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Trauma blood clotting

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https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#1
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29306536/orthodontic-movement-after-regenerative-endodontic-procedure-case-report-and-long-term-observations
#2
Antonis Chaniotis
INTRODUCTION: Although regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the suggested therapeutic endodontic spectrum, little is known about the effect of orthodontic movement in the tissue that has been regenerated. Furthermore, as the number of adults undergoing orthodontic treatment increases, there is an increasing need to investigate the changes that these tissues may undergo during orthodontic movement. Here we describe the alterations observed after the application of orthodontic forces in a case of an apically root-fractured necrotic immature root that had been managed with regenerative endodontic procedures in the past...
January 3, 2018: Journal of Endodontics
https://www.readbyqxmd.com/read/29303761/simple-bone-cyst-rare-incidental-finding-in-the-mandibular-condyle-by-cone-beam-computed-tomography
#3
Eliana Dantas da Costa, Gina Delia Roque-Torres, Priscila Dias Peyneau, Luís Roberto Godolfim, Francisco Haiter Neto, Solange Maria Almeida
The simple bone cyst (SBC) is a benign intraosseous lesion that is considered to be a pseudocyst because the cystic cavity does not present an epithelial lining. The most accepted theory regarding its etiology is that the SBC develops when the blood clot fails to organize subsequent to bleeding caused by trauma. The SBC is asymptomatic, and therefore the diagnosis is made through routine imaging examinations. In imaging examinations, the lesion is characterized by a radiolucent, unilocular, well-delimited appearance and an irregular or scalloped contour with or without a sclerotic halo...
January 2018: General Dentistry
https://www.readbyqxmd.com/read/29289392/abnormalities-of-laboratory-coagulation-tests-versus-clinically-evident-coagulopathic-bleeding-results-from-the-prehospital-resuscitation-on-helicopters-study-prohs
#4
Ronald Chang, Erin E Fox, Thomas J Greene, Michael D Swartz, Stacia M DeSantis, Deborah M Stein, Eileen M Bulger, Sherry M Melton, Michael D Goodman, Martin A Schreiber, Martin D Zielinski, Terence O'Keeffe, Kenji Inaba, Jeffrey S Tomasek, Jeanette M Podbielski, Savitri Appana, Misung Yi, Pär I Johansson, Hanne H Henriksen, Jakob Stensballe, Jacob Steinmetz, Charles E Wade, John B Holcomb
BACKGROUND: Laboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described. METHODS: Prospective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29282877/multifunctional-shape-memory-polymer-foams-with-bio-inspired-antimicrobials
#5
Mary Beth Browning Monroe, Alexandra D Easley, Katie Grant, Grace K Fletcher, Calla Boyer, Duncan J Maitland
Despite a number of clinically available hemostats, uncontrolled bleeding is the primary cause of trauma-related death. Shape-memory polymer (SMP) foams have a number of desirable properties for use as hemostats, including shape recovery to enable delivery into bleed sites, biocompatibility, and rapid blood clotting. To expand upon this material system, the current work aims to incorporate phenolic acids, which are honey-based antimicrobial agents, into SMP foams. We showed that cinnamic acid (CA) can be utilized as a monomer in SMP synthesis to provide foams with comparable pore structure and retained cytocompatibility...
December 28, 2017: Chemphyschem: a European Journal of Chemical Physics and Physical Chemistry
https://www.readbyqxmd.com/read/29276028/evaluation-for-effects-of-severe-acidosis-on-hemostasis-in-trauma-patients-using-thrombelastography-analyzer
#6
Xin Lv, Yong Mao, Zonghe Qin
OBJECTIVE: To investigate effects of metabolic acidosis on hemostasis function in trauma patients using thromboelastography analyzer. METHODS: 65 critically injured patients and 19 healthy volunteers were enrolled in the study. Three samples of whole blood were collected from each patient or healthy volunteer. These three samples were acidified with 50mmol/l phosphate-buffered saline (PBS) (pH5.8) or a neutral buffer (50mmol/l phosphate, pH7.4) and acidified blood sample with target pH of 6...
December 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#7
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248181/principal-component-analysis-of-coagulation-assays-in-severely-injured-children
#8
Christine M Leeper, Matthew D Neal, Christine McKenna, Timothy Billiar, Barbara A Gaines
BACKGROUND: Trauma-induced coagulopathy is common and associated with poor outcome in injured children. Our aim is to identify patterns of coagulation dysregulation after injury and associate these phenotypes with relevant clinical outcomes. METHODS: We performed principal components analysis on prospectively collected data from children with the highest-level trauma activation June 2015-June 2016. Parameters included admission international normalized ratio, platelet count and thromboelastograms...
December 13, 2017: Surgery
https://www.readbyqxmd.com/read/29239953/the-impact-of-prehospital-tranexamic-acid-on-blood-coagulation-in-trauma-patients
#9
Philipp Stein, Jan-Dirk Studt, Roland Albrecht, Stefan Müller, Dieter von Ow, Simon Fischer, Burkhardt Seifert, Sergio Mariotti, Donat R Spahn, Oliver M Theusinger
BACKGROUND: There is limited data on prehospital administration of tranexamic acid (TXA) in civilian trauma. The aim of this study was to evaluate changes in coagulation after severe trauma from on-scene to the hospital after TXA application in comparison to a previous study without TXA. METHODS: The study protocol was registered at ClinicalTrials.gov (NCT02354885). A prospective, multicenter, observational study investigating coagulation status in 70 trauma patients receiving TXA (1 g intravenously) on-scene versus a control group of 38 patients previously published without TXA...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29208274/hemostatic-porous-sponges-of-cross-linked-hyaluronic-acid-cationized-dextran-by-one-self-foaming-process
#10
Jia-Ying Liu, Yang Li, Yang Hu, Gang Cheng, Enyi Ye, Chuanan Shen, Fu-Jian Xu
Effective hemostatic materials are very important for treating trauma cases. Natural polysaccharides have been particularly appealing in the development of new hemostatic materials due to their unique functions in human bodies. In this work, different polysaccharide-based hemostatic porous sponges (SHDP or SHDQ) of cross-linked hyaluronic acid (HA)/cationized dextran were readily prepared by the self-foaming process of HA and poly((2-dimethyl amino)-ethyl methacrylate)-grafted dextran (Dex-PDM) or partially-quaternized Dex-PDM in the presence of sodium trimetaphosphate crosslinkers...
February 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/29200009/antifibrinolytic-therapy-and-perioperative-considerations
#11
Jerrold H Levy, Andreas Koster, Quintin J Quinones, Truman J Milling, Nigel S Key
Fibrinolysis is a physiologic component of hemostasis that functions to limit clot formation. However, after trauma or surgery, excessive fibrinolysis may contribute to coagulopathy, bleeding, and inflammatory responses. Antifibrinolytic agents are increasingly used to reduce bleeding, allogeneic blood administration, and adverse clinical outcomes. Tranexamic acid is the agent most extensively studied and used in most countries. This review will explore the role of fibrinolysis as a pathologic mechanism, review the different pharmacologic agents used to inhibit fibrinolysis, and focus on the role of tranexamic acid as a therapeutic agent to reduce bleeding in patients after surgery and trauma...
December 4, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29180179/preoperative-thrombelastography-maximum-amplitude-predicts-massive-transfusion-in-liver-transplantation
#12
Peter J Lawson, Hunter B Moore, Ernest E Moore, Gregory R Stettler, Thomas J Pshak, Igal Kam, Christopher C Silliman, Trevor L Nydam
BACKGROUND: Massive transfusion (MT) is frequently required during liver transplantation. Risk stratification of transplant patients at risk for MT is an appealing concept but remains poorly developed. Thrombelastography (TEG) has recently been shown to reduce mortality when used for trauma resuscitation. We hypothesize that preoperative TEG can be used to risk stratify patients for MT. MATERIAL AND METHODS: Liver transplant patients had blood drawn before surgical incision and assayed via TEG...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29175047/hemorrhagic-shock-drives-glycocalyx-barrier-and-organ-dysfunction-early-after-polytrauma
#13
Rebecca Halbgebauer, Christian K Braun, Stephanie Denk, Benjamin Mayer, Paolo Cinelli, Peter Radermacher, Guido A Wanner, Hans-Peter Simmen, Florian Gebhard, Daniel Rittirsch, Markus Huber-Lang
Polytrauma (PT) is frequently associated with hemorrhagic shock (HS), which increases morbidity and mortality. Although various aspects of HS have been addressed in PT patients, the impact of an additional HS is largely unknown regarding the development of multiple organ dysfunction associated with disturbed glycocalyx and barrier function early after trauma. A prospective, longitudinal, mono-centered, observational study enrolling severely injured patients (Injury Severity Score, ISS=38.1±2.6) served for an in-depth analysis of blood (drawn on days 0, 1, 2, 3 and 5) and clinical data (up to 21days) of 30 patients who were then stratified into PT with and without HS...
November 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29168170/platelets-derived-from-fresh-and-cold-stored-whole-blood-participate-in-clot-formation-in-rats-with-acute-traumatic-coagulopathy
#14
Xiaowu Wu, Daniel N Darlington, Robbie K Montgomery, Bin Liu, Jeffrey D Keesee, Michael R Scherer, Avi Benov, Jacob Chen, Andrew P Cap
The in vitro haemostatic functions of fresh whole blood (FWB) are well preserved after cold storage. This study aimed to determine whether platelets derived from FWB and stored whole blood (SWB) contribute to clot formation in tissue injury after transfusion into coagulopathic rats with polytrauma/haemorrhage (T/H). The rats were resuscitated 1 h after trauma with FWB or SWB collected from green fluorescence protein (GFP) transgenic rats. After transfusion, a liver incision was made and the tissue was collected 10 min after injury to identify GFP(+) platelets by immunohistochemistry...
November 22, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29162534/nano-and-micro-materials-in-the-treatment-of-internal-bleeding-and-uncontrolled-haemorrhage
#15
REVIEW
Elizabeth Gaston, John F Fraser, Zhi Ping Xu, Hang T Ta
Internal bleeding is defined as the loss of blood that occurs inside of a body cavity. After a traumatic injury, haemorrhage accounts for over 35% of pre-hospital deaths and 40% of deaths within the first 24hours. Coagulopathy, a disorder in which the blood is not able to properly form clots, typically develops after traumatic injury and results in a higher rate of mortality. The current methods to treat internal bleeding and coagulopathy are inadequate due to the requirement of extensive medical equipment that is typically not available at the site of injury...
November 18, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/29156107/hemodynamic-force-triggers-rapid-netosis-within-sterile-thrombotic-occlusions
#16
X Yu, J Tan, S L Diamond
BACKGROUND: Neutrophil extracellular traps (NETs) are released when neutrophils encounter infectious pathogens, especially during sepsis. Additionally, NETosis occurs during venous and arterial thrombosis, disseminated intravascular coagulation, and trauma. OBJECTIVE: We tested if hemodynamic forces trigger NETosis during sterile thrombosis. METHODS: NETs were imaged with Sytox-green during microfluidic perfusion of Factor XIIa-inhibited or thrombin-inhibited human whole blood over fibrillar collagen (± tissue factor)...
November 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29078874/14-day-thawed-plasma-retains-clot-enhancing-properties-and-inhibits-tpa-induced-fibrinolysis
#17
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Raymond Shepherd-Singh, Angela Sauaia, Gregory R Stettler, Geoffrey R Nunns, Christopher C Silliman
BACKGROUND: Plasma-first resuscitation attenuates trauma-induced coagulopathy (TIC); however, the logistics of plasma-first resuscitation require thawed plasma (TP) be readily available due to the obligatory thawing time of fresh frozen plasma (FFP). The current standard is storage of TP for up to 5 days at 4°C, based on factor levels at outdate, for use in patients at risk for TIC, but there remains a 2.2% outdated wastage rate. However, the multitude of plasma proteins in attenuating TIC remains unknown...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29065860/assessment-of-haemostasis-in-patients-undergoing-emergent-neurosurgery-by-rotational-elastometry-and-standard-coagulation-tests-a-prospective-observational-study
#18
Christoph Ellenberger, Najia Garofano, Gleicy Barcelos, John Diaper, Gordana Pavlovic, Marc Licker
BACKGROUND: Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) in patients undergoing emergent neurosurgery. METHODS: Over a four-year period, adult patients who met criteria for emergent neurosurgery lasting more than 90 min were included in the study...
October 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#19
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29019885/two-incision-laparoscopic-appendectomy-for-a-severe-hemophilia-a-child-patient-with-coagulation-factor-vii-deficiency-case-report-and-review-of-literature
#20
Jin Peng He, Jie Xiong Feng
RATIONALE: The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time...
October 2017: Medicine (Baltimore)
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