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Thrombin Hemostatic

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361. Investigating the Effect of Intravenous and Oral Tranexamic Acid on Blood Loss After Primary Hip and Knee Arthroplasty

months of surgery* Use of antiplatelet medication within 7 days of surgery* (Does not include aspirin if dose <300mg). Direct thrombin inhibitors within 2 days of surgery* Factor Xa inhibitors within 2 days of surgery* The International normalized ratio (INR) level is greater than or equal to 1.5 in a patient who has stopped warfarin in preparation for surgery Hepatic failure* Patients with epilepsy Patients requiring therapeutic anticoagulation post-operatively e.g. Metallic heart valves. Pregnant (...) MeSH terms: Layout table for MeSH terms Tranexamic Acid Antifibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Hemostatics Coagulants

2017 Clinical Trials

362. Use of Prothrombin Complex Concentrate in Patients Admitted in Emergency Care Units for Severe Bleeding While Receiving Oral Anticoagulants

First Posted: October 25, 2017 Last Update Posted: February 5, 2019 Last Verified: February 2019 Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Emergencies Hemorrhage Disease Attributes Pathologic Processes Anticoagulants Thrombin Hemostatics Coagulants (...) patients (≥ 18 years old) Receiving oral anticoagulants (VKA or DOAC) With a severe bleeding episode meeting at least one of the following criteria External hemorrhage which cannot be controlled by usual means or Hemodynamic instability: SBP < 90 mmHg or SBP decrease 40 mmHg from usual SBP or mean BP < 65 mmHg or any sign of shock or Patient requiring a hemostatic procedure in emergency: surgery, interventional radiology, endoscopy or Need for transfusion of packed red blood cells or Hemorrhage

2017 Clinical Trials

363. Combined Topical Tranexamic Acid With Floseal® in Total Knee Arthroplasty

that intraoperative infusion of TXA reduced 45% of postoperative blood loss and needs for transfusion from 20% to 4%. There were some reports demonstrating the cost-effectiveness of topical application of TXA in TKA patients. Besides, thrombin-based hemostatic agents, Floseal®(Baxter, Deerfield, Illinois), have been widely used in surgical procedure. Some recent studies demonstrated that topical use of Floseal® in primary TKA can reduce hemoglobin decline and calculated total blood loss after TKA. But other (...) Diseases Tranexamic Acid Thrombin Rivaroxaban Antifibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Hemostatics Coagulants Factor Xa Inhibitors Antithrombins Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Anticoagulants

2017 Clinical Trials

364. Reducing Blood Loss Using Tisseel in TKA

(arterial thrombosis, myocardial infarction and pulmonary embolism). On the other hand, thrombin-based hemostatic agents, Tisseel®, have been widely used in surgical procedure including gynecology, general surgery, and orthopedics which were still attracting the attention and interest of multitudinous surgeons. Some recent studies demonstrated that topic use of Tisseel® in primary TKA can reduce hemoglobin decline and calculated total blood loss after TKA and is not related to adverse reactions (...) Memorial Hospital Study Details Study Description Go to Brief Summary: The purpose of this study is to conduct a prospective randomized controlled trial to investigate the blood-conservation effect of the topical hemostatic agents in patients receiving primary TKA procedures. The investigators will also observe if there is increased risk of blood transfusion rate by using topical hemostatic agents or not. Condition or disease Intervention/treatment Phase Total Blood Loss Drug: Tisseel Drug: Tranexamic

2017 Clinical Trials

365. Administration of Prothrombin Complex Concentrate vs. Standard Transfusion During/After Heart Transplantation

to Share IPD: No Layout table for additional information Studies a U.S. FDA-regulated Drug Product: Yes Studies a U.S. FDA-regulated Device Product: No Product Manufactured in and Exported from the U.S.: Yes Keywords provided by Kathirvel Subramaniam, University of Pittsburgh: Heart transplantation Additional relevant MeSH terms: Layout table for MeSH terms Heart Failure Heart Diseases Cardiovascular Diseases Thrombin Hemostatics Coagulants (...) will receive Kcentra, while the other half will receive fresh frozen plasma. Condition or disease Intervention/treatment Phase Heart Disease End Stage Heart Failure,Congestive Drug: Kcentra Drug: Frozen Plasma Product, Human Phase 3 Detailed Description: This study will be a randomized (1:1; PCC vs. plasma), open-label trial of hemostatic therapies during heart transplantation. The goal is to enroll 60 patients. Informed consent will be obtained from patients meeting the inclusion and exclusion criteria

2017 Clinical Trials

366. Influence of ABO Blood Group on the Risk of Complications in Alcoholic or Viral C Cirrhosis?

information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Fibrosis Liver Cirrhosis Pathologic Processes Liver Diseases Digestive System Diseases Thrombin Hemostatics Coagulants

2017 Clinical Trials

367. Removal of the C-Terminal Domains of ADAMTS13 by Activated Coagulation Factor XI induces Platelet Adhesion on Endothelial Cells under Flow Conditions Full Text available with Trip Pro

(ADAMTS13) regulates this process by cleaving VWF to prevent aberrant platelet adhesion; it is unclear whether the activity of ADAMTS13 itself is regulated. The serine proteases α-thrombin and plasmin have been shown to cleave ADAMTS13. Based on sequence homology, we hypothesized that activated coagulation factor XI (FXIa) would likewise cleave ADAMTS13. Our results show that FXIa cleaves ADAMTS13 at the C-terminal domains, generating a truncated ADAMTS13 with a deletion of part of the thrombospondin (...) type-1 domain and the CUB1-2 domains, while α-thrombin cleaves ADAMTS13 near the CUB1-2 domains and plasmin cleaves ADAMTS13 at the metalloprotease domain and at the C-terminal domain. Using a cell surface immunoassay, we observed that FXIa induced the deletion of the CUB1-2 domains from ADAMTS13 on the surface of endothelial cells. Removal of the C-terminal domain of ADAMTS13 by FXIa or α-thrombin caused an increase in ADAMTS13 activity as measured by a fluorogenic substrate (FRETS) and blocked

2017 Frontiers in medicine

368. Cryopreserved platelets demonstrate reduced activation responses and impaired signaling after agonist stimulation. (Abstract)

, their ability to undergo agonist-induced activation is yet to be fully explored.Buffy coat PLTs were cryopreserved at -80°C with 5% to 6% DMSO and sampled before freezing and after thawing. PLTs were analyzed under resting conditions and after agonist stimulation with adenosine diphosphate, collagen, or thrombin receptor-activating peptide-6. The expression of activation markers, microparticle formation, and calcium mobilization were analyzed by flow cytometry. Soluble PLT proteins present in the PLT (...) in the abundance and phosphorylation of key signaling proteins (Akt, Src, Lyn, ERK, and p38) was seen in cryopreserved PLTs.Cryopreservation of PLTs induces dramatic changes to the basal PLT phenotype and renders them largely nonresponsive to agonist stimulation, likely due to the alterations in signal transduction. Therefore, further efforts are required to understand how cryopreserved PLTs achieve their hemostatic effect once transfused.© 2017 AABB.

2017 Transfusion

369. Platelet populations and priming in hematological diseases. (Abstract)

, platelet ageing, and positive or negative priming of platelets during their time in circulation. Within a hemostatic plug or thrombus, platelet heterogeneity is enhanced by unequal exposure to agonists, with populations of contracted platelets in the thrombus core, discoid platelets at the thrombus surface, patches of ballooned and procoagulant platelets forming thrombin, and coated platelets binding fibrin. Several pathophysiological hematological conditions can positively or negatively prime (...) Platelet populations and priming in hematological diseases. In healthy subjects and patients with hematological diseases, platelet populations can be distinguished with different response spectra in hemostatic and vascular processes. These populations partly overlap, and are less distinct than those of leukocytes. The platelet heterogeneity is linked to structural properties, and is enforced by inequalities in the environment. Contributing factors are variability between megakaryocytes

2017 Blood reviews

370. First Selective 12-LOX Inhibitor, ML355, Impairs Thrombus Formation and Vessel Occlusion In Vivo With Minimal Effects on Hemostasis. Full Text available with Trip Pro

in the regulation of in vivo thrombosis. However, the ability to pharmacologically target 12-LOX in vivo has not been established to date. Here, we studied the effect of the first highly selective 12-LOX inhibitor, ML355, on in vivo thrombosis and hemostasis.ML355 dose-dependently inhibited human platelet aggregation and 12-LOX oxylipin production, as confirmed by mass spectrometry. Interestingly, the antiplatelet effects of ML355 were reversed after exposure to high concentrations of thrombin in vitro. Ex vivo (...) flow chamber assays confirmed that human platelet adhesion and thrombus formation at arterial shear over collagen were attenuated in whole blood treated with ML355 comparable to aspirin. Oral administration of ML355 in mice showed reasonable plasma drug levels by pharmacokinetic assessment. ML355 treatment impaired thrombus growth and vessel occlusion in FeCl3-induced mesenteric and laser-induced cremaster arteriole thrombosis models in mice. Importantly, hemostatic plug formation and bleeding

2017 Thrombosis and Vascular Biology

371. Novel targets for anticoagulants lacking bleeding risk. (Abstract)

Novel targets for anticoagulants lacking bleeding risk. Arterial and venous thromboembolic diseases are associated with significant morbidity and mortality and present a major medical burden. Currently used anticoagulants for the prevention or treatment of thromboembolic events including heparins, vitamin K-antagonists and inhibitors of thrombin or factor Xa target enzymes of the coagulation cascade that are critical for fibrin formation. However, fibrin is also necessary for hemostatic

2017 Current Opinion in Hematology

372. Selective factor VIII activation by the tissue factor-factor VIIa-factor Xa complex. Full Text available with Trip Pro

Selective factor VIII activation by the tissue factor-factor VIIa-factor Xa complex. Safe and effective antithrombotic therapy requires understanding of mechanisms that contribute to pathological thrombosis but have a lesser impact on hemostasis. We found that the extrinsic tissue factor (TF) coagulation initiation complex can selectively activate the antihemophilic cofactor, FVIII, triggering the hemostatic intrinsic coagulation pathway independently of thrombin feedback loops. In a mouse (...) model with a relatively mild thrombogenic lesion, TF-dependent FVIII activation sets the threshold for thrombus formation through contact phase-generated FIXa. In vitro, FXa stably associated with TF-FVIIa activates FVIII, but not FV. Moreover, nascent FXa product of TF-FVIIa can transiently escape the slow kinetics of Kunitz-type inhibition by TF pathway inhibitor and preferentially activates FVIII over FV. Thus, TF synergistically primes FIXa-dependent thrombin generation independently of cofactor

2017 Blood

373. Platelet Drop and Fibrinolytic Shutdown in Patients With Sepsis. Full Text available with Trip Pro

Platelet Drop and Fibrinolytic Shutdown in Patients With Sepsis. Thrombocytopenia is the most common hemostatic disorder during sepsis and is associated with high mortality. We examined whether fibrinolytic changes precede incident thrombocytopenia and predict outcome in patients with severe sepsis.Nested study from the multicenter, randomized, controlled trial on the efficacy of albumin replacement in severe sepsis or septic shock (the Albumin Italian Outcome Sepsis trial).Forty ICUs (...) thrombocytopenia (group 1) and those who developed it later (group 2) had similar illness severity and 90-day mortality, whereas patients without thrombocytopenia (group 3) had milder disease and lower mortality. Fibrinolysis was markedly (and similarly) depressed in groups 1 and 2 as compared with group 3. Major fibrinolytic changes included increased levels of plasminogen activator inhibitor 1 and extensive activation/consumption of thrombin activatable fibrinolysis inhibitor. Most fibrinolytic variables

2017 Critical Care Medicine Controlled trial quality: uncertain

374. Assessment of the procoagulant potential after laparoscopic sleeve gastrectomy: a potential role for extended thromboprophylaxis. (Abstract)

Assessment of the procoagulant potential after laparoscopic sleeve gastrectomy: a potential role for extended thromboprophylaxis. Bariatric surgery is associated with increased thromboembolic risk, which may extend well beyond hospital stay. The hemostatic mechanisms implicated in this risk are not well established.We aimed to determine the dynamics of hemostatic changes and procoagulant potential among patients undergoing laparoscopic sleeve gastrectomy, during both the early and late (...) postoperative periods.A university hospital.Patients who underwent laparoscopic sleeve gastrectomy were recruited consecutively to this study. Blood samples were taken preoperatively, before discharge (postoperative day [POD] 3), and at the first follow-up visit (POD10). All samples were tested for complete blood count, C-reactive protein, von Willebrand factor, factor VIII, fibrinogen, and thrombin generation.The median preoperative body mass index of the 26 participants was 41.3 (38.7-43.3) kg/m2

2017 Surgery for Obesity and Related Diseases

375. Vitamin K1 in the Treatment of Spontaneous Intracerebral Hemorrhage

onset [ Time Frame: Day0 ] Fibrinogen (g/L) The Fibrinogen (g/L)at certain time post onset [ Time Frame: Day3 ] Fibrinogen (g/L) The Fibrinogen (g/L)at certain time post onset [ Time Frame: Day7 ] Fibrinogen (g/L) The Thrombin Time(s) at certain time post onset [ Time Frame: Day0 ] Thrombin Time(s) The Thrombin Time(s) at certain time post onset [ Time Frame: Day3 ] Thrombin Time(s) The Thrombin Time(s) at certain time post onset [ Time Frame: Day7 ] Thrombin Time(s) Other Outcome Measures: length (...) (4 to12); during the hospitalization, no urokinase and other hemostatic drugs were used except for etamsylate and vitamin K1; informed consent signed by the patient's family Exclusion Criteria: irregular lobulated hematoma (volume of hematoma can not be calculated accurately), such as intraventricular hemorrhage; severe liver disease or impaired liver function; pregnant or lactating women; history of using anticoagulation or antiplatelet aggregation drug (including Cilostazol, aspirin

2017 Clinical Trials

376. Changes in Coagulation and Platelet Activation Markers Following Transcatheter Left Atrial Appendage Closure. (Abstract)

of platelet activation. Measurements of all hemostatic markers were performed at baseline just before the procedure, followed by days 7, 30, and 180 after LAAC. Prothrombin fragment 1+2 and thrombin-antithrombin levels increased from 0.27 nmol/L and 4.68 ng/ml, respectively, at baseline to peak values of 0.43 nmol/L and 9.76 ng/ml, respectively, at 7 days, partially returning to baseline levels at days 30 and 180 after LAAC (p <0.001 for both markers). No clinical or procedural factors were associated (...) Changes in Coagulation and Platelet Activation Markers Following Transcatheter Left Atrial Appendage Closure. The recommendations for antithrombotic treatment after left atrial appendage closure (LAAC) remain empirical, and no data exist on the changes in hemostatic markers associated with LACC. The objective of the present study is to determine the presence, degree, and timing of changes in the markers of platelet and coagulation activation after LAAC. Forty-three patients (mean age 76 ± 9

2017 American Journal of Cardiology

377. Myeloid but not epithelial tissue factor exerts protective anti-inflammatory properties in acid aspiration-induced acute lung injury. Full Text available with Trip Pro

Myeloid but not epithelial tissue factor exerts protective anti-inflammatory properties in acid aspiration-induced acute lung injury. Essentials Tissue factor (TF) represents a central link between hemostasis and inflammation. We studied the roles of myeloid and airway epithelial TF in acid-caused acute lung injury (ALI). TF on myeloid cells displays a non-coagulatory role regulating the inflammatory response in ALI. Airway epithelial TF contributes to hemostatic functions, but is dispensable (...) in ALI pathogenesis.Introduction Acute lung injury (ALI) is a life-threatening condition characterized by damaged alveolar-capillary structures and activation of inflammatory and hemostatic processes. Tissue factor (TF) represents a crucial link between inflammation and coagulation, as inflammatory mediators induce myeloid TF expression, and TF initiates extrinsic coagulation. Objective As pulmonary inflammation stimulates TF expression and TF modulates immune responses, we aimed to elucidate its

2017 Journal of Thrombosis and Haemostasis

378. Hemostasis in Intracranial Hemorrhage Full Text available with Trip Pro

Hemostasis in Intracranial Hemorrhage Spontaneous non-traumatic intracerebral hemorrhage (ICH) is associated with high morbidity and mortality throughout the world with no proven effective treatment. Majority of hematoma expansion occur within 4 h after symptom onset and is associated with early deterioration and poor clinical outcome. There is a vital role of ultra-early hemostatic therapy in ICH to limit hematoma expansion. Patients at risk for hematoma expansion are with underlying (...) hemostatic abnormalities. Treatment strategy should include appropriate intervention based on the history of use of antithrombotic use or an underlying coagulopathy in patients with ICH. For antiplatelet-associated ICH, recommendation is to discontinue antiplatelet agent and transfuse platelets to those who will undergo neurosurgical procedure with moderate quality of evidence. For vitamin K antagonist-associated ICH, administration of 3-factor or 4-factor prothrombin complex concentrates (PCCs) rather

2017 Frontiers in neurology

379. Multiple uses of fibrin sealant for nervous system treatment following injury and disease Full Text available with Trip Pro

. The possibility of using hemostatic substances that also function as a scaffold, such as the fibrin sealant, reduces surgical time and improve postoperative recovery. To date, several studies have demonstrated that human blood derived fibrin sealant produces positive effects in different interventions, becoming an efficient alternative to suturing. To provide an alternative to homologous fibrin sealants, the Center for the Study of Venoms and Venomous Animals (CEVAP, Brazil) has proposed a new bioproduct (...) composed of certified animal components, including a thrombin-like enzyme obtained from snake venom and bubaline fibrinogen. Thus, the present review brings up to date literature assessment on the use of fibrin sealant for nervous system repair and positions the new heterologous bioproduct from CEVAP as an alternative to the commercial counterparts. In this way, clinical and pre-clinical data are discussed in different topics, ranging from central nervous system to peripheral nervous system

2017 The journal of venomous animals and toxins including tropical diseases

380. Leptospira Infection Interferes with the Prothrombinase Complex Assembly during Experimental Leptospirosis Full Text available with Trip Pro

Leptospira Infection Interferes with the Prothrombinase Complex Assembly during Experimental Leptospirosis Leptospirosis is a worldwide zoonotic and neglected infectious disease of human and veterinary concern, caused by pathogenic Leptospira species. Although bleeding is a common symptom of severe leptospirosis, the cause of hemorrhage is not completely understood. In severe infections, modulation of hemostasis by pathogens is an important virulence mechanism, and hemostatic impairments (...) the presence of a thrombin-like factor or FX activator, which is able to activate FII in the leptospirosis organ extracts. The activity of those factors is accelerated in the prothrombinase complex. Additionally, we show for the first time that live leptospires act as a surface for the prothrombinase complex assembly. Our results contribute to the understanding of leptospirosis pathophysiological mechanisms and may open new routes for the discovery of novel treatments in the severe manifestations

2017 Frontiers in microbiology

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