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Byline: Jian. Hong, Jason. Widjaja, Ponnie. Dolo, Libin. Yao, Xiaocheng. Zhu Introduction: Staple-line bleeding (SLB) is a common issue during laparoscopic sleeve gastrectomy (SG). Identifying a method or technique intraoperatively [...]

Misoprostol can prevent and treat postpartum haemorrhage. But because it can also cause abortions, availability of the cheap medication is often tightly restricted. Misoprostol can prevent and treat postpartum haemorrhage. But because it can also cause abortions, availability of the cheap medication is often tightly restricted., Author(s): Alla Katsnelson Author Affiliations: Health officers provide information about maternal health in Bangladesh, a country that lets pregnant women have the drug misoprostol. Credit: G. M. B. Akash/Panos Pictures [...]

Byline: Maria. Cecilia, Reeta. Vijayaselvi, Ramandeep. Bansal, Latha. Lakshmi, Ruby. JoseOBJECTIVES: Currently, recommended high-dose oxytocin regimen for the prevention of postpartum hemorrhage (PPH) following cesarean delivery (CD) is associated with [...]

A study was conducted to evaluate the efficacy of platelet dose of prophylactic in the prevention of bleeding or hemorrhage in patients with hypoproliferative thrombocytopenia. Results indicated that only low doses of platelet transfusions led to a reduction in bleeding.

OBJECTIVE: To assess bleeding and activated partial thromboplastin time (APTT) In relation to body mass index (BMI) in patients prescribed weight-based dosing of intravenous unfractionated heparin (UFH) for cardiac indications [...]

Byline: Mitchell Levy (1), Marcel Levi (2), Mark D. Williams (3), Massimo Antonelli (4), Dazhe Wang (3), Mariano Alejandro Mignini (5) Keywords: Severe sepsis; Drotrecogin alfa (activated); Heparin; XPRESS; Clinical trial; Recombinant human activated protein C Abstract: Purpose The safety of using heparin concomitantly with drotrecogin alfa (activated) {DrotAA} was explored in the XPRESS study. No heparin effect on mortality was observed. Safety results from that study are explored in more detail. Methods A randomized, double-blind trial of prophylactic heparin versus placebo in severe sepsis patients treated with DrotAA (24 ug/(kg h) for 96 h) was conducted at 224 sites in 20 countries. Patients were randomized 1:1:2 to receive unfractionated heparin (UFH) (5,000 Units twice daily) (n = 511), low-molecular-weight heparin (LMWH) (enoxaparin, 40 mg per day) (n = 493), or placebo (n = 990) every 12 h during the DrotAA infusion. Results Bleeding events during the DrotAA infusion period (Days 0--6) were higher in the heparin than placebo groups (10.8 vs. 8.1% p = 0.049), but serious bleeding events were similar (heparin 2.3% vs. placebo 2.5% p = 0.72) and central nervous system (CNS) bleeds were rare in both groups (0.3 vs. 0.3%). Fewer heparin patients experienced an ischemic stroke during infusion (0.3 vs. 1.3% p = 0.018) and 28-day period (0.5 vs. 1.8% p = 0.009). Conclusions Coadministration of DrotAA with low-dose heparin in severe sepsis patients did not increase incidence of serious bleeding. Fewer ischemic strokes in the heparin group suggest heparin cessation should be avoided during DrotAA infusion. Author Affiliation: (1) Rhode Island Hospital and Brown University Medical School, 593 Eddy St., Providence, RI, 02903, USA (2) Departments of Vascular Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (3) Lilly Research Laboratories, Eli Lilly & Co., Indianapolis, IN, USA (4) Policlinico Universitario A. Gemelli Universita Cattolica del Sacro Cuore, Rome, Italy (5) Medical Department of Eli Lilly SpA, Sesto Fiorentino, Italy Article History: Registration Date: 30/03/2009 Received Date: 01/07/2008 Accepted Date: 27/03/2009 Online Date: 15/04/2009 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s00134-009-1483-7) contains supplementary material, which is available to authorized users. An erratum to this article can be found at http://dx.doi.org/10.1007/s00134-009-1503-7

Triggering receptor expressed on myeloid cells--like (TREM-like) transcript-1 (TLT-1), a type 1 single Ig domain orphan receptor specific to platelet and megakaryocyte [alpha]-granules, relocates to the platelet surface upon platelet stimulation. We found here that patients diagnosed with sepsis, in contrast to healthy individuals, had substantial levels of soluble TLT-1 (sTLT-1) in their plasma that correlated with the presence of disseminated intravascular coagulation. sTLT-1 bound to fibrinogen and augmented platelet aggregation in vitro. Furthermore, the cytoplasmic domain of TLT-1 could also bind ezrin/radixin/moesin family proteins, suggesting its ability to link fibrinogen to the platelet cytoskeleton. Accordingly, platelets of Treml1-/- mice failed to aggregate efficiently, extending tail-bleeding times. Lipopolysaccharide-treated Treml1-/- mice developed higher plasma levels of TNF and D-dimers than wild-type mice and were more likely to succumb during challenge. Finally, Treml1-/- mice were predisposed to hemorrhage associated with localized inflammatory lesions. Taken together, our findings suggest that TLT-1 plays a protective role during inflammation by dampening the inflammatory response and facilitating platelet aggregation at sites of vascular injury. Therefore, therapeutic modulation of TLT-1-mediated effects may provide clinical benefit to patients with hypercoagulatory conditions, including those associated with inflammation., Introduction Septic shock claims over 200,000 people a year in the United States and is a leading cause of morbidity and mortality. Death from sepsis occurs when the deposition of [...]

Antiplatelet therapy is an evidence-based, guideline-recommended, worldwide standard of care for treatment of patients with atherothrombosis. However, clinical implementation of the guidelines is suboptimal, in part because of physician and [...]

Department of Medicine, UCSD School of Medicine, La Jolla, California, USA. In vitro studies indicate that binding of talin to the [[beta].sub.3] integrin cytoplasmic domain (tail) results in integrin [[alpha].sub.IIb][[beta].sub.3] [...]

Platelets contain both pro- and antiangiogenic factors, but their regulatory role in angiogenesis is poorly understood. Although previous studies showed that platelets stimulate angiogenesis in vitro, the role of platelets in angiogenesis in vivo is largely uncharacterized. To address this topic, we used two in vivo approaches, the cornea micropocket assay and the Matrigel model, in four animal models: thrombocytopenic, [Lyst.sup.bg] (platelet storage pool deficiency), glycoprotein (GP) lb[alpha]/IL4R transgenic (lacking extracellular GPIb[alpha], the receptor for von Willebrand factor as well as other adhesive and procoagulant proteins), and Fc[gamma][R.sup.-/-] (lacking functional GPVI, the collagen receptor) mice. Adult mice were rendered thrombocytopenic by i.p. administration of an antiplatelet antibody. The number of growing vessels in the thrombocytopenic mice was lower in the cornea assay, and they showed significantly increased appearance of hemorrhage compared with mice treated with control IgG. The thrombocytopenic mice also showed more protein leakage and developed hematomas in the Matrigel model. GPIb[alpha]/IL4R transgenic mice presented increased hemorrhage in both assays, but it was less severe than in the platelet-depleted mice. Fc[gamma][R.sup.-/-] and [Lyst.sup.bg] mice showed no defect in experimental angiogenesis. Intravital microscopy revealed a >3-fold increase in platelet adhesion to angiogenic vessels of Matrigel compared with mature quiescent skin vessels. Our results suggest that the presence of platelets not only stimulates angiogenic vessel growth but also plays a critical role in preventing hemorrhage from the angiogenic vessels. The adhesion function of platelets, as mediated by GPIb[alpha], significantly contributes to the process. thrombocytopenic mice | blood vessel | [alpha]-granule | cornea | collagen receptor

Purpose. Skin incision before percutaneous central venous catheterization may cause serious hemorrhage and/or skin cicatrization. To minimize these adverse effects, we improved the shape of a dilator and coated it [...]