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Coagulopathy

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https://www.readbyqxmd.com/read/28742833/translational-approaches-to-coagulopathy-after-trauma-towards-targeted-treatment
#1
Mitchell Jay Cohen
Mitchell J. Cohen discusses why trauma care must go beyond restoring perfusion to target disorders of inflammation and coagulation in severely injured patients.
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742231/different-resuscitation-strategies-and-novel-pharmacologic-treatment-with-valproic-acid-in-traumatic-brain-injury
#2
REVIEW
Simone E Dekker, Vahagn C Nikolian, Martin Sillesen, Ted Bambakidis, Patrick Schober, Hasan B Alam
Traumatic brain injury (TBI) is a leading cause of death in young adults, and effective treatment strategies have the potential to save many lives. TBI results in coagulopathy, endothelial dysfunction, inflammation, cell death, and impaired epigenetic homeostasis, ultimately leading to morbidity and/or mortality. Commonly used resuscitation fluids such as crystalloids or colloids have several disadvantages and might even be harmful when administered in large quantities. There is a need for next-generation treatment strategies (especially in the prehospital setting) that minimize cellular damage, improve survival, and enhance neurological recovery...
July 25, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28740953/analysis-of-risk-factors-affecting-coagulopathy-after-donor-hepatectomy-in-a-newly-established-liver-transplant-center
#3
Sema Aktaş, Şinasi Sevmiş, Mehmet Şeker, Esin Korkut, Hamdi Karakayalı
OBJECTIVE: As might be expected, living donor liver surgery is associated with serious morbidity and mortality risks. Coagulopathy after donor hepatectomy is an important risk factor affecting morbidity. In this study, risk factors affecting the development of coagulopathy after donor hepatectomy was evaluated in a newly-established liver transplant center. MATERIAL AND METHODS: A retrospective evaluation of 46 liver donors to whom hepatectomy was applied in Medipol Universty of School of Medicine Department of Organ Transplantation between April 2014 and July 2015 was made...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740434/a-global-quantitative-survey-of-hemostatic-assessment-in-postpartum-hemorrhage-and-experience-with-associated-bleeding-disorders
#4
Andra H James, David L Cooper, Michael J Paidas
PURPOSE: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worldwide towards assessing massive PPH caused by underlying bleeding disorders. METHODS: A quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan)...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28739563/efficacy-of-new-low-dose-oral-anticoagulants-in-recalcitrant-livedoid-vasculopathy
#5
Fumina Furukawa, Megumi Mizawa, Teruhiko Makino, Tadamichi Shimizu
Livedoid vasculopathy (LV) is a thrombotic skin disease characterised by recurrent painful ulcerations and irreversible scar formation on the lower legs, which is caused by occlusion of the cutaneous microcirculation. Edoxaban is one of new oral anticoagulants. It directly inhibits factor Xa in the coagulation pathway and prevents thrombus formation. A 17-year-old Japanese male presented with a 1-year history of recalcitrant cutaneous ulcers and livedo racemosa on his lower extremities. Initially, the ulcers were treated with antiplatelets therapies; however, he experienced recurrence of ulcerations during summer time...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28737691/coagulopathy-in-the-setting-of-mild-traumatic-brain-injury-truths-and-consequences
#6
REVIEW
Joseph P Herbert, Andrew R Guillotte, Richard D Hammer, N Scott Litofsky
Mild traumatic brain injury (mTBI) is a common, although poorly-defined clinical entity. Despite its initially mild presentation, patients with mTBI can rapidly deteriorate, often due to significant expansion of intracranial hemorrhage. TBI-associated coagulopathy is the topic of significant clinical and basic science research. Unlike trauma-induced coagulopathy (TIC), TBI-associated coagulopathy does not generally follow widespread injury or global hypoperfusion, suggesting a distinct pathogenesis. Although the fundamental mechanisms of TBI-associated coagulopathy are far from clearly elucidated, several candidate molecules (tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), tissue factor (TF), and brain-derived microparticles (BDMP)) have been proposed which might explain how even minor brain injury can induce local and systemic coagulopathy...
July 22, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28735968/epidemiology-and-clinical-features-of-green-pit-viper-trimeresurus-trigonocephalus-envenoming-in-sri-lanka
#7
R M M K Namal Rathnayaka, P E A N Ranathunga, S A M Kularatne
Green pit viper is a venomous endemic snake in Sri Lanka. But little is known regarding its envenoming in the country. This study was carried out in order to find out epidemiology and clinical profile of its bites. A series of 17 patients with Sri Lankan Green pit viper (Trimeresurus trigonocephalus) bites was prospectively studied over 4 years. The mean age was 36 ½ years (range 12-61 years) and comprised 14 (82%) males. Except one case, all bites occurred during day time (0600 h-1800h) due to inadvertent provocation...
July 20, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28730137/pediatric-mycoplasma-pneumoniae-infection-presenting-with-acute-cholestatic-hepatitis-and-other-extrapulmonary-manifestations-in-the-absence-of-pneumonia
#8
Won Jae Song, Ben Kang, Hwa Pyung Lee, Joongbum Cho, Hae Jeong Lee, Yon Ho Choe
Mycoplasma pneumoniae infections mainly involve respiratory tract; however, also can manifestate other symptoms by site involved. Extrapulmonary manifestations of M. pneumoniae infection are rarely known to occur without pneumonia. Herein we report a case of a 9-year-old boy who presented with acute cholestatic hepatitis in the absence of pneumonia. Rhabdomyolysis, skin rash, and initial laboratory results suspicious of disseminated intravascular coagulopathy were also observed in this patient. M. pneumoniae infection was identified by a 4-fold increase in immunoglobulin G antibodies to M...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28729903/tranexamic-acid-and-trauma-induced-coagulopathy
#9
REVIEW
Takeshi Nishida, Takahiro Kinoshita, Kazuma Yamakawa
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly used for reduction of blood loss in perioperative situations, while recently it has attracted attention for clinical use in the trauma field. In 2010, the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage 2 (CRASH-2) trial demonstrated that intravenous administration of TXA improved mortality significantly in trauma patients with significant bleeding...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728489/idarucizumab-for-the-treatment-of-hemorrhage-and-dabigatran-reversal-in-patients-requiring-urgent-surgery-or-procedures
#10
Ovidiu Vornicu, Anne-Sophie Larock, Anne-Sophie Dincq, Jonathan Douxfils, Jean-Michel Dogné, François Mullier, Sarah Lessire
Idarucizumab is a specific antagonist for dabigatran etexilate (DE). The recent market authorization of idarucizumab in Europe and the USA may reassure prescribers of DE, as it can increase the safety of the emergency management of patients taking this anticoagulant. However, idarucizumab use should be limited to specific indications to avoid unnecessary risks to patients and costs to healthcare systems. Areas covered: The authors provide an overview of idarucizumab development and its pharmacokinetic and pharmacodynamic properties...
July 20, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28724319/cerebral-hemorrhage-as-the-initial-manifestation-in-patients-with-systemic-cancer
#11
Gelun Huang, Li Chen, Chao Qin, Daobin Cheng, Qiuhong Lu, Lixia Yu, Zhijian Liang
BACKGROUND: Cerebral hemorrhage as well as ischemic stroke is one of the common complications among patients with cancer. Ischemic stroke could be the initial manifestation in some patients with cancer. Meanwhile, some patients with cancer also could present cerebral hemorrhage as the initial manifestation, and further studies are required to determine whether these patients have their unique clinical features. AIM: To investigate the clinical features and underlying pathogenesis of concealed systemic cancer patients with cerebral hemorrhage as the initial manifestation...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28721927/coagulopathy-and-haemorrhagic-progression-in-traumatic-brain-injury-advances-in-mechanisms-diagnosis-and-management
#12
REVIEW
Marc Maegele, Herbert Schöchl, Tomas Menovsky, Hugues Maréchal, Niklas Marklund, Andras Buki, Simon Stanworth
Normal haemostasis depends on an intricate balance between mechanisms of bleeding and mechanisms of thrombosis, and this balance can be altered after traumatic brain injury (TBI). Impaired haemostasis could exacerbate the primary insult with risk of initiation or aggravation of bleeding; anticoagulant use at the time of injury can also contribute to bleeding risk after TBI. Many patients with TBI have abnormalities on conventional coagulation tests at admission to the emergency department, and the presence of coagulopathy is associated with increased morbidity and mortality...
August 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28720697/inhibition-of-complement-c5-protects-against-organ-failure-and-reduces-mortality-in-a-baboon-model-of-escherichia-coli-sepsis
#13
Ravi Shankar Keshari, Robert Silasi, Narcis Ioan Popescu, Maulin Mukeshchandra Patel, Hala Chaaban, Cristina Lupu, K Mark Coggeshall, Tom Eirik Mollnes, Steven J DeMarco, Florea Lupu
Bacterial sepsis triggers robust activation of the complement system with subsequent generation of anaphylatoxins (C3a, C5a) and the terminal complement complex (TCC) that together contribute to organ failure and death. Here we tested the effect of RA101295, a 2-kDa macrocyclic peptide inhibitor of C5 cleavage, using in vitro whole-blood assays and an in vivo baboon model of Escherichia coli sepsis. RA101295 strongly inhibited E. coli-induced complement activation both in vitro and in vivo by blocking the generation of C5a and the soluble form of TCC, sC5b-9...
July 18, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28717966/association-between-aspirin-use-and-deep-venous-thrombosis-in-mechanically-ventilated-icu-patients
#14
Ena Gupta, Furqan S Siddiqi, Ryan Kunjal, Muhammad Faisal, Farah Al-Saffar, Abubakr A Bajwa, Lisa M Jones, Vandana Seeram, James D Cury, Adil Shujaat
Deep venous thrombosis (DVT) is common in intensive care unit (ICU) patients. It is often silent and may be complicated by pulmonary embolism and death. Thromboprophylaxis with heparin does not always prevent venous thromboembolism (VTE). Aspirin (ASA) reduces the risk of VTE in surgical and high-risk medical patients but it is unknown if ASA may prevent DVT in mechanically ventilated ICU patients. We performed a retrospective chart review of critically ill patients who received mechanical ventilation for >72 h and underwent venous ultrasonography for suspected DVT between Jan 2012 and Dec 2013...
July 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28714924/cross-sectional-study-to-determine-the-prevalence-of-hepatitis-b-and-c-virus-infection-in-high-risk-groups-in-the-northeast-region-of-brazil
#15
Jakeline Ribeiro Barbosa, Cristianne Sousa Bezerra, Filipe Anibal Carvalho-Costa, Carolina Pimentel de Azevedo, Geane Lopes Flores, Jeová Keny Baima Colares, Danielle Malta Lima, Elisabeth Lampe, Lívia Melo Villar
Background: HBV (Hepatitis B Virus) and HCV (Hepatitis C Virus) infections are more prevalent in vulnerable populations than the general population. The objective of this study was to investigate the prevalence of HBV and HCV infection in HIV-positive patients (GI), chronic renal failure (CRF) patients (GII) and coagulation disorder individuals (GIII). Methods: A cross-sectional study was conducted from June 2014 to March 2015. Serum samples were tested for markers of hepatitis B and C by enzyme-linked immunosorbent assay (ELISA)...
July 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28714083/acute-liver-failure-with-amiodarone-infusion-a-case-report-and-systematic-review
#16
P Jaiswal, B M Attar, J E Yap, K Devani, R Jaiswal, Y Wang, R Szynkarek, D Patel, M Demetria
WHAT IS KNOWN AND OBJECTIVE: Amiodarone, a commonly used class III antiarrhythmic agent notable for a relatively long half-life of up to 6 months and its pronounced adverse effect profile, is used for both acute and chronic management of cardiac arrhythmias. Chronic use of amiodarone has been associated with asymptomatic hepatotoxicity; however, acute toxicity is thought to be uncommon. There are only six reported cases of acute liver failure (ALF) secondary to amiodarone. In all these cases the outcome of death during the same hospitalization resulted...
July 16, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28712103/randomised-controlled-trial-of-analgesic-effectiveness-of-three-different-techniques-of-single-shot-interscalene-brachial-plexus-block-using-20-ml-of-0-5-ropivacaine-for-shoulder-arthroscopy
#17
Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
Background Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy ...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28710692/host-factors-involved-in-ebola-virus-replication
#18
Angela L Rasmussen
Ebola virus (EBOV) is a highly pathogenic emerging virus that represents a serious threat to global public health and a major priority for biodefense. The 2014 West African outbreak demonstrated the potential of EBOV to cause an epidemic affecting thousands of people. The severity of disease and high case fatality rate of EBOV is largely due to the host response elicited by the virus. EBOV infection hijacks a number of host pathways to carry out replication and stimulate potent inflammatory responses, while simultaneously subverting the host antiviral immune response...
July 15, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28709582/the-incidence-of-transfusion-and-associated-risk-factors-in-pelvic-reconstructive-surgery
#19
Lopa K Pandya, Courtney Lynch, Andrew F Hundley, Silpa Nekkanti, Catherine O Hudson
BACKGROUND: Almost 400,000 female pelvic reconstructive operations were performed in 2010 for urinary incontinence and pelvic organ prolapse in the United States, and it is likely that this will continue to increase each year. There is a lack of population-based data evaluating the risk of blood transfusion after urogynecologic procedures. OBJECTIVES: To assess the incidence of blood transfusion related to pelvic reconstructive surgery in a large national surgical quality database and to identify transfusion-associated risk factors...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28708016/emergency-separation-of-craniopagus-twins-case-report
#20
Farideh Nejat, Zohreh Habibi, Mehrdad Goudarzi, Mahdi Souraki Azad, Ehsan Moradi, Vahid Heidari, Maliheh Kadivar, Zahra Ebrahim Soltani, Leila Kouchakzadeh
Craniopagus is a very rare congenital anomaly that tends to affect females more often than males. It is classified as partial or total. Most affected twins are either stillborn or die during the perinatal period. Those who survive birth should undergo detailed radiological evaluations soon after their condition becomes stable so that the precise anatomy of the conjoined part can be defined and surgery can be planned in detail by a multidisciplinary team. Recommendations for decreasing the risk of unsuccessful surgery include performing surgery on an elective basis after extensive preoperative radiological evaluations as well as when the twins are at an acceptable age and weight for a complex surgical separation, generally as staged procedures...
July 14, 2017: Journal of Neurosurgery. Pediatrics
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