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https://www.readbyqxmd.com/read/29118829/evaluating-the-safety-and-efficacy-of-regional-citrate-compared-to-systemic-heparin-as-anticoagulation-for-continuous-renal-replacement-therapy-in-critically-ill-patients-a-service-evaluation-following-a-change-in-practice
#1
Roberta Borg, Debra Ugboma, Dawn-Marie Walker, Richard Partridge
Following the implementation of citrate anticoagulation for continuous renal replacement therapy, we evaluate its first year of use and compare it to the previously used heparin, to assess whether our patients benefit from the recently reported advantages of citrate. We retrospectively analysed 2 years of data to compare the safety and efficacy of citrate versus heparin. The results have shown that 43 patients received continuous renal replacement therapy with heparin, 37 patients with citrate. We found no significant difference in metabolic control of pH, urea and creatinine after 72 h...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29058511/pregnancy-in-a-non-communicating-rudimentary-horn-a-cause-of-failed-medical-and-surgical-management-of-second-trimester-pregnancy-loss
#2
Diaa Abd El-Halim, Haitham A Torky
OBJECTIVES: We present the management of a case of failed medical and surgical management of second trimester pregnancy loss due to pregnancy in a non-communicating rudimentary horn. CASE: A 16-week intrauterine fetal death singleton pregnancy was referred to us after failed medical and surgical termination of pregnancy. Ultrasound confirmed the diagnosis and showed minimal blood clots and fluid in the pouch of Douglas. Laparoscopy showed a soft, enlarged right uterine horn not communicating with the cervix and containing the pregnancy, and a left uterine horn communicating with the cervix and showing a posterior wall perforation...
October 23, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/29037192/retroperitoneal-ectopic-pregnancy-a-case-report-and-review-of-the-literature
#3
Man Yang, Lamu Cidan, Dan Zhang
BACKGROUND: Retroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy, with a total of less than 20 cases reported in the English literature. However, failure to recognize REP may result in severe consequences. CASE PRESENTATION: We report a case of 32-year-old woman with REP. She had amenorrhea, left lower abdominal pain, but no vaginal bleeding. Her urine human chorionic gonadotropin (HCG) test was positive and blood HCG level was 1880 m-international units per milliliter (mIU/mL)...
October 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28987395/abciximab-heparin-therapy-for-left-ventricular-assist-device-implantation-in-patients-with-heparin-induced-thrombocytopenia
#4
Chia-Ling Lee, Paolo C Colombo, Andrew Eisenberger, David Diuguid, Douglas L Jennings, Jiho Han, Michael P Salna, Koji Takeda, Paul A Kurlansky, Melana Yuzefpolskaya, Arthur R Garan, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. METHODS: Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg(-1) · min(-1) throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28904343/engineered-factor-xa-variants-retain-procoagulant-activity-independent-of-direct-factor-xa-inhibitors
#5
Daniël Verhoef, Koen M Visscher, C Ruben Vosmeer, Ka Lei Cheung, Pieter H Reitsma, Daan P Geerke, Mettine H A Bos
The absence of an adequate reversal strategy to prevent and stop potential life-threatening bleeding complications is a major drawback to the clinical use of the direct oral inhibitors of blood coagulation factor Xa. Here we show that specific modifications of the substrate-binding aromatic S4 subpocket within the factor Xa active site disrupt high-affinity engagement of the direct factor Xa inhibitors. These modifications either entail amino-acid substitution of S4 subsite residues Tyr99 and/or Phe174 (chymotrypsinogen numbering), or extension of the 99-loop that borders the S4 subsite...
September 13, 2017: Nature Communications
https://www.readbyqxmd.com/read/28881533/-efficacy-and-safety-of-rivaroxaban-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-cryoablation
#6
C Y Di, Z Wan, W H Lin
Objective: To observe the efficacy and safety of the novel oral anticoagulant Rivaroxaban for anticoagulation therapy in patients with nonvalvular atrial fibrillation (AF) during cryoablation. Methods: A total of 137 AF patients from October 2013 to December 2016 underwent cryoablation were divided into two groups according to the application of anticoagulant drugs: Rivaroxaban group (65 cases) and Heparin group (72 cases). Rivaroxaban group: oral administration of Rivaroxaban 20 mg, once a day, was started 3 days before the cryoablation, no anticoagulant was additionally added during cryoablation, the activated clotting time (ACT) was measured, and oral administration of Rivaroxaban was continued for 3 months after cryoablation...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28838463/beware-cold-agglutinins-in-organ-donors-ex%C3%A2-vivo-lung-perfusion-from-an-uncontrolled-donation-after-circulatory-determination-of-death-donor-with-a-cold-agglutinin-a-case-report
#7
A Venkataraman, J W Blackwell, W K Funkhouser, K R Birchard, S E Beamer, W T Simmons, S H Randell, T M Egan
BACKGROUND: We began to recover lungs from uncontrolled donation after circulatory determination of death to assess for transplant suitability by means of ex vivo lung perfusion (EVLP) and computerized tomographic (CT) scan. Our first case had a cold agglutinin with an interesting outcome. CASE REPORT: A 60-year-old man collapsed at home and was pronounced dead by Emergency Medical Services personnel. Next-of-kin consented to lung retrieval, and the decedent was ventilated and transported...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28809406/clot-entrapped-blood-cells-in-synergy-with-human-mesenchymal-stem-cells-create-a-pro-angiogenic-healing-response
#8
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...
September 26, 2017: Biomaterials Science
https://www.readbyqxmd.com/read/28751436/a-striking-image-of-spontaneous-echo-contrast-in-severe-mitral-stenosis-in-a-patient-with-good-international-normalised-ratio-inr-control
#9
Daniel A Jeffery, Guy Lloyd, Arjun K Ghosh
No abstract text is available yet for this article.
September 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28737523/perioperative-management-of-severe-congenital-protein-c-deficiency
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
July 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
#20
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
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