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https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#1
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28902964/plasmatic-coagulation-and-fibrinolysis-in-healthy-and-otostrongylus-affected-northern-elephant-seals-mirounga-angustirostris
#2
Sarrah Kaye, Shawn Johnson, Carlos Rios, Daniel J Fletcher
BACKGROUND: Prepatent Otostrongylus arteritis results in hemorrhagic diathesis in free-ranging Northern elephant seals (Mirounga angustirostris) attributed to aberrant larval migration of the lungworm, Otostrongylus circumlitus. Clinical signs are often nonspecific, including lethargy, anorexia, and blepharospasm, but can progress to spontaneous frank hemorrhage and death within 72 hours of onset. Previously published case reports describe coagulopathy with prolonged PT and APTT, normal to elevated platelet counts, normal antithrombin concentrations, and low concentrations of fibrinogen degradation products...
September 13, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28892658/homozygous-antithrombin-deficiency-type-ii-causing-neonatal-thrombosis
#3
Vanessa Swoboda, Katharina Zervan, Katharina Thom, Christine Mannhalter, Peter Quehenberger, Ingrid Pabinger, Christoph Male
We report four children from different families with homozygous antithrombin (AT) deficiency type II affecting the heparin binding site (p.Leu131Phe mutation). All children had severe spontaneous venous and/or arterial thromboembolic events shortly after birth. This report intends to raise awareness among clinicians about this rare but severe condition. When thrombosis occurs in an otherwise healthy newborn, a severe congenital thrombophilic disorder should be considered. In homozygous AT deficiency type II, AT activity is typically reduced but may also be in the normal range, posing a diagnostic challenge...
September 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28891545/protein-c-and-antithrombin-levels-in-patients-with-sickle-cell-anemia-in-ahmadu-bello-university-teaching-hospital-zaria-nigeria
#4
I U Kusfa, A I Mamman, S M Aminu, A Hassan, H M Muktar
BACKGROUND: Alterations in the components of hemostasis, namely platelet function, the procoagulant, anticoagulant, and the fibrinolytic systems, are observed in sickle cell anemia (SCA) and are in favor of a procoagulant phenotype. Therefore, study of protein C and antithrombin (AT) levels in patients with SCA in steady state may be used in the treatment and/or prevention of SCA-related thrombotic complications. We studied the changes of these naturally occurring anticoagulants in patients with SCA attending the sickle cell clinic in Ahmadu Bello University Teaching Hospital, Zaria...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28888219/factor-xa-inhibition-by-rivaroxaban-in-the-trough-steady-state-can-significantly-reduce-thrombin-generation
#5
Shigeo Horinaka, Rie Sugawara, Yutaka Yonezawa, Toshihiko Ishimitsu
AIMS: The aim of the present study was to demonstrate evidence of reduced thrombin generation at the trough plasma rivaroxaban concentration. METHODS: A single-centre, prospective, non-randomised, drug intervention, self-controlled study was conducted in 51 anticoagulation therapy-naïve patients with non-valvular atrial fibrillation. Plasma rivaroxaban concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and anti-factor Xa chromogenic assay...
September 9, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28882940/varicella-complicated-by-cellulitis-and-deep-vein-thrombosis
#6
Gracinda Nogueira Oliveira, Susana Basso, Teresa Sevivas, Nelson Neves
We report a 16-month-old girl with varicella complicated by cellulitis, invasive Group A Streptococcus (GAS) infection and deep vein thrombosis. She presented with varicella lesions, fever and a painful firm tumefaction on the right lower leg (RLL). Ultrasound showed a local subcutaneous tissue thickening suggestive of cellulitis and antibiotics were initiated. Further swelling of the RLL motivated a second ultrasound that showed an obstructive thrombus for which she was started on enoxaparin. The blood culture confirmed GAS infection leading to directed antibiotherapy...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28880550/a-polymer-therapeutic-having-universal-heparin-reversal-activity-molecular-design-and-functional-mechanism
#7
Manu Thomas Kalathottukaren, Srinivas Abbina, Kai Yu, Rajesh A Shenoi, A Louise Creagh, Charles Haynes, Jayachandran N Kizhakkedathu
Heparins are widely used to prevent blood clotting during surgeries and for the treatment of thrombosis. However, bleeding associated with heparin therapy is a concern. Protamine, the only approved antidote for unfractionated heparin (UFH) could cause adverse cardiovascular events. Here, we describe a unique molecular design used in the development of a synthetic dendritic polycation named as Universal Heparin Reversal Agent (UHRA), an antidote for all clinically used heparin anticoagulants. We elucidate the mechanistic basis for the selectivity of UHRA to heparins and its non-toxic nature...
September 7, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28877605/obesity-paradox-in-patients-with-deep-venous-thrombosis
#8
Ayman El-Menyar, Mohammad Asim, Hassan Al-Thani
We aimed to investigate the association between obesity and deep venous thrombosis (DVT) in a country with a high prevalence of obesity. This is a retrospective cohort study of patients who presented with DVT between 2008 and 2012. Data were analyzed and compared based on body mass index (BMI), and patients were classified into normal (<25), overweight (≥25 to <30), obese I (30 to <35), obese II (35 to <40), and obese III (≥40). Among 662 patients with DVT, 28% were overweight and 49% were obese...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28866705/familial-antithrombin-iii-deficiency-in-a-malay-patient-with-massive-thrombosis
#9
W S Wan Ab Rahman, W Z Abdullah, M N Hassan, A Hussin, Z Zulkafli, J Haron
Patients with low antithrombin III (AT III) has increased risk for arteriovenous thromboembolic (TE) disease. We report a 28-year-old Malay lady who presented with spontaneous right calf pain and swelling of one week duration. She was on oral contraceptive pills and had a history of travelling for a long distance prior to the presentation. Her brother who was diagnosed with AT III deficiency had arterial thrombosis at a young age. She was diagnosed as having right popliteal vein thrombosis by ultrasound and treated with subcutaneous fondaparinux...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28865216/coagulology-biochemical-profile-and-muscle-pathology-in-calves-diagnosed-with-nutritional-muscular-dystrophy
#10
K Żarczyńska, W Baumgartner, P Sobiech
The aim of this study was to explain the correlations between selenium deficiency, hemostatic and biochemical disorders, and the progression of pathological changes in calves diagnosed with nutritional muscular dystrophy (NMD). The study was performed on 20 calves with supplementation of 8 ml selenium and vitamin E preparation and 20 calves with symptoms of NMD. Blood was sampled from calves aged 5, 12 and 19 days. On day 19, samples of the biceps femoris muscle were collected from 6 animals in each group for histopathological analysis...
March 1, 2017: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/28863787/venous-thromboembolism-and-hyperhomocysteinemia-as-first-manifestation-of-pernicious-anemia-a-case-series
#11
W Ammouri, Z Mezalek Tazi, H Harmouche, M Maamar, M Adnaoui
BACKGROUND: Hyperhomocysteinemia has been suspected of favoring thrombosis. Several case-control studies and even a meta-analysis have confirmed a link between venous thrombosis and hyperhomocysteinemia. Homocysteine is due to genetic and acquired factors (poor diet in folate and vitamin B12, older age, renal impairment, thyroid diseases, and malignancies) induced by the intake and the concentrations of vitamin B9 or B12 in the majority of cases. CASES PRESENTATION: We report the cases of four Moroccan patients who presented with acute vein thrombosis of different sites: a 34-year-old man, a 60-year-old man, a 58-year-old man, and a 47-year-old woman...
September 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28861852/antithrombin-deficiency-and-decreased-protein-c-activity-in-a-young-man-with-venous-thromboembolism-a-case-report
#12
Dong Wang, Min Tian, Guanglin Cui, Dao Wen Wang
Antithrombin and protein C are two crucial members in the anticoagulant system and play important roles in hemostasis. Mutations in SERPINC1 and PROC lead to deficiency or dysfunction of the two proteins, which could result in venous thromboembolism (VTE). Here, we report a Chinese 22-year-old young man who developed recurrent and serious VTE in cerebral veins, visceral veins, and deep veins of the lower extremity. Laboratory tests and direct sequencing of PROC and SERPINC1 were conducted for the patient and his family members...
August 31, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28857856/theoretical-modeling-of-coagulation-management-with-therapeutic-plasma-or-prothrombin-complex-concentrate
#13
Herbert Schöchl, Oliver Grottke, Ken Sutor, Kieron Dony, Martin Schreiber, Marco Ranucci, Peter W Collins
Prothrombin complex concentrates (PCCs) have been associated with a possible risk of thromboembolic complications, potentially attributable to an increased ratio of the plasma concentration of factor II (FII) to antithrombin (AT). We developed a mathematical model to examine the relationship between amounts of PCC or therapeutic plasma administered, and plasma levels of FII and AT. The model showed that PCC produces substantial increases in plasma levels of FII but only small changes in AT, increasing the FII:AT ratio...
August 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28857806/reversing-dabigatran-anticoagulation-with-prothrombin-complex-concentrate-versus-idarucizumab-as-part-of-multimodal-hemostatic-intervention-in-an-animal-model-of-polytrauma
#14
Markus Honickel, Till Braunschweig, Rolf Rossaint, Christian Stoppe, Hugo Ten Cate, Oliver Grottke
BACKGROUND: Although idarucizumab is the preferred treatment for urgent dabigatran reversal, it is not always available. Prothrombin complex concentrate (PCC) may be an alternative and, with bleeding in trauma, additional hemostatic therapy may be required. The authors investigated multimodal treatment in a preclinical polytrauma model. METHODS: Dabigatran etexilate (30 mg/kg twice daily) was given orally to 45 male pigs for 3 days. On day 4, animals received a dabigatran infusion before blunt liver injury and bilateral femur fractures...
August 30, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28844073/the-effects-of-dry-ice-exposure-on-plasma-ph-and-coagulation-analyses
#15
Lene Trondsetås, Gustav Mikkelsen, Ingrid Alsos Lian
BACKGROUND: We recently observed that exposure to dry ice lowered sample pH and increased clotting times in lupus anticoagulant analyses, and that such changes could be prevented by placing samples at -80°C after dry ice exposure. In the current study, we sought to evaluate the effects of dry ice exposure on pH and various commonly used coagulation analyses. METHODS: Citrated plasma from 30 healthy blood donors was allocated to four preanalytical regimes: (1) immediate analysis of fresh plasma or (2) storage at -20°C; (3) storage at -20°C followed by dry ice exposure for 24 h or (4) storage at -20°C followed by dry ice exposure for 24 h and storage at -80°C for 24 h before analysis...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28843664/circulating-syndecan-1-predicts-the-development-of-disseminated-intravascular-coagulation-in-patients-with-sepsis
#16
Mitsunori Ikeda, Hisatake Matsumoto, Hiroshi Ogura, Tomoya Hirose, Kentaro Shimizu, Kouji Yamamoto, Ikuro Maruyama, Takeshi Shimazu
PURPOSE: One of the pathophysiological processes in sepsis is endothelial dysfunction, which leads to disseminated intravascular coagulation (DIC). Syndecan-1 is a major structural component of the endothelium and plays a key role in endothelial function. The purpose of this study was to assess the value of syndecan-1 as a predictive marker for DIC in sepsis. METHODS: We performed a prospective observational study of patients with sepsis from February 2014 to July 2015...
July 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28841902/markers-of-acute-kidney-injury-in-patients-with-sepsis-the-role-of-soluble-thrombomodulin
#17
Shinshu Katayama, Shin Nunomiya, Kansuke Koyama, Masahiko Wada, Toshitaka Koinuma, Yuya Goto, Ken Tonai, Jun Shima
BACKGROUND: Endothelial activation and damage occur early during sepsis, with activated coagulopathy and playing a major role in the pathophysiology of sepsis-induced acute kidney injury (AKI). The aim of this study was to compare the various biomarkers of endothelial injury with the biomarkers of coagulation and inflammation and to determine a significant predictor of AKI in patients with sepsis. METHODS: We conducted a single-center, retrospective, observational study on patients with sepsis fulfilling the Third International Consensus Definitions for Sepsis and Septic Shock criteria admitted to an adult intensive care unit (ICU) at a university hospital from June 2011 to December 2016...
August 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28839178/hypercoagulability-progresses-to-hypocoagulability-during-evolution-of-acetaminophen-induced-acute-liver-injury-in-pigs
#18
Karla Chui Luan Lee, Luisa Baker, Susan Mallett, Anne Riddell, Pratima Chowdary, Hatim Alibhai, Yu-Mei Chang, Simon Priestnall, Giacomo Stanzani, Nathan Davies, Rajeshwar Mookerjee, Rajiv Jalan, Banwari Agarwal
Increases in prothrombin time (PT) and international normalised ratio (INR) characterise acute liver injury (ALI) and failure (ALF), yet a wide heterogeneity in clotting abnormalities exists. This study defines evolution of coagulopathy in 10 pigs with acetaminophen (APAP)-induced ALI compared to 3 Controls. APAP administration began at 0 h and continued to 'ALF', defined as INR >3. In APAP pigs, INR was 1.05 ± 0.02 at 0 h, 2.15 ± 0.43 at 16 h and > 3 at 18 ± 1 h. At 12 h thromboelastography (TEG) demonstrated increased clot formation rate, associated with portal vein platelet aggregates and reductions in protein C, protein S, antithrombin and A Disintegrin and Metalloprotease with Thrombospondin type 1 repeats-13 (ADAMTS-13) to 60%, 24%, 47% and 32% normal respectively...
August 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28826407/disseminated-intravascular-coagulation-with-increased-fibrinolysis-during-the-early-phase-of-isolated-traumatic-brain-injury
#19
Takeshi Wada, Satoshi Gando, Kunihiko Maekaw, Kenichi Katabami, Hisako Sageshima, Mineji Hayakawa, Atsushi Sawamura
BACKGROUND: There is evidence to demonstrate that the coagulopathy which occurs in patients with traumatic brain injury coincides with disseminated intravascular coagulation (DIC). We hypothesized that DIC with increased fibrinolysis during the early stage of isolated traumatic brain injury (iTBI) affects the outcome of the patients and that hypoperfusion contributes to hyperfibrinolysis in the DIC. METHODS: This retrospective study included 92 patients with iTBI who were divided into DIC and non-DIC groups according to the Japanese Association Acute Medicine DIC scoring system...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28821129/characterization-and-anticoagulant-activity-of-a-fucosylated-chondroitin-sulfate-with-unusually-procoagulant-effect-from-sea-cucumber
#20
Mohamed Ben Mansour, Rafik Balti, Véronique Ollivier, Hichem Ben Jannet, Frédéric Chaubet, Raoui Mounir Maaroufi
The fucosylated chondroitin sulfate (FuCS) was isolated from the sea cucumber Holothuria polii body wall and then purified by anion exchange chromatography and the structure was characterized by FT-IR and NMR spectroscopy. Anticoagulant activity was measured in plasma by classical anticoagulation tests and the thrombin generation was assessed by calibrated automated thrombography. The results showed that the FuCS obtained at a yield of 4.66% possesses high sulfate content 43% and an average molecular mass of 45...
October 15, 2017: Carbohydrate Polymers
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