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Coagulopathy

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https://www.readbyqxmd.com/read/28535134/upper-airway-obstruction-secondary-to-anticoagulant-rodenticide-toxicosis-in-five-dogs
#1
Corinne Lawson, Mauria O'Brien, Maureen McMichael
Five dogs were presented with clinical signs compatible with upper airway obstruction, including stridor, stertor, coughing, gagging, and varying degrees of respiratory distress. All dogs had radiographic findings of soft tissue opacity in the area of the pharynx, larynx, or trachea, and several had narrowing of the tracheal lumen. Coagulation abnormalities (prolonged prothrombin time, activated partial thromboplastin time) were present in the four dogs that underwent testing. Four of five dogs were treated for the coagulopathy, presumably due to anticoagulant rodenticide toxicosis, and survived to discharge...
May 23, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28534557/-circuit-life-span-of-continuous-renal-replacement-therapy-in-critically-ill-patients-with-or-without-conventional-anticoa-gulation-an-observational-prospective-study
#2
M Sanz Ganuza, F Hidalgo Martínez, N García-Fernández
BACKGROUND: The aim of this study was to describe the efficacy, security and viability of an anticoagulation system with continuous infusion of unfractionated heparin (UFH) versus one without any type of anticoagulant using 0.9% physiological saline washings, in critically ill patients with continuous renal replacement therapy (CRRT) and different risks of bleeding. METHODS: From October 2013 to April 2015 we conducted an observational prospective study in the intensive care unit (ICU)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#3
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28529911/severe-trauma-in-the-geriatric-population
#4
REVIEW
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529666/a-microfluidic-model-of-hemostasis-sensitive-to-platelet-function-and-coagulation
#5
R M Schoeman, K Rana, N Danes, M Lehmann, J A Di Paola, A L Fogelson, K Leiderman, K B Neeves
Hemostasis is the process of sealing a vascular injury with a thrombus to arrest bleeding. The type of thrombus that forms depends on the nature of the injury and hemodynamics. There are many models of intravascular thrombus formation whereby blood is exposed to prothrombotic molecules on a solid substrate. However, there are few models of extravascular thrombus formation whereby blood escapes into the extravascular space through a hole in the vessel wall. Here, we describe a microfluidic model of hemostasis that includes vascular, vessel wall, and extravascular compartments...
February 2017: Cellular and Molecular Bioengineering
https://www.readbyqxmd.com/read/28527677/human-parechovirus-sepsis-induced-coagulopathy-in-an-infant
#6
Jean-Francois Bonnet, Tara M Connelly, Guillermo H Vega, Alfonso Rodriguez Herrera
No abstract text is available yet for this article.
May 17, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28527586/gastrointestinal-bowel-obstruction-in-acute-ischemic-stroke-incidence-risk-factors-and-outcomes-in-a-u-s-nationwide-analysis-of-3-998-667-hospitalizations
#7
Kavelin Rumalla, Ashwath S Kumar, Manoj K Mittal
OBJECTIVE: The prognosis from acute ischemic stroke (AIS) is worsened by poststroke medical complications. The incidence, risk factors, and outcomes of gastrointestinal bowel obstruction (GIBO) in AIS are not known. METHODS: We queried the Nationwide Inpatient Sample (2002-2011) to identify all patients with a primary diagnosis of AIS and subsets with and without a secondary diagnosis of GIBO without hernia. Multivariable analysis was utilized to identify risk factors for GIBO in AIS patients and the association between GIBO, in-hospital complications, and outcomes...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28524847/an-in-vivo-strategy-to-counteract-post-administration-anticoagulant-activity-of-azido-warfarin
#8
Sylvain Ursuegui, Marion Recher, Wojciech Krężel, Alain Wagner
Drugs, usually long acting and metabolically stable molecules, might be the source of adverse effects triggered by complex drug interactions, anaphylaxis and drug-induced coagulopathy. To circumvent this growing drug safety issue, we herein investigate the opportunity offered by bio-orthogonal chemistry for in vivo drug neutralization. We design a small-molecule anticoagulant drug (Warfarin) containing an azide group that acts as a safety pin. It allows drug deactivation and restoration of physiological coagulation via in vivo click reaction with a suitable cyclooctyne-based neutralizing agent...
May 19, 2017: Nature Communications
https://www.readbyqxmd.com/read/28522144/viscoelastic-tissue-plasminogen-activator-challenge-predicts-massive-transfusion-in-15-minutes
#9
Hunter B Moore, Ernest E Moore, Michael P Chapman, Benjamin R Huebner, Peter M Einersen, Solimon Oushy, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Coagulopathy is associated with massive transfusion in trauma, yet most clinical scores to predict this end point do not incorporate coagulation assays. Previous work has identified that shock increases circulating tissue plasminogen activator (tPA). When tPA levels saturate endogenous inhibitors, systemic hyperfibrinolysis can occur. Therefore, the addition of tPA to a patient's blood sample could stratify a patients underlying degree of shock and early coagulation changes to predict progression to massive transfusion...
April 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28514870/biomarker-profile-of-sepsis-associated-coagulopathy-using-biochip-assay-for-inflammatory-cytokines
#10
Amanda Walborn, Debra Hoppensteadt, Daneyal Syed, Michael Mosier, Jawed Fareed
Disseminated intravascular coagulation (DIC) is a major pathophysiological mechanism of sepsis and greatly increases the risk of death in septic patients. Disseminated intravascular coagulation is a complex physiological phenomenon that involves inappropriate activation of coagulation, inflammation, and endothelial processes. The purpose of this study was to analyze the levels of inflammatory cytokines in the plasma of patients with DIC in order to compare the measured levels with those from healthy individuals, draw correlations, and provide a basis for further biomarker panel development...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28509781/correction-of-severe-coagulopathy-and-hyperfibrinolysis-by-tranexamic-acid-and-recombinant-factor-viia-in-a-cirrhotic-patient-after-trauma-a-case-report
#11
Jack Louro, Katherine Andersen, Roman Dudaryk
Coagulopathy induced by trauma or cirrhosis is a well-recognized entity. Viscoelastic testing has been used in either condition for goal-directed transfusion and detection of fibrinolysis since conventional coagulation tests do not correlate with clinical risk of bleeding. Hemostatic resuscitation may not be adequate for a trauma patient with liver disease due to complex alterations in coagulation systems and occasionally require adjuvant therapy. We report a case of trauma-induced coagulopathy presenting as severe hyperfibrinolysis in a cirrhotic patient who was refractory to hemostatic resuscitation but was rapidly corrected by the administration of tranexamic acid and recombinant Factor VIIa...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509684/histone-complexed-dna-fragments-levels-are-associated-with-coagulopathy-endothelial-cell-damage-and-increased-mortality-after-severe-pediatric-trauma
#12
Robert T Russell, Sarah C Christiaans, Tate Nice, Morgan Banks, Vincent Mortellaro, Charity Morgan, Amy Duhachek-Stapelman, Steven J Lisco, Jeffrey D Kerby, Brant M Wagener, Mike K Chen, Jean-François Pittet
BACKGROUND: The release of damage-associated molecular pattern molecules (DAMPs) in the extracellular space secondary to injury has been shown to cause systemic activation of the coagulation system and endothelial cell damage. We hypothesized that pediatric trauma patients with increased levels of histone-complexed DNA fragments (hcDNA) would have evidence of coagulopathy and endothelial damage that would be associated with poor outcomes. METHODS: We conducted a prospective observational study of 149 pediatric trauma patients and 62 control patients at two level 1 pediatric trauma centers from 2013-2016...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28507872/multiple-level-replantation-in-elderly-patients-risk-versus-benefit
#13
Rafael G Jakubietz, Michael G Jakubietz, Rainer H Meffert, Karsten Schmidt
Multiple-level amputations of the upper extremity represent a surgical challenge generally only attempted in young patients. This case demonstrates a successful replantation in an elderly woman. The postoperative course was complicated by disseminated intravascular coagulopathy most likely due to inadequate resuscitation. Hand trauma is often underestimated in its general severity. Upper extremity amputations need to be handled similar to polytraumatized patients.
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28503286/fulminant-hepatic-failure-due-to-metastatic-choroidal-melanoma
#14
Emmanuel Escobar-Valdivia, Roberto Monreal-Robles, Guillermo Delgado-García, Badir Hernández-Velazquez
BACKGROUND: Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported. CASE PRESENTATION: We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28502961/haptoglobin-reduces-inflammatory-cytokine-inf-%C3%AE-and-facilitates-clot-formation-in-acute-severe-burn-rat-model
#15
Hiroyuki Koami, Yuichiro Sakamoto, Taku Miyasho, Ryo Noguchi, Norio Sato, Keita Kai, Kosuke Chris Yamada, Satoshi Inoue
Haptoglobin exerts renal protective function by scavenging free hemoglobin from the urine and blood stream in patients with hemolytic disorders. Recent studies elucidate the relationships between haptoglobin and inflammation. In addition, coagulopathy is often induced by systemic inflammation characterized by the presence of vascular endothelial damage. We hypothesize that haptoglobin might have an anti-inflammatory effect and affect hypercoagulability using rat burn model. Thirty anesthetized rats of six-weeks of age received over 30% full-thickness scald burn on the dorsal skin surface...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28502937/acquired-inhibitors-to-multiple-coagulation-factors-v-ix-and-xii-identified-in-a-unique-patient-with-hepatocellular-carcinoma
#16
Osamu Imataki, Takeshi Arai, Makiko Uemura
An acquired formation of inhibitors to coagulation factors is a rare type of coagulopathy. The development of inhibitors for multiple coagulation factors has never been reported. A 75-year-old Japanese female underwent interventional therapy for hepatocellular carcinoma. Five days after the last intervention, her prothrombin time decreased to 10%, and her activated partial thromboplastin time (APTT) lengthened to 265.1 sec. The activities for coagulation factors showed significantly reduced activities (<10%) of factors V, IX, and XII...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28502540/trends-and-outcomes-in-endovascular-and-open-surgical-treatment-of-visceral-aneurysms
#17
Jason A Chin, Adele Heib, Cassius I Ochoa Chaar, Jonathan A Cardella, Kristine C Orion, Timur P Sarac
OBJECTIVE: Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy. METHODS: The 2003 to 2013 Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (NIS) database was reviewed. Cases with primary diagnosis of VAA and undergoing endovascular or open repair were identified...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501265/an-algorithm-for-the-management-of-coagulopathy-from-postpartum-hemorrhage-using-fibrinogen-concentrate-as-first-line-therapy
#18
S Seto, A Itakura, R Okagaki, M Suzuki, O Ishihara
BACKGROUND: We constructed an algorithm for the management of coagulopathy from massive postpartum hemorrhage. Fibrinogen concentrate was administered preferentially, and the dose of both fibrinogen concentrate and fresh frozen plasma given was determined by the plasma fibrinogen concentration and prothrombin time. The efficacy of the algorithm and the amount of fibrinogen concentrate and fresh frozen plasma transfused were determined. METHODS: The study was conducted in a single teaching perinatal center...
April 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28500652/freeze-dried-plasma-enhances-clot-formation-and-inhibits-fibrinolysis-in-the-presence-of-tissue-plasminogen-activator-similar-to-pooled-liquid-plasma
#19
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Angela Sauaia, Gregory Stettler, Monika Dzieciatkowska, Kirk Hansen, Anirban Banerjee, Christopher C Silliman
BACKGROUND: Systemic hyperfibrinolysis is an integral part of trauma-induced coagulopathy associated with uncontrolled bleeding. Recent data suggest that plasma-first resuscitation attenuates hyperfibrinolysis; however, the availability, transport, storage, and administration of plasma in austere environments remain challenging and have limited its use. Freeze-dried plasma (FDP) is a potential alternative due to ease of storage, longer shelf life, and efficient reconstitution. FDP potentially enhances clot formation and resists breakdown better than normal saline (NS) and albumin and similar to liquid plasma...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28499437/the-effect-of-hemostatic-dressing-prototypes-for-the-uniformed-services-on-selected-blood-coagulation-parameters-in-pigs
#20
Zbigniew Adamiak, Wioletta Krystkiewicz, Andrzej Pomianowski, Danuta Bukowiecka, Waldemar Zubrzycki, Marek Jałyński, Piotr Holak, Joanna Głodek, Paweł Jastrzębski
BACKGROUND: Serious injuries accompanied by severe bleeding are life-threatening. Post-traumatic hemorrhage involves the risk of developing coagulopathy. Hemostatic dressings are widely used to minimize bleeding. The application of procoagulants in control of hemorrhage may lead to thrombosis or disseminated intravascular coagulation. The aim of this study was to evaluate the effect of hemostatic dressing prototypes on the porcine coagulation system. RESULTS: Fibrinogen and D-dimer concentrations were significantly higher in the experimental groups where hemostatic dressings were used in comparison with the control group...
May 12, 2017: Acta Veterinaria Scandinavica
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