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Coagulopathy

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https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#1
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with Glasgow-Blatchford score >7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28632435/relative-effects-of-plasma-fibrinogen-concentrate-and-factor-xiii-on-rotem-coagulation-profiles-in-an-in-vitro-model-of-massive-transfusion-in-trauma
#2
David E Schmidt, Märit Halmin, Agneta Wikman, Anders Östlund, Anna Ågren
Massive traumatic haemorrhage is aggravated through the development of trauma-induced coagulopathy, which is managed by plasma transfusion and/or fibrinogen concentrate administration. It is yet unclear whether these treatments are equally potent in ensuring adequate haemostasis, and whether additional factor XIII (FXIII) administration provides further benefits. In this study, we compared ROTEM whole blood coagulation profiles after experimental massive transfusion with different transfusion regimens in an in vitro model of dilution- and transfusion-related coagulopathy...
June 20, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28629372/novel-nbas-mutations-and-fever-related-recurrent-acute-liver-failure-in-chinese-children-a-retrospective-study
#3
Jia-Qi Li, Yi-Ling Qiu, Jing-Yu Gong, Li-Min Dou, Yi Lu, A S Knisely, Mei-Hong Zhang, Wei-Sha Luan, Jian-She Wang
BACKGROUND: Underlying causes in Chinese children with recurrent acute liver failure (RALF), including liver crises less than full acute liver failure, are incompletely understood. We sought to address this by searching for genes mutated in such children. METHODS: Five unrelated Chinese boys presenting between 2012 and 2015 with RALF of unexplained etiology were studied. Results of whole exome sequencing were screened for mutations in candidate genes. Mutations were verified in patients and their family members by Sanger sequencing...
June 19, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28626212/a-huge-subcutaneous-hematoma-in-an-adult-with-kasabach-merritt-syndrome
#4
Kuan-Lin Wu, Chiung-Ying Liao, Chen-Kuang Chang, Shang-Yun Ho, Yeu-Sheng Tyan, Yuan-Chun Huang
BACKGROUND Kasabach-Merritt syndrome is a potentially fatal disease that consists of hemangioma(s) with thrombocytopenia, microangiopathic hemolytic anemia, and coagulopathy. Extensive hemangiomatosis is rare. We present the radiological features and treatment strategy of a young adult suffering from Kasabach-Merritt syndrome with widespread hemangiomas and an infected huge hematoma in the right thigh. CASE REPORT A 33-year-old Taiwanese male presented with a painful 20-cm mass over his right thigh and gross hematuria for 2 days...
June 19, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28625300/preeclampsia-in-2017-obstetric-and-anaesthesia-management
#5
REVIEW
Ross Hofmeyr, Mushi Matjila, Robert Dyer
In many centres, anaesthesia now incorporates perioperative medicine. Preeclampsia is a perioperative medical challenge requiring a multi-disciplinary team. New definitions stress the rapid progression of the disease and highlight the importance of early detection. Anaesthesiologists should understand the pathophysiology of the disease and develop the ultrasound skills required to assist in the assessment of disease severity. This facilitates the choice of anaesthesia method and perioperative management in complicated cases...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28624430/comparative-assessment-of-immune-complex-mediated-hypersensitivity-reactions-with-biotherapeutics-in-the-non-human-primate-critical-parameters-safety-and-lessons-for-future-studies
#6
Sven Kronenberg, Elisabeth Husar, Christine Schubert, Christian Freichel, Thomas Emrich, Martin Lechmann, Anna Maria Giusti, Franziska Regenass
With the emergence of novel biotherapeutic formats and immunostimulatory biotherapeutics in cancer immunotherapy, an understanding of immune-complex (IC) mediated hypersensitivity reactions in toxicology studies - and their differentiation from pharmacology - remains key to the preclinical evaluation of these drugs. In this review we provide an in-depth evaluation and comparison of case examples where IC-mediated hypersensitivity reactions were observed in cynomolgus monkeys. We provide details of the parameters evaluated in each study to substantiate and guide the interpretation of these findings...
June 15, 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/28624047/viscoelastic-monitoring-in-pediatric-trauma-a-survey-of-pediatric-trauma-society-members
#7
Robert T Russell, Ilan I Maizlin, Adam M Vogel
BACKGROUND: Viscoelastic monitoring (VEM), including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) in the setting of goal-directed hemostatic resuscitation has been shown to improve outcomes in adult trauma. The American College of Surgeons (ACS) Committee on Trauma recommends that "thromboelastography should be available at level I and level II trauma centers". The purpose of this study is to determine the current availability and utilization of VEM in pediatric trauma...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622312/clinical-features-and-prognostic-factors-of-klebsiella-endophthalmitis-10-year-experience-in-an-endemic-region
#8
C Y Chung, E S Wong, C C H Liu, M O M Wong, K K W Li
AimsTo identify the clinical features and prognostic factors of endogenous endophthalmitis caused by Klebsiella pneumoniae.MethodsThis is a retrospective case series of all patients with Klebsiella endophthalmitis managed from January 2006 to December 2015 by Kowloon East Ophthalmic Service. Statistical analysis involved hypothesis testing on the SPSS 18.0 software (SPSS). A significance level of P<0.05 was taken.ResultsIn the 10-year period, K. pneumoniae accounted for 19 out of 39 cases of endogenous endophthalmitis (48...
June 16, 2017: Eye
https://www.readbyqxmd.com/read/28622302/evaluation-of-coagulopathy-before-and-during-induction-chemotherapy-for-acute-lymphoblastic-leukaemia-including-assessment-of-global-clotting-tests
#9
K Burley, J Salem, T Phillips, C Reilly-Stitt, D I Marks, O Tunstall, J Moppett, A Mumford, C A Bradbury
No abstract text is available yet for this article.
June 16, 2017: Blood Cancer Journal
https://www.readbyqxmd.com/read/28614427/a-new-era-of-thromboelastometry
#10
Tomaz Crochemore, Felipe Maia de Toledo Piza, Roseny Dos Reis Rodrigues, João Carlos de Campos Guerra, Leonardo José Rolim Ferraz, Thiago Domingos Corrêa
Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients...
June 12, 2017: Einstein
https://www.readbyqxmd.com/read/28614216/refractory-adult-onset-still-disease-complicated-by-macrophage-activation-syndrome-and-acute-myocarditis-a-case-report-treated-with-high-doses-8%C3%A2-mg-kg-d-of-anakinra
#11
Federico Parisi, Annamaria Paglionico, Valentina Varriano, Gianfranco Ferraccioli, Elisa Gremese
RATIONALE: Myocarditis is a rare but potentially fatal complication of Still's disease (about 7% of total cases). PATIENT CONCERNS: A 42-year-old woman was admitted to our ward with high-grade fever, rash and polyarthralgia, lasting since 4 weeks and rapidly complicated by MAS and acute heart failure. DIAGNOSES: Adult Onset Still's Disease rapidly developping macrophage activation syndrome and disseminated intravascular coagulopathy, further complicated by iperacute myocarditis with cardiac arrest...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28612932/prehospital-parameters-can-help-to-predict-coagulopathy-and-massive-transfusion-in-trauma-patients
#12
J-S David, E-J Voiglio, E Cesareo, O Vassal, E Decullier, P-Y Gueugniaud, S Peyrefitte, K Tazarourte
BACKGROUND: This study aimed to evaluate the accuracy of prehospital parameters, including vital signs and resuscitation (fluids, vasopressor), to predict trauma-induced coagulopathy (TIC, fibrinogen <1·5 g/l or PTratio > 1·5 or platelet count <100 × 10(9) /l), and a massive transfusion (MT, ≥10 RBC units within the first 24 h). METHODS: From a trauma registry (2011-2015), in which patients are prospectively included, we retrospectively retrieved the heart rate (HR), systolic blood pressure (SBP), volume of prehospital fluids and administration of noradrenaline...
June 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#13
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28606160/consumption-coagulopathy-in-acute-aortic-dissection-principles-of-management
#14
Yuyong Liu, Lu Han, Jiachen Li, Ming Gong, Hongjia Zhang, Xinliang Guan
BACKGROUND: The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. METHODS: Sixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period...
June 12, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28605821/abnormal-uterine-bleeding
#15
Cristina Laguna Benetti-Pinto, Ana Carolina Japur de Sá Rosa-E-Silva, Daniela Angerame Yela, José Maria Soares Júnior
Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic...
June 12, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28604569/use-of-four-factor-prothrombin-complex-concentrate-in-the-reversal-of-warfarin-induced-and-nonvitamin-k-antagonist-related-coagulopathy
#16
Hannah Young, Jeremy L Holzmacher, Richard Amdur, Stephen Gondek, Babak Sarani, Mary E Schroeder
: To evaluate the efficacy of international normalized ratio (INR) reversal using four-factor prothrombin complex concentrate (4F-PCC) in nonmedication-induced coagulopathy. We performed a single-site, retrospective cohort study of patients receiving off-label use of 4F-PCC. Cohorts included liver dysfunction if they had acute liver decompensation or cirrhosis without other causative factors of liver failure such as sepsis, coagulopathy of acute sepsis (CAS) if they had documentation of sepsis and no underlying liver disorder, known factor deficiencies, or medication-induced coagulopathy, or warfarin if they were taking warfarin...
June 9, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28603894/a-performance-evaluation-of-a-novel-human-recombinant-tissue-factor-prothrombin-time-reagent-revohem-%C3%A2-pt
#17
C Gardiner, K Kohama, I Patel, P Lane, S Dwyer, S J Machin, I J Mackie
INTRODUCTION: A new prothrombin time reagent (Revohem™ PT) based on recombinant human tissue factor produced by the silkworm-baculovirus expression system was tested. The aim of this study was to compare the performance of the new PT reagent with two widely used routine PT reagents. METHODS: All testing was performed on a Sysmex CS-5100 coagulometer. Revohem(™) PT was tested for imprecision and stability using normal and abnormal lyophilized commercial control plasmas...
June 12, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28602536/national-incidence-of-reportable-quality-metrics-in-the-knee-arthroplasty-population
#18
Joseph E Tanenbaum, Derrick M Knapik, Steven J Fitzgerald, Randall E Marcus
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) characterizes adverse quality events in the inpatient setting as patient safety indicators (PSI). The incidence of PSI has not been quantified in the total knee arthroplasty (TKA) population. METHODS: All patients in the Nationwide Inpatient Sample who underwent primary TKA during an inpatient episode in 2013 were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes...
May 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28602070/a-prognostic-evaluation-and-management-of-alcoholic-hepatitis
#19
Ramesh Rana, Sheng-Lan Wang, Jing Li, Lu Xia, Mei-Yi Song, Chang-Qing Yang
Alcoholic hepatitis is an acute and severe form of alcoholic liver disease associated with high morbidity and mortality of 30-50% worldwide, severity ranging from asymptomatic derangement of liver biochemistries to fulminant liver failure or death. Rapidly progressing jaundice and coagulopathy in prolonged excessive alcohol abusers with or without fever, malnutrition, and tender liver are the clinical hallmarks. The prognostic models (MELD, MDF, ABIC, GAHS, Lille's score) not only predict the short term mortality, but also guide the clinicians to choose appropriate specific therapy (corticosteroid or pentoxifylline) and as a stopping rule if there is no significant benefits of it...
June 9, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28601310/hemoglobin-based-oxygen-carriers-promote-systemic-hyperfibrinolysis-that-is-both-dependent-and-independent-of-plasmin
#20
Alexander P Morton, Ernest E Moore, Hunter B Moore, Eduardo Gonzalez, Michael P Chapman, Erik Peltz, Anirban Banerjee, Christopher Silliman
BACKGROUND: Hyperfibrinolysis plays an integral role in the genesis of trauma-induced coagulopathy. Recent data demonstrate that red blood cell lysis promotes fibrinolysis; however, the mechanism is unclear. Hemoglobin-based oxygen carriers (HBOCs) have been developed for resuscitation and have been associated with coagulopathy. We hypothesize that replacement of whole blood (WB) using an HBOC results in a coagulopathy because of the presence of free hemoglobin. MATERIALS AND METHODS: WB was sampled from healthy donors (n = 6)...
June 1, 2017: Journal of Surgical Research
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