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Heparin induced thrombocytopenia

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https://www.readbyqxmd.com/read/27913490/heparin-induced-thrombocytopenia-research-and-clinical-updates
#1
Oluwatoyosi Onwuemene, Gowthami M Arepally
Heparin-induced thrombocytopenia (HIT) remains an important diagnosis to consider in hospitalized patients developing thrombocytopenia. HIT is an immune-mediated prothrombotic disorder caused by antibodies to platelet factor 4 (PF4) and heparin. Recent basic scientific studies have advanced our understanding of disease pathogenesis through studies of the PF4/heparin structure, immune mechanisms, and cellular basis of thrombosis. Clinical advances have also occurred in areas of HIT prevention, description of disease variants, and diagnostic strategies...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27878507/the-scope-and-value-of-an-anticoagulation-stewardship-program-at-a-community-teaching-hospital
#2
Maura K Wychowski, Christina I Ruscio, Peter A Kouides, Ronald L Sham
To report the impact of an inpatient anticoagulation stewardship program at a community hospital to promote optimal anticoagulant use. The anticoagulation team (ACT) stewardship program consists of two clinical pharmacists and hematologists to provide oversight of anticoagulants, high cost reversal agents including prothrombin complex concentrate (PCC, Kcentra™), and heparin-induced thrombocytopenia (HIT) management. Intervention data and number of charts reviewed were collected. Average cost avoidance data was applied to ACT interventions to estimate cost savings...
November 22, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27864862/heparin-induced-multi-electrode-aggregometry-method-for-heparin-induced-thrombocytopenia-testing-communication-from-the-ssc-of-the-isth
#3
M-C Morel-Kopp, F Mullier, V Gkalea, T Bakchoul, V Minet, I Elalamy, C M Ward
No abstract text is available yet for this article.
September 26, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27850923/1287-defining-heparin-induced-thrombocytopenia-management-failure-in-the-icu
#4
Erin Mancl, Allyson Wexler, Srinath Sriram, Sean Forsythe
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850752/1115-retrospective-study-of-current-practices-of-heparin-induced-thrombocytopenia-diagnosis-and-treatment
#5
Melinda Miller, Farid Sadaka
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850499/861-cost-avoidance-of-a-heparin-induced-thrombocytopenia-diagnostic-pathway-in-an-intensive-care-unit
#6
Heath Oetken, Sara Varnado, Brian Trevarrow, Gregory Peitz
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#7
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27836513/anticoagulant-therapy-for-symptomatic-calf-deep-vein-thrombosis-cactus-a-randomised-double-blind-placebo-controlled-trial
#8
Marc Righini, Jean-Philippe Galanaud, Hervé Guenneguez, Dominique Brisot, Antoine Diard, Pascale Faisse, Marie-Thérèse Barrellier, Claudine Hamel-Desnos, Christine Jurus, Olivier Pichot, Myriam Martin, Lucia Mazzolai, Clarisse Choquenet, Sandrine Accassat, Helia Robert-Ebadi, Marc Carrier, Grégoire Le Gal, Bernadette Mermilllod, Jean-Pierre Laroche, Henri Bounameaux, Arnaud Perrier, Susan R Kahn, Isabelle Quere
BACKGROUND: The efficacy and safety of anticoagulant treatment is not established for patients with acute symptomatic deep vein thrombosis (DVT) of the calf. We aimed to assess whether therapeutic anticoagulation is superior to placebo in patients with symptomatic calf DVT. METHODS: In this randomised, double-blind, placebo-controlled trial, we enrolled low-risk outpatients (without active cancer or previous venous thromboembolic disease) with a first acute symptomatic DVT in the calf from 23 university medical centres or community medical clinics in Canada, France, and Switzerland...
November 7, 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#9
Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
November 7, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27820879/heparin-for-the-treatment-of-thrombosis-in-neonates
#10
REVIEW
Olga Romantsik, Matteo Bruschettini, Simona Zappettini, Luca Antonio Ramenghi, Maria Grazia Calevo
BACKGROUND: Among pediatric patients, newborns are at highest risk of developing thromboembolism. Neonatal thromboembolic (TE) events may consist of both venous and arterial thromboses and often iatrogenic complications (eg, central catheterization). Treatment guidelines for pediatric patients with TE events most often are extrapolated from the literature regarding adults. Options for the management of neonatal TE events include expectant management; nitroglycerin ointment; thrombolytic therapy or anticoagulant therapy, or a combination of the two; and surgery...
November 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27818479/optical-coherence-tomography-findings-in-early-stent-thrombosis-by-heparin-induced-thrombocytopenia
#11
Hiroshi Okamoto, Teruyoshi Kume, Kenzo Fukuhara, Yusuke Kobayashi, Ai Kawamura, Yutaka Goryo, Terumasa Koyama, Tomoko Tamada, Ryotaro Yamada, Koichiro Imai, Yoji Neishi, Shiro Uemura
A 62-year-old man with a family history of coronary artery disease and a history of smoking, diabetes and dyslipidemia was admitted to our hospital with chest pain from acute myocardial infarction. Emergent coronary angiography was performed with intervention to a mid-right coronary occlusion with drug-eluting stent implantation. Optical coherence tomography (OCT) visualized well-apposed stent struts and no remarkable tissue protrusion, stent underexpansion, malapposition, edge dissection, and hematoma. Immediately after OCT imaging, a coronary angiogram showed a filling defect surrounded by contrast medium at the site of the stented lesion...
November 4, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27817998/-economic-consequences-of-biological-monitoring-and-medical-complications-of-injectable-anticoagulants-in-france
#12
P Paubel, M Cousin, C Amar, J Gourmelen, C Fabron, B Detournay
AIM: To assess the frequency of platelet monitoring and bleeding risks associated with the use of injectable anticoagulants in a real life setting and to estimate the associated costs. METHOD: An analysis of the 2013 data from a random sample of ≈600,000 patients registered in the French National Health Insurances reimbursement database was conducted to identify platelet counts performed during injectable anticoagulants exposure period and treatment interruptions due to heparin-induced thrombocytopenia or transfusion...
November 3, 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27797404/pentasaccharides-for-the-prevention-of-venous-thromboembolism
#13
REVIEW
Kezhou Dong, Yanzhi Song, Xiaodong Li, Jie Ding, Zhiyong Gao, Daopei Lu, Yimin Zhu
BACKGROUND: Venous thromboembolism (VTE) is a common condition with potentially serious and life-threatening consequences. The standard method of thromboprophylaxis uses an anticoagulant such as low molecular weight heparin (LMWH) or warfarin. In recent years, another type of anticoagulant, pentasaccharide, an indirect factor Xa inhibitor, has shown good anticoagulative effect in clinical trials. Three types of pentasaccharides are available: short-acting fondaparinux, long-acting idraparinux and idrabiotaparinux...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27795525/how-to-choose-and-understand-clinical-laboratory-tests-in-daily-clinical-management-of-hematologic-diseases
#14
Yoshinobu Seki
General statements have been published regarding the clinical laboratory tests for thrombosis and hemostasis to be used by hematologists who do not specialize in this field. Screening tests for bleeding are bleeding time, capillary fragility test, platelet count, prothrombin time, activated partial thromboplastin time (APTT), fibrinogen, fibrin/fibrinogen degradation products (FDP), and the cross mixing test conducted by measuring APTT. Screening tests for thrombosis and related factors include measurements of FDP, D-dimer, and thrombin-antithrombin complex...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27795522/spontaneous-heparin-induced-thrombocytopenia-hit-syndrome-hit-without-any-heparin-exposure
#15
Shigeki Miyata
Heparin-induced thrombocytopenia (HIT) is a pro-thrombotic side effect of heparin therapy caused by HIT antibodies with platelet-activating properties. Recent advances in understanding of spontaneous HIT syndrome, which can occur even without any heparin exposure despite its clinical and serological characteristics being similar to those of HIT, reveal the following HIT clinical features atypical for an immune-mediated disease. Heparin-naïve patients can develop IgG antibodies as early as day 4, as in a secondary immune response...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27793877/cost-effectiveness-of-anticoagulants-for-the-management-of-suspected-heparin-induced-thrombocytopenia-in-the-us
#16
Ahmed Aljabri, Yvonne Huckleberry, Jason Karnes, Mahdi Gharaibeh, Hussam I Kutbi, Yuval Raz, Seongseok Yun, Ivo Abraham, Brian Erstad
Despite the availability of multiple non-heparin anticoagulants for the treatment of heparin-induced thrombocytopenia (HIT), little data is available comparing the cost-effectiveness of these agents. This analysis is particularly important considering differences in risks of adverse effects, routes of administration, requirements for phlebotomy and laboratory monitoring, and overall drug costs. We conducted a cost-effectiveness analysis of argatroban, bivalirudin, and fondaparinux for the treatment of suspected HIT from the institutional perspective...
October 28, 2016: Blood
https://www.readbyqxmd.com/read/27790761/single-molecule-force-spectroscopy-applied-to-heparin-induced-thrombocytopenia
#17
REVIEW
Thi-Huong Nguyen
Heparin-induced thrombocytopenia (HIT), occurring up to approximately 1% to 5% of patients receiving the antithrombotic drug heparins, has a complex pathogenesis involving multiple partners ranging from small molecules to cells/platelets. Recently, insights into the mechanism of HIT have been achieved by using single-molecule force spectroscopy (SMFS), a methodology that allows direct measurements of interactions among HIT partners. Here, the potential of SMFS in unraveling the mechanism of the initial steps in the pathogenesis of HIT at single-molecule resolution is highlighted...
October 28, 2016: Journal of Molecular Recognition: JMR
https://www.readbyqxmd.com/read/27788711/-one-case-of-type-ii-heparin-induced-thrombocytopenia-occurring-in-artificial-extracorporeal-liver-support-therapy
#18
L Yu, M Yuan, Y Wang, M Y Chen, X Y Yin, M Wang, L C Wang
No abstract text is available yet for this article.
August 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27787285/heparin-induced-thrombocytopenia-a-tremendous-opportunity-for-randomization
#19
Austin Lammers, Thomas DeLoughery, Vinay Prasad
Heparin-induced thrombocytopenia and thrombosis (HITT) is both life-threatening with a complex immune-mediated process and clinically challenging to diagnose and treat. What further complicates matters is that thrombocytopenia is a frequently encountered laboratory value but rarely results in clinical signs of HITT. Decades into its initial description, we have anticoagulants with a small therapeutic index and associated high cost. The diagnosis is sometimes equivocal given our current laboratory diagnostics, and can take days to confirm...
October 25, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/27765766/tula-2-t-cell-ubiquitin-ligand-2-inhibits-the-platelet-fc-receptor-for-igg-iia-fc%C3%AE-riia-signaling-pathway-and-heparin-induced-thrombocytopenia-in-mice
#20
Yuhang Zhou, Shaji Abraham, Stephanie Renna, Leonard C Edelstein, Carol A Dangelmaier, Alexander Y Tsygankov, Satya P Kunapuli, Paul F Bray, Steven E McKenzie
OBJECTIVE: The objective of this study is to investigate the role of T-cell ubiquitin ligand-2 (TULA-2) in the platelet Fc receptor for IgG IIA (FcγRIIA) pathway and in the pathogenesis of heparin-induced thrombocytopenia (HIT). APPROACH AND RESULTS: HIT is a life-threatening thrombotic disease in which IgG antibodies against the heparin-platelet factor 4 complex activate platelets via FcγRIIA. We reported previously differential expression of TULA-2 in human population was linked to FcγRIIA responsiveness...
October 20, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
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