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G I bleed

María T Álvarez-Román, Ihosvany Fernández-Bello, Víctor Jiménez-Yuste, Mónica Martín-Salces, Elena G Arias-Salgado, María I Rivas Pollmar, Raúl Justo Sanz, Nora V Butta
Despite their low platelet count some immune thrombocytopenia (ITP) patients seldom bleed, indicating the presence of factors to compensate thrombocytopenia. Moreover, ITP patients may have an increased risk for thrombosis. These facts suggest the presence of procoagulant mechanisms that have not been clarified yet. The aim of this study was to identify these possible factors. Moreover, the utility of rotational thromboelastometry (ROTEM(®) ) to test haemostasis in these patients was also evaluated. Patients with ITP presented a procoagulant profile due to an increased amount of platelet- and red cell-microparticles, an increased resistance to protein C and the formation of a clot more resistant to fibrinolysis due to augmented levels of plasminogen activator inhibitor-1, which might reflect an endothelial damage/activation in ITP patients...
October 21, 2016: British Journal of Haematology
Xiaohong Ruby Xu, Naadiya Carrim, Miguel Antonio Dias Neves, Thomas McKeown, Tyler W Stratton, Rodrigo Matos Pinto Coelho, Xi Lei, Pingguo Chen, Jianhua Xu, Xiangrong Dai, Benjamin Xiaoyi Li, Heyu Ni
Platelets are central mediators of thrombosis and hemostasis. At the site of vascular injury, platelet accumulation (i.e. adhesion and aggregation) constitutes the first wave of hemostasis. Blood coagulation, initiated by the coagulation cascades, is the second wave of thrombin generation and enhance phosphatidylserine exposure, can markedly potentiate cell-based thrombin generation and enhance blood coagulation. Recently, deposition of plasma fibronectin and other proteins onto the injured vessel wall has been identified as a new "protein wave of hemostasis" that occurs prior to platelet accumulation (i...
2016: Thrombosis Journal
Paul J Karanicolas, Yulia Lin, Jordan Tarshis, Calvin H L Law, Natalie G Coburn, Julie Hallet, Barto Nascimento, Janusz Pawliszyn, Stuart A McCluskey
BACKGROUND: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection. METHODS: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery...
October 17, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Vinciya Pandian, Christoph T Hutchinson, Adam J Schiavi, David J Feller-Kopman, Elliott R Haut, Nicole A Parsons, Jessica S Lin, Chad Gorbatkin, Priya G Angamuthu, Christina R Miller, Marek A Mirski, Nasir I Bhatti, Lonny B Yarmus
PURPOSE: Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early tracheostomy tube change, possible bleeding, or loss of the airway. We sought to identify predictors of nonstandard tracheostomy tubes. MATERIALS AND METHODS: In this matched case-control study at an urban, academic, tertiary care medical center, we reviewed 1220 records of patients who received a tracheostomy...
June 4, 2016: Journal of Critical Care
Iris van Moort, Marieke Joosten, Moniek P M de Maat, Frank W G Leebeek, Marjon H Cnossen
Measurements of factor VIII coagulation activity (FVIII:C) may vary and result in misclassification of hemophilia A with delay in initiation of prophylactic treatment. We describe two young brothers who were diagnosed as moderate hemophilia patients and therefore not prophylactically treated with factor VIII concentrate despite frequent bleeding events. These findings emphasize the importance of (i) multiple measurements of FVIII:C by certified laboratories, (ii) adjustment of treatment when test results do not correspond to clinical symptoms, (iii) relevance of additional DNA mutation analysis in patients with hemophilia A, and (iv) treatment in centers with expertise...
October 13, 2016: Pediatric Blood & Cancer
Wan-Ting Hung, Shu-Chien Huang, Dania El Mazloum, Wen-Hsi Lin, Hui-Hsin Yang, Hung-Chieh Chou, En-Ting Wu, Chien-Yi Chen, Po-Nien Tsao, Wu-Shiun Hsieh, Wen-Ming Hsu, Yih-Sharng Chen, Hong-Shiee Lai
BACKGROUND/PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a treatment option for stabilizing neonates with congenital diaphragmatic hernia (CDH) in a critical condition when standard therapy fails. However, the use of this approach in Taiwan has not been previously reported. METHODS: The charts of all neonates with CDH treated in our institute during the period 2007-2014 were reviewed. After 2010, patients who could not be stabilized with conventional treatment were candidates for ECMO...
October 7, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Navkaranbir S Bajaj, Rajat Kalra, Nirav Patel, Taimoor Hashim, Hemant Godara, Sameer Ather, Garima Arora, Tilak Pasala, Thomas T Whitfield, David C McGiffin, Mustafa I Ahmed, Steven G Lloyd, Nita A Limdi, Pankaj Arora
BACKGROUND: Multiple novel oral anticoagulants and left atrial appendage closure devices (WATCHMAN) have been tested against dose-adjusted vitamin K antagonists in randomized controlled trials for stroke prophylaxis in non-valvular atrial fibrillation. No direct comparisons of these strategies are available from randomized controlled trials. We conducted the current analyses by combining efficacy and safety characteristics of all FDA approved stroke prophylaxis treatment strategies for patients with non-valvular atrial fibrillation...
2016: PloS One
Evangelos K Oikonomou, Theodoros I Repanas, Christos Papanastasiou, Damianos G Kokkinidis, Michael Miligkos, Attila Feher, Dipti Gupta, Polydoros N Kampaktsis
BACKGROUND: In-hospital acquired thrombocytopenia (TP) is relatively common among patients hospitalized with acute coronary syndromes (ACS). However, its effect on short-term and long-term outcomes has yet to be reviewed systematically. METHODS: We conducted a systematic review and meta-analysis of clinical studies assessing the relationship between new-onset in-hospital TP and adverse outcomes among ACS patients. MEDLINE, Scopus and the Cochrane Library were searched for eligible studies published before March 20, 2016...
September 24, 2016: Thrombosis Research
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Ghulam Hussain, Hammad Azam, Mirza Ahmad Raza Baig, Naseem Ahmad
OBJECTIVES: To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. METHODS: This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group)...
July 2016: Pakistan Journal of Medical Sciences Quarterly
A Casini, P de Moerloose
INTRODUCTION: No evidence-based guidelines for the management of patients suffering from afibrinogenaemia and hypofibrinogenaemia are available. AIM AND METHOD: The aim of this study was to harmonize patient's care among invited haemophilia experts from Belgium, France and Switzerland. A Delphi-like methodology was used to reach a consensus on: prophylaxis, bleeding, surgery, pregnancy and thrombosis management. RESULTS: The main final statements are as follows: (i) a secondary fibrinogen prophylaxis should be started after a first life-threatening bleeding in patients with afibrinogenaemia; (ii) during prophylaxis the target trough fibrinogen level should be 0...
September 19, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Anine H Stam, Parul H Kothari, Aisha Shaikh, Andreas Gschwendter, Joanna C Jen, Suzanne Hodgkinson, Todd A Hardy, Michael Hayes, Peter A Kempster, Katya E Kotschet, Ingeborg M Bajema, Sjoerd G van Duinen, Marion L C Maat-Schieman, Paulus T V M de Jong, Marc D de Smet, Didi de Wolff-Rouendaal, Greet Dijkman, Nadine Pelzer, Grant R Kolar, Robert E Schmidt, JoAnne Lacey, Daniel Joseph, David R Fintak, M Gilbert Grand, Elizabeth M Brunt, Helen Liapis, Rula A Hajj-Ali, Mark C Kruit, Mark A van Buchem, Martin Dichgans, Rune R Frants, Arn M J M van den Maagdenberg, Joost Haan, Robert W Baloh, John P Atkinson, Gisela M Terwindt, Michel D Ferrari
Cerebroretinal vasculopathy, hereditary vascular retinopathy, and hereditary endotheliopathy, retinopathy, nephropathy and stroke are neurovascular syndromes initially described as distinct entities. Recently they were shown to be one disease caused by C-terminal frame-shift mutations in TREX1, which was termed 'retinal vasculopathy with cerebral leukodystrophy'. Here we defined the genetic and clinicopathologic spectrum of this clinically and pathophysiologically poorly characterized and frequently misdiagnosed fatal neurovascular disorder...
September 6, 2016: Brain: a Journal of Neurology
Malin Skagerlind, Bernd Stegmayr
Introduction Intermittent hemodialysis (IHD) is sometimes necessary in patients with a bleeding risk, i.e., before/after surgery or brain hemorrhage. In such case IHD has to be modified to limit the conventional anticoagulation used to avoid clotting of the extracorporeal circuit (ECC). We evaluated if priming using a heparin and albumin (HA) mixture could minimize the exposure to heparin. Methods Retrospective data from 1995 to 2013 were collected from 1408 acute dialysis treatment protocols that included 321 patients...
August 31, 2016: Hemodialysis International
M Testa, S Erbiti, A Delgado, I L Cardenas
The aim of this study was to evaluate the relationship among nutritional status, gingival health and the composition of oral microbiota in children of a public school from a very poor area of San Miguel de Tucuman. Forty-five children ranging in age from 6 to 14 years old, 13 males and 32 females were studied. Twenty of these children were undernourished (Lejarraga-Morasso Table) and twenty-five were eutrophic. A clinical study that included DMF and dmf indexes, Löe Silness Plaque Index and bleeding on probing was performed...
August 20, 2016: Anaerobe
S V Barinov, I V Shamina, O V Lazareva, Yu I Tirskaya, V V Ralko, L L Shkabarnya, G B Dikke, D M Kochev, L L Klementyeva
OBJECTIVE: This study aimed to compare the efficacy of combined use of Arabin pessary, cervical cerclage and progesterone with progesterone-only management of pregnant women at high risk of preterm birth. MATERIALS AND METHODS: The study included 203 pregnant women at high risk of preterm birth who were randomised to receive Arabin pessary (Group 1, n = 82) and progesterone, circular cervical cerclage and progesterone (Group 2 = 121), or progesterone treatment only (Group3, controls, n = 50)...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Marcin Magierowski, Katarzyna Magierowska, Jakub Szmyd, Marcin Surmiak, Zbigniew Sliwowski, Slawomir Kwiecien, Tomasz Brzozowski
BACKGROUND: Alendronate is an inhibitor of osteoclast-mediated bone resorption, but its clinical utility is limited due to gastrointestinal complications including bleeding erosions. AIMS: We studied whether potent vasodilators hydrogen sulfide (H2S) and carbon monoxide (CO) can protect against alendronate-induced gastric lesions in rats exposed to mild stress. METHODS: Three series (A, B, and C) of Wistar rats received alendronate (150-700 mg/kg i...
November 2016: Digestive Diseases and Sciences
Vivian Sarmento Vasconcelos, Cristiane R Macedo, Alexsandra de Souza Pedrosa, Edna Pereira Gomes Morais, Gustavo J M Porfírio, Maria R Torloni
BACKGROUND: An estimated 1% to 3% of all individuals will receive a diagnosis of epilepsy during their lives, which corresponds to approximately 50 million affected people worldwide. The real prevalence is possibly higher because epilepsy is underreported in developing countries. Although most will achieve adequate control of their disease though the use of medication, approximately 25% to 30% of all those with epilepsy are refractory to pharmacological treatment and will continue to have seizures despite the use of two or more agents in adequate dosages...
2016: Cochrane Database of Systematic Reviews
Hyun-Seung Yoo, Young-Ho Cho, Young-Soo Byun, Min-Guek Kim
PURPOSE: The purpose of this study was to evaluate whether we have to stop the antiplatelet agents prior to hemiarthroplasty surgery in patients with displaced femur neck fractures to reduce postoperative complications. MATERIALS AND METHODS: We enrolled forty-three patients with displaced femur neck fractures who were treated by bipolar hemiarthroplasty and were taking antiplatelet agents. Group I included 21 patients who discontinued antiplatelet agents and had delayed operations at an average 5...
September 2015: Hip Pelvis
T Mundt, N Passia, W Att, G Heydecke, S Freitag-Wolf, R G Luthardt, S Kappel, I K Konstantinidis, M Stiesch, S Wolfart, M Kern
OBJECTIVES: This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading. MATERIALS AND METHODS: Edentulous patients in nine German dental schools received a midline implant with a length of 11 mm...
August 12, 2016: Clinical Oral Investigations
Jasna Kuljis, Arthur G Money, Mark Perry, Julie Barnett, Terry Young
BACKGROUND: Oral anticoagulation therapy requires regular blood testing to ensure therapeutic levels are maintained and excessive bleeding/clotting is avoided. Technology-assisted self-testing and management is seen as one of the key areas in which quality of care can be improved whilst reducing costs. Nevertheless, levels of patient engagement in self-testing and management remain low. To date, little research emphasis has been placed on understanding the patients' perspectives for low engagement...
August 8, 2016: Scandinavian Journal of Caring Sciences
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