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At least 721 records · Page 40Linked to original sources
PubMed2006

New generation tissue sealants and hemostatic agents: innovative urologic applications.

Control of blood loss during urologic surgery is paramount to the success of patient recovery. Hemostatic agents and tissue sealants are used routinely to prevent excess blood loss and in reconstruction during surgical repair. Some of the available products include thrombin sealant, fibrin glue, bovine serum/albumin/glutaraldehyde, and gelatin matrix. Each of these agents differs in mechanism, cost, and application. Complications can include allergic reactions or thromboembolism and the risk of contracting bovine spongiform encephalitis or hepatitis. Many new hemostatic agents are being developed and approved. The benefits and risks of use of these agents versus conventional treatment need to be considered on a case-by-case basis by the surgeon.

Journal Article↗
PubMedDate not supplied

[Hemostatic problems in surgery].

In this study the authors analyse hemostatic problems in surgery, with particular reference to the perioperative management of the patient. They examine the numerous factors giving rise to hemorrhagic and thrombotic complications, namely, the hemostatic technique adopted, the use of drainages, patient risk factors, pharmacological prophylaxis, etc. Prevention of bleeding, however, depends essentially on adequate preparation of the patient at surgery and on the surgeon's skill and experience.

Blood Coagulation Disorders↗
PubMed1991

Effect of recombinant human erythropoietin (rHuEpo) on the hemostatic system in chronic hemodialysis patients.

Hemostatic measurements were undertaken in eight chronic hemodialysis uremic patients on recombinant human erythropoietin (rHuEpo). Same measurements were repeated in another seven patients in whom anemia was corrected by the transfusion of red blood cells. The correction of the anemia by rHuEpo therapy was accompanied by 1. correction of the prolonged Simplate Bleeding Time (BT) to normal less than 10.0, minutes after 16 weeks of rHuEpo treatment; 2. significant increases in the levels of fibrinogen, clotting FVIII:C, vWF:antigen, vWF:ristocetin cofactor and platelet count; 3. enhanced aggregation responses to ADP, adrenaline, arachidonic acid, collagen and ristocetin. There was no significant fluctuation in other coagulation parameters PT, APTT, TT, reptilase time and antithrombin III and plasma fibrinogen. In patients who were treated with RBC transfusion and despite the correction of the anemia, the bleeding time shortened significantly but not corrected, mean BT before and after RBC transfusion was 17.1 +/- 1.4 and 11.6 +/- 1.9 minutes respectively. Besides there was significant elevation of vWF:Ricofactor levels but not FVIII:C, vWF:Ag or platelet count. Platelet aggregation responses to ADP remained unchanged. It is concluded that significant elevations of FVIII:related activities, plasma fibrinogen, improved platelet aggregability and correction of the BT are salient hemostatic changes that follow rHuEpo therapy in uremic patients.

Adult↗
PubMed1991

Hemostatic responses to mental stress during the menstrual cycle.

To study the effect of sex hormones on the hemostatic responses to stress, blood samples were collected before, during, and after 20 min of mental stress from 9 healthy, non-smoking female volunteers, examined in the follicular and luteal phase. Mental stress caused significant increases in heart rate, blood pressure, and plasma catecholamines. In addition, analysis of variance indicated significant changes of leukocyte count, hematocrit, fibrinogen, von Willebrand factor antigen, t-PA activity and antigen in response to the stress test. However, in contrast to a male group previously investigated, there were no significant changes in factor VII coagulant activity in either menstrual phase. Overall the responses were more pronounced in the luteal as compared to the follicular phase. The findings support the concept that both gender and physiological variations in female sex hormones may modulate hemostatic responses to psychosocial stress.

Adult↗
PubMed1991

Hemostatic abnormalities in HIV disease.

Hemostatic abnormalities are prominent and enigmatic features of HIV infection. In the foregoing discussion, many questions have been raised about the pathogenesis and treatment of HIV-related ITP, TTP, and ACA. The mechanism of platelet destruction in HIV-infected patients remains poorly defined, and the way in which HIV triggers these hemostatic abnormalities is unknown. Treatment of patients in the shadow of AIDS also poses unique problems for the clinician. Nevertheless, HIV-related thrombocytopenia provides a model for other forms of immune cytopenias, and better understanding of this form of ITP will lead to improved treatment modalities for other autoimmune diseases. Conversely, HIV-related ITP, TTP, and ACA should be viewed as part of a spectrum of autoimmune processes triggered by HIV. By defining the significance of these autoimmune processes in AIDS, more effective approaches to the treatment of HIV disease can and will be developed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Factor XIII subunits in relation to some other hemostatic parameters in ulcerative colitis.

The hemostatic parameters, particularly with respect to F.XIII subunits, were examined in 48 untreated UC patients (22 at active and 26 at quiescent stage). UC active patients showed a significant decrease of F.XIII subunit "a," compared with healthy subjects, as well as in UC patients in remission. In contrast, the level of F.XIII subunit "b" in each group was similar. Compared with normal subjects, UC active patients revealed a significant decrease in AT III concentration, prolonged ELT, and elevated fibrinogen level. In addition, the elevated titer of SDPS test for SFMC appeared in approximately 40% of those patients. However, no strict relationship was found between the presence of positive SDPS and diminution of AT III, as well as of F.XIIII subunit "a" in active UC state. In patients in remission, AT III level and ELT were similar to those as in the control group, but fibrinogen concentration was elevated. Such constellation of hemostatic parameters may indicate a tendency to blood hypercoagulability in UC active patients, whereas, in general, these changes are not associated with the stage of remission. The present data may also suggest that F.XIII behavior pattern should be taken into account in the clinical management of UC.

Adolescent↗
PubMed1990

Blood cell production and hemostatic mechanism in Thai vegetarians.

The activity of hemostatic mechanism and blood cell production of 50 Thai vegetarians and 30 nonvegetarians were compared. The hemostatic mechanism of both vegetarians and nonvegetarians showed no significant difference, whereas, a significant decrease in hemoglobin, hematocrit and red blood cell count with significant increase in hypersegmented neutrophils were found in vegetarians who had taken vegetarian diets for over 4 years.

Adolescent↗
PubMed1990

[Diverse hemostatic abnormalities in a patient with biclonal multiple myeloma].

A 58-year-old female was referred to us because of M-proteinemia and anemia. Bone marrow showed normal cellularity with 14.8% of atypical plasma cells. Serum electrophoresis on cellulose acetate membrane revealed a single M-peak (56.9%). Immunoelectrophoresis showed large M-bows against anti-IgA and anti-lambda, together with small M-bows against anti-IgG and anti-kappa of the same electrophoretic mobility. In the urine, lambda type Bence Jones protein was found. The skull X-ray showed multiple punched out lesions. APTT was 61 seconds, fibrinogen 118 mg/dl, factor VIII clotting activity 25% with normal factor VIII related antigen, and factor IX clotting activity 38%. Circulating anticoagulants were not detected. These hemostatic abnormalities were thought ascribable to the interference of clotting activities by paraproteins. On the 33rd hospital day, she suffered from intracerebral hemorrhage, which was possibly due to these hemostatic abnormalities.

Blood Coagulation Disorders↗
PubMedDate not supplied

Variability in response to cryoprecipitate treatment for hemostatic defects in uremia.

Cryoprecipitate is frequently administered as treatment for hemostatic defects in patients with uremia. The only published data supporting this approach however, involves seven patients described by Janson and colleagues in whom bleeding times were shortened and bleeding complications reduced after cryoprecipitate infusion. We retrospectively reviewed our institution's experience with cryoprecipitate in this setting. Five patients had sufficiently complete data for evaluation of the efficacy of therapy with cryoprecipitate, including pretreatment bleeding time greater than 15 minutes, normal coagulation studies, and platelet count greater than 100,000/microliters. Two patients had normalization of their bleeding time and a favorable clinical outcome after cryoprecipitate infusion. Three patients failed to shorten their bleeding time after cryoprecipitate infusion or, in one case, multiple infusions. One of these latter patients had correction of his abnormal bleeding time after subsequent administration of deamino-8-D-arginine vasopressin (DDAVP). We conclude that the hemostatic response to cryoprecipitate therapy is variable, and that cryoprecipitate therapy does not achieve restoration of normal hemostasis in some patients with uremic bleeding.

Bleeding Time↗
PubMed1990

Improved prognosis of fulminant hepatic failure (FHF) after plasma derivative replacement therapy. Enhanced proteolysis of hemostatic proteins confirmed by proteinase-inhibitor complexes determination.

In fulminant hepatic failure disturbances of blood coagulation are caused by both delayed synthesis and increased consumption of hemostatic proteins. The enhanced turnover of clotting factors and inhibitors may be induced by thrombin and plasmin after activation of the coagulation system by thromboplastic material and activators of plasminogen released from necrotic liver cells. Additionally, proteases such as elastase released from granulocytes, may be involved when infectious complications occur. The immunologic determination of the specific proteinase-inhibitor complexes thrombin-antithrombin III, plasmin-alpha 2 antiplasmin, and elastase-alpha 1 antitrypsin is of great diagnostic value to verify and differentiate the proteolysis of hemostatic proteins. Five patients with FHF were treated with plasma derivatives (FFP and AT III concentrates) until the liver had recovered and resumed synthesis of clotting factors and their inhibitors. The coagulation parameters normalized, bleeding complications and microcirculatory failure could be prevented. The data suggest that a comprehensive substitution of plasma components improves considerably the prognosis of acute liver failure.

Adult↗
PubMed1990

[Endoscopic hemostatic injection treatment of bleeding gastroduodenal ulcer].

Out of 88 patients suffering from bleeding gastroduodenal ulcer 36 with active bleeding or stigmata of recent hemorrhage and shock underwent endoscopic hemostatic injection treatment. There were three rebleedings, two of them from the same bleeding source (chronic duodenal ulcer). These two patients underwent emergency surgery without postoperative complications. A third patient had been operated for perforating gastric ulcer and died from pulmonary embolism. Injection treatment is considered the hemostatic technique of choice in patients with bleeding peptic ulcer.

Aged↗
PubMed1989

[Dynamic changes in the hemostatic indices of diabetics during biostator control].

In 25 patients with insulin-dependent diabetes and without microangiopathic complications the main hemostatic inhibitors antithrombin III, alpha-2-macroglobulin, and alpha-2-antiplasmin were examined before and after an optimal compensation of the carbohydrate metabolism was achieved. The patients were treated for 24 hours with the help of an artificial endocrine pancreas--biostator. The initial mean value of hyperglycemia of 15.61 mmol/l fell significantly to a mean value of 5.67 mmol/l at the end of the 24 hour treatment. During this 24 hour period the levels of the indices followed up did not change significantly. They were as follows: antithrombin III--98.48%, alpha-2-macroglobulin--112.25%, alpha-2-antiplasmin--110.68%. The lack of changes in the hemostatic inhibitors is explained by the short term biostator treatment.

Adolescent↗
PubMed1989

[Prevention and treatment of hemostatic disorders in patients with liver cirrhosis].

Disorders of the different links of the hemostatic system in patients with liver cirrhosis can be corrected by simultaneous prescription of minimal doses of heparin, vicasol and curantyl. As a result, treatment of liver cirrhosis, including cases with initial manifestations of the hemorrhagic syndrome, produced significant improvement of the hemostatic parameters and abatement of this syndrome. It is expedient to include this method in the combined treatment of this category of patients.

Blood Coagulation Disorders↗
PubMed1987

Hemostatic derangement in dengue haemorrhagic fever.

Forty children, aged 1/2-14 years, with serologically proven dengue haemorrhagic fever were daily studied for hemostatic tests. There were 4, 20 and 16 cases of grade I, II III respectively. Hemostatic derangements in DHF is a multifactorial mechanism. Vasculopathy, thrombocytopenia, platelet dysfunction were found in most cases. Mild to moderate degree of prothrombin complex deficiency was observed in 15% and 50% of grade II and grade III respectively while laboratory evidence of consumptive coagulopathy was noted in 30% of shock cases and 10% of non-shock cases. Hypofibrinogenemia and increased PTT are commonly seen in grade III reflect the presence of stimulation of intrinsic coagulation pathway probably from immunologic reaction. Frank DIC is very rarely observed. FDP is slightly increased but not as high as in classical DIC. Further study on the role of platelet-endothelial interaction should be elucidated including the efficient management to stop bleeding in severe shock cases.

Adolescent↗
PubMed1986

Endotoxin-induced changes in the hemostatic system in neonatal calves: the effect of antiserum to a mutant Escherichia coli (J-5).

Changes in the hemostatic system were studied in 22 neonatal calves given a small dosage of Escherichia coli endotoxin (0.5 microgram/kg) by slow (5-hour) IV infusion. The effect of pretreatment with an antiserum to mutant of E coli O111:B4 (J-5) was evaluated. The platelet count, plasma fibrinogen concentration, prothrombin time, and activated partial thromboplastin time changed significantly from base line during and after endotoxin infusions in all calves. The mean platelet count was significantly decreased from 1 through 24 hours after endotoxin infusion was started. Mean plasma fibrinogen was decreased 2 through 12 hours after endotoxin infusion was started. The mean prothrombin time and activated partial thromboplastin time were significantly greater than base line at 3 to 6 hours and 3 to 12 hours, respectively, after endotoxin infusion was started. Serum concentration of fibrinolytic degradation products remained less than 10 micrograms/ml. Bovine J-5 antiserum did not prevent the endotoxin-induced changes in the hemostatic system of these neonatal calves.

Animals↗
PubMed1986

Increased risk of thrombosis due to abnormalities of the hemostatic system.

In recent years a number or hereditary or acquired abnormalities of the hemostatic system have been discovered which predispose to thrombosis. The type of this abnormality determines not only whether there is a tendency to venous or arterial thrombosis but also predisposes in some instances to thrombosis at a specific site. Such hemostatic abnormalities may be present in 10-30% of patients with a history of venous thrombosis. The detection of a thrombophilic state has important implications as regards the choice and the duration of antithrombotic treatment.

Blood Coagulation Disorders↗
PubMed1984

The effect of prostacyclin infusion on platelet hemostatic function in patients undergoing cardiopulmonary bypass.

Prostacyclin (PGI2) infusion was studied in patients during cardiopulmonary bypass for coronary artery bypass grafting to assess its capacity to protect platelet hemostatic function. Twelve patients received PGI2 at doses ranging from 20 to 70 ng/kg/min by continuous infusion directly into the bubble oxygenator. Nine control patients were also studied. Platelet counts were not different in the two groups; the platelet count at the completion of the operation was decreased by a mean of 29% in treated patients and 40% in control patients (p greater than 0.15). Bleeding times were uniformly greater than 30 minutes following 30 minutes on bypass in both groups (p greater than 0.5). Also there was no difference in the bleeding times between the treated and untreated groups in the immediate postbypass period (p greater than 0.05). In addition, no difference in transfusion requirements was observed between the treated and control groups. However, plasma levels of platelet factor 4 were lower in the treated patients (p less than 0.05), and, more significantly, blood pressure was lower at all time points in the treated patients (p less than 0.001) despite the greater use of vasopressors. We conclude that PGI2 infusion in this study was of no hemostatic benefit but produced significant hypotension, a potential source of morbidity.

Adult↗