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Antifibrinolytics

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https://www.readbyqxmd.com/read/29446520/lenalidomide-as-a-novel-therapy-for-gastrointestinal-angiodysplasia-in-von-willebrand-disease
#1
N V Khatri, B Patel, D R Kohli, S S Solomon, K Bull-Henry, C M Kessler
INTRODUCTION: Lenalidomide is a thalidomide analog with anti-angiogenic properties. Previous case reports suggest its efficacy in preventing gastrointestinal bleeding (GIB) secondary to angiodysplasia (AD) in hereditary haemorrhagic telangiectasia and potentially in reversing AD. We present the first case series to explore lenalidomide as a treatment for AD-related GIB in patients with von Willebrand disease (VWD). METHODS: A retrospective chart review was conducted to include patients with VWD, who were evaluated from 2010 to 2013 and who had received lenalidomide to treat recurrent GIB secondary to AD...
February 15, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
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
#2
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
#3
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/29413743/safety-of-a-high-dose-tranexamic-acid-protocol-in-complex-adult-spinal-deformity-analysis-of-100-consecutive-cases
#4
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
#5
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/29389542/tranexamic-acid-for-treatment-of-women-with-post-partum-haemorrhage-in-nigeria-and-pakistan-a-cost-effectiveness-analysis-of-data-from-the-woman-trial
#6
Bernadette Li, Alec Miners, Haleema Shakur, Ian Roberts
BACKGROUND: Sub-Saharan Africa and southern Asia account for almost 85% of global maternal deaths from post-partum haemorrhage. Early administration of tranexamic acid, within 3 h of giving birth, was shown to reduce the risk of death due to bleeding in women with post-partum haemorrhage in the World Maternal Antifibrinolytic (WOMAN) trial. We aimed to assess the cost-effectiveness of early administration of tranexamic acid for treatment of post-partum haemorrhage. METHODS: For this economic evaluation we developed a decision model to assess the cost-effectiveness of the addition of tranexamic acid to usual care for treatment of women with post-partum haemorrhage in Nigeria and Pakistan...
February 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29378695/how-i-treat-type-2b-von-willebrand-disease
#7
Rebecca Kruse-Jarres, Jill M Johnsen
Type 2B von Willebrand disease (VWD) is an inherited bleeding disorder caused by changes in von Willebrand factor (VWF) that enhance binding of VWF to GPIb on platelets. Although this disorder is seemingly well defined due to this single molecular defect, in reality type 2B VWD is a clinically heterogeneous disorder that can be difficult to identify and manage. Diagnostic criteria include a history of mucocutaneous bleeding, laboratory studies showing enhanced VWF binding of platelets and/or a 2B VWD genetic variant, and a family history consistent with autosomal dominant inheritance...
January 29, 2018: Blood
https://www.readbyqxmd.com/read/29354728/efficacy-of-tranexamic-acid-in-reducing-blood-loss-and-blood-transfusion-in-idiopathic-scoliosis-a-systematic-review-and-meta-analysis
#8
Turki Alajmi, Halah Saeed, Khalid Alfaryan, Ahmed Alakeel, Thamer Alfaryan
Background: Tranexamic acid is a synthetic lysine-analogue antifibrinolytic that competitively inhibits the activation of plasminogen to plasmin, it is a well-documented blood sparing agent. However, its routine use in idiopathic scoliosis surgery is poorly documented. The objective of this meta-analysis was to determine TXA's efficacy in reducing blood loss and blood transfusion in idiopathic scoliosis surgery. Methods: Five databases (Medline, PubMed, Web of Science, Embase and The Cochrane Central Register of Controlled Trials) were searched to identify the relevant randomized controlled trials (RCTs), prospective cohort control (PCC), and retrospective controlled trails regarding the TXA efficacy in idiopathic scoliosis surgery...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29350594/determinants-of-perioperative-transfusion-risk-in-patients-with-adult-spinal-deformity
#9
Varun Puvanesarajah, Sandesh S Rao, Hamid Hassanzadeh, Khaled M Kebaish
OBJECTIVE To determine predictors of perioperative allogeneic packed red blood cell (pRBC) transfusion requirement (total units transfused) in patients with adult spinal deformity (ASD). METHODS The authors retrospectively analyzed records of patients aged 18 years or older who underwent surgical correction of ASD that involved 4 or more spinal levels by the same spine surgeon between 2010 and 2016. Data regarding patient characteristics, comorbidities, surgical factors, and perioperative transfusions (up to 10 days after surgery) were analyzed using a linear regression model...
January 19, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29346202/ischemic-preconditioning-and-the-role-of-antifibrinolytic-drugs-translation-from-bench-to-bedside
#10
Quintin J Quinones, Jerrold H Levy
No abstract text is available yet for this article.
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29339919/effect-of-oral-tranexamic-acid-on-macular-edema-associated-with-retinal-vein-occlusion-or-diabetes
#11
Masayuki Takeyama, Fumio Takeuchi, Masahiko Gosho, Keijiro Sugita, Masahiro Zako, Masayoshi Iwaki, Motohiro Kamei
Purpose: Tranexamic acid (TXA) is a widely used antifibrinolytic agent that can also cause a decrease in vascular permeability. We hypothesized that TXA could improve macular edema (ME) that is caused by an increase in retinal vascular permeability. The aim of this study is to evaluate the efficacy of oral TXA for ME associated with retinal vein occlusion (RVO) or diabetic ME (DME). Patients and methods: Oral TXA (1,500 mg daily for 2 weeks) was administered to patients with persistent ME secondary to RVO (7 eyes) and DME (7 eyes)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29324486/fibrinolysis-and-antifibrinolytic-treatment-in-the-trauma-patient
#12
Lewis S Gall, Ross A Davenport
PURPOSE OF REVIEW: The role of antifibrinolytics in trauma haemorrhage and early coagulopathy remains controversial with respect to patient selection, dosage, timing of treatment, and risk of thrombotic complications. This review presents our current understanding of the mechanisms of fibrinolysis in trauma, diagnostic evaluation, and the evidence base for treatment. RECENT FINDINGS: Excessive fibrinolysis following severe injury is a major component of acute traumatic coagulopathy and contributes to the high mortality from trauma haemorrhage...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29322515/current-practices-in-perioperative-blood-management-for-patients-undergoing-liver-resection-a-survey-of-surgeons-and-anesthesiologists
#13
Sean Bennett, Abdul Ayoub, Alexandre Tran, Shane English, Alan Tinmouth, Daniel I McIsaac, Dean Fergusson, Guillaume Martel
BACKGROUND: Development of intraoperative techniques and blood management strategies in liver resection, and the multidisciplinary nature of perioperative transfusion decision making, creates an opportunity for practice variation. The aim of this study was to describe the current practices in perioperative blood management and explore differences between surgeons and anesthesiologists. STUDY DESIGN AND METHODS: A Web-based survey was developed, piloted, and circulated to Canadian liver surgeons and anesthesiologists...
January 10, 2018: Transfusion
https://www.readbyqxmd.com/read/29318575/post-partum-haemorrhage-and-tranexamic-acid-a-global-issue
#14
REVIEW
Stephen P Hibbs, Ian Roberts, Haleema Shakur-Still, Beverley J Hunt
Post-partum haemorrhage (PPH) remains the major cause of maternal death worldwide, with the overwhelming majority of bleeding deaths occurring in low income countries. These bleeding deaths occur due to a complex network of biological and socioeconomic factors, including changes to haemostasis and fibrinolysis during pregnancy. Tranexamic acid (TxA) has been shown to reduce death in bleeding trauma patients safely and is effective in reducing bleeding in surgical patients, however its role in PPH has been less well established...
January 9, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29305756/on-aneurysmal-rupture-and-rerupture
#15
Eelco F M Wijdicks
A warning leak is a curious phenomenon attributed to cerebral aneurysms. Once the leak occurs, it has been postulated it could lead to a more catastrophic rebleeding. The designation "warning leak" trickled into neurosurgery vocabulary as early as the 1950s. The phenomenon has been poorly understood and characterized, but its presence spurs emergency physicians and neurointensivists to take action to secure the aneurysm. Rapid treatment of a recently discovered aneurysm is now commonplace, but it has not always been so...
January 5, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#16
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29296712/antifibrinolytic-therapy-for-preventing-vwd-related-postpartum-hemorrhage-indications-and-limitations
#17
Peter A Kouides
Publisher's Note: This article has a companion Counterpoint by Ragni. Publisher's Note: Join in the discussion of these articles at Blood Advances Community Conversations.
April 25, 2017: Blood Advances
https://www.readbyqxmd.com/read/29290382/hypothermia-ph-and-postoperative-red-blood-cell-transfusion-in-massively-transfused-adult-cardiac-surgery-patients-a-retrospective-cohort-study
#18
Brittney Williams, Evan Chriss, Jennifer Kaplan, Alexander Cartron, Bradley Taylor, James Gammie, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: To determine the relationships between hypothermia and pH at surgery end and postoperative red blood cell (RBC) transfusion in massively transfused adult cardiac surgery patients. DESIGN: Retrospective cohort study. SETTING: Single tertiary care, academic medical center. PARTICIPANTS: A total of 395 adult patients having cardiac surgery with cardiopulmonary bypass who were massively transfused during an 8-year period...
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#19
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29249111/-hereditary-angioedema-by-c1-inhibitor-deficit-diagnostic-and-therapeutic-challenges-case-report
#20
Álvaro José Mayorga, Gerardo José Ayestas-Moreno
BACKGROUND: Hereditary angioedema is a disease which manifests itself with episodes of spontaneous edema on skin, mucosal and airway. Treatment includes acute and prophylactic approach to minimize the attacks and severity. In many parts of the world, androgen derivatives, antifibrinolytic and fresh frozen plasma are the therapies available for prophylaxis. CLINICAL REPORT: 16 years old teenager of without history of immune decease, has in the course of 1-year repetitive episodes of painless, non-pruritic angioedema, does not respond to antihistamine therapy, corticosteroids or adrenaline; fresh frozen plasma is applied in 1 occasion exacerbating episode with severity...
October 2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
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