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Annemarie Bluecher, Sascha Meyer Dos Santos, Nerea Ferreirós, Sandra Labocha, Isabel Maria Rodrigues Meyer Dos Santos, Bettina Picard-Willems, Sebastian Harder, Oliver C Singer
Reliable detection of anticoagulation status in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) is challenging but of importance especially in the emergency setting. This study evaluated the potential of a whole-blood clotting time assay based on Surface Acoustic Waves (SAW-CT) in stroke-patients. The SAW-technology was used for quick and homogenous recalcification of whole blood inducing a surface-activated clotting reaction quantified and visualised by real-time fluorescence microscopy with automatic imaging processing...
January 26, 2017: Thrombosis and Haemostasis
Andreas Koster, Jost Niedermeyer, Jan Gummert, Andre Renner
A patient scheduled for lung transplantation needed veno-venous extracorporeal membrane oxygenation (ECMO) and developed acute heparin-induced thrombocytopenia (HIT). After 21 days on ECMO support, lung transplantation was successfully performed using veno-arterial ECMO with bivalirudin anticoagulation. The target activating clotting time values of 160-180 s resulted in low bivalirudin infusion rates of 0.1 mg/kg/h. Diffuse bleeding stopped quickly after ending the continuous bivalirudin infusion.
January 2, 2017: European Journal of Cardio-thoracic Surgery
Mads Madsen Søndergaard, Amela Tursunovic, Peter Thye-Rønn, Jacob Christian Bang, Inger Marie Jensen Hansen
BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012, with Icterohaemorrhagiae and Sejroe now being predominant. CASE REPORT A 45-year-old Danish woman living in an area endemic for Hanta virus, without prior medical history, was admitted because of lower back pain radiating to the left hip, fever, headache, nausea, and malaise...
November 24, 2016: American Journal of Case Reports
Nurettin Sahiner, Selin Sagbas, Mehtap Sahiner, Coskun Silan
Super porous poly(2-hydroxy ethyl methacrylate) (p(HEMA)) cryogel was successfully synthesized by using polyethylene glycol diacrylate (p(EGDA)) crosslinker under cryogenic conditions. Poly(Tannic acid) (p(TA)) macro-, micro-, and nanoparticles prepared from a natural polyphenol, tannic acid (TA), were embedded into p(HEMA) cryogel networks to obtain composite p(TA) particle-embedded p(HEMA) cryogel. Different size ranges of spherical p(TA) particles, 2000-500μm, 500-200μm, 200-20μm, and 20-0.5μm size, were included in the cryogel network and illustrated by digital camera, optic microscope, and SEM images of the microgel-cryogel network...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
Tomoko Matsumoto, Keiji Nogami, Midori Shima
Patients with mild/moderate hemophilia (H)A, acquired HA (AHA) and lupus anticoagulants (LA), have prolonged aPTTs with low levels of factor (F)VIII activity, but the differentiation of these disorders is complex and time consuming. We established an approach to quickly differentiate these disorders using comprehensive coagulation tests. Patients' plasmas with mild/moderate HA, AHA, LA without anti-phospholipid syndrome [LA-APS(-)], and LA with APS [LA-APS(+)] were examined using clot waveform analysis (CWA) and thrombin generation test (TGT)...
October 11, 2016: International Journal of Hematology
Moritz Scherer, Jonas Cordes, Alexander Younsi, Yasemin-Aylin Sahin, Michael Götz, Markus Möhlenbruch, Christian Stock, Julian Bösel, Andreas Unterberg, Klaus Maier-Hein, Berk Orakcioglu
BACKGROUND AND PURPOSE: ABC/2 is still widely accepted for volume estimations in spontaneous intracerebral hemorrhage (ICH) despite known limitations, which potentially accounts for controversial outcome-study results. The aim of this study was to establish and validate an automatic segmentation algorithm, allowing for quick and accurate quantification of ICH. METHODS: A segmentation algorithm implementing first- and second-order statistics, texture, and threshold features was trained on manual segmentations with a random-forest methodology...
November 2016: Stroke; a Journal of Cerebral Circulation
Nicholas J Olson, Donna Robert, Amin A Hedayat, Xiaoying Liu, Deborah L Ornstein
Factor V inhibitors are rare and have varied clinical presentations. We report on a 76-year-old female admitted to the hospital for pneumonia and treated with multiple antibiotics. Her baseline prothrombin time was 15.6 s and the activated partial thromboplastin time was 35 s. On admission day 10, she developed arm weakness and brain imaging showed a subdural hematoma. The prothrombin time was now 59.1 s with an activated partial thromboplastin time of more than 160 s and a normal thrombin time. A mixing study did not correct the clotting times and coagulation factor assays showed a nonspecific inhibition pattern...
September 24, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Aldo Bonaventura, Fabrizio Montecucco, Franco Dallegri
INTRODUCTION: Acute ischemic stroke (AIS) represents a major cause of death and disability all over the world. The recommended therapy aims at dissolving the clot to re-establish quickly the blood flow to the brain and reduce neuronal injury. Intravenous administration of recombinant tissue-type plasminogen activator (rt-PA) is clinically used with this goal. AREAS COVERED: A description of beneficial and detrimental effects of rt-PA treatment is addressed. An overview of new therapies against AIS, such as new thrombolytics, sonolysis and sonothrombolysis, endovascular procedures, and association therapies is provided...
November 2016: Expert Opinion on Biological Therapy
Albert Busch, Sabine Hoffjan, Frauke Bergmann, Birgit Hartung, Helena Jung, Daniela Hanel, Andeas Tzschach, Janos Kadar, Yskert von Kodolitsch, Christoph-Thomas Germer, Heiner Trobisch, Erwin Strasser, René Wildenauer
BACKGROUND: The vascular type represents a very rare, yet the clinically most fatal entity of Ehlers-Danlos syndrome (EDS). Patients are often admitted due to arterial bleedings and the friable tissue and the altered coagulation contribute to the challenge in treatment strategies. Until now there is little information about clotting characteristics that might influence hemostasis decisively and eventually worsen emergency situations. RESULTS: 22 vascular type EDS patients were studied for hemoglobin, platelet volume and count, Quick and activated partial thromboplastin time, fibrinogen, factor XIII, von Willebrand disease, vitamin D and platelet aggregation by modern standard laboratory methods...
2016: Orphanet Journal of Rare Diseases
Hilde Gundersen, Barry Moynihan
Our objective is to present the case of an uncommon but probably under-recognized cause of stroke: Non-bacterial thrombotic endocarditis (NBTE). A 59-year-old man presented to our hospital with multiple bihemispheric infarcts despite taking rivaroxaban for pulmonary emboli diagnosed 2 weeks earlier. The patient's symptoms progressed quickly and he died within a week of his initial presentation despite attempts at neuroradiologically guided clot retrieval and early recognition and treatment of disseminated intravascular coagulation...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Eric Daniel Tenda, Abraham Yakub, Ceva Wicaksono Pitoyo, Fauziah Fardizza
Life threatening event due to central airway obstruction caused by very large blood clot formation with profuse on going bleeding its very challenging to manage. Interventional pulmonologist must aware about this situation which can lead to respiratory failure. There are several choices to treat this unlikely situation, in example flexible bronchoscopy with forceps, bronchial lavage, and suction. We present a case with post-surgical tracheostomy bleeding which caused a giant blood clot formation in a disseminated intravascular coagulation due to severe sepsis in end stage renal disease patient, successfully managed with cryoextraction and argon plasma coagulation...
2016: Respiratory Medicine Case Reports
Ishtyaque Ansari, Sameer Futane, Ashfaque Ansari
BACKGROUND: Sub-acute/chronic epidural hematoma (EDH) may present with nagging symptoms of headache, nausea, vomiting, lethargy, etc. We attempted to offer a minimally invasive, single burr hole, endoscope-assisted evacuation of EDHs instead of a conventional craniotomy. METHODS: Seven patients with sub-acute/chronic EDH (six supratentorial and one infratentorial) presented to us 3 to 7 days after low-velocity road traffic accidents with complaints of headache and lethargy...
August 2016: Acta Neurochirurgica
I Vasilenko, E Vlasova, V Metelin, A Balkanov, O Bichenkov
INTRODUCTION: Close correlation between oncologic diseases and blood coagulation disturbances dictates a necessity of prognosis of the main disease course and contemporary prevention of the thrombotic complications revealed. For this purpose, the global test for the hemostasis system assessment was used to reveal bleeding and thrombogenesis risks - "Thrombodynamics" (TD) allowing analysis in the real time of the thrombogenesis parameters in conditions the most resembling the natural functioning of the blood coagulation system...
April 2016: Thrombosis Research
Tiantian Luo, Shilei Hao, Xiaoliang Chen, Ju Wang, Qian Yang, Yazhou Wang, Yulan Weng, Huimin Wei, Jin Zhou, Bochu Wang
Uncontrolled bleeding frequently occurs in some emergencies which can result in severe injury and even death. Keratin hydrogel has been found that it had good ahemostatic efficacy in the previous studies. However, an ideal hemostatic agent should not require mixing or preparation in advance, and hydrogel is not easy to store and carry. In the present study, the kerateine was firstly extracted from human hair, and then was prepared nanoparticles by a modified emulsion diffusion method. The synthesized nanoparticles showed spherical morphology with an average diameter of approximately 200 nm...
June 2016: Materials Science & Engineering. C, Materials for Biological Applications
Kecheng Quan, Guofeng Li, Lei Tao, Qian Xie, Qipeng Yuan, Xing Wang
2,3-Diaminopropionic acid (DapA), a medicinal amino acid, is used for the first time to prepare a DapA cross-linked graphene sponge (DCGS) for hemostasis treatment. In a comparison with the reported ethanediamine (EDA) cross-linked graphene sponge (CGS), this carboxyl-functionalized DCGS can not only quickly absorb plasma, but also stimulate erythrocytes and platelets to change their normal form and structure at the interface, which largely affects a cell's metabolism and biofunction, thus further promoting blood coagulation...
March 2016: ACS Applied Materials & Interfaces
Daniel Dirkmann, Martin W Britten, Henning Pauling, Juliane Weidle, Lothar Volbracht, Klaus Görlinger, Jürgen Peters
BACKGROUND: Sugammadex prolongs activated partial thromboplastin time (aPTT) and prothrombin time (PT) suggestive of anticoagulant effects. To pinpoint its presumed anticoagulant site of action, the authors assessed Sugammadex's impact on a panel of coagulation assays. METHODS: Sugammadex, Rocuronium, Sugammadex and Rocuronium combined, or saline were added to blood samples from healthy volunteers and analyzed using plasmatic (i.e., aPTT, thrombin time, and fibrinogen concentration) (n = 8 each), PT (quick), activities of plasmatic coagulation factors, and whole blood (extrinsically and intrinsically activated thromboelastometry) assays (n = 18 each)...
June 2016: Anesthesiology
Shweta Dikshit
INTRODUCTION: Fibrinogen degradation products (e.g. D-dimer) arise from digested fibrin clots and fibrinogen. Elevated concentrations accompany activation of coagulation and fibrinolysis and indicate chronic inflammatory diseases. D-Dimer tests are a quick, noninvasive method to rule out abnormal clotting. Periodontitis strongly affects the haemostatic system and evokes a procoagulant state. Correlation of chronic periodontitis with early indicators of disease (biomarkers) might be useful...
December 2015: Journal of Clinical and Diagnostic Research: JCDR
Kevin Andrew Woodson, Yungah Lee, Kavitha Gopalratnam, Stephanie Halene
Autoimmune haemolytic anaemia (AIHA) is a disease characterised by the production of pathological antibodies that attach to the surface of a patient's own red blood cells, resulting in haemolysis. It can present in either an acute or a chronic manner. In addition to the obvious consequence of anaemia, there are other potentially deadly complications that can arise from AIHA, such as venous thromboembolism (VTE) and pulmonary hypertension. We report a case of a 52-year-old woman who developed a pulmonary embolism (PE) soon after being diagnosed with AIHA...
January 14, 2016: BMJ Case Reports
Alfonso Fiorelli, Roberto Scaramuzzi, Saveria Costanzo, Antonio Volpicelli, Mario Santini
BACKGROUND: We evaluated the use of TachoSil(®) for anchoring middle lobe to lower lobe after upper right lobectomy. METHODS: The fixation of middle lobe to lower lobe was required in 39/213 consecutive upper lobectomies. In 19/39 (49%) cases, it was performed with suturing and/or stapler (standard group) and in 20 cases (TachoSil group) with Tachosil(®) alone. RESULTS: The operative time, complications, length of chest drain and hospital stay were similar between two groups...
October 2015: Translational Lung Cancer Research
David S Palmer, Jesper Sørensen, Birgit Schiøtt, Maxim V Fedorov
We demonstrate that the relative binding thermodynamics of single-point mutants of a model protein-peptide complex (the bovine chymosin-bovine κ-casein complex) can be calculated accurately and efficiently using molecular integral equation theory. The results are shown to be in good overall agreement with those obtained using implicit continuum solvation models. Unlike the implicit continuum models, however, molecular integral equation theory provides useful information about the distribution of solvent density...
December 10, 2013: Journal of Chemical Theory and Computation
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