Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
-
Blood Coagul. Fibrinolysis · Jul 2013
ReviewMay-Hegglin anomaly and pregnancy: a systematic review.
May-Hegglin anomaly (MHA) is an autosomal dominant disorder, characterized by a variable degree of thrombocytopaenia, large platelets and inclusion bodies in white blood cells. Bleeding manifestations are generally mild, but severe bleeding episodes have been reported. This is a systematic review of literature for MHA during pregnancy. ⋯ No obvious bleeding complications were reported among the neonates. MHA can present challenges during pregnancy and be associated with adverse maternal and neonatal outcome because of bleeding complications. Joint management by obstetrician and haematologists is required to minimize these risks.
-
Blood Coagul. Fibrinolysis · Jul 2013
Influence of resuscitation fluids, fresh frozen plasma and antifibrinolytics on fibrinolysis in a thrombelastography-based, in-vitro, whole-blood model.
Hyperfibrinolysis has been identified as a mechanism of trauma coagulopathy associated with poor outcome. The aim of the study was to create a trauma coagulopathy model (TCM) with a hyperfibrinolysis thrombelastography (TEG) pattern similar to injured patients and test the effects of different resuscitation fluids and antifibrinolytics on fibrinolysis. TCM was established from whole blood by either 15% dilution with isotonic saline, lactated Ringer's, Plasma-Lyte, 5% albumin, Voluven, Hextend, 6% dextran in isotonic saline or 30% dilution with lactated Ringer's plus Voluven and supplementation with tissue factor and tissue plasminogen activator (tPA). ⋯ A total of 15% dilution of whole blood in the presence of tissue factor plus tPA results in a hyperfibrinolysis TEG pattern similar to that observed in severely injured patients. Synthetic colloids worsen TEG variables with a further increase of fibrinolysis. Low concentrations of TXA or ACA reversed hyperfibrinolysis, but the efficient concentrations were dependent on the degree of fibrinolysis and whole-blood dilution.
-
Blood Coagul. Fibrinolysis · Jul 2013
Inhibition of tissue factor pathway inhibitor increases the sensitivity of thrombin generation assay to procoagulant microvesicles.
Patients with cancer have a seven-fold to 10-fold increased risk of developing venous thromboembolism (VTE). Circulating microvesicles could be a predictive biomarker for VTE in cancer. Thrombin generation assay (TGA) is a useful technique to detect procoagulant activity of microvesicles. ⋯ Thrombin generation is a very sensitive method to study the procoagulant activity of tissue factor bearing microvesicles. The sensitivity can be increased by inhibition of TFPI with specific monoclonal antibody against its Kunitz domain I. A two times plasma dilution is an interesting cheaper alternative to study the procoagulant activity of microvesicles by TGA with a good sensitivity, especially when low plasma quantities are available.
-
Blood Coagul. Fibrinolysis · Jul 2013
Comparative StudyEvaluation of the hemostatic and histopathological effects of Ankaferd Blood Stopper in experimental liver injury in rats.
We studied the hemostatic and histopathological effects, and intra-abdominal adhesion scores of a new hemostatic agent, Ankaferd Blood Stopper (ABS), in an experimental liver injury model and compared it with regenerated oxidized cellulose. Thirty-six rats were randomly assigned to ABS, oxidized cellulose (Surgicel), and control groups (n=12, each). A wedge resection was performed on the left medial lobe of the liver. ⋯ All livers in the ABS group completed their regeneration process with minimal signs of inflammation. Our findings suggest that ABS is more effective than Surgicel and control groups in achieving hemostasis and in reducing blood loss. Apart from this, ABS causes more encouraging histopathological changes and better intra-abdominal adhesion scores in rat experimental liver trauma model.
-
Blood Coagul. Fibrinolysis · Jun 2013
Tobacco smoke-induced hypercoagulation in human plasma: role of carbon monoxide.
Virtually every disease state associated with chronic or acute thrombosis has had smoking identified as a risk factor. Further, smoking enhances clot strength as assessed by thrombelastography. Critically, carbon monoxide, a product of cigarette smoking, has been demonstrated to enhance plasmatic coagulation in vitro via modulation of a heme associated with fibrinogen. ⋯ Forty-five percent of smokers had plasma clot strength that exceeded the 95th percentile of normal participant plasma values; 45% of smoking participants had detectable COHF; and 20% of smoking participants were both hypercoagulable with COHF present. We conclude that smoking induced a hypercoagulable state and COHF formation in an important portion of participants tested. Future investigations of the effects of smoking, plasmatic hypercoagulation and COHF formation are planned in populations with established atherosclerotic/thrombotic disease.