Journal of thrombosis and haemostasis : JTH
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J. Thromb. Haemost. · Oct 2007
Evaluation of aprotinin and tranexamic acid in different in vitro and in vivo models of fibrinolysis, coagulation and thrombus formation.
The serine protease inhibitor aprotinin and plasminogen inhibitor tranexamic acid are used in coronary artery bypass graft (CABG) surgery to reduce bleeding. Clinicians may consider these agents as readily substitutable regarding their pharmacological profiles. ⋯ These data show that aprotinin and tranexamic acid have differential effects on hemostasis and are not necessarily substitutable with respect to mechanism of action. Although both agents have been shown to reduce bleeding in patients undergoing CABG, their divergent effects on thrombus formation observed in vitro and in vivo should be critically evaluated clinically.
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J. Thromb. Haemost. · Sep 2007
Randomized Controlled TrialFondaparinux combined with intermittent pneumatic compression vs. intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison.
The benefit of combined mechanical and pharmacologic methods for venous thromboembolism prevention after abdominal surgery has not been clearly established. ⋯ In patients undergoing abdominal surgery and receiving intermittent pneumatic compression, fondaparinux 2.5 mg reduced the venous thromboembolism rate by 69.8% as compared to pneumatic compression alone, with a low bleeding risk as compared to placebo.
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J. Thromb. Haemost. · Aug 2007
Randomized Controlled TrialLong-term dalteparin in pregnancy not associated with a decrease in bone mineral density: substudy of a randomized controlled trial.
The risk of decreased bone mineral density (BMD) with prophylactic dose long-term low-molecular-weight heparin (LMWH) is unknown. ⋯ ISRCTN87441504 at http://www.controlled-trials.com.
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J. Thromb. Haemost. · Aug 2007
Clinical TrialPilot dose-finding and safety study of bivalirudin in infants <6 months of age with thrombosis.
Thrombosis is not uncommon in children with serious medical conditions. Unfractionated heparin, the most commonly used anticoagulant in the acute management of thrombosis, has significant pharmacologic limitations, especially in infants. Newer anticoagulants have improved properties relative to heparin, and this may enhance the outcome in children. ⋯ This study demonstrates the potential utility of bivalirudin in the pediatric population.
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J. Thromb. Haemost. · Aug 2007
Restoring hemostatic thrombin generation at the time of cutaneous wounding does not normalize healing in hemophilia B.
We recently reported that wound healing is abnormal in hemophilia B (HB) mice [1]. The wounds show abnormal histology: s.c. hematoma formation; delayed re-epithelialization; delayed macrophage influx; and an increase in wound site angiogenesis. ⋯ Restoring initial hemostasis can modulate some of the parameters of wound healing. However, an extended period of adequate hemostatic function is necessary to achieve normal healing, probably because the risk of hemorrhage is increased by vascular remodeling and angiogenesis during the healing process.