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https://www.readbyqxmd.com/read/29337406/validation-of-flow-cytometric-analysis-of-platelet-function-in-patients-with-a-suspected-platelet-function-defect
#1
Ivar van Asten, Roger E G Schutgens, Marije Baaij, Judith Zandstra, Mark Roest, Gerard Pasterkamp, Albert Huisman, Suzanne J A Korporaal, Rolf T Urbanus
BACKGROUND: Light transmission aggregometry (LTA) is the most commonly used test for the diagnosis of platelet function disorders (PFDs), but has moderate sensitivity for mild PFDs. Flow cytometry has been recommended for additional diagnostics of PFDs but is not yet standardized as a diagnostic test. We developed a standardized protocol for flow cytometric analysis of platelet function that measures fibrinogen binding and P-selectin expression as platelet activation markers in response to agonist stimulation...
January 16, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29336401/bleeding-in-the-lung-complicates-a-routine-intracardiac-repair-what-went-wrong
#2
Neeti Makhija, Rohan Magoon, Minati Choudhury, Sivasubramanian Ramakrishnan
Cyanotic congenital heart disease presents an increased tendency to bleed in view of subtle coagulation defects. Airway bleeding can be particularly difficult to manage while maintaining an adequate ventilation. An isolated lung bleed with the exclusion of possible traumatic, medical and surgical causes of bleeding, should alert the attending anesthesiologist to the possibility of the collateral-related bleeding. Preoperative coil embolization remains an important initial management step in a case of tetralogy of Fallot (TOF) with major aortopulmonary collaterals...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29321442/acquired-von-willebrand-syndrome-due-to-aortic-valve-stenosis-in-a-case-with-antiphospholipid-antibody
#3
Hiroaki Tanaka, Yurie Nagai, Chihiro Kuwabara, Ryo Shimizu, Akihide Umeki, Tetsufumi Yamamoto
Acquired von Willebrand syndrome (AVWS) is a bleeding disorder caused by an acquired deficiency of von Willebrand factor (vWF). Some patients with AVWS show a low bleeding tendency and are diagnosed by the presence of a mild prolongation of activated partial thromboplastin time (APTT) preoperatively. Another cause of APTT prolongation is the presence of antiphospholipid antibody (aPL). We experienced a case of AVWS due to aortic valve stenosis in a patient with aPL in whom aortic valve replacement surgery was successful with vWF replacement...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29304874/total-arterial-revascularization-in-patients-with-acute-myocardial-infarction-feasibility-and-outcomes
#4
Philippe Grieshaber, Lukas Oster, Tobias Schneider, Victoria Johnson, Coskun Orhan, Peter Roth, Bernd Niemann, Andreas Böning
BACKGROUND: In acute situations such as acute myocardial infarction (AMI) with indication for coronary artery bypass grafting (CABG), total arterial revascularization (TAR) is often rejected in favour of saphenous vein (SV) grafting, which is assumed to allow for quicker vessel harvesting, a simpler anastomosis technique, and thus quicker revascularization and fewer bleeding complications. The aim of this study was to evaluate whether reluctance to apply TAR in AMI is still justified from a technical point of view in the current era and whether superiority of TAR results is also evident in emergency patients with AMI undergoing CABG...
January 5, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29304534/platelet-function-in-itp-independent-of-platelet-count-is-consistent-over-time-and-is-associated-with-both-current-and-subsequent-bleeding-severity
#5
A L Frelinger, R F Grace, A J Gerrits, S L Carmichael, E E Forde, A D Michelson
BACKGROUND:  Treatment decisions for patients with immune thrombocytopenia (ITP) are difficult because patients with similarly low platelet counts differ in their bleeding tendency. We recently reported that platelet function tests, independent of platelet count, are associated with concurrent bleeding severity, suggesting that these tests may be useful indicators of future bleeding in ITP. OBJECTIVES:  To test this hypothesis, we evaluated the consistency of these platelet function tests over time and their association with subsequent bleeding severity...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29287794/effect-of-glucocorticoid-treatment-on-baff-and-april-expression-in-patients-with-immune-thrombocytopenia-itp
#6
Julian Kamhieh-Milz, Nuha Ghosoun, Viktor Sterzer, Abdulgabar Salama
Immune thrombocytopenic purpura (ITP) is an idiopathic bleeding disorder. B cell activating factor (BAFF) and 'A proliferation-inducing ligand' (APRIL) have regulatory effects on B and T cells and may represent relevant factors in the pathogenesis of ITP. Serum levels and gene expression were investigated in ITP patients. Both BAFF and APRIL serum levels were significantly elevated in active ITP. However, gene expression analysis revealed both factors to have a tendency toward downregulation. Glucocorticoid treatment significantly reduced BAFF but not APRIL serum levels, which may be mediated by differences in transcription factor binding sites...
December 26, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29282384/hepatocyte-nuclear-factor-1%C3%AE-mutated-hepatocellular-adenomas-an-atypical-presentation
#7
Camila Maria Neves Sousa, Patricia Maria Miranda Gadelha, Rafaella de Sousa Cartaxo, George Washington Holanda Pedrosa, Rodrigo Schuler Honorio, José Milton de Castro Lima, Gustavo Rêgo Coelho, Clovis Rêgo Coelho
Hepatocellular adenomas (HCAs) are rare benign monoclonal hepatic tumors that commonly occur in females (3-4 per 100,000 women) due to the use of oral contraceptives, its primary risk factor. Recently, HCAs have been classified into 4 distinct subtypes according to genotypic and phenotypic characteristics and clinical features: inflammatory HCA (40-50%), which are hypervascular with marked peliosis and a tendency to bleed; hepatocyte nuclear factor 1α (HNF1A)-mutated HCA (H-HCA, 30-40%) that are diffusely steatotic and rarely undergo malignant transformation; β-catenin activated HCA (10-15%), which frequently undergo malignant transformation and may seem hepatocellular carcinoma on imaging; and unclassified HCA (10-25%)...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29241236/diving-and-antidepressants
#8
Abraham L Querido
Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29239153/time-to-change-the-classical-vision-of-coagulation-in-liver-disease-from-the-balance-disequilibrium-to-the-systems-biology-network-modelling
#9
Annabel Blasi, Joan C Reverter
The longstanding dogma that patients with liver disease have a hemostasis related bleeding tendency is neglected from the last 10 years however, despite this tremendous change of paradigm no longer progress had been made in this field. A mathematical model is a description of a system using mathematical concepts and language. Mathematical models are able to analyze large amount of data and they can make predictions about behavior. Mathematical models are used in the social sciences, engineering as well as in medicine...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29224322/-%C3%AE-1-antitrypsin-pittsburg-mutations-report-of-two-cases-in-the-same-family
#10
L J Cao, X Bai, Z Q Yu, W Zhang, J Su, Z Y Wang, C G Ruan
Objective: To analyze the clinical and laboratory abnormalities of two patients with α1-antitrypsin (α1-AT) Pittsburgh in a family and review the literatures. Methods: Both plasma clotting time and factor activities were performed using clotting or substrate methods. Platelet aggregation was evaluated using an optical aggregometer. The serum protein electrophoresis was performed on Sebia HYDRASYS by using Agarose gel. The exons of α1-AT were amplified by using polymerase chain reaction (PCR) and then sequenced and compared with NCBI GenBank records...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29216800/vascular-ehlers-danlos-syndrome-with-a-novel-missense-col3a1-mutation-present-with-pulmonary-complications-and-iliac-arterial-dissection
#11
Guangchao Gu, Hang Yang, Lijia Cui, Yuanyuan Fu, Fangda Li, Zhou Zhou, Yuehong Zheng
Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder due to its high tendency of arterial and organ rupture. Pulmonary complications in vEDS are rare. We present a young male patient with vEDS who developed severe pulmonary complications and severe rupture of the iliac artery at different stages of his life. Vascular Ehlers-Danlos syndrome was diagnosed based on clinical manifestations and confirmed by the identification of COL3A1 gene mutation. Due to high bleeding tendency and weak cardiopulmonary capacity, conservative treatment was taken for him...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29194678/bleeding-complications-in-acute-liver-failure
#12
R Todd Stravitz, Caitlyn Ellerbe, Valerie Durkalski, Michael Schilsky, Robert J Fontana, Carolyn Peterseim, William M Lee
In patients with acute liver failure (ALF), elevatedprothrombin time and thrombocytopeniacan fuel a perception of a bleeding tendency. However, the incidence, site, risk factors, and clinical significance of bleeding complications have not been previously quantified in a large cohort of patients with ALF. We studied 1770adult patients enrolled in the ALF Study Group Registry between 1998 and 2016.Bleeding complications and blood component transfusions were collected for 7days after admission. The relationship of bleeding complications to 21-day mortality was assessed...
December 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29176380/congenital-hypofibrinogenemia-in-pregnancy-a-report-of-11-cases
#13
He Cai, Meiying Liang, Jingjing Yang, Xiaohui Zhang
: To investigate the obstetrical outcomes and plasma concentrations of fibrinogen (FIB) in patients with congenital hypofibrinogenemia in pregnancy, 11 cases with hypofibrinogenemia in pregnancy were analyzed retrospectively. The demographic database, bleeding tendency, plasma levels of FIB throughout pregnancy, peripartum management, as well as, maternal and neonatal outcomes were assessed. FIB levels in our patients remained relatively stable throughout the pregnancy. The mean FIB levels during the three trimesters of pregnancy were 75...
November 23, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29169605/relation-of-stroke-and-bleeding-risk-profiles-to-efficacy-and-safety-of-edoxaban-for-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-warfarin-in-subjects-undergoing-cardioversion-of-atrial-fibrillation-ensure-af-study
#14
Gregory Y H Lip, Jose L Merino, G Andrei Dan, Sakis Themistoclakis, Kenneth A Ellenbogen, Raffaele De Caterina, Assen Goudev, James Jin, Michael Melino, Shannon M Winters, Andreas Goette
In the EdoxabaN versus warfarin in subjectS UndeRgoing cardiovErsion of Atrial Fibrillation (ENSURE-AF) study, edoxaban was compared with enoxaparin-warfarin in patients who underwent electrical cardioversion of nonvalvular atrial fibrillation, showing comparable low rates of bleeding and thromboembolism. The present study is an ancillary analysis investigating differences in relation to stroke and bleeding risk profiles. It also determined the relation of patients' clinical risk profiles to the quality of anticoagulation control in the warfarin arm...
November 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29161790/-anticoagulation-in-patients-with-liver-cirrhosis
#15
REVIEW
Jae Youn Cheong
Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29158366/therapeutic-anticoagulation-in-patients-with-primary-brain-tumors-or-secondary-brain-metastasis
#16
REVIEW
Richard J Lin, David L Green, Gunjan L Shah
Patients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagulation with low molecular weight heparin or direct oral anticoagulants, although thrombocytopenia (platelet count less than 50,000/μL) and other coagulopathies are relative contraindications...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29154519/current-treatments-for-anal-condylomata-acuminata
#17
Massimiliano Mistrangelo, Ivano Dal Conte, Silvio Volpatto, Giulio DI Benedetto, Valentina Testa, Francesca Currado, Mario Morino
INTRODUCTION: Condylomata acuminate are the most common sexually transmitted disease worldwide. They are usually a serious problem, but it causes emotional distress to patient and physician alike because of its marked tendency to recurrence. The presence of anogenital warts mandates treatment, also for potential degeneration of the lesions. EVIDENCE ACQUISITION: A review of the Literature has been performed to analyze proposed treatments for anogenital warts. EVIDENCE SYNTHESIS: Many treatments have been employed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29145319/primary-myelofibrosis-and-pregnancy-outcomes-after-low-molecular-weight-heparin-administration-a-case-report-and-literature-review
#18
REVIEW
Roxana Elena Bohîlţea, Monica Mihaela Cîrstoiu, Crîngu Antoniu Ionescu, Emilia Niculescu-Mizil, Ana Maria Vlădăreanu, Irina Voican, Mihai Dimitriu, Natalia Turcan
RATIONALE: Primary myelofibrosis is encountered with the myeloproliferative diseases and is the least prevalent among women of childbearing age. The prognosis is guided by pancytopenia, leukemic transformation and thrombosis which are the dominant complications. PATIENT CONCERNS: Data regarding protocol management during pregnancy in the context of myelofibrosis are insufficient. Fewer than ten cases have been described until now and half of this cases have resulted in fetal death due to placental infarction during the second and third trimesters...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29125443/neurosurgical-management-in-children-with-bleeding-diathesis-auditing-neurological-outcome
#19
Zaitun Zakaria, Chandrasekaran Kaliaperumal, Darach Crimmins, John Caird
OBJECTIVE The aim of this study was to assess the outcome of neurosurgical treatment in children with bleeding diathesis and also to evaluate the current management plan applied in the authors' service. METHODS The authors retrospectively analyzed all cases in which neurosurgical procedures were performed in pediatric patients presenting with intracranial hematoma due to an underlying bleeding tendency over a 5-year period at their institution. They evaluated the patients' neurological symptoms from the initial referral, hematological abnormalities, surgical treatment, neurological outcome, and scores on the Pediatric Glasgow Outcome Scale-Extended (GOS-E Peds) obtained 1 year after the last operation...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29118792/anchoring-pipeline-flow-diverter-construct-in-the-treatment-of-traumatic-distal-cervical-carotid-artery-injury
#20
Krishna Amuluru, Fawaz Al-Mufti, William Roth, Charles J Prestigiacomo, Chirag D Gandhi
Background: Traumatic extracranial internal carotid artery (ICA) dissections are uncommon and can be difficult to treat. Thinning of adventitia and dilatation may occur following arterial dissection, thus resulting in a fusiform pseudoaneurysm, which can subsequently cause bleeding, expanding, or pulsatile hematoma. Currently, medical management with anticoagulation remains the first line of treatment and yields good outcomes in 75% of cases with a mortality rate of 3-4%. Endovascular intervention is indicated with failure of medical therapy, progressive enlargement of a traumatic pseudoaneurysm, acute flow-related infarcts due to vessel occlusion, or when anticoagulation is contraindicated due to risk of pseudoaneurysm rupture and hemorrhage...
October 2017: Interventional Neurology
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