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[Diagnosis, causes, relevance of a complex phenomenon. Resistance to aspirin and clopidogrel]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19572355 [PubMed - indexed for MEDLINE] (Source: Hamostaseologie)
Source: Hamostaseologie - October 1, 2009 Category: Hematology Authors: Mani H, Lindhoff-Last E Tags: Pharm Unserer Zeit Source Type: journals

[Orthopedic patients with or without thrombophilia : Diagnostic, therapy and peri-operative strategies.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Venous thrombosis and pulmonary embolisms are currently associated with high mortality rates in Europe as well as in the United States (mortality rate >300,000-500,000/year). The highest risk is attributed to orthopedic surgery. Besides the use of antithrombotic agents, surgical and anesthesiological procedures as well as a multitude of trigger mechanisms, many thrombophilic risk conditions have to be considered. The incidence of thrombotic complications could be continuously reduced by the improvement of different antithrombotic strategies and use of drugs. According to national and international guidelines low mol...
Source: Hamostaseologie - September 3, 2009 Category: Hematology Authors: Schenk JF, Stephan B, Kusma M, Groß J, Eichler H Tags: Orthopade Source Type: journals

Anticoagulants of primary haemostasis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Inhibition of platelet function plays an important role in the treatment and secondary prevention of cardiovascular or cerebrovascular ischemic diseases. Established antiplatelet agents use different pharmacological targets for this role. Acetylic salicylic acid achieves a reduction of thromboxane A2 formation by inhibition of COX-1. Ticlopidin or clopidogrel are ADP-P2Y12 receptor antagonists. Tirofiban, abciximab or eptifibatid are used for the inhibition of the glycoprotein IIb/IIIa receptor which is activated at the surface of platelets preceding the final step of their aggregation. The mechanism of dipyridamole is...
Source: Hamostaseologie - August 2, 2009 Category: Hematology Authors: Kössler J, Steigerwald U, Walter U Tags: Hamostaseologie Source Type: journals

Patients with oral anticoagulation - Bridging anticoagulation in the perioperative phase.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Oral anticoagulation with a vitamin K-antagonist requires special consideration when surgery or interventional procedures are planned. This is mainly due to the half life of vitamin K-antagonists and to the need for safe and effective anticoagulation prior to and during surgery as well as in the postoperative period. So far, the continuous infusion of unfractionated heparin (UFH) has been the medication of choice to "bridge" patients to surgery. The use of low molecular weight heparins (LMWH) has been prospectively investigated in this setting and represents a safe alternative. The advantages of LMWH are the better dos...
Source: Hamostaseologie - August 2, 2009 Category: Hematology Authors: Koscielny J, Ziemer S, von Heymann C Tags: Hamostaseologie Source Type: journals

Monitoring anticoagulation of primary haemostasis - Estimation of platelet function in whole blood assays.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides an overview on current commercially available methods to determine primary haemostasis as a target of drug-mediated anticoagulation. It focuses on whole blood methods only, and references the currently major achievements that have been reported with each method in respect to its clinical use. Advantages and disadvantages of the various methods are presented, based on considerations of platelet physiology, and on feasibility of the procedures. PMID: 19644601 [PubMed - as supplied by publisher] (Source: Hamostaseologie)
Source: Hamostaseologie - August 2, 2009 Category: Hematology Authors: Calatzis A, Leitner M, Panzer S Tags: Hamostaseologie Source Type: journals

Factor Xa inhibitors - New anticoagulants for secondary haemostasis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Oral factor Xa (FXa) inhibitors are a promising alternative to current anticoagulants. This paper reviews the latest developments of oral direct FXa inhibitors and focuses on those which have been approved for the prevention of venous thromboembolism (VTE) after total hip or knee replacement or are in advanced development and have passed phase II (proof of principle) testing. The most advanced drugs are apixaban, betrixaban, edoxaban, eribaxaban, rivaroxaban, LY517717, TAK-442, and YM150. Rivaroxaban (Xareltoâ) is the first direct FXa inhibitor which has recently been approved for the prevention of VTE in adult pa...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Perzborn E Tags: Hamostaseologie Source Type: journals

The present state of aspirin and clopidogrel resistance.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Antiplatelet therapy has demonstrated significant clinical benefit in the treatment of acute coronary syndrome. However, as with any treatment strategy it has been unable to prevent all cardiovascular events. This is far from surprising when considering the complexity of arterial thrombosis and more specifically platelet physiology. This lack of treatment success has provoked the introduction of various diagnostic tests and testing platforms with the intent of guiding and optimizing clinical treatment. Such tests have resulted in the generation of clinical data that suggest suboptimal response to antiplatelet agents su...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Guyer KE Tags: Hamostaseologie Source Type: journals

Monitoring of anticoagulants of secondary haemostasis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Vitamin K-antagonists and heparin belong to the established indirect acting anticoagulants. For many years these drugs were the only possibility for prophylaxis and treatment of venous and arterial thrombosis. The challenges for the routine laboratory related to the treatment with vitamin K-antagonists and heparin can be regarded as solved. However, in recent years a rapid development of new anticoagulants began. Although they are developed with guidelines for use without monitoring, the control of effective levels may be necessary in selected cases. As a consequence new challenges for the routine laboratory have to be...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Schuster B Tags: Hamostaseologie Source Type: journals

Haemostaseologic effects of fractionated snake venoms.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Comparative investigation concerning gelfiltration as well as haemostaseologic analysis of venoms and venom fractions of some snakes (elapidae and viperidae) have shown that in elapidae an inhibition of coagulation is dominant whilst in viperidae the stimulation of coagulation is of importance. Our investigations produce a basis to select substances for activation of coagulation and substances for inhibition of coagulation. Under pharmacological viewpoints the data may produce information to use snake fractions for anticoagulation or for procoagulant therapy in bleeding tendency. PMID: 19644602 [PubMed - in process...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Béress L, Bodendiek I, Forssmann WG, Gresch U, Kallsen B, Lammers T, Ständker L, Thieme F, Bruhn HD Tags: Hamostaseologie Source Type: journals

Established anticoagulants in secondary haemostasis - Vitamin K antagonists, heparins.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In respect to the actual discussion of new anticoagulants in secondary haemostasis, we will give a short review on established oral anticoagulation with vitamin K antagonists and parenteral anticoagulation by use of heparin. The different cumarin derivatives phenprocoumon, warfarin, and acenocoumarol are compared concerning to the management and influence of pharmacogenetic and pharmacokinetic factors. Studies to improve the safety of oral anticoagulation by vitamin K supplementation will be briefly discussed. The therapy with heparins include until now some problems of dose-response control. It is necessary to pay att...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Langer E, Ziemer S Tags: Hamostaseologie Source Type: journals

New anticoagulants for secondary haemostasis - Anti IIa inhibitors.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In contrast to heparins and oral anticoagulants, anti IIa inhibitors (thrombin inhibitors) are able to directly inhibit the protease activity of thrombin and can thereby precisely control the blood coagulation process. Direct thrombin inhibitors are either biosimilars (r-hirudin) or synthetically produced substances (bivalirudin, argatroban, dabigatran). In 1997 r-hirudin was introduced into clinical practice, however due to its narrow therapeutic range and the necessity of drug monitoring it has not gained widespread clinical use by now. Since 2004 and 2005 the synthetic thrombin inhibitors bivalirudin and argatroban,...
Source: Hamostaseologie - July 31, 2009 Category: Hematology Authors: Nowak G Tags: Hamostaseologie Source Type: journals

Resistenz gegenüber ASS und Clopidogrel. Diagnostik, Ursachen, Relevanz eines komplexen Phänomens.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Resistenz gegenüber ASS und Clopidogrel. Diagnostik, Ursachen, Relevanz eines komplexen Phänomens. Pharm Unserer Zeit. 2009 Jul 1;38(4):342-350 Authors: Mani H, Lindhoff-Last E Die Therapie mit ASS oder Clopidogrel variiert stark. Mit Hilfe verschiedener Thrombozytenfunktionstests konnte gezeigt werden, dass Subgruppen von Patienten unter ASS- und/oder Clopidogrel-Therapie den erwarteten plättchenhemmenden Effekt vermissen lassen. In monozentrischen Studien korrelierte die laborchemische Non-Response mit dem nachfolgenden Auftreten vaskulärer Ereignisse.Der Mechanismus, welcher einer Resiste...
Source: Hamostaseologie - June 30, 2009 Category: Hematology Authors: Mani H, Lindhoff-Last E Tags: Pharm Unserer Zeit Source Type: journals

Guest Editor BIO.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19497786 [PubMed - as supplied by publisher] (Source: Hamostaseologie)
Source: Hamostaseologie - June 1, 2009 Category: Hematology Authors: Moog R Tags: Transfus Apher Sci Source Type: journals

[Hematopoietic stem cell transplantation. Indications, foundations and perspective]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The hematopoietic stem cell transplantation (HSCT) has become a standard therapy for many inherited and acquired disorders of the bone marrow and immune system. Autologous HSCT is mainly done as part of the primary therapy in multiple myeloma and as part of relapse therapy in malignant lymphoma. In contrast, allogeneic HSCT is predominantly performed in patients with acute leukemias. The selection process for allogeneic HSCT takes disease-specific as well as patient-specific factors into account. Risk factors which can predict for poor response to chemotherapy can now be identified in acute myeloid as well as lymphoid ...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Buchholz S, Ganser A Tags: Internist (Berl) Source Type: journals

[Relevance of a single dose of 270 microg/kg recombinant factor VIIa for the treatment of patients with haemophilia and inhibitors - Recommendations from the GTH experts]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recombinant factor VIIa (rFVIIa; NovoSeven) is, besides other indications, authorised for the treatment of bleeding episodes in patients with hereditary haemophilia A or B and inhibitors. Based on the results of three clinical studies, marketing authorisation was granted for the single dose of 270 microg/kg body weight rFVIIa for the treatment of mild to moderate bleeding episodes in patients with haemophilia A or B with inhibitors in March 2007. Thereupon, an expert group analysed the relevance of this additional treatment option for clinical routine. Compared with the repeated application of 90 microg/kg body weight ...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Auerswald G, Muntean W, Kemkes-Matthes B, Klamroth R, Krause M, Kurnik K, Oldenburg J, Pabinger-Fasching I, Schramm W, Zimmermann R, Zotz RB Tags: Hamostaseologie Source Type: journals

Spontaneous disappearance of high titre factor VIII inhibitor 15 years after unsuccessful ITI.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report on a patient with a high titre FVIII inhibitor that persisted after ITI but spontaneously disappeared 15 years later. PMID: 19404512 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Thom K, Male C, Falger J, Pabinger I Tags: Hamostaseologie Source Type: journals

Lepirudin treatment in a boy with suspected HIT II after surgery because of tetralogy of Fallot.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: In children with progressive thrombocytopenia in the setting of heparin exposure and signs of major or micro thrombosis HIT II must be ruled out. Even if a first early test turns out negative repeated testing should be performed. Lepirudin anticoagulation is effective and should be monitored correctly. Platelet transfusion should be avoided in HITII. PMID: 19404513 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Hanke CA, Barth K, Nakamura L, Budde U, Arnold R, Zieger B, Stiller B Tags: Hamostaseologie Source Type: journals

[Clinical and laboratory aspects of the Aspirin-like defect as hereditary thrombocytopathy]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: In case of a bleeding tendency diagnostic procedures should rule out primary haemostatic defects. Hereditary platelet function defects including ALD are an important differential diagnosis. Family studies are reasonable. PMID: 19404514 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Rolf N, Bugert P, Gehrisch S, Siegert G, Suttorp M, Knöfler R Tags: Hamostaseologie Source Type: journals

Coagulation testing in the evaluation of suspected child abuse.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Every year in Germany nearly 3000 cases of child abuse were reported. When children are presented at emergency units with suspicious injuries and bruises a detailed documentation an evaluation is necessary after emergency treatment. As differential diagnosis inherited or acquired bleeding disorders should be excluded. In addition to a detailed evaluation of personal and family history and a physical evaluation different coagulation test to exclude defects of primary and secondary hemostasis should be performed. Clinician must know the limitations of these tests and keep in mind that an abnormal coagulation test does no...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Olivieri M, Kurnik K, Bidlingmaier C Tags: Hamostaseologie Source Type: journals

Identification of a novel factor X deletion in combination with a missense mutation in the F10 gene - Genotype-phenotype correlation in a girl with severe factor X deficiency.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The genotype-phenotype relationship of compound heterozygous factor X deficiency in a young girl with severe factor X deficiency and bleeding symptoms is characterized. We identified a novel deletion of exon 6 and a missense mutation (c.856G>A, Val286Met) in exon 7 of the F10 gene leading to a compound heterozygous state and causing severe factor X deficiency. Therapeutic options for patients with symptomatic factor X deficiency are demonstrated. PMID: 19404516 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Hainmann I, Oldenburg J, Pavlova A, Superti-Furga A, Zieger B Tags: Hamostaseologie Source Type: journals

A large Swiss family with Bernard-Soulier syndrome - Correlation phenotype and genotype.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report on a large Swiss family of whom four family members suffer from BSS. Here, a homozygous missense mutation in position 1829 (A(R)G) of the GPIX gene constituting a N45S substitution is the cause for the bleeding symptoms. A total of 38 family members within two generations were analyzed regarding the N45S mutation by DNA sequencing and restriction fragment length polymorphism. The laboratory parameters which are characteristically for BSS such as platelet count, platelet volume and the expression of CD42a (GPIX), CD42b (GPIbalpha) and CD41 (GPIIb) were measured for all 38 individuals. The four homozygous patients ...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Zieger B, Jenny A, Tsakiris DA, Bartsch I, Sandrock K, Schubart C, Schäfer S, Busse A, Wuillemin WA Tags: Hamostaseologie Source Type: journals

Acquired von Willebrand syndrome as side effect of valproic acid therapy in children is rare.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To determine the frequency and clinical relevance of acquired von Willebrand syndrome (aVWS) due to antiepileptic therapy by valproic acid, we investigated 50 consecutive children in three neuropediatric institutions. Coagulation factors were determined in local laboratories before and three times after starting therapy with valproic acid. Parameters of von Willebrand factor (VWF) were additionally investigated in a reference laboratory including multimeric analysis. Significant changes in the coagulation system were found concerning fibrinogen (decreased from 287 +/- 70 mg/dl to 222 +/- 67 mg/dl; p < 0.001) and pla...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Eberl W, Budde U, Bentele K, Christen HJ, Knapp R, Mey A, Schneppenheim R Tags: Hamostaseologie Source Type: journals

ITI with high-dose FIX and combined immunosuppressive therapy in a patient with severe haemophilia B and inhibitor.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of successful inhibitor elimination with a combined immune-modulating therapy and high-dose factor IX (FIX). This boy had developed a FIX inhibitor at the age of 5 years and had a history of allergic reactions to FIX and to FEIBAO. Under on-demand treatment with recombinant activated FVII the inhibitor became undetectable but the boy suffered from multiple joint and muscle bleeds. At the age of 11.5 years ITI was attempted with a combination of rituximab, MMF, dexamethasone, intravenous immunoglobulins and high-dose FIX. The inhibitor did not reappear and FIX half-life normalized. No allergic reaction, no...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Beutel K, Hauch H, Rischewski J, Kordes U, Schneppenheim J, Schneppenheim R Tags: Hamostaseologie Source Type: journals

The problem of novel FVIII missense mutations for haemophilia A genetic counseling.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: This case emphasizes the necessity to establish the molecular diagnosis in the family's index case and to perform expression studies of novel mutations to prove their causative nature. PMID: 19404520 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Schneppenheim R, Schröder J, Obser T, Oyen F, Schneppenheim S, Oldenburg J Tags: Hamostaseologie Source Type: journals

Reassessment of treatment modalities for paediatric patients with chronic immune thrombocytopenia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Approximately 70% of children have the acute form of immune thrombocytopenia (ITP), which is defined by recovery within six months of presentation with or without treatment. Chronic ITP is to be reserved for patients with platelets < 100000/microl for more than twelve months and exclusion of other diagnosis like systemic lupus erythematosus or bone marrow failures. In children, the chance of spontaneous recovery is 52% after diagnosis of chronic ITP. The Intercontinental Childhood ITP Study group recommends that children without bleeding may not require therapy regardless of their platelet count. Whereas in patients...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Laws HJ, Janssen G, Borkhardt A Tags: Hamostaseologie Source Type: journals

Inhibitor treatment by rituximab in congenital haemophilia A - Two case reports.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Rituximab may be favourable for patients with congenital haemophilia, high-titre inhibitors and a severe clinical course in whom standard ITI has failed. Prospective studies are required to determine safety, efficacy and predictors of success. PMID: 19404522 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Streif W, Escuriola Ettingshausen C, Linde R, Kropshofer G, Zimmerhackl LB, Kreuz W Tags: Hamostaseologie Source Type: journals

[Contraception and thrombophilia]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Thrombophilic women are good candidates for progestin-only contraceptive methods. PMID: 19404523 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Rott H, Kruempel A, Kappert G, Nowak-Göttl U, Halimeh S Tags: Hamostaseologie Source Type: journals

Response to DDAVP in children with von Willebrand disease type 2.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Children with VWD type 2 show a variable response to desmopressin depending on the mutation that correlates with the functional defect and the presence or absence as well as the half-life of large VWF multimers. Our data emphasize the usefulness of DDAVP testing even in patients with VWD type 2, possibly with the exception of VWD type 2B. PMID: 19404524 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Schneppenheim R, Budde U, Beutel K, Hassenpflug WA, Hauch H, Obser T, Oyen F, Schneppenheim S, Schrum J Tags: Hamostaseologie Source Type: journals

[Severe prekallikrein deficiency due to a compound heterozygosis in the KLKB1-gene]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 14 year old boy was referred to us for a detailed coagulation study because a previously performed aPTT has been found prolonged. The boy had no history of bleeding symptoms and also the family history was negative for bleeding or thrombotic events. The aPTT in the patient was 96 s (reference range: 24-36 s), prothrombin time and thrombin time were both normal. As the cause for the prolonged aPTT we identified a severe prekallikrein deficiency (prekallikrein activity < 1%). The prekallikrein deficiency results from two mutations in the KLKB 1-gene: first, an insertion of 1 bp in codon 149 in exon 5 and, second, a ...
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Maak B, Kochhan L, Heuchel P, Jenderny J Tags: Hamostaseologie Source Type: journals

Paediatric haemostaseology.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19492466 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - April 30, 2009 Category: Hematology Authors: Schneppenheim R Tags: Hamostaseologie Source Type: journals

Molecular targeted therapies for solid tumors: management of side effects.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This review will provide physicians and oncologists with an overview of side effects related to targeted agents that inhibit vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and mammalian target of rapamycin (mTOR) signaling in the treatment of solid tumors. Such targeted agents can be divided into monoclonal antibodies, tyrosine kinase inhibitors, multitargeted tyrosine kinase inhibitors and serine/threonine kinase inhibitors. Molecular targeted therapies are generally well tolerated, but inhibitory effects on the biological function of the targets in healthy tissue can result in specific treat...
Source: Hamostaseologie - March 1, 2009 Category: Hematology Authors: Grünwald V, Soltau J, Ivanyi P, Rentschler J, Reuter C, Drevs J Tags: Onkologie Source Type: journals

Blood coagulation dynamics in haemostasis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Our studies involve computational simulations, a reconstructed plasma/platelet proteome, whole blood in vitro and blood exuding from microvascular wounds. All studies indicate that in normal haemostasis, the binding of tissue factor (TF) with plasma factor (F) VIIa (extrinsic FXase complex) results in the initiation phase of the procoagulant response. This phase is negatively regulated by tissue factor pathway inhibitor (TFPI) in combination with antithrombin (AT) and the protein C (PC) pathway. The synergy between these inhibitors provides a threshold-limited reaction in which a stimulus of sufficient magnitude must b...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Mann KG, Orfeo T, Butenas S, Undas A, Brummel-Ziedins K Tags: Hamostaseologie Source Type: journals

Mouse models to study von Willebrand factor structure-function relationships in vivo.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Von Willebrand factor (VWF) structure-function relationship has been studied only through in vitro approaches. The VWF-deficient mouse model has been extremely useful to examine the in vivo function of VWF but does not allow a more subtle analysis of the relative importance of its different domains. However, considering the large size of VWF and its capacity to interact with various ligands in order to support platelet adhesion and aggregation, the necessity to evaluate independently these interactions appeared increasingly crucial. A recently developed technique, known as hydrodynamic injection, which allows transient...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Denis CV, Marx I, Badirou I, Pendu R, Christophe O Tags: Hamostaseologie Source Type: journals

Platelet function under high shear conditions.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Blood platelets are the first line of defense against bleeding and as such involved in the haemostatic repair of damaged vasculature. Their true prowess seems to be displayed under high shear conditions where platelets interact with a variety of plasma proteins, all of which are tightly regulated to close the leak but at the same time prevent lumen occlusion and thromboembolism. The first task is to arrest fast flowing platelets on exposed collagen of the damaged subendothelial surface. Although platelets are endowed with several collagen receptors, most notably integrin alpha2bbeta1 and the immunoglobulin superfamily ...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Reininger AJ Tags: Hamostaseologie Source Type: journals

Assessment of platelet function in the laboratory.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Platelet function testing is essential for the diagnosis of congenital/acquired bleeding disorders and may be useful for the prediction of surgical bleeding. Nowadays there is also much interest in monitoring the efficacy of anti-platelet therapy and measuring platelet hyper-function. However, this often presents clinical laboratories with significant challenges as platelet function tests are complex, poorly standardized, time consuming and quality assurance is not straightforward. There are also few comprehensive modern guidelines available and many recent published surveys have revealed poor standardization between l...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Harrison P Tags: Hamostaseologie Source Type: journals

Role of von Willebrand factor in vascular disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Plasma levels of von Willebrand factor (VWF) are increased in patients with cardiovascular risk factors. Various studies aimed to elucidate the relation of VWF with thromboembolic cardiovascular events, ischaemic stroke as well as with peripheral arterial occlusive disease. In the general population, there is only a weak association between VWF levels and future cardiovascular events or stroke. In contrast, VWF levels are predictive in patients with documented vascular disease. Those patients with increased VWF suffer a higher incidence of major adverse cardiac events including death. The extent of the VWF release and ...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Paulinska P, Spiel A, Jilma B Tags: Hamostaseologie Source Type: journals

Key transcriptional regulators of the vasoprotective effects of shear stress.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Atherosclerotic plaque rupture and subsequent thrombosis is the main cause of sudden coronary death. Remarkably, atherosclerosis only develops in certain predisposed areas of the vasculature. Endothelial cells in these predisposed areas experience low or oscillatory shear stress, which activates the proinflammatory and procoagulant transcription factors activator protein 1 (AP-1) and nuclear factor kappaB (NFkappaB), thus inducing a proinflammatory, procoagulant surface. In contrast, healthy endothelial cells that are exposed to prolonged high laminar shear stress, express anti-inflammatory and anticoagulant genes. The...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Boon RA, Horrevoets AJ Tags: Hamostaseologie Source Type: journals

Obesity and vascular risk.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Obesity is a common disorder and a known risk factor for vascular thrombotic complications. Development of obesity is associated with extensive modifications in adipose tissue involving adipogenesis, angiogenesis and extracellular matrix proteolysis. Studies using a nutritionally induced obesity model in transgenic mice support a role of the fibrinolytic (plasminogen/plasmin) and matrix metalloproteinase (MMP) systems in these processes. Venous or arterial thrombosis models in obese mice confirm a prothrombotic risk associated with obesity. PMID: 19151845 [PubMed - in process] (Source: Hamostaseologie)
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Lijnen HR Tags: Hamostaseologie Source Type: journals

Pathophysiologic significance of procoagulant microvesicles in cancer disease and progression.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Microvesicles (MV) are submicrometric membrane fragments (0.1 to 1 mum), released from the plasma membrane of activated or apoptotic cells. They are characterized by most of the antigenic profile of the cells they originate from, and by the presence of procoagulant phospholipids at their surface. MV are detectable in the peripheral blood of mammals and considered as efficient effectors in the haemostatic or thrombotic responses, able to remotely initiate or amplify beneficial or deleterious processes, depending on the circumstances. Variations in their level and phenotype make them relevant pathogenic markers of thromb...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Castellana D, Kunzelmann C, Freyssinet JM Tags: Hamostaseologie Source Type: journals

Haemostatic testing prior to elective surgery in children? Not always!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In Germany, preoperative coagulation tests are commonly used, based on the belief that these tests should identify patients with an increased bleeding risk. However, published evidence does not longer support this approach for both traditional screening tests and novel techniques of global assessment of haemostasis. Unselected screening yields many false positive results and detects irrelevant disorders. It leads to postponement of surgery, anxiety in parents and patients, and is not cost effective. Even worse, it does not reliably detect relevant bleeding disorders such as the most common coagulopathy, von Willebrand ...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Bidlingmaier C, Eberl W, Knöfler R, Olivieri M, Kurnik K Tags: Hamostaseologie Source Type: journals

Use of recombinant factor VIIa in the perioperative period.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recombinant activated factor VII (rFVIIa) is a pro-haemostatic agent that can be used for patients with haemophilia and inhibiting antibodies towards a coagulation factor. Recombinant factor VIIa is, however, increasingly used for several other indications, including patients who experience serious and life-threatening bleeding. In addition, rFVIIa has been evaluated for the prevention of major blood loss in patients undergoing surgical procedures that are known to be associated with major blood loss. In this manuscript we review the data on efficacy and safety of rFVIIa in the prevention of excessive blood loss and tr...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Levi M Tags: Hamostaseologie Source Type: journals

The improved factor concentrate.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The current treatment of haemophilia with coagulation protein replacement therapy is both effective and safe. Nevertheless, this therapy requires frequent, repeated intravenous infusions and approximately 25% of treated haemophilia A patients develop antibodies to the replacement protein. Furthermore, the cost and limited availability of current concentrates has restricted access to therapy to less than 30% of the global haemophilia population. With this background, efforts are now underway to develop coagulation concentrates with enhanced biological properties that further improve the quality of care for haemophiliacs...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Lillicrap D Tags: Hamostaseologie Source Type: journals

Acute immune thrombocytopenic purpura. To treat or not to treat?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Immune thrombocytopenia in children is usually a self-limiting illness, but in adults the disease is likely to be chronic, and may be associated with other pathology which predisposes to bleeding. Despite very low platelet counts serious bleeding is rare in both adults and children. More than 80% of children have mild clinical manifestations. Intracranial haemorrhage is rare at all ages, is unpredictable and can occur at any time when the count is very low. Currently recommended therapies for both adults and children are associated with significant side effects and occasional deaths. Treatment may interfere with qualit...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Bolton-Maggs P Tags: Hamostaseologie Source Type: journals

Chronic immune thrombocytopenic purpura. New agents.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
First generation thrombopoietic growth factors (rhTPO and PEG-rHuMGDF), investigated in the early 2000s, proved effective in increasing platelet count in normal volunteers, in thrombocytopenia due to chemotherapy and also in a few cases of immune thrombocytopenic purpura (ITP). These agents did not complete their clinical development since one of them induced antibodies in the recipients that cross reacted with endogenous thrombopoietin (TPO), thus causing thrombocytopenia. This promoted the ingenious design of a new generation of thrombopoietic growth factors having no sequence homology with natural TPO. The two main ...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Rodeghiero F, Ruggeri M Tags: Hamostaseologie Source Type: journals

Antithrombotic therapy in children with venous thromboembolism.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Antithrombotic therapy has recently become more frequent for the treatment of venous thromboembolism (VTE) in the paediatric population. This can be explained by the increased awareness of morbidities and mortalities of VTE in children, as well as the improved survival rate of children with various kinds of serious illnesses. Considering the large number of years a child is expected to survive, associated morbidities such as postthrombotic syndrome and risk of recurrence can significantly impact on the quality of life in children. Therefore, timely diagnosis, evidence-based treatment and prophylaxis strategies are crit...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Yang J, Paredes N, Chan AK Tags: Hamostaseologie Source Type: journals

Thrombosis prophylaxis in patients with ischaemic (cardioembolic) stroke. How long is long enough?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cardioembolism accounts for approximately 20% of ischaemic strokes, and is associated with high mortality and propensity to recurrences. Approximately, 30% of ischaemic strokes remain cryptogenic despite improved imaging modalities and technological improvements to identify their cause. Of the long list of various cardiac conditions associated with an increased risk of cardioembolic strokes, non-valvular atrial fibrillation is the most common cause. Unsurprisingly, the stroke risk associated with these conditions is highly variable and non-homogenous, with many risk factors additive to the overall risk profile. Treatme...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Lip GY, Krishnamoorthy S Tags: Hamostaseologie Source Type: journals

Consequences of thrombophilia screening for life quality in women before prescription of oral contraceptives and family members of VTE patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A large number of hereditary and acquired alterations in the coagulation system that are associated with an increased risk of venous thrombosis have been described. Screening for these thrombophilic defects has become particularly popular in women before the prescription of oral contraceptives. The relevance of the results with regard to the management of the patients remains, however, to be questioned. In a recent review of six articles that were aimed to determine the nature and extent of psychological impact of thrombophilia screening, no valid conclusions could be drawn about the psychological impact due to heterog...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Eichinger S Tags: Hamostaseologie Source Type: journals

Identifying cancer patients at risk for venous thromboembolism.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Venous thromboembolism (VTE) is a known complication of cancer which impacts on patient mortality and quality of life. Despite the known deleterious effects of VTE, the benefits of thromboprophylaxis have not been fully established. Identification of patients at highest risk of VTE could lead to better targeting of thromboprophylaxis. Several risk factors have been identified as contributing to VTE such as site and stage of cancer, age, comorbidities, obesity, and acquired prothrombotic states. Anti-cancer agents as well as the use of growth factor support have also been implicated in VTE. Recent data have identified b...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Sousou T, Khorana A Tags: Hamostaseologie Source Type: journals

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Hamostaseologie. 2009;29(1):1-2 Authors: Pabinger-Fasching I, Weltermann A PMID: 19151838 [PubMed - as supplied by publisher] (Source: Hamostaseologie)
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Pabinger-Fasching I, Weltermann A Tags: Hamostaseologie Source Type: journals

Microparticles and female issues.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Emerging evidence suggests that circulating, cell-derived microparticles (MP) play a role in various physiological and pathophysiological processes. MP are involved in coagulation, inflammation and transportation. The role of circulating MP in the field of obstetrics and gynaecology has been investigated only recently. Healthy women show menstrual cycle-specific differences in circulating MP which differ significantly from age-matched men. With regard to obstetrics, MP were elevated in subgroups of patients with miscarriage or preeclampsia. Whether MP contribute to the pathogenesis of the diseases themselves is part of...
Source: Hamostaseologie - January 22, 2009 Category: Hematology Authors: Toth B Tags: Hamostaseologie Source Type: journals