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Coagulation, hemostasis

Haiying Li, Yuhan Xue, Bei Jia, Yun Bai, Yueyue Zuo, Shugeng Wang, Yanyan Zhao, Wenzhi Yang, Hongbo Tang
A series of hyaluronic acid grafted pullulan (HA-g-Pu) polymers with different hyaluronic acid (HA) moieties degrees of substitution (DS) were synthesized and characterized by fourier transform infrared (FT-IR), proton nuclear magnetic resonance (1 H NMR) and differential scanning calorimetry measurement (DSC). Compared to pure HA, HA-g-Pu polymers obtained better anti-enzymatic degradation ability in vitro, and the degradation rate of HA-g-Pu polymers depended on their different DS of HA moieties. The HA-g-Pu films were made of leaf-shape cascading arrangement with many small porous ranging from 0 to 100 μm in diameter when observed by scanning electron microscopy (SEM)...
May 15, 2018: Carbohydrate Polymers
Ashley Barratclough, Ruth Francis Floyd, Roger L Reep, Ray L Ball, Bobbi J Conner
BACKGROUND: Thromboelastography (TEG) provides a comprehensive evaluation of blood clot formation. This test can be used to identify abnormalities in coagulation by assessing multiple aspects of the clotting cascade, including the speed of clot initiation and formation, clot strength, and ultimately fibrinolysis. Thromboembolic disease has been hypothesized to play a role in the pathophysiology of cold stress syndrome (CSS), an important cause of mortality in the threatened Florida manatee (Trichechus manatus latirostris)...
March 9, 2018: Veterinary Clinical Pathology
Praneet Wander, Daniel Castaneda, Lionel D'Souza, Simi Singh, Sam Serouya, Ana I Velazquez, Rifat Mamun, Rebecca Voaklander, Petros Benias, David L Carr-Locke
BACKGROUND: To assess the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS: This is the first large series reporting this clip in achieving hemostasis. A retrospective descriptive chart review was performed on patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016. Results are expressed in absolute numbers, percentages, and trends...
April 2018: Journal of Clinical Gastroenterology
Liliya E Nikitina, Sergei V Kiselev, Valeriya A Startseva, Andrei V Bodrov, Zulfiya R Azizova, Olga T Shipina, Inna V Fedyunina, Sergei V Boichuk, Olga A Lodochnikova, Vladimir V Klochkov, Leisan F Galiullina, Aliya V Khaliullina
In this article we present the synthesis of enantiomerically pure sulfoxide and study the influence of this compound on hemostasis. Detailed NMR studies and molecular dynamics simulations using sodium dodecyl sulfate (SDS) membrane models indicated that the bicyclic fragment of sulfoxide was embedded into the SDS micelle whereas the -SO(CH2 )2 OH fragment remained on the surface of the micelle and was in contact with the solvent. We also found that the pro-coagulative activity of sulfoxide was due to its ability to inhibit platelet activation and inhibited the catalytic activity of phospholipid surface which was involved in formation of coagulation clotting factor complexes...
2018: Frontiers in Pharmacology
Gyeung Mi Seon, Mi Hee Lee, Byeong-Ju Kwon, Min Sung Kim, Min-Ah Koo, Young Seomun, Jong-Tak Kim, Tae Hee Kim, Jong-Chul Park
The choice of hemostat is determined by the situation and the degree of hemorrhage. One common hemostat, the nonwoven dressing, is easy to handled and controls severe bleeding on wider wounds. In this study, chitosan-based nonwoven dressings with recombinant batroxobin (rBat) were used as efficacious hemostatic dressing agents. Hemostatic agents need to absorb blood quickly in the early stages of blood coagulation cascade to rapidly and effectively control of excessive hemorrhages. To date, most studies of hemostatic agents focused on a single material and hemostats composed of multiple materials have not been studied sufficiently...
March 4, 2018: International Journal of Biological Macromolecules
María Elena Arnáiz-García, Jose María González-Santos, Javier López-Rodríguez, Ana María Arnáiz-García, Javier Arnáiz
Postoperative bleeding with its important socioeconomic cost is associated with an increased morbidity and mortality. It causes hemodynamic instability, increases blood loss, and multiplies the number of transfusions required. Especially in vascular or aortic surgery, postoperative bleeding can become a life-threatening complication due to anticoagulant or antiaggregation preoperative status or postoperative coagulation dysfunction after a high level of heparinization. Presently described is the case of a patient who underwent an aortic valve and ascending aorta replacement...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
C Rubod, E Jean Dit Gautier, C Yazbeck
Surgical management of ovarian endometrioma is most often part of a global approach of endometriosis pathology. Isolated endometrioma are rare. Laparoscopic cystectomy is the gold standard for surgical management of endometrioma. Nevertheless, this technique impacts the ovarian function. The hemostasis of the ovarian cyst bed should be performed to conserve the ovarian stroma. Ultrasonography-guided cyst aspiration, laparoscopic drainage and simple bipolar coagulation are not recommended as first line of treatment...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Yongzhi Wang, Lingtao Luo, Oscar Ö Braun, Johannes Westman, Raed Madhi, Heiko Herwald, Matthias Mörgelin, Henrik Thorlacius
Abdominal sepsis is associated with dysfunctional hemostasis. Thrombin generation (TG) is a rate-limiting step in systemic coagulation. Neutrophils can expell neutrophil extracellular traps (NETs) and/or microparticles (MPs) although their role in pathological coagulation remains elusive. Cecal ligation and puncture (CLP)-induced TG in vivo was reflected by a reduced capacity of plasma from septic animals to generate thrombin. Depletion of neutrophils increased TG in plasma from CLP mice. Sepsis was associated with increased histone 3 citrullination in neutrophils and plasma levels of cell-free DNA and DNA-histone complexes and administration of DNAse not only eliminated NET formation but also elevated TG in sepsis...
March 5, 2018: Scientific Reports
Anna Clebone
PURPOSE OF REVIEW: Trauma is the most common cause of pediatric mortality. Much of the research that led to life-saving interventions in adults, however, has not been replicated in the pediatric population. Children have important physiologic and anatomic differences from adults, which impact hemostasis and transfusion. Hemorrhage is a leading cause of death in trauma, and children have important differences in their coagulation profiles. Transfusion strategies, including the massive transfusion protocol and use of antifibrinolytics, are still controversial...
April 2018: Current Opinion in Anaesthesiology
Mathilde Fénelon, Sabine Castet, Jean-Christophe Fricain, Sylvain Catros
Introduction: Von Willebrand Disease is the most common inherited bleeding disorder. In the general population, 1/8000 patients are affected. Primary hemostasis (platelet adhesion) and coagulation (protection of Factor VIII) are altered. Among several bleeding symptoms, these patients suffer from excessive bleeding of oral mucosa and dental management requires a close collaboration between haematologists and oral surgeons. Materials & Methods: Guided implant surgery can be used to increase the accuracy of implant placement and to reduce the overall morbidity of this surgical procedure by using a flapless surgery technique...
2018: Open Dentistry Journal
Coen Maas, Thomas Renné
Combinations of proinflammatory and procoagulant reactions are the unifying principle for a variety of disorders affecting the cardiovascular system. The factor XII-driven-contact system starts coagulation and inflammatory mechanisms via the intrinsic pathway of coagulation and the bradykinin-producing kallikrein-kinin system, respectively. The biochemistry of the contact system in vitro is well understood, however its in vivo functions are just beginning to emerge. Challenging the concept of the coagulation balance, targeting factor XII or its activator polyphosphate provides protection from thromboembolic diseases without interfering with hemostasis...
February 26, 2018: Blood
Jessica P E Davis, Patrick G Northup, Stephen H Caldwell, Nicolas M Intagliata
Long thought to be hypocoagulable, new evidence suggests cirrhosis patients have "rebalanced" coagulation in the setting of decreased synthesis of both pro- and anti-coagulant factors. Traditional testing like PT/INR reflects only the decreased synthesis of pro-coagulant factors and thus does not correspond to bleeding or clotting risk in this population. In this review, we discuss the use of viscoelastic testing (VET), an assay of global hemostasis in cirrhosis patients. We describe the technique and interpretation of commercially available VET and assess the application of VET in both transplant and non-transplant cirrhosis populations...
March 1, 2018: Annals of Hepatology
Edward F Plow, Yunmei Wang, Daniel I Simon
Current antithrombotic drugs, including widely used antiplatelet agents and anticoagulants, are associated with significant bleeding risk, which increases morbidity and mortality. Nevertheless, there is emerging experimental evidence that suggests that the molecular and cellular mechanisms of hemostasis and thrombosis can be separated, thereby raising the possibility of new antithrombotic therapeutic targets with reduced bleeding risk. We summarize some recently emerging examples of agents with antithrombotic activities that seem to spare hemostasis...
February 21, 2018: Blood
Stefan Uderhardt, Jochen A Ackermann, Tobias Fillep, Victoria J Hammond, Johann Willeit, Peter Santer, Manuel Mayr, Markus Biburger, Meike Miller, Katie R Zellner, Konstantin Stark, Alexander Zarbock, Jan Rossaint, Irene Schubert, Dirk Mielenz, Barbara Dietel, Dorette Raaz-Schrauder, Cihan Ay, Thomas Gremmel, Johannes Thaler, Christian Heim, Martin Herrmann, Peter W Collins, Gernot Schabbauer, Nigel Mackman, David Voehringer, Jerry L Nadler, James J Lee, Steffen Massberg, Manfred Rauh, Stefan Kiechl, Georg Schett, Valerie B O'Donnell, Gerhard Krönke
No abstract text is available yet for this article.
February 20, 2018: Journal of Experimental Medicine
Songyu Chen, Xin Zhang, Fuxin Lin, Shujun Xu, Xingang Li, Xiangyu Ma
Clean and fast craniotomy and closure (CAC) is a fundamental part of modern microneurosurgery, and is an essential technique that young neurosurgeons shall master. The hemostatic instruments of CAC have evolved from forceps to raney clips. Thanks to the wide application of bipolar coagulation, local infiltration anesthesia combined with cauterization is become an effective method of hemostasis. The authors worked out a standard operating procedure (SOP) of CAC assisted by fishhooks without the application of raney clips...
February 14, 2018: Journal of Craniofacial Surgery
Giuseppe Lippi, Emmanuel J Favaloro
Physiological hemostasis is an intricate biological system, where procoagulant and anticoagulant forces interplay and preserves blood fluidity when blood vessels are intact, or trigger clot formation to prevent excessive bleeding when blood vessels are injured. The modern model of hemostasis is divided into two principal phases. The first, defined as primary hemostasis, involves the platelet-vessel interplay, whilst the second, defined as secondary hemostasis, mainly involves coagulation factors, damaged cells and platelet surfaces, where the so-called coagulation cascade rapidly develops...
February 19, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
PURPOSES: Modern electrosurgical tools have a specific coagulation mode called "soft coagulation". However, soft coagulation has not been widely accepted for surgical operations. To optimize the soft coagulation environment, we developed a novel suction device integrated with an electrosurgical probe, called the "Suction ball coagulator" (SBC). In this study, we aimed to optimize the SBC design with a prototyping process involving a bench test and preclinical study; then, we aimed to demonstrate the feasibility, safety, and potential effectiveness of the SBC for laparoscopic surgery in clinical settings...
February 17, 2018: Surgery Today
Ronit Beck-Fruchter, Israel Gavish, Shira Baram, Yoel Geslevich, Amir Weiss
OBJECTIVE: Thromboelastography (TEG) is a viscoelastic test of hemostasis which allows measurement of the processes of clot initiation, propagation, stabilization, and dissolution in real time. In this study we aimed to evaluate the alterations in coagulation as measured by TEG during In Vitro Fertilization (IVF) stimulation cycles and to investigate whether final oocyte maturation with recombinant hCG (rhCG) versus GnRH agonist results in a different coagulation state. STUDY DESIGN: This is a prospective observational study which included fifty-three normogonadotrophic women...
February 10, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ezeldeen Abuelkasem, Kenichi A Tanaka, Raymond M Planinsic
Liver transplantation is an ever-evolving field and understanding coagulation management and hemostatic therapies is essential for good outcomes. In this review, we discuss current monitoring tools available in the operating room and the hemostatic agents available to control hemostasis. Multifactorial coagulation defects are discussed and point-of care monitoring is reviewed to guide selection of hemostatic agents when indicated.
February 14, 2018: Minerva Anestesiologica
Daniel Millar, Larry Murphy, Audrey Labrie, Elisabeth Maurer-Spurej
Platelet inventory management based on screening microparticle content in platelet concentrates is a new quality improvement initiative for hospital blood banks. Cells fragment off microparticles (MP) when they are stressed. Blood and blood components may contain cellular fragments from a variety of cells, most notably from activated platelets. When performing their roles as innate immune cells and major players in coagulation and hemostasis, platelets change shape and generate microparticles. With dynamic light scattering (DLS)-based microparticle detection, it is possible to differentiate activated (high microparticle) from non-activated (low microparticle) platelets in transfusions, and optimize the use of this scarce blood product...
January 31, 2018: Journal of Visualized Experiments: JoVE
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