Thrombosis research
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Thrombosis research · Dec 2010
ReviewCatheter-related thrombosis in children with intestinal failure and long-term parenteral nutrition: how to treat and to prevent?
Survival of children with chronic intestinal failure has increased as result of administration of home parenteral nutrition. Crucial for the successful management of home parenteral nutrition is the availability of an adequate central venous access. ⋯ Management and prevention of catheter-related thrombosis are of vital importance. For patients with compromised venous access, alternative measures are reported, most of them used as a bridge to bowel transplantation.
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Thrombosis research · Sep 2010
Review Practice GuidelineFrench clinical practice guidelines on the management of patients on vitamin K antagonists in at-risk situations (overdose, risk of bleeding, and active bleeding).
The present report from several French medical societies in the field and the French National Authority for Health provides an expert consensus for the management of patients on vitamin K antagonists in at-risk situations (overdose, risk of bleeding, and active bleeding). Asymptomatic VKA overdose is defined as an International Normalized Ratio (INR) value above the upper limit of the therapeutic target. ⋯ Regarding the haemorrhagic complications, the guidelines address the management of these patients according to the severity of bleeding, and especially focus on the use of prothrombin complex concentrate. Finally, the consensus addresses the management of patients in cases of elective or emergency surgery or other invasive procedures, and discusses whether treatment should be continued or not, and whether VKA substitution by heparin--"bridging anticoagulation"--is needed.
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Thrombosis research · Apr 2010
ReviewFuture directions in hemostasis: normalizing the lives of patients with hemophilia.
The ultimate goal of hemophilia research is to cure the disease by permanently replacing the abnormal or deficient clotting factor. The most promising current approach is to insert a functional gene into the patient that will lead to the production of either the native protein or a compatible non-immunogenic equivalent version. This protein will circulate at adequate levels to prevent spontaneous bleeds and to treat traumatic hemorrhage. ⋯ Ease of administration may be accomplished by the introduction of room temperature stable products and the development of subcutaneous and even orally administered therapeutics. It is conceivable that a broad spectrum hemostatic agent capable of normalizing thrombin generation in a variety of deficiencies could be developed. If this is accomplished, the steps to a room temperature stable agent, contained within a pre-filled pen, capable of self-delivery by subcutaneous injection are already within the realm of current developmental capabilities.
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Thrombosis research · Apr 2010
ReviewAntimetastatic activities of heparins and modified heparins. Experimental evidence.
Heparin is commonly used for prevention or treatment of cancer-associated thromboembolism. Recent clinical evidence indicates that heparin, and low-molecular weight heparin improves survival of cancer patients. ⋯ The delineation of antimetastatic activity of heparin is in the focus of several ongoing investigations. This review summarizes the current experimental evidence on the biology of heparin as a potential treatment cancer progression.