placeholder
and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Proceed order?

Export
Filter
Language
Year
  • 1
    Language: English
    In: Journal of thrombosis and haemostasis, 2020-06, Vol.18 (6), p.1310-1319
    Description: Background Postpartum hemorrhage (PPH), a major cause of maternal mortality, has several known risk factors but frequently occurs unexpectedly. PPH incidence and related maternal morbidity and mortality are rising worldwide. Objective To evaluate the impact of defined prepartum blood coagulation parameters on postpartum blood loss. Methods This single‐center, prospective cohort study analyzed prepartum activities of coagulation factors II and XIII and fibrinogen levels in 1300 women. Blood samples were obtained at labor onset and analyzed only after the last patient had delivered, to prevent a potential treatment bias. Blood loss was quantified using a validated technique. The influence of coagulation factors on measured blood loss was assessed by continuous outcome logistic regression. Results Prepartum factor XIII activity strongly influenced measured blood loss: every one unit (%) increase in prepartum factor XIII was associated with an odds ratio of 1.011 (95% confidence interval, 1.006‐1.015; P 〈 .001) to keep blood loss below any given cut‐off level. For illustration, this suggests that a 30% increase in factor XIII activity increases the odds of not suffering PPH (defined as blood loss ≥500 mL) by 38.9%. This effect remained significant after stratification for the delivery mode, when correcting for other risk factors, and was independent of the statistical model used. Factor II but not fibrinogen had a partially comparable, but much less pronounced, effect. Conclusion In the largest population analyzed for the influence of prepartum coagulation factors on PPH to date, prepartum factor XIII activity had a strong impact on postpartum blood loss across every statistical model and clinical subgroup. Our hypothesis that early replenishment of factor XIII levels might constitute a new tool in the prevention and effective early treatment of PPH should be evaluated in future trials.
    Subject(s): blood coagulation factors ; postpartum hemorrhage ; factor XIII ; fibrinogen ; parturition ; Pregnancy ; Prospective Studies ; Postpartum Hemorrhage - diagnosis ; Factor XIII ; Humans ; Risk Factors ; Fibrinogen ; Female ; Postpartum Period
    ISSN: 1538-7933
    E-ISSN: 1538-7836
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Article
    Article
    2008
    ISSN: 0941-4355 
    Language: English
    In: Supportive care in cancer, 2008-03, Vol.16 (3), p.223-228
    Description: The association of cancer and venous thromboembolism (VTE) becomes increasingly important. VTE has been recognised as an increasingly frequent complication in cancer care. Furthermore, recent clinical trials have shown that therapy and prophylaxis of VTEs with low-molecular weight heparin (LMWH) is, in general, superior to oral anticoagulation with warfarin. Also, prolonged therapy of or prophylaxis for VTE in cancer patients seems to be associated with an improved outcome.Research on patient preferences for therapy and prophylaxis of VTE is still rare; but it seems clear that, as in other areas, cancer patients wish to be involved in the decision-making process. Patients seem to accept LMWH over oral anticoagulation despite the need for subcutaneous injections.Cancer and thrombosis/hypercoagulability is an increasingly important association. The use of antithrombotics in cancer patients warrants increased attention since it’s importance seems underecognized.
    Subject(s): Pain Medicine ; Rehabilitation Medicine ; Nursing ; Medicine & Public Health ; Deep venous thrombosis ; Oncology ; Embolism ; Venous thromboembolism ; Nursing Management/Nursing Research ; Neoplasms - complications ; Primary Prevention ; Prognosis ; Humans ; Quality of Life ; Anticoagulants - therapeutic use ; Venous Thrombosis - physiopathology ; Venous Thrombosis - prevention & control ; Heparin, Low-Molecular-Weight - therapeutic use ; Venous Thrombosis - etiology ; Warfarin - therapeutic use ; Molecular weight ; Cancer
    ISSN: 0941-4355
    E-ISSN: 1433-7339
    Source: Alma/SFX Local Collection
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    Language: English
    In: Journal of clinical medicine, 2020-07-31, Vol.9 (8), p.2456
    Description: Unexpected intraoperative bleeding is associated with a reduced availability of crosslinking capacity (provided through factor XIII (FXIII)) per unit of generated thrombin. Furthermore, FXIII deficiency and thrombocytopenia (but not fibrinogen deficiency) are the most prevalent modulators of clot firmness in the immediate postoperative setting. In this study, we therefore evaluated whether levels of FXIII, fibrinogen, or the platelet count influenced the probability of intraoperative red cell transfusions in patients in the operating theatre. This retrospective study was comprised of 1023 patients, which were in need of blood product support in the operating theatre and of which 443 received red cell transfusions. Due to standard operating procedures, FXIII activity, fibrinogen concentration, and platelet count were measured before transfusion took place, but without influencing the decision to transfuse. FXIII deficiency was frequent (50%), as was thrombocytopenia (49%), but not fibrinogen deficiency (9%). FXIII deficiency was associated with a significantly increased probability to receive red cell transfusions (OR 4.58, 95% CI 3.46–6.05) as was thrombocytopenia (OR 1.94, 95% CI 1.47–2.56), but not fibrinogen deficiency (OR 1.09, 95% CI 0.67–1.76). Similar results were seen for cut-off independent evaluations (receiver operating characteristics (ROC) curves, using continuously distributed variables), where the areas under the curves (AUC) of red cell transfusion for FXIII activity was 0.744 (95% CI 0.716–0.770)/0.632 (95% CI 0.601–0.661) for the platelet count, and 0.578 (95% CI 0.547–0.609) for fibrinogen concentration. All AUCs were significantly different from each other (p 〈 0.0001 and p = 0.0106, respectively), indicating that FXIII activity was a significantly better predictor of red blood cell (RBC) transfusion than platelet count and fibrinogen concentration. These results suggest that pre-transfusion FXIII activity and to a lesser extent the platelet count influence the probability of intraoperative red cell transfusions. Modifying FXIII activity and/or the platelet count might influence the need for downstream red cell transfusion, thus potentially reducing transfusion associated morbidity. This, however, needs confirmation in future studies.
    Subject(s): platelet count ; FXIII activity ; pre-transfusion level ; transfusion ; intraoperative bleeding ; fibrinogen
    ISSN: 2077-0383
    E-ISSN: 2077-0383
    Source: Academic Search Ultimate
    Source: PubMed Central
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    Language: English
    In: The Journal of thoracic and cardiovascular surgery, 2013, Vol.146 (4), p.927-939
    Description: Objectives Cardiac surgery with cardiopulmonary bypass frequently leads to excessive bleeding, obligating blood product transfusions. Because low factor XIII (FXIII) levels have been associated with bleeding after cardiac surgery, we investigated whether administering recombinant FXIII after cardiopulmonary bypass would reduce transfusions. Methods In this double-blinded, placebo-controlled, multicenter trial, 409 cardiac surgical patients at moderate risk for transfusion were randomized to receive an intravenous dose of recombinant FXIII, 17.5 IU/kg (n = 143), 35 IU/kg (n = 138), or placebo (n = 128) after cardiopulmonary bypass. Transfusion guidelines were standardized. The primary efficacy outcome was avoidance of allogeneic blood products for 7 days postsurgery. Secondary outcomes included amount of blood products transfused and reoperation rate. Serious adverse events were measured for 7 weeks. Results Study groups had comparable baseline characteristics and an approximately 40% decrease in FXIII levels after cardiopulmonary bypass. Thirty minutes postdose, FXIII levels were restored to higher than the lower 2.5th percentile of preoperative activity in 49% of the placebo group, and 85% and 95% of the 17.5- and 35-IU/kg recombinant FXIII groups, respectively ( P  〈 .05 for both treatments vs placebo). Transfusion avoidance rates were 64.8%, 64.3%, and 65.9% with placebo, 17.5 IU/kg, and 35 IU/kg recombinant FXIII (respective odds ratios against placebo, 1.05 [95% confidence interval, 0.61-1.80] and 0.99 [95% confidence interval, 0.57-1.72]). Groups had comparable adverse event rates. Conclusions Replenishment of FXIII levels after cardiopulmonary bypass had no effect on transfusion avoidance, transfusion requirements, or reoperation in moderate-risk cardiac surgery patients ( ClinicalTrials.gov identifier: NCT00914589 ).
    Subject(s): Cardiothoracic Surgery ; Postoperative Hemorrhage - prevention & control ; United States ; Cardiopulmonary Bypass - adverse effects ; Humans ; Middle Aged ; Male ; Cardiac Surgical Procedures - adverse effects ; Factor XIII - administration & dosage ; Blood Transfusion ; Time Factors ; Coagulants - administration & dosage ; Female ; Reoperation ; Double-Blind Method ; Drug Administration Schedule ; Europe ; Japan ; Risk Factors ; Logistic Models ; Treatment Outcome ; Factor XIII - adverse effects ; Preoperative Care ; Recombinant Proteins - administration & dosage ; Canada ; Postoperative Hemorrhage - etiology ; Aged ; Infusions, Intravenous ; Israel ; Coagulants - adverse effects ; Medical colleges ; Biological products ; Coronary artery bypass ; Surgery ; Clinical trials ; Anesthesia ; Blood transfusion ; Abridged Index Medicus
    ISSN: 0022-5223
    E-ISSN: 1097-685X
    Source: Alma/SFX Local Collection
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Article
    Article
    2008
    ISSN: 0941-4355 
    Language: English
    In: Supportive care in cancer, 2008-03, Vol.16 (3), p.315-315
    Subject(s): Oncology ; Pain Medicine ; Rehabilitation Medicine ; Nursing ; Medicine & Public Health ; Nursing Management/Nursing Research
    ISSN: 0941-4355
    E-ISSN: 1433-7339
    Source: Alma/SFX Local Collection
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Language: English
    In: Sleep and Breathing, 2012-06, Vol.16 (2), p.405-412
    Description: The aim of this study was to assess serum tumor necrosis factor alpha (TNFA) concentrations 8 months of continuous positive airway pressure (CPAP) therapy.This study used prospective, observational clinical trial.Sixty-six patients with newly diagnosed sleep apnea syndrome (12 women, 54 men), age 52.3 ± 9.8 (mean ± SD) with a body mass index of 29.7 ± 4.4 and an apnea-hypopnea index of 39.7 ± 26.8, were studied.CPAP was administered for a mean of 7.8 ± 1.3 months.TNFA concentrations using an ultrasensitive ELISA assay at baseline and follow-up. TNFA decreased in men with high (5.2 ± 1.7 h/night, −0.46 ± 1.1 ng/l, p = 0.001) and with low (2.5 ± 1.0 h/night −0.63 ± 0.77 ng/l, p = 0.001) adherence but not in women. Average number of hours of CPAP use correlated positively with delta TNFA (R 2 0.08, p = 0.04)Long-term CPAP positively affects TNFA even in men with poor adherence to CPAP.
    Subject(s): Adherence ; Neurology ; Pediatrics ; Obstructive sleep apnea syndrome ; Pneumology/Respiratory System ; CPAP ; Medicine & Public Health ; Tumor necrosis factor ; Internal Medicine ; Otorhinolaryngology ; Inflammation ; Dentistry ; Fundamental and applied biological sciences. Psychology ; Vertebrates: nervous system and sense organs ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Cerebrospinal fluid. Meninges. Spinal cord ; Biological and medical sciences ; Medical sciences ; Sleep. Vigilance ; Nervous system (semeiology, syndromes) ; Body Composition ; Continuous Positive Airway Pressure ; Sleep Apnea, Obstructive - therapy ; Prospective Studies ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Humans ; Middle Aged ; Tumor Necrosis Factor-alpha - blood ; Sleep Apnea, Obstructive - blood ; Male ; Statistics as Topic ; Biomarkers - blood ; Polysomnography ; Abdominal Fat ; Sex Factors ; Adult ; Female ; Patient Compliance
    ISSN: 1520-9512
    E-ISSN: 1522-1709
    Source: Alma/SFX Local Collection
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    Language: English
    In: Journal of blood medicine, 2014, Vol.5 (default), p.107-113
    Description: Circulating factor XIII (FXIII) consists of two active (A) and two carrier (B) subunits in tetrameric form. Congenital FXIII deficiency is a rare autosomal-recessive trait that mostly results from an FXIII A-subunit deficiency. Classic coagulation assays, such as prothrombin time or activated partial thromboplastin time, are not sensitive to FXIII; therefore, specific FXIII assays are necessary to detect the deficiency. The clinical picture of congenital FXIII deficiency comprises abortions, umbilical cord bleeding, increased surgical bleeding, intracerebral hemorrhage (which can, unfortunately, be the very first sign of severe FXIII deficiency), menorrhagia, and wound-healing disorders. Given the risk of intracranial hemorrhage, continued prophylaxis is to be recommended in severe deficiency, even in the actual absence of bleeding symptoms. Functional FXIII half-life decreases in consumptive processes (eg, surgery), explaining why increased dosing is needed in such situations. A recombinant FXIII (rFXIII) subunit-A molecule, which is expressed in Saccharomyces cerevisiae, has been evaluated for replacement therapy in congenital FXIII deficiency. The bleeding frequency under continued rFXIII prophylaxis during a year-long treatment period was significantly lower compared to on-demand treatment. Importantly, no severe spontaneous bleedings occurred, and bleeding requiring additional intervention only occurred after relevant trauma. Treatment with rFXIII proved to be safe: antibodies against rFXIII detected in four patients were not considered clinically relevant. No allergic reactions were observed. These data show that rFXIII can be used safely and effectively for continued prophylaxis in congenital FXIII deficiency; it is conceivable that this also holds true for treatment of acute bleeding, but clinical proof of this is pending.
    Subject(s): Blood clotting disorders ; Dosage and administration ; Blood coagulation factors ; Drug therapy ; Congenital diseases ; Peptides ; Laboratories ; Surgery ; Hemophilia ; Mutation ; Hemorrhage ; Binding sites ; Polymorphism
    ISSN: 1179-2736
    E-ISSN: 1179-2736
    Source: PubMed Central
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    Language: English
    In: Supportive care in cancer, 2007-03, Vol.15 (3), p.239-241
    Subject(s): Oncology ; Pain Medicine ; Rehabilitation Medicine ; Nursing ; Medicine & Public Health ; Nursing Management/Nursing Research ; Lung Neoplasms - drug therapy ; Predictive Value of Tests ; Reproducibility of Results ; Anemia - epidemiology ; Antineoplastic Agents - adverse effects ; Chemotherapy, Adjuvant - adverse effects ; Humans ; Anemia - chemically induced ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Models, Statistical ; Palliative Care - methods
    ISSN: 0941-4355
    E-ISSN: 1433-7339
    Source: Alma/SFX Local Collection
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Language: English
    In: BMC public health, 2016-09-09, Vol.16 (1), p.956-956
    Description: Associations between socioeconomic status (SES) and risk factors for noncommunicable diseases (NCD-RFs) may differ in populations at different stages of the epidemiological transition. We assessed the social patterning of NCD-RFs in a study including populations with different levels of socioeconomic development. Data on SES, smoking, physical activity, body mass index, blood pressure, cholesterol and glucose were available from the Modeling the Epidemiologic Transition Study (METS), with about 500 participants aged 25-45 in each of five sites (Ghana, South Africa, Jamaica, Seychelles, United States). The prevalence of NCD-RFs differed between these populations from five countries (e.g., lower prevalence of smoking, obesity and hypertension in rural Ghana) and by sex (e.g., higher prevalence of smoking and physical activity in men and of obesity in women in most populations). Smoking and physical activity were associated with low SES in most populations. The associations of SES with obesity, hypertension, cholesterol and elevated blood glucose differed by population, sex, and SES indicator. For example, the prevalence of elevated blood glucose tended to be associated with low education, but not with wealth, in Seychelles and USA. The association of SES with obesity and cholesterol was direct in some populations but inverse in others. In conclusion, the distribution of NCD-RFs was socially patterned in these populations at different stages of the epidemiological transition, but associations between SES and NCD-RFs differed substantially according to risk factor, population, sex, and SES indicator. These findings emphasize the need to assess and integrate the social patterning of NCD-RFs in NCD prevention and control programs in LMICs.
    Subject(s): Blood Pressure ; United States - epidemiology ; Epidemiologic Studies ; Prevalence ; Cholesterol - blood ; Developing Countries - statistics & numerical data ; Humans ; Middle Aged ; Risk Factors ; Chronic Disease - epidemiology ; Male ; Social Class ; Socioeconomic Factors ; Exercise ; Rural Population ; Smoking - epidemiology ; Obesity - epidemiology ; Adult ; Female ; Hypertension - epidemiology ; Chronic diseases ; Public health administration ; Social classes ; Health aspects ; Risk factors ; Hypertension ; Obesity ; Socioeconomic status ; Physical activity ; Noncommunicable diseases ; Low and middle income countries ; Smoking
    ISSN: 1471-2458
    E-ISSN: 1471-2458
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Language: English
    In: BMC public health, 2017-05-12, Vol.17 (1), p.438-438
    Description: Cardiovascular risk factors are increasing in most developing countries. To date, however, very little standardized data has been collected on the primary risk factors across the spectrum of economic development. Data are particularly sparse from Africa. In the Modeling the Epidemiologic Transition Study (METS) we examined population-based samples of men and women, ages 25-45 of African ancestry in metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles. Key measures of cardiovascular disease risk are described. The risk factor profile varied widely in both total summary estimates of cardiovascular risk and in the magnitude of component factors. Hypertension ranged from 7% in women from Ghana to 35% in US men. Total cholesterol was well under 200 mg/dl for all groups, with a mean of 155 mg/dl among men in Ghana, South Africa and Jamaica. Among women total cholesterol values varied relatively little by country, following between 160 and 178 mg/dl for all 5 groups. Levels of HDL-C were virtually identical in men and women from all study sites. Obesity ranged from 64% among women in the US to 2% among Ghanaian men, with a roughly corresponding trend in diabetes. Based on the Framingham risk score a clear trend toward higher total risk in association with socioeconomic development was observed among men, while among women there was considerable overlap, with the US participants having only a modestly higher risk score. These data provide a comprehensive estimate of cardiovascular risk across a range of countries at differing stages of social and economic development and demonstrate the heterogeneity in the character and degree of emerging cardiovascular risk. Severe hypercholesterolemia, as characteristic in the US and much of Western Europe at the onset of the coronary epidemic, is unlikely to be a feature of the cardiovascular risk profile in these countries in the foreseeable future, suggesting that stroke may remain the dominant cardiovascular event.
    Subject(s): Economic Development - statistics & numerical data ; Epidemiologic Studies ; Jamaica - epidemiology ; Prevalence ; Developing Countries - statistics & numerical data ; Europe ; Humans ; Middle Aged ; Risk Factors ; South Africa - epidemiology ; Male ; Socioeconomic Factors ; Ghana - epidemiology ; African Continental Ancestry Group - statistics & numerical data ; Seychelles - epidemiology ; Cardiovascular Diseases - epidemiology ; Adult ; Female ; Chicago - epidemiology ; African diaspora ; Human development index ; Cardiovascular risk
    ISSN: 1471-2458
    E-ISSN: 1471-2458
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...