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Thrombin Hemostatic

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341. The expression and localization of RNase and RNase inhibitor in blood cells and vascular endothelial cells in homeostasis of the vascular system. Full Text available with Trip Pro

in the human umbilical vein endothelial cell line, EAhy926. Additionally, we further investigated the effect of thrombin on the expression of RNase 1 and RI in platelets. We used an RNase activity assay, reverse transcription-polymerase chain reaction, western blot, immunocytochemistry, transmission electron microscopy, and immunoelectron microscopy (pre- and post-embedding methods). RNase activity in the supernatant from EAhy926 cells was 50 times than in blood cells (after 60 min). RNase 1 mRNA (...) injury show very low RNase activity, which may support hemostatic thrombus formation. However, activated platelets and leukocytes may accelerate pathologic thrombus formation.

2017 PLoS ONE

342. Thrombin generation testing for monitoring hemophilia treatment: a clinical perspective. (Abstract)

Thrombin generation testing for monitoring hemophilia treatment: a clinical perspective. Thrombin generation is a key process that determines the extent of a hemostatic plug or a thrombotic process. The ensuing thrombin burst is crucial for the formation of a stable fibrin clot. During its active life, thrombin exerts a multitude of highly regulated actions on the blood and the vessel wall, among which is the clotting of fibrinogen. The inappropriate generation of thrombin may lead (...) to pathological processes, foremost of which are hemorrhagic or thrombotic diseases. The coagulation system is usually investigated by means of two in vitro classical clotting tests, the activated partial thromboplastin time and prothrombin time. These assays assess only the time taken to form a clot and do not entirely reflect global hemostatic balance. They permit identification of connectivity between the component activities identified as required for plasma coagulation and define the concept of intrinsic

2010 Seminars In Thrombosis And Hemostasis

343. von Willebrand factor and thrombin activation in children with newly diagnosed acute lymphoblastic leukemia: an impact of peripheral blasts. (Abstract)

von Willebrand factor and thrombin activation in children with newly diagnosed acute lymphoblastic leukemia: an impact of peripheral blasts. The pathogenesis and the impact of therapy on thrombin activation in children with acute lymphoblastic leukemia (ALL) are unknown. Steroids may contribute to ALL-associated thrombosis. We explored the hemostatic effects of methylprednisolone monotherapy (MpMT) (32 mg/m2/day IV x 3 days) in children with newly diagnosed ALL.Children (>1 to < or = 18 years (...) of age) enrolled on DFCI ALL05-01 protocol (n = 30; mean age 6.3 years), without prior steroid therapy, were eligible for study. Overnight fasting pre- and post-MpMT samples were analyzed for coagulation factors [FVIII:C, von Willebrand factor antigen (vWF:Ag) and fibrinogen] and parameters of thrombin generation [prothrombin fragments 1.2 (F1.2), thrombin-antithrombin complex (TAT), and D-dimer].At diagnosis F1.2 (1.5 nmol/L), TAT (10.9 microg/L), and D-dimers (2,766 ng/ml) levels were increased

2010 Pediatric blood & cancer Controlled trial quality: uncertain

344. Quality Improvement Guidelines for Vascular Access and Closure Device Use

advantage of this VCD design is the dual mode of action of promoting clot formation and providing a mechanical seal. However, a signi?cant drawback of collagen-based devices are the potential risks attendant to immediate repeat puncture, which include infection and dislodgment of the hemostatic plug resulting in distal embolization. Moreover, the in?ammatory response incited by the collagen plug has been implicated as a cause for scarred groin. Some data exist to suggest that these concerns may (...) . The Duett device (Vascular Solutions, Minneapolis, Min- nesota) is a mechanical plug-based VCD that employs an intravas- cular balloon catheter to occlude the arteriotomy intraluminally (1). A mixture of thrombin and collagen are then injected into the tissues overlying the arteriotomy to promote hemostasis. The balloon is then de?atedandretracted,leavingbehindnointravascularcomponent.The Duett device is not used in clinical practice today and is only included for historical completeness. Active

2014 Society of Interventional Radiology

349. Measurement of non-coumarin anticoagulants and their effects on tests of Haemostasis

anticoagulants licensed for use in the UK at the time of writing are listed in Table . Table 1. Anticoagulants (excluding vitamin K antagonists) currently licensed for use in the UK. Mode of administration Drug Major mode of action Potential laboratory tests Oral Dabigatran Inhibition of FIIa Anti‐IIa, Thrombin Clotting Time, ECT Rivaroxaban Inhibition of FXa Anti‐Xa, Apixaban Inhibition of FXa Anti‐Xa, Intravenous or subcutaneous Unfractionated heparin Inhibition of FIIa and FXa APTT Anti‐Xa, Anti‐IIa (...) , ; Schulman et al , ; EINSTEIN Investigators, ; Patel et al , ). Arguments for and against laboratory monitoring of the new anticoagulants have been published (Bounameux & Reber, ; Mismetti & Laporte, ). The lack of a need for monitoring is based on the assumed similarity in pharmacokinetic and pharmacodynamic responses between individuals within a relatively wide therapeutic window. It has been estimated that the same dose of direct inhibitors of thrombin and activated factor X (Xa) can have up to 30

2014 British Committee for Standards in Haematology

350. Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease Full Text available with Trip Pro

. 2013;128:2622–2703 You are viewing the most recent version of this article. Previous versions: Table of Contents 1.Introduction2624 2.Hemostasis in Children2625 2.1.Initiation of Coagulation2626 2.2.Amplification2627 2.3.Propagation2627 2.4.Regulation of Thrombin and Fibrin2627 2.5.Developmental Hemostasis2628 2.6.Laboratory Measures of Hemostasis2628 2.6.1.Common Measures of Hemostasis2628 2.6.2.Global Measures of Hemostasis2629 2.6.2.1.Activated Clotting Time2629 2.6.2.2.Thromboelastogram2629 2.6.3 (...) to Coagulopathy in Children With Heart Disease 2639 4.1.1.Abnormalities in Hemostatic Proteins in Children With CHD 2639 4.1.2.Abnormalities in Hemostatic Function in Children With CHD 2639 4.1.2.1.Risk of Thrombosis 2639 4.1.2.2.Abnormalities in Blood Flow 2639 4.1.2.3.Abnormalities in Blood Composition 2640 4.1.2.4.Abnormalities in Vessel Wall Integrity 2640 4.1.3.Risk of Hemorrhage 2640 4.1.3.1.Polycythemia and Hyperviscosity 2640 4.1.3.2.Platelet Abnormalities 2640 4.1.3.3.Increased Fibrinolysis 2641 4.2

2013 American Heart Association

352. Diagnosis and management of acquired coagulation factor inhibitor

with bleeding, it is important to exclude treatment with anticoagulant therapy. See Fig for further details. Figure 1 Investigation of acquired coagulation factor inhibitors. TT , thrombin time; PT , prothrombin time; aPTT , activated partial thromboplastin time; FBC , full blood count; LA , lupus anticoagulant; DIC , disseminated intravascular coagulation; VWF : RCo , ristocetin cofactor activity. 1Correction tests/mixing studies – these can be difficult to interpret. For markedly prolonged PT or aPTT (...) reduced factors whilst the specifically reduced factor will remain low. Thus it is important that factor assay design includes multiple dilutions of test plasma, and an evaluation of linearity against the calibration curve. In some cases, for example for defects of fibrin polymerization, thromboelastometry may be useful. Some highly specialized laboratories may extend investigation to global assays, such as thrombin generation, but this is not recommended outside research studies. Inhibitors to FVIII

2013 British Committee for Standards in Haematology

353. Management of Patients with Ulcer Bleeding

ulcers. “Overt” indicates that patients present with symptoms of he- matemesis, melena, and/or hematochezia. We fi rst discuss the initial management of UGIB in patients without known portal hypertension, including initial assessment and risk stratifi cation, pre-endoscopic use of medications and gastric lavage, and tim- ing of endoscopy. We then focus on the endoscopic and medical management of ulcer disease, including endoscopic fi ndings and their prognostic implications, endoscopic hemostatic (...) visible vessels . Gut 1994 ; 35 : 1389 – 93 . 44 . E l m unzer BJ , Y o un g S D , I n ado mi JM et al. S yst ema t ic r e vie w o f t h e p r edic- tors of recurrent hemorrhage aft er endoscopic hemostatic therapy for b leedin g p ep t ic ulcer s . Am J Gas t r o en t er o l 2008 ; 103 : 2625 – 32 . 45 . L a ine L , P e t er s o n WL . B l eedin g p ep t ic ulcer . N En g l J M e d 1994 ; 331 : 717 – 27 . 46 . Sa vides T S , J e n s en D M . GI b leedin g . I n : F e ldma n M, F r iedma n LS, B ra n

2012 American College of Gastroenterology

354. Adverse events of upper GI endoscopy

, 210,216,224,225 but a few cases have been reported. 227 Aspiration pneumonia and bacte- rial peritonitis after EBL have been reported in approxi- mately 1% and 4% of patients, respectively. 210,216,224,225 Endoscopic nonvariceal hemostasis The overall incidence of major adverse events associ- ated with endoscopic nonvariceal hemostasis (ie, perfora- tion and exacerbation of bleeding) is less than 0.5%. 228-230 Injection hemostasis with cyanoacrylate, polidocanol, eth- anol, or thrombin has been rarely (...) www.giejournal.org Volume 76, No. 4 : 2012 GASTROINTESTINAL ENDOSCOPY 711ENDOSCOPIC MANAGEMENT OF ADVERSE EVENTS OF ENDOLUMINAL THERAPY Many of the adverse events associated with endoluminal therapy can be treated endoscopically. Bleeding can be con- trolled with injection hemostasis, APC, hemostatic graspers, or endoscopic clips. 147,148,241 The risk of delayed bleeding after EMR may be reduced by prophylactic closure of muco- sal defects with endoscopic clips. 142,242 High-dose proton pump inhibitor therapy

2012 American Society for Gastrointestinal Endoscopy

355. KDIGO Clinical Practice Guideline for Acute Kidney Injury

. Kidney International Supplements (2012) 2, 8–12 11 summary of recommendation statements5.3.4: In a patient with heparin-induced thrombocytopenia (HIT), all heparin must be stopped and we recommend using direct thrombin inhibitors (such as argatroban) or Factor Xa inhibitors (such as danaparoid or fondaparinux) rather than other or no anticoagulation during RRT. (1A) 5.3.4.1: In a patient with HITwho does not have severe liver failure, we suggest using argatroban rather than other thrombin or Factor

2012 National Kidney Foundation

356. 2012 Update to The Society of Thoracic Surgeons Guideline on Use of Antiplatelet Drugs in Patients Having Cardiac and Noncardiac Operations

on circulating platelets. Platelet transfusion can indirectly reverse the effects of aspirin by increasing the total circulating pool of platelets while agents like recombi- nant factor VIIa can overcome the aspirin effect by stimulating other platelet receptors (eg, thrombin recep- tors) that are more potent platelet-activating agents. There is strong clinical evidence to support the value of aspirin for reducing death, myocardial infarction, and stroke in patients at risk for thrombotic events; however (...) of bleeding [40]. Although the GP IIb/IIIa receptor antagonists share similar contraindications and precautions related to bleeding risk, the three medications vary in mechanism and duration of action. The long-acting abciximab is a monoclonal antibody that binds the 3 subunit of the GP IIb/IIIa platelet receptor. Unlike the other agents in the class, abciximab inhibits thrombin generation [41], blocks the vitronectin receptor V3 that shares a subunit with the intended target, and demonstrates cross

2012 Society of Thoracic Surgeons

357. Quality Improvement Guidelines for Endovascular Treatment of Traumatic Hemorrhage

indicate whether hemostatic control is best achieved by nonoperative management (NOM), IR, or damage control surgery (DCS). Resuscitation can and should continue in modern CT environments. The ongoing REACT II trial will, in the future, provide level 1 evidence on the effect of a CT-?rst protocol. If the CT scanner is not in the emergency department, then assessment should de?ne what is possible within existing architectural, staf?ng, and transport limitations. In every case, the optimal service should (...) interventional radiologists may need to stop hemorrhage and/or restore blood ?ow. Controlling Bleeding Percutaneous transcatheter embolization is the most fre- quent treatment. Permanent (coils, plugs, polyvinyl acetate, glue) or temporary (Gelfoam/Spongostan, thrombin) materials are appropriate in different situations. Covered stent grafts can also be used in major vessel injury and suitably sized vessels where preservation of ?ow is desir- able. Appropriate equipment should be readily available and stocked

2012 Cardiovascular and Interventional Radiological Society of Europe

358. Laboratory aspects of assays used in haemostasis and thrombosis

or thrombin generation will not be considered here. Pre‐Analytical Variables Blood sample collection and processing The requirements for blood collection, handling and storage have been discussed in detail elsewhere - , but key points are summarized as recommendations in Table . Particular attention is drawn to the correct filling of tubes containing the appropriate anticoagulant and the effects of high haematocrit. Table 1. Summary of recommendations for blood collection, handling and storage Blood (...) is constructed through the data points of the standard and then the best parallel straight line is constructed for the test sample (Figure b). In some cases, coagulation times may need to be log transformed to achieve linearity. This process allows not only quantification of relative potency, but also reveals any evidence of inhibition (e.g. because of the presence of antibodies to coagulation factors, LA, unfractionated heparin (UFH), direct factor Xa (FXa) or thrombin inhibitor), or test sample activation

2012 British Committee for Standards in Haematology

359. Management of bleeding in patients on antithrombotic agents

‐life and length of functional defect induced by the drug Assess the source of bleeding Request full blood count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen concentration, creatinine concentration If available, request a specific laboratory test to measure the antithrombotic effect of the drug Correct haemodynamic compromise with intravenous fluids and red cell transfusion Apply mechanical pressure, if possible Use endoscopic, radiological or surgical measures (...) ) (Magnani & Gallus, ). Continued bleeding after cardiopulmonary bypass surgery (CPB) on danaparoid has been reported despite intensive blood product replacement (Schmahl et al , ; Westphal et al , ; Gitlin et al , ; Fernandes et al , ; Pamboukian et al , ). There is no specific antidote for danaparoid. However, plasmapheresis removes danaparoid effectively from the circulation (Schmahl et al , ). An ex vivo study showed partial restoration of thrombin generation when rFVIIa was added at supra

2012 British Committee for Standards in Haematology

360. 2012 ACCF/SCAI Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

4- or 5-F sheaths and 2 to 4 hours after 6- to 8-F sheaths is suggested. The radial approach obviates prolonged bed rest. All patients should have the access site auscultated prior to discharge. Should a pseudoaneurysm occur, most can be closed with compression and percutane- ous thrombin. A bleeding risk score for PCI has been developed from the NCDR database. It provides an opportunity to identify those at highest risk for a vascular complication. The use of vascular occlusion devices has

2012 Society for Cardiovascular Angiography and Interventions

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