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https://www.readbyqxmd.com/read/28592490/functional-analyses-yield-detailed-insight-into-the-mechanism-of-thrombin-inhibition-by-the-antihemostatic-salivary-protein-ce5-from-anopheles-gambiae
#1
Luciano Pirone, Jorge Ripoll-Rozada, Marilisa Leone, Raffaele Ronca, Fabrizio Lombardo, Gabriella Fiorentino, John F Andersen, Pedro José Barbosa Pereira, Bruno Arcà, Emilia Pedone
Saliva of blood-feeding arthropods carries several antihemostatic compounds whose physiological role is to facilitate successful acquisition of blood. The identification of novel natural anticoagulants and the understanding of their mechanism of action may offer opportunities for designing new antithrombotics disrupting blood clotting. We report here an in depth structural and functional analysis of the anophelin family member cE5, a salivary protein from the major African malaria vector Anopheles gambiae that specifically tightly and quickly binds and inhibitss thrombin...
June 7, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28566834/the-utility-of-computed-tomographic-angiography-in-a-neonate-on-extracorporeal-membrane-oxygenation-with-extreme-cyanosis-after-blalock-taussig-shunt
#2
Jess D Rames, Minoo N Kavarana, U Joseph Schoepf, Anthony Marcus Hlavacek
A modified Blalock-Taussig shunt (mBTS) is often employed to provide pulmonary blood flow in neonates that are born with cyanotic congenital heart defects. However, acute shunt thrombosis can occur in the postoperative period, resulting in profound cyanosis. In this case report, we describe the utility of computed tomographic angiography (CTA) in the management of a neonate with extreme cyanosis after placement of a mBTS while on extracorporeal membrane oxygenation. Using CTA, several small clots were identified in the shunt as well as stenosis of the left pulmonary artery; neither of which were identified with echocardiography...
May 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28552917/the-evaluation-of-resorbable-haemostatic-wound-dressings-in-contact-with-blood-in-vitro
#3
Maria Szymonowicz, Magdalena Kucharska, Maria Wiśniewska-Wrona, Maciej Dobrzyński, Kamila Kołodziejczyk, Zbigniew Rybak
PURPOSE: For many years research has been conducted on the development of resorbable, polymer, haemostatic materials designed to provide first aid and preliminary protection of injuries. The biological properties in vitro of a dressing in powder form called Hemoguard are expected to provide the ability to instantaneously stem bleeding with safe conditions of use. The aim of the study was to evaluate the haemostatic properties of a model of dressing based on micro- and nanofibrids of the chitosan, sodium/calcium alginate and/or carboxymethylcellulose complex...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#4
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28532047/porous-chitosan-microspheres-for-application-as-quick-in-vitro-and-in-vivo-hemostat
#5
Jixiang Li, Xiaowei Wu, Yanqing Wu, Zonghao Tang, Xun Sun, Meng Pan, Yufeng Chen, Juanjuan Li, Rongdong Xiao, Zhengchao Wang, Haiqing Liu
Controlling massive hemorrhage is of great importance to lower transfusional medical cost, and to reduce death and mobility rate in battlefield and civilian accidents. We reported the fabrication of porous chitosan microspheres (CSMS) with tunable surface pore size by microemulsion combined with thermally induced phase separation technique, and its application as a quick hemostat. Their hemostatic property was characterized by blood clotting kinetics, adherence interaction between red blood cells/platelets and CSMS, in vitro and in vivo hemostasis by rat tail amputation and liver laceration models, and histological analysis...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28414934/blood-clot-parameters-thromboelastography-and-scanning-electron-microscopy-in-research-and-clinical-practice
#6
Etheresia Pretorius, Albe C Swanepoel, Sulette DeVilliers, Janette Bester
BACKGROUND: Clotting parameters are informative of overall haematological healthiness of an individual. Particularly, clotting parameters can be used as a measure of the degree of pathology of the coagulation system. Thromboelastography (TEG) is a well-known technique that is an important point-of-care method, as well as research method. Scanning electron microscopy (SEM) is a novel research method, but with possible clinical application. However, there are no clear standardized guidelines for TEG and SEM result interpretation...
April 11, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28365649/clinical-application-of-prothrombin-complex-concentrate-in-blood-management-in-patients
#7
Sherri Ozawa, Tiffany Nelson
Management of patients receiving anticoagulants is a major factor in achieving better outcomes. Anticoagulant therapy may need to be discontinued or rapidly reversed before urgent surgery or invasive procedures. In these situations, treatment with concentrated vitamin K, fresh frozen plasma, and/or clotting factors can achieve more rapid anticoagulant reversal than can drug discontinuation alone. Activated prothrombin complex concentrate is used to treat hemophiliac patients with acquired factor VIII inhibitors...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28347320/life-threatening-massive-pulmonary-embolism-rescued-by-venoarterial-extracorporeal-membrane-oxygenation
#8
Fillipo Corsi, Guillaume Lebreton, Nicolas Bréchot, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Charles-Edouard Luyt, Pascal Leprince, Jean Chastre, Alain Combes, Matthieu Schmidt
BACKGROUND: Despite quick implementation of reperfusion therapies, a few patients with high-risk, acute, massive, pulmonary embolism (PE) remain highly hemodynamically unstable. Others have absolute contraindication to receive reperfusion therapies. Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) might lower their right ventricular overload, improve hemodynamic status, and restore tissue oxygenation. METHODS: ECMO-related complications and 90-day mortality were analyzed for 17 highly unstable, ECMO-treated, massive PE patients admitted to a tertiary-care center (2006-2015)...
March 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28346965/point-of-care-coagulation-tests-monitoring-of-direct-oral-anticoagulants-and-their-reversal-therapy-state-of-the-art
#9
Giacomo E Iapichino, Paolo Bianchi, Marco Ranucci, Ekaterina Baryshnikova
Direct oral anticoagulants (DOACs) exert similar anticoagulant effects to vitamin K antagonists and are increasingly used worldwide. Nevertheless, an evidence-based approach to patients receiving DOACs when any unplanned urgent surgery or bleeding (either spontaneous or traumatic) occurs is still missing. In this review, we investigate the role of point-of-care coagulation tests when other, more specific tests are not available. Indeed, thromboelastography and activated clotting time can detect dabigatran-induced coagulopathy, while their accuracy is limited for apixaban and rivaroxaban, mostly in cases of low drug plasma concentrations...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#10
REVIEW
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28299222/complete-obstruction-of-endotracheal-tube-in-an-infant-with-a-retropharyngeal-and-anterior-mediastinal-abscess
#11
Dennis B Thapa, Nathaniel H Greene, Andrea G Udani
Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28289550/blood-clot-detection-using-magnetic-nanoparticles
#12
Hafsa Khurshid, Bruce Friedman, Brent Berwin, Yipeng Shi, Dylan B Ness, John B Weaver
Deep vein thrombosis, the development of blood clots in the peripheral veins, is a very serious, life threatening condition that is prevalent in the elderly. To deliver proper treatment that enhances the survival rate, it is very important to detect thrombi early and at the point of care. We explored the ability of magnetic particle spectroscopy (MSB) to detect thrombus via specific binding of aptamer functionalized magnetic nanoparticles with the blood clot. MSB uses the harmonics produced by nanoparticles in an alternating magnetic field to measure the rotational freedom and, therefore, the bound state of the nanoparticles...
May 2017: AIP Advances
https://www.readbyqxmd.com/read/28277288/ct-imaging-selection-in-acute-stroke
#13
Laurie Bouchez, Roman Sztajzel, Maria Isabel Vargas, Paolo Machi, Zsolt Kulcsar, Pierre-Alexandre Poletti, Vitor Mendes Pereira, Karl-Olof Lövblad
Acute stroke has become an increasingly treatable cause of acute neurological deficits. Indeed, over the last two decades, the introduction of first thrombolysis, and now thrombectomy has improved patient outcomes and extended the therapeutic window. Computed tomography has been established as the most simple and readily available technique for the diagnosis and management of patients with acute stroke. Indeed, CT allows easy confirmation or exclusion of acute hemorrhage on the one hand, and on the other hand the early signs are quite reliable in the detection of ischemia...
October 26, 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/28124061/microfluidic-coagulation-assay-for-monitoring-anticoagulant-therapy-in-acute-stroke-patients
#14
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
https://www.readbyqxmd.com/read/28043990/low-dose-bivalirudin-anticoagulation-for-lung-transplantation-with-extracorporeal-membrane-oxygenation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#15
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.
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27881835/leptospirosis-associated-severe-pulmonary-hemorrhagic-syndrome-with-lower-back-pain-as-an-initial-symptom
#16
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
https://www.readbyqxmd.com/read/27770897/p-ta-macro-micro-nanoparticle-embedded-super-porous-p-hema-cryogels-as-wound-dressing-material
#17
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
https://www.readbyqxmd.com/read/27730530/a-combined-approach-using-global-coagulation-assays-quickly-differentiates-coagulation-disorders-with-prolonged-aptt-and-low-levels-of-fviii-activity
#18
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)...
February 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/27703089/development-and-validation-of-an-automatic-segmentation-algorithm-for-quantification-of-intracerebral-hemorrhage
#19
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
https://www.readbyqxmd.com/read/27676645/fatal-hemorrhage-due-to-a-spontaneous-factor-v-inhibitor-with-lupus-anticoagulant-properties
#20
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
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