Thrombosis research
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Thrombosis research · Dec 2010
Comparative StudyComparison of the fibrinogen Clauss assay and the fibrinogen PT derived method in patients with dysfibrinogenemia.
Fibrinogen assays are an important screening tool for blood coagulation disorders. Although different methods are available, no consensus has been reached as to which method is preferable. In 27 patients with dysfibrinogenemia, plasma fibrinogen concentration was measured by Clauss and PT-derived methods on two fully automated coagulation analyzers utilizing different reagents. In addition, immunological and heat fibrinogen concentrations as well as global coagulation tests were measured. ⋯ Although many patients with dysfibinogenemia are asymptomatic, in case of bleeding, immediately diagnosis and treatment is warranted. The Clauss assay is the diagnostic tool of choice when diagnosing or treating patients with low fibrinogen levels. The use of the PT-derived method may potentially pose a greater risk to patients, as the plasma concentration may be erroneously reported as normal.
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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 · Oct 2010
Comparative StudyReference values for thromboelastometry (ROTEM®) in cynomolgus monkeys (Macaca fascicularis).
The imbalance in clotting homeostasis, tending towards hypercoagulation, is recognized as the real barrier to the long-term survival of porcine xenografts in pig-to-primate xenotransplatation. The present study aimed to validate in primate blood the applicability of whole blood rotation thromboelastometry, performed by ROTEM®, which evaluates the characteristics of clot formation by dynamic monitoring. ⋯ ROTEM® depicts a hypercoagulable profile in primates as compared to humans. Taken together these data suggest that, with regard to coagulation, xenotransplantation in cynos may represent a much more difficult situation than xenotransplantation in humans.
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Thrombosis research · Oct 2010
Knowledge of the D-dimer test result influences clinical probability assessment of pulmonary embolism.
In patients with suspected pulmonary embolism (PE), an unlikely or non-high probability assessment combined with a normal D-dimer test can safely exclude the diagnosis. We studied the influence of early D-dimer knowledge on clinical probability assessment. ⋯ Knowledge of the D-dimer test influences the physician in how the clinical probability for PE is scored. This will have direct clinical consequences, such as unnecessary imaging testing or inappropriate exclusion of the diagnosis. Physicians should therefore make sure that they examine the patient before they take notice of the D-dimer test result.
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Thrombosis research · Oct 2010
Clinical outcomes in patients with isolated subsegmental pulmonary emboli diagnosed by multidetector CT pulmonary angiography.
CT Pulmonary Angiography has been shown to be equivalent to Ventilation/ Perfusion scanning in 3-month outcome studies, but it detects more pulmonary emboli. Isolated subsegmental pulmonary emboli are thought to account for some of the increase in diagnosis, but it is not known whether these emboli represent a harbinger for future thromboembolic events. The objective of this study was to determine the 3-month clinical outcomes of a cohort of patients diagnosed with isolated subsegmental pulmonary emboli. ⋯ Patients diagnosed with isolated subsegmental pulmonary emboli have favorable 3-month outcomes. Short-term prognosis for recurrent thromboembolism may be lower than the risk of adverse events with anticoagulation in patients at high risk of hemorrhage.