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https://www.readbyqxmd.com/read/28751436/a-striking-image-of-spontaneous-echo-contrast-in-severe-mitral-stenosis-in-a-patient-with-good-inr-control
#1
Daniel A Jeffery, Guy Lloyd, Arjun K Ghosh
A 38 year old man was referred to our valve clinic for assessment. He had been diagnosed with untreated rheumatic mitral stenosis (MS) in 2009. He was diagnosed with atrial fibrillation in 2016 [on warfarin with good INR control]. Transthoracic echocardiography demonstrated severe MS. A large amount of spontaneous echo contrast (SEC) was noted in the severely dilated left atrium and a transoesophageal echocardiogram (TOE) was requested for further assessment of the MS (Image 1 and Videos 1-3). He was symptomatic with shortness of breath and reduced exercise tolerance consistent with NYHA class III-IV...
July 27, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28737523/perioperative-management-of-severe-congenital-protein-c-deficiency
#2
Kentaro Watanabe, Motohiro Kato, Tetsuya Ishimaru, Mitsuteru Hiwatari, Tomonori Suzuki, Yoshihiro Minosaki, Junko Takita, Jun Fujishiro, Akira Oka
: Perioperative care of congenital protein C deficiency has not been well established. Here, we describe a patient with congenital protein C deficiency who underwent laparoscopic fundoplication and gastrostomy at 2 years of age. Preoperatively, we stopped warfarin, administered fresh frozen plasma, and activated protein C. These procedures were performed without bleeding or clotting events, and at 3 days after the procedures, we restarted warfarin. Several episodes of abdominal hemorrhage and purpura fulminans occurred 2-4 weeks postoperatively, and the events were managed conservatively...
July 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28715312/new-directions-for-treating-bleeding-disorders-from-tests-for-platelet-strength-to-malleable-hydrogel-research-is-advancing-understanding-diagnosis-and-treatment-of-this-difficult-condition
#3
Mary Bates
Most people don't worry about small cuts or wounds, because their bodies form clots to stop the bleeding. This process, called coagulation or hemostasis, requires certain blood cells, platelets, and protein clotting factors to interact correctly and form a clot to stanch the bleeding and begin repair of the damaged blood vessel.
July 2017: IEEE Pulse
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#4
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28692575/rendering-factor-xa-zymogen-like-as-a-therapeutic-strategy-to-treat-bleeding
#5
Nabil K Thalji, Rodney M Camire
PURPOSE OF REVIEW: New therapies are needed to control bleeding in a range of clinical conditions. This review will discuss the biochemical properties of zymogen-like factor Xa, its preclinical assessment in different model systems, and future development prospects. RECENT FINDINGS: Underlying many procoagulant therapeutic approaches is the rapid generation of thrombin to promote robust clot formation. Clinically tested prohemostatic agents (e.g., factor VIIa) can provide effective hemostasis to mitigate bleeding in hemophilia and other clinical situations...
September 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28679384/transperineal-ultrasound-guided-prostate-biopsy-is-safe-even-when-patients-are-on-combination-antiplatelet-and-or-anticoagulation-therapy
#6
Kimitoshi Saito, Satoshi Washino, Yuhki Nakamura, Tsuzumi Konishi, Masashi Ohshima, Yoshiaki Arai, Tomoaki Miyagawa
BACKGROUND: To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy. METHODS: In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group...
July 5, 2017: BMC Urology
https://www.readbyqxmd.com/read/28662704/thrombocytopenia-induced-by-dabigatran-two-case-reports
#7
Hyun Goo Kang, Seung Jae Lee, Ji Yeon Chung, Jin Sung Cheong
BACKGROUND: Vitamin K inhibitors (e.g. warfarin) and indirect thrombin inhibitors (e.g. heparin) are widely used to prevent thromboembolic disorders (e.g. myocardial infarction, venous thromboembolism, and stroke). These agents have been mainstays of anticoagulation for people older than 60 years. However, their administration is associated with a risk of bleeding and requires careful monitoring of patients. Novel oral anticoagulants (NOACs), such as dabigatran, are significantly safer in preventing thromboembolism than warfarin and heparin (sporadically causes thrombocytopenia) and are more specific for their target protein, thrombin...
June 29, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28559387/haemobilia-due-to-hepatic-artery-pseudoaneurysm
#8
Cristina Teixeira, Suzane Moura Ribeiro, Ana Luisa Alves, Isabelle Cremers
An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery...
May 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28532176/synthesis-of-n-alkylated-chitosan-and-its-interactions-with-blood
#9
Yuchen Huang, Yi Zhang, Longbao Feng, Liumin He, Rui Guo, Wei Xue
When hydrophobically modified chitosan (HM-CHI) comes into contact with red blood cells (RBCs), it can cause agglomeration. This property leads HM-CHI to be a potential agent to form a rapid haemostatic plug to stop bleeding at wound sites. In this study, we investigated the properties of the HM-CHI biopolymer to act as an agent that rapidly clots blood. We have examined the synthesis and structural characteristics of HM-CHI - blood substances using X-ray diffraction, infrared spectroscopy and elemental analysis...
May 22, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28511448/rectus-sheath-haematoma-secondary-to-enoxaparin-injection-a-rare-case-report
#10
Sidharth Agarwal, Yamanur P Lamani, Bhimanagouda V Goudar, Eshwar B Kalburgi, Bheemappa K Bhavi
Rectus sheath haematoma is a well-documented condition with an elusive diagnosis. It is an uncommon complication of anti-coagulation therapy, which can have a mortality of upto 25%. The patient discussed here is a 40-year-old female who was on Inj. Enoxaparin, who developed severe abdominal pain and hypovolemia after three days of treatment. Ultrasonography and CT scan showed a large rectus sheath haematoma on the right side, which was crossing the midline towards the left side. Inj. Enoxaparin was stopped and the patient was posted for surgery...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28488236/dabigatran-plasma-levels-aptt-and-thromboelastography-in-patients-with-af-implications-for-allowing-early-non-elective-surgical-procedures
#11
Athanasios Pipilis, Stamatis Makrygiannis, Georgios Anagnostou, Sotirios Kaliampakos, Georgios Tsakonas, Nikolaos Sourlas, Panagiotis Mallios, Theodora Kostelidou
According to current recommendations, patients on dabigatran should stop the drug 24-96 h before scheduled surgery. This may seem too long for non-elective cases. The aim of our study was to assess the number of patients on dabigatran who could theoretically undergo surgery 12 h post last drug dosing. We measured dabigatran plasma trough concentration by Hemoclot assay in 75 consecutive patients receiving dabigatran. Coagulation was assessed by aPTT and thromboelastography (TEG). Plasma levels ≤30 ng/ml were considered low...
May 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28457369/safety-and-efficacy-of-citrate-anticoagulation-for-continuous-renal-replacement-therapy-for-acute-kidney-injury-after-liver-transplantation-a-single-center-experience
#12
N Pertica, L Cicciarella, A Carraro, U Montin, P Violi, A Lupo, G Zaza
BACKGROUND: Acute kidney injury (AKI) after liver transplantation (LT) is a frequent and serious complication. The incidence of AKI requiring continuous renal replacement therapy (CRRT) ranges from 10% to 30%. Kidney Disease: Improving Global Outcomes guidelines indicate the use of citrate as a locoregional anticoagulant drug for CRRT regardless of the patient's hemorrhagic risk. Despite this indication, however, the use of citrate is still under debate in patients with liver failure and/or LT owing to the potential risk of plasmatic citrate accumulation due to reduced liver clearance...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28395294/treatment-of-persistent-gross-hematuria-with-tranexamic-acid-in-autosomal-dominant-polycystic-kidney-disease
#13
Qing Yao, Ming Wu, Jie Zhou, Meiyang Zhou, Dongping Chen, Lili Fu, Rongrong Bian, Xiaohong Xing, Lijun Sun, Xiaohong Hu, Lin Li, Bing Dai, Rudolf P Wüthrich, Yiyi Ma, Chang-Lin Mei
BACKGROUND/AIMS: In this retrospective study we aimed to compare the effect of tranexamic acid (TXA) vs etamsylate, two hemostatic agents, on hematuria duration in autosomal dominant polycystic kidney disease (ADPKD) patients with persistent gross hematuria. METHODS: This is a retrospective study of 40 patients with ADPKD and macroscopic hematuria. 20 patients receiving TXA and snake venom blood clotting enzyme injection were compared with 20 matched patients receiving etamsylate and snake venom blood clotting enzyme injection...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28360438/comparing-adrenaline-with-tranexamic-acid-to-control-acute-endobronchial-bleeding-a-randomized-controlled-trial
#14
Mitra Samareh Fekri, Seyed Mehdy Hashemi-Bajgani, Ahmad Shafahi, Rozita Zarshenas
BACKGROUND: Hemoptysis occurs due to either pulmonary diseases or bronchoscopy interventions. The aim of the present study was to compare the efficacy of the endobronchial instillation of adrenaline with that of tranexamic acid. METHODS: Fifty patients were randomly selected as 2 double-blinded sample groups (n=25). In these patients, bleeding could not be controlled with cold saline lavage during bronchoscopy and they, therefore, required prescription of another medicine...
March 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28286384/an-assessment-of-the-incidence-of-prolonged-postoperative-bleeding-after-dental-extraction-among-patients-on-uninterrupted-low-dose-aspirin-therapy-and-to-evaluate-the-need-to-stop-such-medication-prior-to-dental-extractions
#15
Brigit V Eapen, M F Baig, S Avinash
PURPOSE: To propose that low dose aspirin therapy need not be withdrawn for routine dental extraction procedure. AIM: This study was designed to evaluate the post operative bleeding in patients on low dose aspirin therapy by dividing them into two groups: one with withdrawing and the other without withdrawing the regime before dental extraction. MATERIALS AND METHODS: This study included 80 patients on low dose aspirin therapy. They were divided into two groups of 40 patients each; Group I (control group) included patients on who were asked to stop the medication 5 days prior to dental extraction; Group II (test group) included patients who were asked not to stop the medication prior to dental extraction...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28269228/leg-fluid-accumulation-during-prolonged-sitting
#16
Daniel Vena, Jonathan Rubianto, Milos Popovic, Azadeh Yadollahi
The accumulation of fluid in the legs due to sedentariness can be a health risk in extreme cases. Negative health impacts associated with leg fluid accumulation include leg edema and risk of blood clots. Furthermore, fluid accumulating in the legs is accompanied by fluid shift into the upper body which is also associated with health risks such as: increased blood pressure when lying down, respiratory problems in people with heart failure, and increased sleep apnea. Understanding the pattern by which fluid accumulates in the legs can aid in the development of devices for reducing leg fluid accumulation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227459/leg-fluid-accumulation-during-prolonged-sitting
#17
Daniel Vena, Jonathan Rubianto, Milos Popovic, Azadeh Yadollahi, Daniel Vena, Jonathan Rubianto, Milos Popovic, Azadeh Yadollahi, Daniel Vena, Azadeh Yadollahi, Jonathan Rubianto, Milos Popovic
The accumulation of fluid in the legs due to sedentariness can be a health risk in extreme cases. Negative health impacts associated with leg fluid accumulation include leg edema and risk of blood clots. Furthermore, fluid accumulating in the legs is accompanied by fluid shift into the upper body which is also associated with health risks such as: increased blood pressure when lying down, respiratory problems in people with heart failure, and increased sleep apnea. Understanding the pattern by which fluid accumulates in the legs can aid in the development of devices for reducing leg fluid accumulation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28184956/-hemorrhagic-shock-general-principles
#18
T I Eiben, V Fuhrmann, B Saugel, S Kluge
Bleeding associated with hemorrhagic shock is often seen in emergency medical services or in the intensive care unit. Identifying the origin of the bleeding and additional disorders helps to determine the degree of the hemorrhagic shock. In order to be effective, the initial therapy until blood products are available needs to be differentiated to be effective in terms of hemodynamic stabilization and coagulation. Crystalloidal and colloidal solutions should be used carefully since those solutions bear a risk within themselves...
March 2017: Der Internist
https://www.readbyqxmd.com/read/28163378/low-temperature-plasma-equipment-applied-on-surgical-hemostasis-and-wound-healings
#19
REVIEW
Kenji Miyamoto, Sanae Ikehara, Hajime Sakakita, Yuzuru Ikehara
Low temperature plasma (LTP) coagulation equipment, which avoids causing burn injuries to patients, has been introducing into minimally invasive surgery. The mechanism by which this equipment stops bleeding is to directly occupy the injury with the formed blood clots, and different from the mechanism of the common electrical hemostatic devices that cauterize the tissues around the bleeding to stem the blood flow. A noteworthy point is that LTP treatment with our equipment is not confined only to the blood coagulation system, but it has significant effects on the other blood components to form clots with or without hemolysis, and that there is a plasma current threshold that determines whether the treatment makes stable clots...
January 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28126753/evaluation-of-collaterals-and-clot-burden-using-time-resolved-c-arm-conebeam-ct-angiography-in-the-angiography-suite-a-feasibility-study
#20
P Yang, K Niu, Y Wu, T Struffert, A Doerfler, P Holter, B Aagaard-Kienitz, C Strother, G-H Chen
BACKGROUND AND PURPOSE: The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study...
January 26, 2017: AJNR. American Journal of Neuroradiology
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