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Tranexamic Acid

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https://www.readbyqxmd.com/read/29447730/no-163-gynaecological-and-obstetric-management-of-women-with-inherited-bleeding-disorders
#1
Christine Demers, Christine Derzko, Michele David, Joanne Douglas
OBJECTIVE: The prevalence of bleeding disorders, notably von Willebrand disease (vWD), among adult women with objectively documented menorrhagia is consistently reported to be 10% to 20% and is even higher in adolescents presenting with menorrhagia. OPTIONS: Diagnostic tools and specific medical and, where appropriate, surgical alternatives to management are reviewed and evidence-based recommendations presented. EVIDENCE: A MEDLINE search of the English literature between January 1975 and November 2003 was performed using the following key words: menorrhagia, uterine bleeding, pregnancy, von Willebrand, congenital bleeding disorder, desmopressin/DDAVP, tranexamic acid, oral contraceptives, medroxyprogesterone, therapy, hysterectomy, anesthesia, epidural, spinal...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29438816/the-effect-of-tranexamic-acid-in-unilateral-and-bilateral-total-knee-arthroplasty-in-the-south-asian-population-a-retrospective-cohort-study
#2
Syed Hamza Mufarrih, Azeem Tariq Malik, Nada Qaisar Qureshi, Riaz Hussain Lakdawala, Umar Rabbani, Arif Ali, Shahryar Noordin
INTRODUCTION: Together with evidence of higher bleeding tendencies, the vulnerability of the South Asian population to anemia secondary to a higher prevalence of hemoglobinopathies and micronutrient deficiencies merits further exploration of the effects of tranexamic acid on this population. Additionally, limited access to self-care facilities and certain sociocultural beliefs and practices may not be conducive to a speedy recovery from surgical complications. The aim of this study is to investigate the effects of intraoperative administration of tranexamic acid during total knee arthroplasty when considering the South Asian population...
February 10, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29437056/efficacy-and-safety-of-intra-articular-versus-intravenous-tranexamic-acid-in-reducing-perioperative-blood-loss-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-equivalence-trial
#3
RANDOMIZED CONTROLLED TRIAL
K N Subramanyam, P Khanchandani, P V Tulajaprasad, J Jaipuria, A V Mundargi
AIMS: The aims of this study were to compare the efficacy and safety of intra-articular and intravenous (IV) tranexamic acid (TXA) in controlling perioperative blood loss in total knee arthroplasty (TKA) using a randomized, double-blinded equivalence trial. PATIENTS AND METHODS: A total of 182 patients aged between 45 and 75 years undergoing unilateral TKA at a tertiary centre were randomized to receive TXA, either 1.5 g intra-articularly after closure of the wound (n = 91) or two doses of 10 mg/kg IV (n = 91)...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29435595/-blood-management-in-complex-reconstructive-spine-surgery-in-asd-patients-do-effective-measures-to-reduce-bleeding-exist
#4
REVIEW
V Bullmann, M Granitzka
BACKGROUND: Blood management in reconstructive spine surgery is a challenge and must be managed interdisciplinarily. An experienced team of anesthesiologists and spine surgeons needs to work closely together. THERAPY: After optimal preoperative preparation, the patient is given an initial dose of 1000 mg tranexamic acid. The most adequate medium blood pressure is about 80 mm Hg during surgery. The surgeon must watch for subperiosteal preparation and subtle stypsis...
February 12, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29435313/comparison-of-the-efficacy-of-intravenous-tranexamic-acid-with-and-without-topical-administration-versus-placebo-in-urgent-endoscopy-rate-for-acute-gastrointestinal-bleeding-a-double-blind-randomized-controlled-trial
#5
Nader Tavakoli, Marjan Mokhtare, Shahram Agah, Ali Azizi, Mohsen Masoodi, Hassan Amiri, Mehrdad Sheikhvatan, Bahare Syedsalehi, Behdad Behnam, Mehran Arabahmadi, Maryam Mehrazi
Background: Tranexamic acid (TXA), a synthetic antifibrinolytic drug, is effective as a treatment for serious hemorrhage, including bleeding arising from major trauma and post-operative interventions. Significant acute gastrointestinal bleeding may have a poor outcome despite routine medical and endoscopic treatments. The aim of this study was to assess whether early intravenous and/or intravenous plus topical administration of TXA reduces the need for urgent endoscopy for acute gastrointestinal bleeding...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29431141/does-tranexamic-acid-lead-to-changes-in-mri-measures-of-brain-tissue-health-in-patients-with-spontaneous-intracerebral-haemorrhage-protocol-for-a-mri-substudy-nested-within-the-double-blind-randomised-controlled-tich-2-trial
#6
Rob A Dineen, Stefan Pszczolkowski, Katie Flaherty, Zhe K Law, Paul S Morgan, Ian Roberts, David J Werring, Rustam Al-Shahi Salman, Tim England, Philip M Bath, Nikola Sprigg
OBJECTIVES: To test whether administration of the antifibrinolytic drug tranexamic acid (TXA) in patients with spontaneous intracerebral haemorrhage (SICH) leads to increased prevalence of diffusion-weighted MRI-defined hyperintense ischaemic lesions (primary hypothesis) or reduced perihaematomal oedema volume, perihaematomal diffusion restriction and residual MRI-defined SICH-related tissue damage (secondary hypotheses). DESIGN: MRI substudy nested within the double-blind randomised controlled Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 trial (ISRCTN93732214)...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29430682/enolase-1-expression-in-the-stratum-corneum-is-elevated-with-parakeratosis-of-atopic-dermatitis-and-disrupts-the-cellular-tight-junction-barrier-in-keratinocytes
#7
Takeshi Tohgasaki, Naoko Ozawa, Takashi Yoshino, Shioji Ishiwatari, Shoko Matsukuma, Shigeru Yanagi, Hidetsugu Fukuda
OBJECTIVE: Previous studies have shown that enolase-1 (ENO1) in the stratum corneum (SC) is more highly expressed in patients with atopic dermatitis (AD) than in healthy individuals, suggesting that it is a novel biomarker for evaluating skin condition in patients with AD. However, the mechanism underlying high ENO1 expression in the SC and its pathological relevance in AD are unclear. In this study, the relationship between ENO1 expression and keratinization of epidermis was investigated and the role of high ENO1 expression in keratinocytes was characterized...
February 11, 2018: International Journal of Cosmetic Science
https://www.readbyqxmd.com/read/29428263/evidence-based-diagnosis-and-management-of-chronic-subdural-hematoma-a-review-of-the-literature
#8
REVIEW
Vikram Mehta, Stephen C Harward, Eric W Sankey, Gautam Nayar, Patrick J Codd
Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the subdural space on a non-contrast computed tomography (CT) scan, best appreciated on sagittal or coronal reformats. Initial medical management involves reversing anticoagulant/antiplatelet therapies, and often initiation of anti-epileptic drugs (AEDs). Operative interventions, such as twist-drill craniostomy (TDC), burr-hole craniostomy (BHC), and craniotomy are indicated if imaging implies compression (maximum fluid collection thickness >1 cm) or the patient is symptomatic...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29426608/the-effect-of-tranexamic-acid-on-hidden-bleeding-in-older-intertrochanteric-fracture-patients-treated-with-pfna
#9
Shuwei Tian, Zheyuan Shen, Yang Liu, Yanlong Zhang, Aqin Peng
OBJECTIVE: To investigate the effect of tranexamic acid (TXA) on hidden bleeding in older intertrochanteric fracture patients treated with intramedullary nails. METHOD: Between January 2016 and January 2017, 100 cases of intertrochanteric fractures eligible for the study were treated with proximal femoral nail antirotation (PFNA) in our hospital. All patients were divided into two groups of 50 patients each: the TXA group and a blank control group. In the TXA group, all patients received TXA at a dose of 10 mg/kg-1 intravenously, 10 min preoperatively and 5 h postoperatively...
February 2, 2018: Injury
https://www.readbyqxmd.com/read/29421836/drugs-in-pregnancy-and-lactation-medications-used-in-swiss-obstetrics
#10
Larissa Schenkel, Ana Paula Simões-Wüst, Irene Hösli, Ursula von Mandach
BACKGROUND: In order to improve the safety for drugs in pregnancy and lactation, data on the clinical practice must be collected and validated. METHODS: Data on the medications routinely used were requested from the university hospitals for obstetrics and the non-university perinatal centres in Switzerland and recommendations and guidelines of scientific societies for the various fields of application were sought. RESULTS: Part I: For during pregnancy and the peripartal period respectively, 69 and 21 different active constituents of medications were identified from at least 4 centres...
February 8, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29418039/topical-tranexamic-acid-for-epistaxis-in-patients-on-antiplatelet-drugs-a-new-use-for-an-old-drug
#11
Michael S Runyon
"The remedy is worse than the disease." - Francis Bacon While Bacon may not have been referring specifically to antiplatelet drugs, one cannot blame the emergency physician expressing this same sentiment while caring for a patient presenting with epistaxis while on one of these medications. Achieving hemostasis in these cases can be challenging for the very best emergency physician, and a miserable experience for the most stoic of patients. In this issue of Academic Emergency Medicine, Zahed, et al. This article is protected by copyright...
February 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29416215/a-difference-in-bleeding-and-use-of-blood-and-blood-products-in-patients-who-were-preoperatively-on-aspirin-or-dual-antiplatelet-therapy-before-coronary-artery-bypass-grafting
#12
Slavenka Straus, Ilirijana Haxhibeqiri-Karabdic, Sanja Granov Grabovica, Nermir Granov
Background: Postoperative bleeding in patients who underwent elective coronary artery bypass surgery (CABG) may increase due to preoperative anticoagulant therapy indicative of their disease - acute coronary syndrome or implanted coronary artery stent. Increased bleeding in many cases requires the use of blood and blood derivatives, and sometimes even reoperation. Their use poses the risk of complications, may extend the hospitalization. Methods: Our observation retrospective study included 131 patients, 41 treated with aspirin and 90 treated with aspirin and clopidogrel...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29413743/safety-of-a-high-dose-tranexamic-acid-protocol-in-complex-adult-spinal-deformity-analysis-of-100-consecutive-cases
#13
James D Lin, Lawrence G Lenke, Jamal N Shillingford, Joseph L Laratta, Lee A Tan, Charla R Fischer, Mark A Weller, Ronald A Lehman
STUDY DESIGN: Retrospective review of high-dose tranexamic acid (TXA) use in consecutive patients. OBJECTIVE: To determine the safety profile of a high-dose TXA protocol in complex adult spinal deformity patients. SUMMARY OF BACKGROUND DATA: Adult spinal deformity (ASD) surgery may involve significant amounts of blood loss, especially when various osteotomy techniques are used. Antifibrinolytic agents such as TXA have been used to reduce intraoperative blood loss...
March 2018: Spine Deformity
https://www.readbyqxmd.com/read/29411358/optimisation-of-the-dosage-of-tranexamic-acid-in-trauma-patients-with-population-pharmacokinetic-analysis
#14
S Grassin-Delyle, O M Theusinger, R Albrecht, S Mueller, D R Spahn, S Urien, P Stein
Tranexamic acid is used both pre-hospital and in-hospital as an antifibrinolytic drug to treat or prevent hyperfibrinolysis in trauma patients; dosing, however, remains empirical. We aimed to measure plasma levels of tranexamic acid in patients receiving pre-hospital anti-hyperfibrinolytic therapy and to build a population pharmacokinetic model to propose an optimised dosing regimen. Seventy-three trauma patients were enrolled and each received tranexamic acid 1 g intravenously pre-hospital. A blood sample was drawn after arrival in the emergency department, and we measured the plasma tranexamic acid concentration using liquid chromatography-mass spectrometry, and modelled the data using non-linear mixed effect modelling...
February 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29408472/tranexamic-acid-plus-drain-clamping-can-reduce-blood-loss-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#15
REVIEW
Lele Liao, You Chen, Qi Tang, Yi-Yue Chen, Wan-Chun Wang
BACKGROUND: The efficacy of tranexamic acid (TXA) plus drain-clamping in reducing blood loss after total knee arthroplasty (TKA) is controversial. This meta-analysis aimed to identify whether combined tranexamic acid and drain-clamping was superior to TXA alone, drain clamping alone and control treatments. METHODS: We searched the PubMed, EMBASE, Web of Science and Google databases and the Cochrane Database of Systematic Reviews. Patients prepared for primary TKA and who underwent TXA plus drain-clamping for blood loss were included in this meta-analysis...
February 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29399799/synergistic-effects-of-intravenous-and-intra-articular-tranexamic-acid-on-reducing-hemoglobin-loss-in-revision-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#16
Xiangwei Yuan, Jiaxing Wang, Qiaojie Wang, Xianlong Zhang
BACKGROUND: Tranexamic acid decreases blood loss in primary total knee arthroplasty, and no related prospective randomized clinical trials have been conducted to evaluate the effectiveness and safety of tranexamic acid in revision total knee arthroplasty. Thus, we conducted this work to evaluate the synergistic effects of intravenous plus intra-articular tranexamic acid on reducing hemoglobin loss compared with intra-articular tranexamic acid alone in revision total knee arthroplasty...
February 4, 2018: Transfusion
https://www.readbyqxmd.com/read/29398669/anti-inflammatory-effect-of-tranexamic-acid-against-trauma-hemorrhagic-shock-induced-acute-lung-injury-in-rats
#17
Yue Teng, Cong Feng, Yunen Liu, Hongxu Jin, Yan Gao, Tanshi Li
It has been demonstrated that tranexamic acid (TXA), a synthetic derivative of lysine, alleviates lung damage in a trauma-hemorrhagic shock (T/HS) model. Nevertheless, the mechanism of TXA against acute lung injury (ALI) has not deeply elaborated. In this study, we generated a T/HS rat model based on previous research, and TXA (50 mg/kg and 100 mg/kg) was intravenously injected into these rats prior to or post T/HS. The results revealed that the decreased survival rate and impaired lung permeability of the rats caused by T/HS were improved by TXA pretreatment or posttreatment...
February 2, 2018: Experimental Animals
https://www.readbyqxmd.com/read/29396806/effect-of-knee-flexion-position-and-combined-application-of-tranexamic-acid-on-blood-loss-following-primary-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#18
Yi Zeng, Haibo Si, Canfeng Li, Yuangang Wu, Bin Shen
PURPOSE: The aim of this study was to demonstrate the association between tranexamic acid (TXA)-combined application and knee flexion in the first 24 hour post-operatively that could reduce total blood loss and transfusion need in patients undergoing total knee arthroplasty (TKA), without sacrificing safety. METHODS: Ninety TKA patients were divided into three groups randomly: the flexion group: the knee was in 90° flexion position for the first 12 hour post-surgery and kept at 60°for the next 12 hour, combined with 1 g TXA topical and 1 g TXA intravenous application...
February 2, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29393992/medical-treatment-of-epistaxis-in-hereditary-hemorrhagic-telangiectasia-an-evidence-based-review
#19
Ashleigh A Halderman, Matthew W Ryan, Christopher Clark, Raj Sindwani, Douglas D Reh, David M Poetker, Rosangela Invernizzi, Bradley F Marple
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant hereditary disorder resulting in vascular dysplasia and formation of arteriovenous malformations. Recurrent epistaxis is a hallmark of the disease. An array of medical therapies are used in this patient population, but robust evidence-based recommendations regarding the medical treatment of epistaxis are lacking. This systematic review was performed to look at the current literature and make meaningful evidence-based recommendations...
February 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29392737/management-of-injured-patients-who-were-jehovah-s-witnesses-where-blood-transfusion-may-not-be-an-option-a-retrospective-review
#20
A Olaussen, J Bade-Boon, M C Fitzgerald, B Mitra
INTRODUCTION: Management of major haemorrhage as a result of trauma is particularly challenging when blood is not an option (BNAO). Evidence on therapeutic strategies in this situation is limited. The aim of this study was to evaluate the management and outcomes of patients who identified themselves as Jehovah's Witnesses (who usually refuse blood products) with traumatic haemorrhage at an Australian major trauma centre. METHODS: A retrospective review of patients from The Alfred Trauma Registry was conducted, including patients who were Jehovah's Witnesses presenting between January 2010 and January 2017...
February 2, 2018: Vox Sanguinis
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