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Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
For acute MI prior to hospitalization, emergency personnel establish a good IV route, give oxygen by nasal cannula, and begin continuous single-lead ECG monitoring. Medications include antiplatelet drugs, anticoagulants, and antianginal drugs. Antiplatelet drugs include aspirin, clopidogrel, prasugrel, and ticagrelor. Anticoagulants include various types of heparin, and bivalirudin. Nitroglycerin is the predominant antianginal agent, and morphine is used more selectively based on the individual patient. Beta-blockers, ACE inhibitors, and statins are also given.
Obstetric Analgesia
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Relative contraindications include sepsis, spinal cord lesions, thrombocytopenia, bleeding disorders, and patients on anticoagulant therapy. There is no standard cut-off value for platelet count in literature, below which neuraxial blockade is deemed unfit. Instead of the absolute value, the trend of change in platelet count along with platelet function is a better indicator.
Acquired Bleeding Disorders Associated with Disease and Medications
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
William A. Rock, Sue D. Walker
b. Nephrotic Syndrome. In nephrotic syndrome the renal tubules cease to function, resulting in the urinary loss of AT-III, F IX, factor XII, and prekallikrein (64). Patients present with thrombosis but rarely with bleeding. Renal vein thrombosis, lower-extremity deep vein thrombosis, pulmonary embolus, stroke, and acute myocardial infarction do occur, but the exact mechanism has not been well defined. Treatment with anticoagulants may be required and may result in a risk for bleeding.
Therapeutic effects and mechanism of human amnion-derived mesenchymal stem cells on hypercoagulability in a uremic calciphylaxis patient
Published in Renal Failure, 2023
Anning Bian, Xiaoxue Ye, Jing Wang, Ming Zeng, Jiayin Liu, Kang Liu, Song Ning, Yugui Cui, Shaowen Tang, Xueqiang Xu, Yanggang Yuan, Zhonglan Su, Yan Lu, Jing Zhou, Xiang Ma, Guang Yang, Yaoyu Huang, Feng Chen, Youjia Yu, Mufeng Gu, Xiaolin Lv, Ling Wang, Jing Zhao, Xiuqin Wang, Ningxia Liang, Changying Xing, Lianju Qin, Ningning Wang
We performed skin biopsy on this CUA patient before hAMSC treatment, which is consistent with the characteristic pathological manifestations of calciphylaxis. Multidisciplinary therapies for this CUA patient involving analgesics, antibiotic administration, wound care, nutrition support, continuous kidney replacement therapy (CKRT), sodium thiosulfate [intravenous infusion of 7.68 g of sodium thiosulfate (each vial contained 0.64 g sodium thiosulfate and 12 vials were used each time), 30 min before the completion of hemodialysis] and anticoagulation [1,2] were applied, but without improvement in skin lesions and pain relief. As there were no alternative therapeutic options available, we rescue this CUA patient with hAMSCs as a candidate [11]. The dosage of sodium thiosulfate remained unchanged during the initial 4 months of hAMSC treatment, but it was withdrawn afterwards due to its high cost and improvements in her skin lesions. During the entire follow-up process, the dosage of anticoagulants continued at the original dose.
Pullulan based derivatives: synthesis, enhanced physicochemical properties, and applications
Published in Drug Delivery, 2022
Surendra Agrawal, Divya Budhwani, Pravina Gurjar, Darshan Telange, Vijay Lambole
Anticoagulants are used to stop the thickening of the blood and the formation of clots. Heparin is one of the popular anticoagulants. Pullulan derivatization via sulfation has been done with the aim to develop an alternative to heparin. Sulfated pullulan can be obtained by the reaction of pullulan and sulfur trioxide–pyridine complex in DMF (dimethylformamide) at 75 °C and 95 °C for 3–8 h. Sulfate pullulan can also be obtained from pullulan reaction with SO3-DMF (N,N-dimethyl formamide) complex, but due to SO3–DMF complex, resultant pullulan becomes more reactive and less viscous; therefore, SO3–Py (pyridine) complex is more preferred to achieve stable and viscous derivative. Pullulan sulfate C-6 is the most preferential position for sulfation, followed by C-3, while C-4 remained mostly unsulfated (Mähner et al., 2001). It was reported that pullulan sulfate prevents coagulation by interfering with several stages of coagulation (Alban et al., 2002).
Comparison of efficacy, safety, and patient satisfaction between thermal ablation, conventional/open thyroidectomy, and endoscopic thyroidectomy for symptomatic benign thyroid nodules
Published in International Journal of Hyperthermia, 2022
Xiao-Wan Bo, Feng Lu, Song-Yuan Yu, Wen-Wen Yue, Xiao-Long Li, Man Hu, Li-Li Wu, Zhu-Ying Lv, Li-Ping Sun, Hui-Xiong Xu
Before the operation, all patients were evaluated using conventional ultrasound, color Doppler ultrasound, laboratory tests, FNA cytology, and physical examination. Contrast-enhanced ultrasound (CEUS) was performed routinely to visualize the vascularity of the nodules before ablation. The laboratory tests included the measurements of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT4), free triiodothyronine (FT3), total antithyroperoxidase antibodies (TPOAb), calcitonin concentration, routine blood examination, prothrombin time, and activated partial thromboplastin time. Patients taking anticoagulant treatment were instructed to stop taking the treatment for 7 days if anticoagulant was taken daily. Nodule volume was calculated using the ellipsoid formula (volume = length × width × depth × 0.524).