patient. Most bleedings can be stopped simply with compression, in some cases a homeostatic therapy is necessary. For local compression, a swab with tranexamic acid is useful. If local compression is not sufficient, sutures are often an option...
June 18, 2018: Swiss Dental Journal
Michelle Ng, Jerrold Perrott, Sarah Burgess
INTRODUCTION: Tranexamic acid (TXA) has been shown to decrease mortality in adult trauma patients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult trauma patients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive trauma patients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury...
June 5, 2018: American Journal of Emergency Medicine
Wenbo Wei, Shajie Dang, Dapeng Duan, Ling Wei
BACKGROUND: To investigate the clinical effectiveness of intravenous (IV) and topical tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA) by comparing safety, efficacy and patient-reported outcomes. METHODS: In this prospective single-blind clinical trial, 64 patients were randomized into two groups (n = 32 each). The Intravenous Group was administered TXA 10 mg/kg IV (Reyong, Shandong, China) 10 min prior to tourniquet deflation. In the Topical Group, 1...
June 13, 2018: BMC Musculoskeletal Disorders
Nicole Lay Tin Tan, Justin Lindley Hunt, Stella May Gwini
BACKGROUND: Enhanced recovery after surgery programs may improve recovery and reduce duration of hospital stay after joint replacement surgery. However, uptake is incomplete, and the relative importance of program components is unknown. This before-and-after quality improvement study was designed to determine whether adding 'non-surgical' components, to pre-existing 'surgical' components, in an Australian private healthcare setting, would improve patient recovery after total hip replacement...
June 13, 2018: BMC Anesthesiology
Christian Ovesen, Janus Christian Jakobsen, Christian Gluud, Thorsten Steiner, Zhe Law, Katie Flaherty, Rob A Dineen, Philip M Bath, Nikola Sprigg, Hanne Christensen
OBJECTIVE: We present the statistical analysis plan of a prespecified Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 sub-study aiming to investigate, if tranexamic acid has a different effect in intracerebral haemorrhage patients with the spot sign on admission compared to spot sign negative patients. The TICH-2 trial recruited above 2000 participants with intracerebral haemorrhage arriving in hospital within 8 h after symptom onset. They were included irrespective of radiological signs of on-going haematoma expansion...
June 13, 2018: BMC Research Notes
Nicole Souper, Claudia Jiménez, Felipe Maldonado
Decompressive craniectomy (DC) is a therapeutic alternative for reducing intracranial pressure after a middle cerebral artery stroke. If thrombolytic therapy is administered, craniectomy is usually postponed for at least 24 hours due to a risk of severe bleeding. We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed...
June 11, 2018: A&A practice
Pablo Mariani, Martin A Buttaro, Pablo A Slullitel, Fernando M Comba, Gerardo Zanotti, Pablo Ali, Francisco Piccaluga
INTRODUCTION: Hip revision surgery is associated with a high probability of the necessity for a blood transfusion. Different studies support the use of tranexamic acid (TXA) to decrease the rate of transfusions in primary hip surgery. Nevertheless, the use of this drug in hip revision surgery has not yet been widely accepted. The aim of our study was to establish the rate of blood transfusion with and without TXA in hip revision surgery. METHODS: We retrospectively studied 125 hip revision surgery patients operated on between 2011 and 2014...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mauricio Polanco-García, Ana María Capielo, Xavier Miret, Antonio Chamero, Julio Sainz, Elena Revilla, Antoni Guinjoan, Teresa Arranz
BACKGROUND AND OBJECTIVES: Patient blood management in orthopaedic surgery reduces transfusion risk. The best protocol is unknown. The effectiveness of a protocol based on the Seville Consensus on the reduction of transfusion risk is evaluated and a predictive transfusion equation is proposed in knee surgery. PATIENTS AND METHODS: Cohort study in patients undergoing knee and hip arthroplasty from January 2014 to December 2015 at a second level complexity hospital in Vilafranca del Penedès (Barcelona)...
June 7, 2018: Medicina Clínica
Sherif Dabash, Leticia C Barksdale, Colin A McNamara, Preetesh D Patel, Juan C Suarez
The purpose of this study is to determine the effectiveness of tranexamic acid (TXA) alone and in conjunction with a bipolar sealer in reducing postoperative transfusions during direct anterior (DA) total hip arthroplasty (THA).In this retrospective review, we analyzed 173 consecutive patients who underwent primary unilateral DA THA performed by 2 surgeons during a 1-year period. Subjects were divided into 3 groups based on TXA use: 63 patients received TXA alone (TXA group), 49 patients received TXA in addition to a bipolar sealer (TXA + bipolar sealer group), and 61 patients received neither TXA nor a bipolar sealer (control group)...
May 2018: American Journal of Orthopedics
Dacia D C A Henriquez, Kitty W M Bloemenkamp, Johanna G van der Bom
Postpartum hemorrhage is the leading cause of maternal mortality and severe morbidity. Despite efforts to improve maternal outcomes, management of postpartum hemorrhage still faces at least four challenges, discussed in this review. First, current definitions for severe postpartum hemorrhage hamper early identification of women with high risk of adverse outcome. Adaptations to the definitions and the use of clinical tools such as shock index and early warning systems may facilitate this early identification...
June 8, 2018: Journal of Thrombosis and Haemostasis: JTH
Amy Brenner, Haleema Shakur-Still, Rizwana Chaudhri, Bukola Fawole, Sabaratnam Arulkumaran, Ian Roberts
BACKGROUND: In severe post-partum haemorrhage, death can occur within hours of bleeding onset so interventions to control the bleeding must be given immediately. In clinical trials of treatments for life-threatening bleeding, established treatments are given priority and the trial treatment is usually given last. However, enrolling patients in whom severe maternal morbidity or death is imminent or inevitable at the time of randomisation may dilute the effects of a trial treatment. METHODS: We conducted an exploratory analysis of data from the WOMAN trial, an international, randomised placebo-controlled trial of the effects of tranexamic acid on death and surgical intervention in 20,060 women with post-partum haemorrhage...
June 7, 2018: BMC Pregnancy and Childbirth
Moslem Shakeri, Firooz Salehpour, Ghaffar Shokouhi, Kamkar Aeinfar, Javad Aghazadeh, Farhad Mirzaei, Seyed Ahmad Naseri Alavi
STUDY DESIGN: A randomized double-blind placebo controlled study. PURPOSE: In the present study, we aimed to assess the efficacy of tranexamic acid (TXA) in reducing blood loss after laminectomy and posterolateral fusion of the spine. OVERVIEW OF LITERATURE: Blood loss is the most significant complication involved with surgery, especially in spinal surgery. Multilevel laminectomy and laminectomy with instrumentation (pedicle screws and rods) are complex spine surgeries and are considered as medium-risk procedures for bleeding...
June 2018: Asian Spine Journal
J Jiang, O Akinseye, A Tovar-Garza, A G Pandya
Melasma is a common disorder of hyperpigmentation characterized by tan or brown macules and patches affecting sun-exposed areas, particularly the face. Melasma has been shown to have a significant impact on the quality of life and self-esteem of those affected. We interviewed six patients who were diagnosed with moderate-to-severe melasma with regard to the effect of their disorder on their self-esteem. All patients reported a significant negative effect on their quality of life and self-esteem. With successful therapy using a triple combination of cream and oral tranexamic acid to treat their melasma, all reported a marked improvement in self-esteem...
March 2018: International Journal of Women's Dermatology
Tomaz Crochemore, Felicio A Savioli
BACKGROUND: Hemorrhagic shock is a medical emergency that often complicates vascular surgery and can lead to death. Hemorrhagic shock is characterized by hypoperfusion and hemodynamic abnormalities leading to the collapse of homeostasis due to massive blood loss. Early diagnosis is critical for a favorable outcome. Thromboelastometry has been considered an effective tool for bleeding management in critically ill patients. Thromboelastometry can guide transfusion therapy quickly, reducing the need for blood products...
June 2, 2018: Journal of Medical Case Reports
Riccardo I Ambrogio, Marci H Levine
Clinicians often perform dental procedures and dentoalveolar surgery on patients who take prescribed anticoagulant medications. Such medications can present clinical challenges with regard to modifying or temporarily discontinuing a patient's anticoagulant regimen, which may not be medically indicated. In many instances discontinuation or altering of anticoagulation can be avoided through use of local hemostatic factors while patients are therapeutically continued on their prescribed warfarin doses. This article discusses a useful adjunct to dental treatment for the warfarin-anticoagulated patient- tranexamic acid (TA)...
June 2018: Compendium of Continuing Education in Dentistry
Yuangang Wu, Yi Zeng, Xianchao Bao, Huazhang Xiong, Xiwei Fan, Bin Shen
: Tranexamic acid (TXA) and diluted epinephrine (DEP) has been reported to be an efficient and well tolerated way for reducing blood loss in total hip arthroplasty (THA). This meta-analysis was designed to compare the effectiveness of combination application of TXA with DEP in primary THA. The following electronic databases were searched, including PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure and Google Search Engine, for published studies involving the TXA with DEP in primary THA...
May 24, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Farid Ahmad Chaudhary, Zahid Pervaz, Sana Ilyas, Muhammad Nabeel Niaz
OBJECTIVE: To determine the efficacy of topical pouring of tranexamic acid in reducing post-operative mediastinal bleeding, requirement for blood products and the rate of re-exploration for re-securing haemostasis or relief of pericardial tamponade after open heart surgery. METHODS: The prospective, randomised, placebo-controlled, double-blind comparative study was conducted from March 2013 to September 2015 at Rehmatul-lil-Alameen Institute of Cardiology, Punjab Employees Social Security Institution, Lahore, and comprised patients scheduled for primary isolated elective or urgent open heart surgery...
April 2018: JPMA. the Journal of the Pakistan Medical Association
Hossam El Beheiry, Ashley Lubberdink, Nigel Clements, Kiran Dihllon, Vicky Sharma
BACKGROUND: Tranexamic acid effects in older people are difficult to predict. This study investigated the following research questions: 1) Is tranexamic acid effective in older patients undergoing primary total hip arthroplasty (THA)? and 2) Is there a difference in the effect of tranexamic acid between younger and older patients? METHODS: This was a 2-phase retrospective matched-pair study of patients who underwent THA in 2007-2013. All procedures were performed by surgeons with at least 10 years' experience as senior consultant...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Peter Shores, Kyle Mullen, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
BACKGROUND: A growing body of published research on tranexamic acid (TXA) suggests that it is effective in reducing blood loss and the risk for transfusion in total knee arthroplasty (TKA). The purpose of this network meta-analysis was to evaluate TXA in primary TKA as the basis for the efficacy recommendations of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine on the use of TXA in primary total joint arthroplasty...
May 5, 2018: Journal of Arthroplasty
Irene de Miguel, Josune Orbe, Juan A Sánchez-Arias, José A Rodríguez, Agustina Salicio, Obdulia Rabal, Miriam Belzunce, Elena Sáez, Musheng Xu, Wei Wu, Haizhong Tan, Hongyu Ma, José A Páramo, Julen Oyarzabal
In an effort to find novel chemical series as antifibrinolytic agents, we explore α-phenylsulfonyl-α-spiropiperidines bearing different zinc-binding groups (ZBGs) to target those metalloproteinases involved in the fibrinolytic process: MMP3 and MMP10. Surprisingly, all these new chemical series were inactive against these metalloproteinases; however, several new molecules retained the antifibrinolytic activity in a phenotypic functional assay using thromboelastometry and human whole blood. Further optimization led to compound 38 as a potent antifibrinolytic agent in vivo, three times more efficacious than the current standard-of-care (tranexamic acid, TXA) at 300 times lower dose...
May 10, 2018: ACS Medicinal Chemistry Letters
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