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https://www.readbyqxmd.com/read/28813763/simultaneous-onset-of-deep-vein-thrombosis-pulmonary-embolism-cerebral-infarction-and-myocardial-infarction-in-a-patient-with-patent-foramen-ovale
#1
Jimmy Yee, Vishesh Kumar, Alex Pham, Kashif Shaikh, Muhammad Omar, Adam Stys, Marian Petrasko
Paradoxical embolism is a known complication with intra-cardiac shunts. It should be considered in the differential as the pathophysiologic mechanism of simultaneous thromboembolism in the venous and systemic vasculature. We present a case of simultaneous deep venous thrombosis, pulmonary embolism and myocardial infarction in the presence of a confirmed patent foramen ovale on echocardiography. Thrombolytic therapy was administered. Subsequent concerns of intracranial hemorrhage on imaging of the brain complicated the management and added to the challenge of co-managing the clot burden in our patient...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813732/gastric-zygomycosis-in-a-previously-healthy-56-year-old-male
#2
Ashwyna Sunassee, Desirae M Muirhead
Zygomycosis refers to invasive fungal infections caused by fungi belonging to the phylum zygomycota. Infections generally occur in immunocompromised individuals. The following case is of a previously healthy 56 year-oldmale admitted to the hospital following a motor vehicle accident. During his hospitalization, there was a significant drop in hemoglobin with no obvious source of bleeding. This prompted the clinician to insert a nasogastric tube which returned at least 2 liters of black fluid and led to an upper gastrointestinal endoscopy...
April 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28811743/retroperitoneal-bleeding-an-experience-during-prophylactic-anticoagulation-in-a-patient-with-nephrotic-syndrome
#3
Mari Okada, Tetsu Akimoto, Mutsumi Kawamata, Toshimi Imai, Erika Hishida, Marina Kohara, Atsushi Miki, Takuya Murakami, Taro Sugase, Takahiro Masuda, Yuko Ono, Yoshihiko Ueda, Osamu Saito, Shigeaki Muto, Daisuke Nagata
The association between nephrotic syndrome (NS) and a hypercoagulable state has been demonstrated. Controlling the blood clotting activity may therefore be attractive for patients with nephrosis in terms of thromboembolism prophylaxis. We herein report a 75-year-old woman with minimal change disease who developed pains in the right back, groin, and thigh because of retroperitoneal bleeding during prophylactic anticoagulation with unfractionated heparin. Although this procedure has not been accepted as the standard of care for patients with nephrosis, pharmacologic prophylaxis may already be practiced empirically, as in the present patient...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28811641/joint-inflammation-related-citrullination-of-functional-arginines-in-extracellular-proteins
#4
Kalle H Sipilä, Vipin Ranga, Pekka Rappu, Markku Mali, Laura Pirilä, Ilona Heino, Johanna Jokinen, Jarmo Käpylä, Mark S Johnson, Jyrki Heino
We report the extent, specific sites and structural requirements of joint inflammation related citrullination in extracellular proteins. A total of 40 synovial fluid samples derived from chronically inflamed human joints were analysed by heparin-agarose fractionation and LC-MS/MS. Citrullination of 55 arginines in extracellular proteins was detected. Importantly, 20% of the sites have a characterized function related to the hallmarks of destructive joint inflammation. E.g. four arginine residues, shown here to be citrullinated, are also affected by mutations in inherited diseases causing haemolysis or blood clotting dysfunction...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28809724/comparison-of-hemostasis-times-with-a-kaolin-based-hemostatic-pad-quikclot-radial-vs-mechanical-compression-tr-band-following-transradial-access-a-pilot-prospective-study
#5
Jonathan S Roberts, Jianli Niu, Juan A Pastor-Cervantes
BACKGROUND: Hemostasis following transradial access (TRA) is usually achieved by mechanical compression. We investigated use of the QuikClot Radial hemostasis pad (Z-Medica) compared with the TR Band (Terumo Medical) to shorten hemostasis after TRA. METHODS: Thirty patients undergoing TRA coronary angiography and/or percutaneous coronary intervention were randomized into three cohorts post TRA: 10 patients received mechanical compression with the TR Band, 10 patients received 30 min of compression with the QuikClot Radial pad, and 10 patients received 60 min of compression with the QuikClot Radial pad...
August 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28809406/clot-entrapped-blood-cells-in-synergy-with-human-mesenchymal-stem-cells-create-a-pro-angiogenic-healing-response
#6
Melanie A Burkhardt, Isabel Gerber, Cameron Moshfegh, Miriam S Lucas, Jasmin Waser, Maximilian Y Emmert, Simon P Hoerstrup, Falko Schlottig, Viola Vogel
Blood clots stop bleeding and provide cell-instructive microenvironments. Still, in vitro models used to study implant performance typically neglect any possible interactions of recruited cells with surface-adhering blood clots. Here we study the interaction and synergies of bone marrow derived human mesenchymal stem cells (hMSCs) with surface-induced blood clots in an in vitro model by fluorescence microscopy, scanning and correlative light and electron microscopy, ELISA assays and zymography. The clinically used alkali-treated rough titanium (Ti) surfaces investigated here are known to enhance blood clotting compared to native Ti and to improve the healing response, but the underlying mechanisms remain elusive...
August 15, 2017: Biomaterials Science
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#7
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
July 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28806993/successful-intravenous-thrombolysis-for-ischemic-stroke-after-reversal-of-dabigatran-anticoagulation-with-idarucizumab-a-case-report
#8
Sergio Agosti, Laura Casalino, Enrico Rocci, Gabriele Zaccone, Eugenia Rota
BACKGROUND: Non-vitamin K antagonist oral anticoagulants, including dabigatran, are currently widely used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment for immediate reversal of dabigatran-induced anticoagulation, has been introduced into the market to be used in life-threatening bleeding or urgent surgery, allowing for rapid normalization of clotting parameters. The use of idarucizumab is not yet well established in patients presenting with acute ischemic stroke on dabigatran who are candidates for thrombolytic therapy...
August 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28804851/thrombin-generation-assays-tgas
#9
Gian Luca Salvagno, Erik Berntorp
In recent years, there has been a revival of interest in a time-honored tool of the clotting trade: the thrombin generation curve or thrombin generation (TG) assay (TGA) as we now call it. Thrombin generation is a key coagulation process that determines the extent of a hemostatic plug or a thrombotic process. The recent development of newer tests based on the continuous registration of TG under in vitro conditions that mimic more closely what occurs in vivo prompted us to reinvestigate the balance between procoagulants and anticoagulants in patients...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#10
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804829/lupus-anticoagulant-testing-activated-partial-thromboplastin-time-aptt-and-silica-clotting-time-sct
#11
Armando Tripodi, Veena Chantarangkul
Actvated partial thromboplastin time and its congener test Silica clotting time are used for the laboratory detection of lupus anticoagulants. Their performance consists of mixing test plasma with activators of the contact coagulation factors, phospholipids and calcium chloride, and recording the clotting time. Here we describe the principle, performance and extensive practical details of the two methods, the problems that may be encountered and how they can be identified and overcome.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804827/assessment-of-hereditary-thrombophilia-performance-of-antithrombin-at-testing
#12
Jana N Gausman, Richard A Marlar
Antithrombin (AT) is a naturally occurring plasma inhibitor of coagulation, which is a synthesized in the liver. AT inhibits coagulation serine proteases (the enzymatically activated forms of the clotting factors), mainly thrombin (factor IIa) and factor Xa, but also to a lesser extent factors IXa, XIa, and XIIa. Acting alone, AT inhibits coagulation factors, but does this very slowly; however, when coupled with heparin as a cofactor, the speed of inhibition is increased many fold. The AT/Heparin complex is the most powerful naturally occurring anticoagulant in blood...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804825/assessment-of-hereditary-thrombophilia-performance-of-protein-c-pc-testing
#13
Richard A Marlar, Jana N Gausman
Protein C (PC) is a plasma Vitamin K-dependent pro-enzyme protein that is synthesized in the liver. Upon activation, PC regulates the coagulation process by neutralizing the procoagulant activities of factors V and VIII in the presence of the cofactor Protein S. PC is a major regulator of the coagulation process. The clotting based Protein C assay, the protocol described in this chapter, quantitates the amount of functional PC present in the specimen in a proportional fashion based on the prolongation of the Activated Partial Thromboplastin Time (APTT)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804824/laboratory-testing-for-activated-protein-c-resistance-apcr
#14
Soma Mohammed, Emmanuel J Favaloro
Activated protein C resistance (APCR) describes a hemostatic disorder characterized by a poor anticoagulant response to activated protein C (APC). This results in an increased risk of venous thrombosis, including deep vein thrombosis and pulmonary embolism. Protein C is a natural anticoagulant that is synthesized in the liver and is activated to APC via proteolysis. APC then degrades Factors Va and VIIIa. APCR describes the reduced inability of APC to cleave Factors Va and VIIIa, which therefore promotes increased thrombin generation and potentially leads to a prothrombotic state...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804823/an-overview-of-thrombophilia-and-associated-laboratory-testing
#15
Martina Montagnana, Giuseppe Lippi, Elisa Danese
Venous thromboembolism, usually entailing deep vein thrombosis, pulmonary embolism, or both, is a complex and multifactorial disorder, in which a number of putative conditions interplay and finally contribute to propel the individual risk over a certain degree, so ultimately culminating in the development of venous occlusive disorders. Thrombophilia is commonly defined as a propensity to develop venous thromboembolism on the basis of an underlying hypercoagulable state attributable to inherited or acquired disorders of blood coagulation or fibrinolysis...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804822/determination-of-fibrinogen-and-thrombin-time-tt
#16
Anetta Undas
Fibrinogen is measured in plasma most commonly using the Clauss method, based on the comparison of thrombin clotting times of dilutions of plasma against a plasma standard. Thrombin time (TT) is a coagulation assay, which reflects the conversion of fibrinogen to fibrin after addition of thrombin reagent. Measurement of clottable fibrinogen and TT allows detecting inborn (congenital) and acquired qualitative and quantitative disorders of fibrinogen that can lead to thrombotic or bleeding events.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804820/performance-and-interpretation-of-mixing-tests-in-coagulation
#17
Geoffrey Kershaw
Mixing tests in coagulation studies allow the laboratory to correctly differentiate factor deficiency from inhibitors as the cause of a prolonged clotting time. This is important in terms of subsequent laboratory follow-up and clinical patient management. In this chapter, a suggested method of performing mixing tests is given, with procedures applying two different formulas for interpretation, the percent correction and the index of circulating anticoagulant.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804819/performance-of-activated-partial-thromboplastin-time-aptt-determining-reagent-sensitivity-to-factor-deficiencies-heparin-and-lupus-anticoagulants
#18
Geoffrey Kershaw
The activated partial thromboplastin time (APTT) is a useful global assay for the assessment of the contact factor pathway of hemostasis and its inhibitors. The test is usually performed on fully automated analyzers using commercially prepared reagents. The three main clinical areas of interest are detection of factor deficiencies, detection of lupus anticoagulants and in the monitoring of therapy with unfractionated heparin. Methods are described here for assessing APTT reagents for their sensitivity to clotting time prolongation in each of these areas of interest...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803746/air-bubbles-and-hemolysis-of-blood-samples-during-transport-by-pneumatic-tube-systems
#19
Garrett R Mullins, David E Bruns
BACKGROUND: Transport of blood samples through pneumatic tube systems (PTSs) generates air bubbles in transported blood samples and, with increasing duration of transport, the appearance of hemolysis. We investigated the role of air-bubble formation in PTS-induced hemolysis. METHODS: Air was introduced into blood samples for 0, 1, 3 or 5min to form air bubbles. Hemolysis in the blood was assessed by (H)-index, lactate dehydrogenase (LD) and potassium in plasma. In an effort to prevent PTS-induced hemolysis, blood sample tubes were completely filled, to prevent air bubble formation, and compared with partially filled samples after PTS transport...
August 10, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28803708/anti-phospholipid-syndrome-current-opinion-on-mechanisms-involved-laboratory-characterization-and-diagnostic-aspects
#20
REVIEW
Jean Amiral, Marie Peyrafitte, Claire Dunois, Anne Marie Vissac, Jerard Seghatchian
Anti-phospholipid syndrome is a complex and severe clinical situation, associated with symptoms such as recurrent thrombosis, arterial or venous, at any site, pregnancy loss, and other related syndromes. These clinical burdens, are highly variable from patient to patient, and are associated with biological abnormalities, such as the presence of the Lupus Anticoagulant or phospholipid dependent antibodies, confirmed on two occasions at least 12 weeks apart. From the diagnosis standpoint, both, functional (clotting) or immunological assays, are difficult to standardize and to optimize, due to the absence of reference material, or a characteristic clinical group, and international reference preparations...
July 15, 2017: Transfusion and Apheresis Science
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