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Thrombosis Journal

Osamah Al-Asadi, Manar Almusarhed, Hany Eldeeb
Aims: Peripherally inserted central catheters(PICC) lines are becoming increasingly popular in solid cancer patients for the administration of chemotherapy. This study aims looking at the incidence of PICC line related and distant thromboembolism associated with these catheters and exploring risk factors. Methods: Records were reviewed for 158 patients who underwent PICC line insertion over the two years period in the medical oncology unit, Milton Keynes University Hospital...
2019: Thrombosis Journal
Yayoi Yokoyama, Takashi Ito, Tomotsugu Yasuda, Hiroaki Furubeppu, Chinatsu Kamikokuryo, Shingo Yamada, Ikuro Maruyama, Yasuyuki Kakihana
Background: Nuclear histone proteins are released into the extracellular space, and act as major mediators of coagulopathy and remote organ failure in septic animals. However, the circulating histone levels in septic patients have not been precisely quantified. Methods: Using a novel enzyme-linked immunosorbent assay for histone H3 detection, we measured the serum histone H3 levels in 85 patients admitted to the intensive care unit because of infectious diseases...
2019: Thrombosis Journal
Anthonie W A Lensing, Christoph Male, Guy Young, Dagmar Kubitza, Gili Kenet, M Patricia Massicotte, Anthony Chan, Angelo C Molinari, Ulrike Nowak-Goettl, Ákos F Pap, Ivet Adalbo, William T Smith, Amy Mason, Kirstin Thelen, Scott D Berkowitz, Mark Crowther, Stephan Schmidt, Victoria Price, Martin H Prins, Paul Monagle
Background: Venous thromboembolism (VTE) is a relatively rare condition in childhood with treatment mainly based on extrapolation from studies in adults. Therefore, clinical trials of anticoagulation in children require novel approaches to deal with numerous challenges. The EINSTEIN-Jr program identified pediatric rivaroxaban regimens commencing with in vitro dose finding studies followed by evaluation of children of different ages through phase I and II studies using extensive modeling to determine bodyweight-related doses...
2018: Thrombosis Journal
Graeme Greenfield, Mary Frances McMullin
Background: Splanchnic Vein Thrombosis (SVT) is strongly associated with underlying JAK2 V617F positive myeloproliferative neoplasms (MPN). Methods: Patients attending the tertiary haematology service in Northern Ireland with SVT and underlying JAK2 V617F MPN were identified by consultant staff. A retrospective audit was undertaken to examine therapeutic interventions and relevant outcomes. Descriptive statistics were used for qualitative data whilst students t-test allowed comparison of quantitative data...
2018: Thrombosis Journal
Susan Louw, Reenelle Gounden, Elizabeth Sarah Mayne
Background: The thrombotic microangiopathies (TMAs) is a heterogeneous group of relatively uncommon but serious disorders presenting with thrombocytopenia and microangiopathic haemolysis. Thrombotic thrombocytopenic purpura (TTP) is one of these microangiopathic processes. HIV infection is an acquired cause of TTP but the pathogenesis is poorly understood. HIV-associated TTP was previously described to be associated with advanced immunosuppression. The incidence of HIV-related TTP was expected to decline with access to anti-retroviral therapy (ART)...
2018: Thrombosis Journal
Stefan Willmann, Kirstin Thelen, Dagmar Kubitza, Anthonie W A Lensing, Matthias Frede, Katrin Coboeken, Jan Stampfuss, Rolf Burghaus, Wolfgang Mück, Jörg Lippert
Background: The EINSTEIN-Jr program will evaluate rivaroxaban for the treatment of venous thromboembolism (VTE) in children, targeting exposures similar to the 20 mg once-daily dose for adults. A physiologically based pharmacokinetic (PBPK) model for pediatric rivaroxaban dosing has been constructed. Methods: We quantitatively assessed the pharmacokinetics (PK) of a single rivaroxaban dose in children using population pharmacokinetic (PopPK) modelling and assessed the applicability of the PBPK model...
2018: Thrombosis Journal
Dagmar Kubitza, Stefan Willmann, Michael Becka, Kirstin Thelen, Guy Young, Leonardo R Brandão, Paul Monagle, Christoph Male, Anthony Chan, Gili Kennet, Ida Martinelli, Paola Saracco, Anthonie W A Lensing
Background: The EINSTEIN-Jr program will evaluate rivaroxaban for the treatment of venous thromboembolism (VTE) in children, targeting exposures similar to the 20 mg once-daily dose for adults. Methods: This was a multinational, single-dose, open-label, phase I study to describe the pharmacodynamics (PD), pharmacokinetics (PK) and safety of a single bodyweight-adjusted rivaroxaban dose in children aged 0.5-18 years. Children who had completed treatment for a venous thromboembolic event were enrolled into four age groups (0...
2018: Thrombosis Journal
Elizabeth Sarah Mayne, Malcolm Tait, Barry Frank Jacobson, Evashin Pillay, Susan J Louw
Background: Autoimmune paraphenomena, are associated with B-cell lymphoproliferative disorders, including monoclonal gammopathy of uncertain significance. These paraphenomena can rarely include acquired bleeding disorders. Case presentation: This case study reports an unusual clinical presentation of 2 acquired bleeding disorders, Acquired von Willebrand syndrome (disease) and Acquired Glanzmann's thrombasthenia, in an elderly patient with monoclonal gammopathy of uncertain significance...
2018: Thrombosis Journal
Anne-Laure Sennesael, Anne-Sophie Larock, Jonathan Douxfils, Laure Elens, Gabriel Stillemans, Martin Wiesen, Max Taubert, Jean-Michel Dogné, Anne Spinewine, François Mullier
Background: Serious bleeding events have been frequently described in patients taking direct oral anticoagulants (DOAC). In secondary analyses of phase 3 trials, DOAC plasma concentrations were shown to correlate with bleeding outcomes. This study aimed to describe rivaroxaban plasma levels in patients admitted to the emergency department (ED) for bleeding events. For each patient, risk factors for experiencing bleeding events were also investigated. Methods: This analysis was part of an observational study conducted in the ED of two teaching hospitals...
2018: Thrombosis Journal
Anthony Chan, Anthonie W A Lensing, Dagmar Kubitza, Grahaem Brown, Dolores Elorza, Marta Ybarra, Jacqueline Halton, Sebastian Grunt, Gili Kenet, Damien Bonnet, Amparo Santamaria, Paola Saracco, Tina Biss, Francesco Climent, Philip Connor, Joseph Palumbo, Kirstin Thelen, William T Smith, Amy Mason, Ivet Adalbo, Scott D Berkowitz, Eva Hurst, Jeroen van Kesteren, Guy Young, Paul Monagle
Background: Venous thromboembolism (VTE) in young children is not well documented. Methods: Clinicians from 12 institutions retrospectively evaluated the presentation, therapeutic management, and outcome of VTE in children younger than 2 years seen in 2011-2016. Feasibility of recruiting these children in EINSTEIN-Jr. phase III, a randomized trial evaluating rivaroxaban versus standard anticoagulation for VTE, was assessed. Results: We identified 346 children with VTE, of whom 227 (65...
2018: Thrombosis Journal
Francesco Dragoni, Flavia Chiarotti, Anna Paola Iori, Ursula La Rocca, Arturo Cafolla
Five patients with paroxysmal nocturnal haemoglobinuria and thrombotic complications under oral antithrombotic treatment with vitamin K antagonist were switched to receive the direct oral anticoagulant rivaroxaban an factor Xa inhibitor. In all five patients haematological and biochemical parameters and adverse events were evaluated for a period of twelve months. Therapy with rivaroxaban was well tolerated in all cases and one patient showed a significant reduction of bleeding and transfusion requirement. All patients obtained a significant reduction in days of hospitalization with a consequent improvement in their quality of life after rivaroxaban treatment...
2018: Thrombosis Journal
Andrew Kotaska
A majority of deep vein thromboses identified in screening studies of hospitalized patients remain clinically insignificant. Guidelines based on these studies markedly overestimate the risk of clinical venous thromboembolism (VTE) and the benefit of heparin prophylaxis. Accordingly, in 2012, the American College of Chest Physicians (ACCP) removed screening studies from the 9th edition of its Antithrombotic and Thrombolytic Therapy guideline (AT9), and downgraded recommendations. Involvement of authors of the 8th edition (AT8) was restricted due to financial and intellectual conflicts of interest...
2018: Thrombosis Journal
Jean Jacques Noubiap, Mazou N Temgoua, Ronni Tankeu, Joel Noutakdie Tochie, Ambroise Wonkam, Jean Joël Bigna
Background: Globally, sickle cell disease (SCD) is one of the most common haemoglobinopathy. Considered a public health problem, it leads to vessel occlusion, blood stasis and chronic activation of the coagulation system responsible for vaso-occlussive crises and venous thromboembolism (VTE) which may be fatal. Although contemporary observational studies suggest a relationship between SCD or sickle trait (SCT) and VTE, there is lack of a summary or meta-analysis data on this possible correlation...
2018: Thrombosis Journal
Takuro Arishima, Takashi Ito, Tomotsugu Yasuda, Nozomi Yashima, Hiroaki Furubeppu, Chinatsu Kamikokuryo, Takahiro Futatsuki, Yutaro Madokoro, Shotaro Miyamoto, Tomohiro Eguchi, Hiroyuki Haraura, Ikuro Maruyama, Yasuyuki Kakihana
Background: Recombinant human soluble thrombomodulin (rTM) has been used for the treatment of disseminated intravascular coagulation in Japan, and an international phase III clinical trial for rTM is currently in progress. rTM mainly exerts its anticoagulant effects through an activated protein C (APC)-dependent mechanism, but the circulating APC levels after rTM treatment have not been clarified. This prospective observational study investigated plasma APC levels after rTM treatment...
2018: Thrombosis Journal
Eyob Alemayehu Gebreyohannes, Akshaya Srikanth Bhagavathula, Henok Getachew Tegegn
Background: Atrial fibrillation (AF) is a major risk factor for stroke as it increases the incidence of stroke nearly fivefold. Antithrombotic treatment is recommended for the prevention of stroke in AF patients. However, majorly due to fear of risk of bleeding, adherence to recommendations is not observed. The aim of this study was to investigate the impact of antithrombotic undertreatment, on ischemic stroke and/or all-cause mortality in patients with AF. Methods: A retrospective cohort study was conducted from January 7, 2017 to April 30 2017 using medical records of patients with AF attending Gondar University Hospital (GUH) between November 2012 and September 2016...
2018: Thrombosis Journal
Alexander T Cohen, Anthony Maraveyas, Jan Beyer-Westendorf, Agnes Y Y Lee, Lorenzo G Mantovani, Miriam Bach
Background: Around 20% of venous thromboembolism (VTE) cases occur in patients with cancer. Current guidelines recommend low molecular weight heparin (LMWH) as the preferred anticoagulant for VTE treatment. However, some guidelines state that vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) are acceptable alternatives for long-term therapy in some patients if LMWHs are not available. LMWHs and VKAs have a number of drawbacks that can increase the burden on patients...
2018: Thrombosis Journal
Abeer Berry, George Degheim, Souheil Saba
Background: Anticoagulation therapy for mechanical prosthetic valves is limited to vitamin K antagonists, unfractionated heparin and low-molecular-weight-heparin. Other forms of anticoagulation are either contraindicated or have not been well studied. Hence, anticoagulation for preexisting mechanical valves is controversial if vitamin K antagonists are contraindicated. We present a case involving an end-stage-renal disease patient with both mitral and aortic mechanical valves who developed warfarin-induced calciphylaxis...
2018: Thrombosis Journal
Takahiro Kato, Katsuhiko Matsuura
Background: Disseminated intravascular coagulation (DIC) is associated with high mortality in patients with sepsis. Several studies reporting that recombinant human soluble thrombomodulin (rhTM) reduced mortality in sepsis patients. This retrospective cohort study aimed to evaluate the efficacy of rhTM for patients with mild coagulopathy compared with those with severe coagulopathy. Methods: We evaluated about 90-day mortality and SOFA score. SOFA score was also evaluated for the following components: respiratory, cardiovascular, hepatic, renal and coagulation...
2018: Thrombosis Journal
Jae C Chang
TTP is characterized by microangiopathic hemolytic anemia and thrombocytopenia associated with brain and kidney dysfunction. It occurs due to ADAMTS13 deficiency. TTP-like syndrome occurs in critically ill patients with the similar hematologic changes and additional organ dysfunction syndromes. Vascular microthrombotic disease (VMTD) includes both TTP and TTP-like syndrome because their underlying pathology is the same disseminated intravascular microthrombosis (DIT). Microthrombi are composed of platelet-unusually large von Willebrand factor multimers (ULVWF) complexes...
2018: Thrombosis Journal
Hironori Matsumoto, Jun Takeba, Kensuke Umakoshi, Satoshi Kikuchi, Muneaki Ohshita, Suguru Annen, Naoki Moriyama, Yuki Nakabayashi, Norio Sato, Mayuki Aibiki
Background: We conducted a prospective observational study for investigating coagulofibrinolytic changes and mechanisms of antithrombin (AT) alternations in trauma. Methods: Trauma patients hospitalized for more than seven days were analyzed for coagulofibrinolytic biomarkers. The patients were stratified into two groups according to AT activity level on admission (day 0), comprising normal AT and low AT patients. Results: Thirty-nine patients (median Injury Severity Score 20) exhibited initial coagulatory activation and triphasic fibrinolytic changes...
2018: Thrombosis Journal
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