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MEDICAL SCIENCES (2241 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 601 - 800 of 3562 Journals sorted alphabetically
F&S Science : Official journal of the American Society for Reproductive Medicine     Open Access  
Facial Plastic Surgery & Aesthetic Medicine     Full-text available via subscription   (Followers: 2)
Facta Universitatis, Series : Medicine and Biology     Open Access  
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Practice     Hybrid Journal   (Followers: 17)
Family Practice & Palliative Care     Open Access   (Followers: 5)
Family Practice Management     Full-text available via subscription   (Followers: 4)
Faridpur Medical College Journal     Open Access  
FEM : Revista de la Fundación Educación Médica     Open Access  
Finlay : Revista de Enfermedades no Transmisibles     Open Access  
Fisioterapia     Full-text available via subscription   (Followers: 2)
Fisioterapia & Saúde Funcional     Open Access  
Flugmedizin · Tropenmedizin · Reisemedizin - FTR     Hybrid Journal  
FMC - Formación Médica Continuada en Atención Primaria     Full-text available via subscription  
Folia Medica     Open Access  
Folia Medica Indonesiana     Open Access  
Folia Morphologica     Full-text available via subscription  
Folia Phoniatrica et Logopaedica     Full-text available via subscription   (Followers: 1)
Fontanus     Open Access  
Food Hydrocolloids for Health     Open Access  
Foodborne Pathogens and Disease     Hybrid Journal   (Followers: 11)
Foot & Ankle Specialist     Hybrid Journal   (Followers: 4)
Foot and Ankle Clinics     Full-text available via subscription   (Followers: 12)
Foot and Ankle Online Journal     Full-text available via subscription   (Followers: 6)
Forensic Science International : Mind and Law     Open Access   (Followers: 4)
Forum Medycyny Rodzinnej     Hybrid Journal  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontières     Full-text available via subscription   (Followers: 3)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Medical Technology     Open Access  
Frontiers in Medicine     Open Access   (Followers: 2)
Frontiers in Network Physiology     Open Access   (Followers: 2)
Frontiers in Neuroprosthetics     Open Access   (Followers: 6)
Frontiers in Synaptic Neuroscience     Open Access   (Followers: 2)
Frontiers in Tropical Diseases     Open Access  
Frontiers of Medical and Biological Engineering     Hybrid Journal  
Frontiers of Medicine     Hybrid Journal   (Followers: 2)
Fuss & Sprunggelenk     Hybrid Journal  
Future Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Future Prescriber     Hybrid Journal  
Future Science OA     Open Access  
Gaceta Médica Boliviana     Open Access  
Gaceta Médica Espirituana     Open Access  
Galen Medical Journal     Open Access  
Galician Medical Journal     Open Access   (Followers: 1)
Galle Medical Journal     Open Access  
Gefäßmedizin Scan     Hybrid Journal  
Gender and the Genome     Open Access   (Followers: 1)
Gene Expression     Full-text available via subscription   (Followers: 1)
General Reanimatology     Open Access  
Genes     Open Access   (Followers: 2)
Genome Instability & Disease     Hybrid Journal  
Geoforum     Hybrid Journal   (Followers: 25)
Gestão e Desenvolvimento     Open Access  
Ghana Medical Journal     Open Access   (Followers: 1)
GigaScience     Open Access   (Followers: 4)
Gimbernat : Revista d’Història de la Medicina i de les Ciències de la Salut     Open Access  
Glia     Hybrid Journal   (Followers: 5)
Global Advances in Health and Medicine     Open Access  
Global Bioethics     Open Access   (Followers: 5)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access  
Global Journal of Cancer Therapy     Open Access  
Global Journal of Fertility and Research     Open Access  
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Infectious Diseases and Clinical Research     Open Access  
Global Journal of Medical and Clinical Case Reports     Open Access  
Global Journal of Obesity, Diabetes and Metabolic Syndrome     Open Access   (Followers: 1)
Global Journal of Perioperative Medicine     Open Access  
Global Journal of Rare Diseases     Open Access  
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Reproductive Health     Open Access  
Grande Medical Journal     Open Access  
Growth Factors     Hybrid Journal   (Followers: 2)
GSTF Journal of Advances in Medical Research     Open Access  
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi     Open Access  
Hamdan Medical Journal     Open Access  
Hämostaseologie     Hybrid Journal   (Followers: 5)
Hämostaseologie     Open Access  
Hand     Hybrid Journal   (Followers: 4)
Hand Clinics     Full-text available via subscription   (Followers: 6)
Hand Therapy     Hybrid Journal   (Followers: 11)
Hard Tissue     Open Access  
Head & Face Medicine     Open Access   (Followers: 1)
Head and Neck Cancer Research     Open Access  
Head and Neck Tumors     Open Access  
Health Information : Jurnal Penelitian     Open Access  
Health Matrix : The Journal of Law-Medicine     Open Access  
Health Notions     Open Access  
Health Science Journal of Indonesia     Open Access  
Health Science Reports     Open Access   (Followers: 1)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Sciences Review     Open Access  
Health Security     Hybrid Journal   (Followers: 1)
Healthcare Technology Letters     Open Access  
Hearing, Balance and Communication     Hybrid Journal   (Followers: 6)
Hearts     Open Access   (Followers: 1)
HEC Forum     Hybrid Journal   (Followers: 1)
Heighpubs Otolaryngology and Rhinology     Open Access  
Heilberufe     Hybrid Journal  
HeilberufeSCIENCE     Hybrid Journal  
Heilpflanzen     Hybrid Journal   (Followers: 3)
Helicobacter     Hybrid Journal  
HemaSphere     Open Access   (Followers: 2)
Hemoglobin     Hybrid Journal  
Hepatology, Medicine and Policy     Open Access  
HERALD of North-Western State Medical University named after I.I. Mechnikov     Open Access  
Herald of the Russian Academy of Sciences     Full-text available via subscription  
Herzschrittmachertherapie + Elektrophysiologie     Hybrid Journal  
Highland Medical Research Journal     Full-text available via subscription  
Hipertensión y Riesgo Vascular     Full-text available via subscription  
HIV Australia     Full-text available via subscription   (Followers: 3)
Homeopathy     Hybrid Journal   (Followers: 1)
Homoeopathic Links     Hybrid Journal  
Hong Kong Physiotherapy Journal     Open Access   (Followers: 14)
Horizonte Medico     Open Access  
Hormones : International Journal of Endocrinology and Metabolism     Hybrid Journal  
Hospital a Domicilio     Open Access  
Hospital Practices and Research     Open Access  
Hospital Topics     Hybrid Journal   (Followers: 1)
Hua Hin Sook Jai Klai Kangwon Journal     Open Access  
Huisarts en wetenschap     Hybrid Journal   (Followers: 4)
Human & Veterinary Medicine - International Journal of the Bioflux Society     Open Access   (Followers: 4)
Human Factors in Healthcare     Open Access  
Human Fertility     Hybrid Journal   (Followers: 4)
Humanidades Médicas     Open Access  
I.P. Pavlov Russian Medical Biological Herald     Open Access  
Iatreia     Open Access  
Ibnosina Journal of Medicine and Biomedical Sciences     Open Access  
IDCases     Open Access  
IEEE Journal of Biomedical and Health Informatics     Hybrid Journal   (Followers: 14)
IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology     Hybrid Journal  
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 5)
IEEE Open Journal of Engineering in Medicine and Biology     Open Access   (Followers: 1)
IEEE Transactions on Medical Robotics and Bionics     Hybrid Journal   (Followers: 3)
IEEE/ACM Transactions on Computational Biology and Bioinformatics     Hybrid Journal   (Followers: 18)
IJID Regions     Open Access   (Followers: 1)
IJS Global Health     Open Access  
IJU Case Reports     Open Access  
iLiver     Open Access   (Followers: 2)
Im OP     Hybrid Journal  
Image Analysis & Stereology     Open Access   (Followers: 1)
IMAGING     Full-text available via subscription   (Followers: 1)
Imaging in Medicine     Open Access  
Imaging Journal of Clinical and Medical Sciences     Open Access   (Followers: 1)
Imam Journal of Applied Sciences     Open Access  
Indian Journal of Ayurveda and lntegrative Medicine Klue     Open Access   (Followers: 3)
Indian Journal of Burns     Open Access   (Followers: 2)
Indian Journal of Clinical Medicine     Open Access  
Indian Journal of Community and Family Medicine     Open Access   (Followers: 2)
Indian Journal of Community Medicine     Open Access   (Followers: 1)
Indian Journal of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian Journal of Medical Microbiology     Open Access   (Followers: 1)
Indian Journal of Medical Research     Open Access   (Followers: 3)
Indian Journal of Medical Sciences     Open Access   (Followers: 2)
Indian Journal of Medical Specialities     Hybrid Journal  
Indian Journal of Otology     Open Access   (Followers: 1)
Indian Journal of Public Health     Open Access   (Followers: 1)
Indian Journal of Transplantation     Open Access  
Indian Spine Journal     Open Access  
Indo-Pacific Journal of Phenomenology     Open Access   (Followers: 1)
Indonesia Journal of Biomedical Science     Open Access   (Followers: 1)
Indonesian Biomedical Journal     Open Access  
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Medicine     Open Access  
Indonesian Journal of Tropical and Infectious Disease     Open Access  
Infant Observation: International Journal of Infant Observation and Its Applications     Hybrid Journal   (Followers: 1)
Inflammation     Hybrid Journal   (Followers: 3)
Inflammation Research     Hybrid Journal   (Followers: 4)
Info Diabetologie     Full-text available via subscription   (Followers: 1)
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
Informatics in Medicine Unlocked     Open Access  
Injury Prevention     Hybrid Journal   (Followers: 6)
InnovAiT     Hybrid Journal   (Followers: 1)
Innovare Journal of Health Science     Open Access  
Innovare Journal of Medical Science     Open Access  
Innovation in Aging     Open Access   (Followers: 1)
Inside Precision Medicine     Full-text available via subscription   (Followers: 3)
Insights in Biology and Medicine     Open Access  
Integrative and Complementary Therapies     Full-text available via subscription   (Followers: 3)
Integrative Medicine Insights     Open Access   (Followers: 1)
Integrative Medicine International     Open Access   (Followers: 1)
Integrative Medicine Research     Open Access   (Followers: 3)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 12)
Intelligence-Based Medicine     Open Access  
Intelligent Medicine     Open Access   (Followers: 1)
intensiv     Hybrid Journal   (Followers: 1)
interactive Journal of Medical Research     Open Access  
Interdisciplinary Perspectives on Infectious Diseases     Open Access  
Interdisciplinary Sciences : Computational Life Sciences     Hybrid Journal   (Followers: 2)
Internal Medicine     Open Access   (Followers: 1)
International Biomechanics     Open Access   (Followers: 1)
International Health     Hybrid Journal   (Followers: 5)
International Health Trends and Perspectives     Open Access  
International Journal for Numerical Methods in Biomedical Engineering     Hybrid Journal   (Followers: 2)
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 10)
International Journal of Academic Medicine     Open Access   (Followers: 1)
International Journal of Advance in Medical Science     Open Access  
International Journal of Advanced Medical and Health Research     Open Access  

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Hämostaseologie
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0720-9355 - ISSN (Online) 2567-5761
Published by Thieme Publishing Group Homepage  [233 journals]
  • GTH 2022: Sustainable Collaboration
    • Hamostaseologie 2022; 42: 007-008
      DOI: 10.1055/a-1694-4829



      Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Hamostaseologie 2022; 42: 007-0082022-02-23T00:00:00+0100
      Issue No: Vol. 42, No. 01 (2022)
       
  • Treatment of Atypical Clots

    • Authors: Ageno; Walter
      Pages: 010 - 018
      Abstract: The term unusual site thrombosis refers to the occurrence of venous thromboembolism outside of the lower limbs and the pulmonary arteries. Unusual site thrombosis can virtually affect any venous segment, with the most common and/or clinically relevant sites including the upper limbs veins, the retinal veins, the splanchnic veins and the cerebral veins. Clinical features are obviously heterogeneous, while many predisposing factors are common, though with different prevalence among the various disorders. Antithrombotic therapy is prescribed to most patients, but the type, intensity, and duration of treatment vary both within and among patient groups. Increasing evidence is supporting the use of the direct oral anticoagulants in patients with upper limb deep vein thrombosis, cerebral vein thrombosis, and with splanchnic vein thrombosis. This article will review available evidence on the treatment of venous thrombosis occurring in unusual sites.
      Citation: Hamostaseologie 2022; 42: 010-018
      PubDate: 2022-02-23T00:00:00+0100
      DOI: 10.1055/a-1669-3336
      Issue No: Vol. 42, No. 01 (2022)
       
  • Diagnosis of Platelet Function Disorders: A Challenge for Laboratories

    • Authors: Wagner; Miriam, Uzun, Günalp, Bakchoul, Tamam, Althaus, Karina
      Pages: 036 - 045
      Abstract: In patients with normal plasmatic coagulation and bleeding tendency, platelet function defect can be assumed. Congenital platelet function defects are rare. Much more commonly they are acquired. The clinical bleeding tendency of platelet function defects is heterogeneous, which makes diagnostic approaches difficult. During the years, a large variety of tests for morphological phenotyping and functional analysis have been developed. The diagnosis of platelet function defects is based on standardized bleeding assessment tools followed by a profound morphological evaluation of the platelets. Platelet function assays like light transmission aggregation, luminoaggregometry, and impedance aggregometry followed by flow cytometry are commonly used to establish the diagnosis in these patients. Nevertheless, despite great efforts, standardization of these tests is poor and in most cases, quality control is lacking. In addition, these tests are still limited to specialized laboratories. This review summarizes the approaches to morphologic phenotyping and platelet testing in patients with suspected platelet dysfunction, beginning with a standardized bleeding score and ending with flow cytometry testing. The diagnosis of a functional defect requires a good collaboration between the laboratory and the clinician.
      Citation: Hamostaseologie 2022; 42: 036-045
      PubDate: 2022-02-23T00:00:00+0100
      DOI: 10.1055/a-1700-7036
      Issue No: Vol. 42, No. 01 (2022)
       
  • Thrombophilia, Thrombosis and Thromboprophylaxis in Pregnancy: For What
           and in Whom'

    • Authors: Middeldorp; Saskia, Naue, Christiane, Köhler, Christina
      Pages: 054 - 064
      Abstract: Compared with nonpregnant women, pregnancy carries a four- to fivefold higher risk of venous thromboembolism (VTE). Despite increasing use of heparin prophylaxis in identified high-risk patients, pulmonary embolism still is the leading cause of maternal mortality in the western world. However, evidence on optimal use of thromboprophylaxis is scarce. Thrombophilia, the hereditary or acquired tendency to develop VTE, is also thought to be associated with complications in pregnancy, such as recurrent miscarriage and preeclampsia. In this review, the current evidence on optimal thromboprophylaxis in pregnancy is discussed, focusing primarily on VTE prevention strategies but also discussing the potential to prevent recurrent pregnancy complications with heparin in pregnant women with thrombophilia.
      Citation: Hamostaseologie 2022; 42: 054-064
      PubDate: 2022-02-23T00:00:00+0100
      DOI: 10.1055/a-1717-7663
      Issue No: Vol. 42, No. 01 (2022)
       
  • An Update on Safe Anticoagulation

    • Authors: Mailer; Reiner K., Kuta, Piotr, Renné, Thomas
      Pages: 065 - 072
      Abstract: Blood coagulation is essential to maintain the integrity of a closed circulatory system (hemostasis), but also contributes to thromboembolic occlusion of vessels (thrombosis). Thrombosis may cause deep vein thrombosis, pulmonary embolism, myocardial infarction, peripheral artery disease, and ischemic stroke, collectively the most common causes of death and disability in the developed world. Treatment for the prevention of thromboembolic diseases using anticoagulants such as heparin, coumarins, thrombin inhibitors, or antiplatelet drugs increase the risk of bleeding and are associated with an increase in potentially life-threatening hemorrhage, partially offsetting the benefits of reduced coagulation. Thus, drug development aiming at novel targets is needed to provide efficient and safe anticoagulation. Within the last decade, experimental and preclinical data have shown that some coagulation mechanisms principally differ in thrombosis and hemostasis. The plasma contact system protein factors XII and XI, high-molecular-weight kininogen, and plasma kallikrein specifically contribute to thrombosis, however, have minor, if any, role in hemostatic coagulation mechanisms. Inherited deficiency in contact system proteins is not associated with increased bleeding in humans and animal models. Therefore, targeting contact system proteins provides the exciting opportunity to interfere specifically with thromboembolic diseases without increasing the bleeding risk. Recent studies that investigated pharmacologic inhibition of contact system proteins have shown that this approach provides efficient and safe thrombo-protection that in contrast to classical anticoagulants is not associated with increased bleeding risk. This review summarizes therapeutic and conceptual developments for selective interference with pathological thrombus formation, while sparing physiologic hemostasis, that enables safe anticoagulation treatment.
      Citation: Hamostaseologie 2022; 42: 065-072
      PubDate: 2022-02-23T00:00:00+0100
      DOI: 10.1055/a-1717-7958
      Issue No: Vol. 42, No. 01 (2022)
       
  • When and How to Combine Antiplatelet and Anticoagulant Drugs'

    • Authors: Espinola-Klein; Christine
      Pages: 073 - 079
      Abstract: Antiplatelet and anticoagulant drugs work at different places in the coagulation system. Antiplatelet drugs are usually indicated in patients with atherosclerosis. Anticoagulant drugs are mostly used in patients with atrial fibrillation, venous thromboembolism, or technical heart valves. In some clinical situations, combination of antiplatelet and anticoagulant therapy can be indicated. The most recent situations are a more intensive antithrombotic therapy for risk reduction in patients with atherosclerosis and temporary addition of antiplatelet drugs in patients with indication for long-term anticoagulation. Temporary combination of antiplatelet and anticoagulant drugs is usually necessary after coronary intervention in patients with atrial fibrillation. In patients with high-risk atherosclerosis, the combination of low-dose rivaroxaban and aspirin reduces major adverse cardiovascular events (myocardial infarction, stroke, cardiovascular death) and major adverse limb events. But every combination of antiplatelet and antithrombotic drugs can increase bleeding risk. Therefore, a careful assessment of thrombotic versus bleeding risk is necessary for each patient.
      Citation: Hamostaseologie 2022; 42: 073-079
      PubDate: 2022-02-23T00:00:00+0100
      DOI: 10.1055/a-1724-4922
      Issue No: Vol. 42, No. 01 (2022)
       
  • Neuigkeiten zur Ablösung der geplanten Ablösung der
           In-Vitro-Diagnostika-Richtlinie durch die In-Vitro-Diagnostika-Verordnung
           (IVDR) 05/2022 und Plasmaversorgung in Deutschland/EU und Fortführung der
           konzertierten Aktion des BDDH mit den Selbsthilfegruppen
    • Hamostaseologie 2022; 42: 081-083
      DOI: 10.1055/a-1694-4640



      Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis     Volltext

      Hamostaseologie 2022; 42: 081-0832022-02-23T00:00:00+0100
      Issue No: Vol. 42, No. 01 (2022)
       
  • Assessment and Monitoring of Coagulation in Patients with COVID-19: A
           Review of Current Literature

    • Authors: Uzun; Günalp, Althaus, Karina, Hammer, Stefanie, Bakchoul, Tamam
      Abstract: Coagulation abnormalities are common in patients with COVID-19 and associated with high morbidity and mortality. It became a daily challenge to navigate through these abnormal laboratory findings and deliver the best possible treatment to the patients. The unique character of COVID-19-induced coagulopathy necessitates not only a dynamic follow-up of the patients in terms of hemostatic findings but also the introduction of new diagnostic methods to determine the overall function of the coagulation system in real time. After the recognition of the high risk of thromboembolism in COVID-19, several professional societies published their recommendations regarding anticoagulation in patients with COVID-19. This review summarizes common hemostatic findings in COVID-19 patients and presents the societal recommendations regarding the use of coagulation laboratory findings in clinical decision-making. Although several studies have investigated coagulation parameters in patients with COVID-19, the methodological shortcomings of published studies as well as the differences in employed anticoagulation regimens that have changed over time, depending on national and international guidelines, limit the applicability of these findings in other clinical settings. Accordingly, evidence-based recommendations for diagnostics during acute COVID-19 infection are still lacking. Future studies should verify the role of coagulation parameters as well as viscoelastic methods in the management of patients with COVID-19.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-04-27T00:00:00+01:00
      DOI: 10.1055/a-1755-8676
       
  • Interventional Treatment Options in Children with Extracranial Vascular
           Malformations

    • Authors: Schmidt; Vanessa F., Olivieri, Martin, Häberle, Beate, Masthoff, Max, Deniz, Sinan, Sporns, Peter B., Wohlgemuth, Walter A., Wildgruber, Moritz
      Abstract: Extracranial vascular malformations vary greatly and belong to the complex field of orphan diseases and can involve all segments of the vascular tree: arteries, capillaries, and veins, and similarly the lymphatic system. The classification according to the International Society for the Study of Vascular Anomalies (ISSVA) represents an important guidance for selecting appropriate therapy. Although many of the principles of endovascular treatment, including image-guided sclerotherapy and embolization, are similar in adult and pediatric practice, there are some distinct differences regarding the treatment of vascular malformations of children. Thus, it is crucial to involve longer-term plan about managing these chronic diseases and their impact on a growing child. This review provides a detailed overview over the clinical presentation of venous, lymphatic, and arteriovenous malformations in children and emphasizes the specifics of their interventional treatment options, including distinct pediatric dose limitations and procedure-related side effects.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-03-09T00:00:00+0100
      DOI: 10.1055/a-1728-5686
       
  • Cardiac and Cerebral Arterial Complications of Lemierre Syndrome: Results
           from a Systematic Review and Individual Patient Data Meta-analysis

    • Authors: Pleming; William, Barco, Stefano, Voci, Davide, Sacco, Clara, Zane, Federica, Granziera, Serena, Corsi, Gabriele, Konstantinides, Stavros V., Kucher, Nils, Pecci, Alessandro, Valerio, Luca
      Abstract: Background Lemierre syndrome is a potentially life-threatening disease, which affects otherwise healthy young adults and adolescents. It is characterized by acute neck vein thrombosis and septic embolism, usually complicating a bacterial infection. Data on the syndrome are sparse, particularly concerning arterial complications. Methods We evaluated the frequency and patterns of cerebral arterial and cardiac involvement (“arterial complications”) in an individual patient level cohort of 712 patients, representing all cases described over the past 20 years in the medical literature who fulfilled the criteria: (1) bacterial infection in the neck/head site and (2) objectively confirmed thrombotic complication or septic embolism. The study outcomes were defined as all-cause in-hospital deaths and the occurrence of clinical sequelae at discharge or in the postdischarge period. Results A total of 55 (7.7%) patients had an arterial complication. The most frequent arterial complications were carotid involvement (52.7%), stroke (38.2%), and pericardial complications (20%). Patients with an arterial involvement were more likely to be treated with a greater number of antibiotics (23 vs. 10%) and to receive anticoagulation. In addition, patients with arterial complications had a greater risk of all-cause death (n = 20/600, 3.3% vs. n = 6/52, 12%; odds ratio [OR]: 3.8; 95% confidence interval [CI]: 1.5–9.9) and late clinical sequelae (n = 49/580, 9.0% vs. n = 15/46, 35%; OR: 5.2; 95% CI: 2.65–10.37). Conclusions While Lemierre syndrome is known to be primarily characterized by venous thromboembolic events, our results suggest that local or distant arterial complications may occur in approximately one-tenth of patients and may be associated with a greater risk of long-term sequelae and death.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-03-07T00:00:00+0100
      DOI: 10.1055/a-1694-8723
       
  • High Prevalence of Plasminogen Activator Inhibitor-1 4G/5G Polymorphism
           among Patients with Venous Thromboembolism in Kerala, India

    • Authors: Tony; Ann Maria, Vinod, Vivek, Nambiar, Vivek, Krishnan, Sajitha, Biswas, Lalitha
      Abstract: Venous thromboembolism (VTE) is a multifactorial clotting disorder in which inherited and environmental factors synergistically contribute to its pathogenesis. The aim of this case–control study was to analyze the prevalence of hereditary thrombophilic risk factors, provoking and non-provoking environmental risk factors in patients with VTE from Kerala, India. We have observed a low prevalence of factor V Leiden (7%), prothrombin G20210A (2%), and prothrombin G20030A (2%) mutations and a high prevalence of plasminogen activator inhibitor-1 (PAI-1) 4G/5G (52%), PAI-1 4G/4G (24%) genotypes in the VTE patients (n = 147). Deficiency of anticoagulants, antithrombin (3.4%), and protein C (4.1%) was relatively low. None of the risk factors were observed in 17% of the patients. Majority of VTE patients were younger than 50 years with a median age of 43 years. In conclusion, our results indicate a high prevalence of PAI-1 4G/5G polymorphism among the VTE patients which is in concordance with previous studies in the Asian population. The PAI-1 4G/5G polymorphism could be a potential biomarker for assessing VTE risk, particularly among the Indian population.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-03-07T00:00:00+0100
      DOI: 10.1055/a-1733-2143
       
  • Experiences in Routine Genetic Analysis of Hereditary Hemorrhagic,
           Thrombotic, and Platelet Disorders

    • Authors: Pezeshkpoor; B., Oldenburg, J., Pavlova, A.
      Abstract: Hemostasis is a complex and tightly regulated system that attempts to maintain a homeostatic balance to permit normal blood flow, without bleeding or thrombosis. Hemostasis reflects the subtle balance between procoagulant and anticoagulant factors in the pathways of primary hemostasis, secondary hemostasis, and fibrinolysis. The major components in this interplay include the vascular endothelium, platelets, coagulation factors, and fibrinolytic factors. After vessel wall injury, the subendothelium is exposed to the blood stream, followed by rapid activation of platelets via collagen binding and von Willebrand factor–mediated platelet adhesion to the damaged vessel wall through platelet glycoprotein receptor Ib/IX/V. Activated platelets change their shape, release bioactive molecules from their granules, and expose negatively charged phospholipids on their surface. For a proper function of this process, an adequate number of functional platelets are required. Subsequently, a rapid generation of sufficient amounts of thrombin begins; followed by activation of the coagulation system and its coagulation factors (secondary hemostasis), generating fibrin that consolidates the platelet plug. To maintain equilibrium between coagulation and anticoagulation, the naturally occurring anticoagulants such as protein C, protein S, and antithrombin keep this process in balance. Deficiencies (inherited or acquired) at any level of this fine-tuned system result in pathologic bleedings or increased hypercoagulability states leading to thrombosis. This review will focus on genetic diagnosis of inherited bleeding, thrombotic, and platelet disorders, discussing strengths and limitations of existing diagnostic settings and genetic tools and highlight some important considerations necessary for clinical application.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-02-28T00:00:00+0100
      DOI: 10.1055/a-1726-4793
       
  • Novel Likely Pathogenic Variant in the A3 Domain of von Willebrand Factor
           Leading to a Collagen-Binding Defect

    • Authors: Fels; Salome, Boeckelmann, Doris, Glonnegger, Hannah, Büchsel, Martin, Zieger, Barbara
      Abstract: Von Willebrand disease (VWD) is the most prevalent congenital bleeding disorder. Diagnosis and classification of VWD is complex due to its heterogeneity regarding clinical manifestations and molecular genetic analysis. Genetic investigations became an inherent part of diagnosis and help distinguish different types/subtypes of VWD. Although many variants have been listed being causative for VWD, the genetic etiology remains undefined in a lot of patients. We report about two siblings with severely reduced values for von Willebrand factor collagen-binding activity (VWF:CB). Genetic analysis using panel sequencing identified a heterozygous non-synonymous single nucleotide variant in exon 30. At the protein level, the alteration (p.Ser1731Leu) is located in the A3 collagen-binding domain. The amino acid position is already known to be important for collagen binding because p.Ser1731Thr has been reported to affect the VWF:CB.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-02-01T00:00:00+0100
      DOI: 10.1055/a-1701-2181
       
  • An Update on Laboratory Diagnostics in Haemophilia A and B

    • Authors: Müller; Jens, Miesbach, Wolfgang, Prüller, Florian, Siegemund, Thomas, Scholz, Ute, Sachs, Ulrich J.
      Abstract: Haemophilia A (HA) and B (HB) are X-linked hereditary bleeding disorders caused by lack of activity of coagulation factors VIII (FVIII) or IX (FIX), respectively. Besides conventional products, modern replacement therapies include FVIII or FIX concentrates with an extended half-life (EHL-FVIII/FIX). Two main strategies for measuring plasma FVIII or FIX activity are applied: the one-stage clotting assay (OSCA) and the chromogenic substrate assay (CSA), both calibrated against plasma (FVIII/FIX) standards. Due to the structural modifications of EHL-FVIII/FIX, reagent-dependent assay discrepancies have been described when measuring the activity of these molecules. Assay discrepancies have also been observed in FVIII/FIX gene therapy approaches. On the other hand, nonfactor replacement by the bispecific antibody emicizumab, a FVIIIa-mimicking molecule, artificially shortens activated partial thromboplastin time–based clotting times, making standard OSCAs inapplicable for analysis of samples from patients treated with this drug. In this review, we aim to give an overview on both, the currently applied and future therapies in HA and HB with or without inhibitors and corresponding test systems suitable for accompanying diagnostics.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-02-01T00:00:00+0100
      DOI: 10.1055/a-1665-6232
       
  • Successful Secondary Endovascular Intervention in Pediatric Patients with
           Venous Thromboembolic Events

    • Authors: Glonnegger; Hannah, Zieger, Barbara, Grohmann, Jochen, Freund, Gabriele, Zeller, Thomas, Uhl, Markus, Stiller, Brigitte
      Abstract: Background In the past, pediatric patients with venous thromboembolic events (VTE) were treated with low-molecular-weight heparin (LMWH) which was successful in around 70% of the cases. However, anticoagulation alone might not restore patency in all patients, and advanced therapeutic options to prevent postthrombotic syndrome are needed. During recent years, endovascular interventions have become a treatment option for pediatric patients with persistent thrombotic occlusion, not only in life- or limb-threatening VTE. Methods We evaluated 12 consecutive patients (11–17 years) with newly diagnosed VTE being treated at our department during the last 4 years (2017–2020). In case follow-up examination showed persistent venoocclusion under anticoagulation, patients received secondary interventional therapy like recanalization, percutaneous transluminal angioplasty with or without catheter-directed thrombolysis, and stenting. Patients with no clinical signs of venoocclusion or regredient thrombosis in imaging examination received anticoagulation alone. Results Six of 12 (50%) patients underwent catheter intervention. Median time from diagnosis to intervention was 4 months (0–12 months). Reintervention was necessary in one (8%) case and complete recanalization failed in one (8%) case. There were no major bleeding events or other major postinterventional complications, no acute or late local recurrence, and all patients reported clinical improvement after the procedure. Conclusion If endovascular intervention is used in teenage patients with persistent symptomatic VTE, reduction of postthrombotic symptoms is possible, even if intervention is performed secondary to failure of anticoagulation. Multidisciplinary treatment decisions can be based on the clinical course and follow-up imaging.
      Citation: Hamostaseologie ; : -
      PubDate: 2022-01-13T00:00:00+0100
      DOI: 10.1055/a-1701-2098
       
  • Laudatio auf Rüdiger E. Scharf

    • Pages: 425 - 426
      Abstract: Verehrte Leserinnen und Leser,die Ihnen vorliegende Ausgabe der Hämostaseologie – Progress in Haemostasis dient neben der gewohnt hochka-rätigen Informationsübermittlung als Festschrift anlässlich des 70. Geburtstags von Universitätsprofessor Dr. med. Rüdiger Eberhard Scharf, des langjährigen Herausgebers. Er ist emeritierter Lehrstuhlinhaber und ehemaliger Direktor des Instituts für Hämostaseologie, Hämotherapie und Transfusionsmedizin des Universitätsklinikums der Heinrich-Heine-Universität in Düsseldorf.
      Citation: Hamostaseologie 2021; 41: 425-426
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1370-0394
      Issue No: Vol. 41, No. 06 (2021)
       
  • Thromboinflammation as a Driver of Venous Thromboembolism

    • Authors: Gauchel; Nadine, Krauel, Krystin, Hamad, Muataz Ali, Bode, Christoph, Duerschmied, Daniel
      Pages: 428 - 432
      Abstract: Thrombus formation has been identified as an integral part in innate immunity, termed immunothrombosis. Activation of host defense systems is known to result in a procoagulant environment. In this system, cellular players as well as soluble mediators interact with each other and their dysregulation can lead to the pathological process of thromboinflammation. These mechanisms have been under intensified investigation during the COVID-19 pandemic. In this review, we focus on the underlying mechanisms leading to thromboinflammation as one trigger of venous thromboembolism.
      Citation: Hamostaseologie 2021; 41: 428-432
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1661-0257
      Issue No: Vol. 41, No. 06 (2021)
       
  • Anti-inflammatory Strategies in Atherosclerosis

    • Authors: Bugger; Heiko, Zirlik, Andreas
      Pages: 433 - 442
      Abstract: Atherosclerotic vascular disease and its related complications are the major cause of mortality in Western societies. Atherosclerosis is a chronic inflammatory disease of the arterial wall triggered by traditional and nontraditional risk factors and mediated by inflammatory and immune responses. Recent clinical trials provided compelling evidence corroborating that atherosclerosis is an inflammatory disease and demonstrated efficacy of anti-inflammatory interventions in reducing cardiovascular events and mortality. Traditional risk factors drive vascular inflammation, further justifying the instrumental role of intensified risk factor management in attenuating and preventing atherosclerotic disease and complications. Promising therapeutic approaches specifically related to inhibition of inflammation span traditional anti-inflammatory drugs, specific immunomodulation, and development of vaccination against atherosclerotic disease. Here, we review the inflammatory component in atherogenesis, the available evidence from clinical trials evaluating efficacy of therapeutic anti-inflammatory interventions in patients with high cardiovascular risk, and discuss potential future targets for anti-inflammatory or immune modulatory treatment in atherosclerotic cardiovascular disease.
      Citation: Hamostaseologie 2021; 41: 433-442
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1661-0020
      Issue No: Vol. 41, No. 06 (2021)
       
  • A Vicious Circle of Clonal Haematopoiesis of Indeterminate Potential and
           Cardiovascular Disease

    • Authors: Ehlert; Carolin A., Hilgendorf, Ingo
      Pages: 443 - 446
      Abstract: Clonal haematopoiesis of indeterminate potential (CHIP) represents a recently identified overlap between cancer and cardiovascular disease (CVD). CHIP develops as a result of certain acquired somatic mutations that predispose to leukaemia, but clinically even more prevalent, associate with increased risk for CVD and CVD-related death. Experimental studies suggest a causal role for CHIP aggravating inflammatory processes in CVD, and recent epidemiologic and genetic studies indicate that classical CVD risk factors may increase the risk of acquiring CHIP driver mutations, thus fuelling a vicious circle. The potential mechanism underlying the associative link between CHIP and CVD and mortality has been the focus of a few recent excellent experimental and observational studies which are summarized and discussed in this concise non-systematic review article. These data support a pathomechanistic view of a spiralling vicious circle in which CHIP aggravates the inflammatory immune response in CVD, and CVD-driven elevated haematopoietic activity promotes CHIP development.
      Citation: Hamostaseologie 2021; 41: 443-446
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1576-4059
      Issue No: Vol. 41, No. 06 (2021)
       
  • Modulating Autoimmunity against LDL: Development of a Vaccine against
           Atherosclerosis

    • Authors: Marchini; Timoteo, Abogunloko, Tijani, Wolf, Dennis
      Pages: 447 - 457
      Abstract: Atherosclerosis is a chronic inflammatory disease of the arterial wall that leads to the build-up of occluding atherosclerotic plaques. Its clinical sequelae, myocardial infarction and stroke, represent the most frequent causes of death worldwide. Atherosclerosis is a multifactorial pathology that involves traditional risk factors and chronic low-grade inflammation in the atherosclerotic plaque and systemically. This process is accompanied by a strong autoimmune response that involves autoreactive T cells in lymph nodes and atherosclerotic plaques, as well as autoantibodies that recognize low-density lipoprotein (LDL) and its main protein component apolipoprotein B (ApoB). In the past 60 years, numerous preclinical observations have suggested that immunomodulatory vaccination with LDL, ApoB, or its peptides has the potential to specifically dampen autoimmunity, enhance tolerance to atherosclerosis-specific antigens, and protect from experimental atherosclerosis in mouse models. Here, we summarize and discuss mechanisms, challenges, and therapeutic opportunities of immunomodulatory vaccination and other strategies to enhance protective immunity in atherosclerosis.
      Citation: Hamostaseologie 2021; 41: 447-457
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1661-1908
      Issue No: Vol. 41, No. 06 (2021)
       
  • Editorial

    • Pages: 459 - 459
      Abstract: Dear colleagues,With this issue of HÄMOSTASEOLOGIE – Progress in Haemostasis it is time to deeply thank Prof Rüdiger Scharf for his accomplishments and his engagement as the journal's Editor-in-Chief (EIC) for more than 10 years.
      Citation: Hamostaseologie 2021; 41: 459-459
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1694-5259
      Issue No: Vol. 41, No. 06 (2021)
       
  • Pathogenic Aspects of Inherited Platelet Disorders

    • Authors: Boeckelmann; Doris, Glonnegger, Hannah, Sandrock-Lang, Kirstin, Zieger, Barbara
      Pages: 460 - 468
      Abstract: Inherited platelet disorders (IPDs) constitute a large heterogeneous group of rare bleeding disorders. These are classified into: (1) quantitative defects, (2) qualitative disorders, or (3) altered platelet production rate disorders or increased platelet turnover. Classically, IPD diagnostic is based on clinical phenotype characterization, comprehensive laboratory analyses (platelet function analysis), and, in former times, candidate gene sequencing. Today, molecular genetic analysis is performed using next-generation sequencing, mostly by targeting enrichment of a gene panel or by whole-exome sequencing. Still, the biochemical and molecular genetic characterization of patients with congenital thrombocytopathias/thrombocytopenia is essential, since postoperative or posttraumatic bleeding often occurs due to undiagnosed platelet defects. Depending upon the kind of surgery or trauma, this bleeding may be life-threatening, e.g., after tonsillectomy or in brain surgery. Undiagnosed platelet defects may lead to additional surgery, hysterectomy, pulmonary bleeding, and even resuscitation. In addition, these increased bleeding symptoms can lead to wound healing problems. Only specialized laboratories can perform the special platelet function analyses (aggregometry, flow cytometry, or immunofluorescent microscopy of the platelets); therefore, many IPDs are still undetected.
      Citation: Hamostaseologie 2021; 41: 460-468
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1665-6249
      Issue No: Vol. 41, No. 06 (2021)
       
  • Type 2B von Willebrand Disease: Early Manifestation as Neonatal
           Thrombocytopenia

    • Authors: Kranzhöfer; David, Pavlova, Anna, Schneider, Hendryk, Franck, Peter, Glonnegger, Hannah, Büchsel, Martin, Yoshimi-Nöllke, Ayami, Oldenburg, Johannes, Zieger, Barbara
      Pages: 469 - 474
      Abstract: Here, we report about a preterm female newborn with a prolonged course of severe thrombocytopenia and hematomas. The family history was positive for von Willebrand disease type 2B (VWD 2B). Diagnosis of VWD 2B was identified analyzing von Willebrand factor (VWF) parameters (VWF:antigen, VWF:activity, VWF multimer analyses) and performing light transmission aggregometry (with half concentration of ristocetin). In addition, the diagnosis was confirmed by molecular genetic analysis: identification of a disease-causing missense mutation (Val1316Met) in the VWF gene associated with a severe course of VWD 2B, which had been previously reported. Treatment with a VWF-containing plasma concentrate was initiated. Because the combination of prematurity and very low platelet count is often associated with intracranial bleeding, at the beginning platelet concentrates were transfused. Fortunately, the patient did not develop serious bleeding episodes. Interestingly, the patient had a mutation in the VWF gene, which had been described to be associated with aggravation of thrombocytopenia especially in stressful situations. Therefore, we replaced venous blood withdrawals by capillary blood samplings when possible and, consequently, we observed an increase of the platelet count after this change in management. At the age of 2 months, the patient was discharged after stabilization of the platelet count without any bleeding signs and without a need of long-term medication.
      Citation: Hamostaseologie 2021; 41: 469-474
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1665-6185
      Issue No: Vol. 41, No. 06 (2021)
       
  • GTH News
    • Hamostaseologie 2021; 41: 502-505
      DOI: 10.1055/s-0041-1741324



      Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

      Artikel in Thieme eJournals:
      Inhaltsverzeichnis

      Hamostaseologie 2021; 41: 502-5052021-12-23T00:00:00+0100
      Issue No: Vol. 41, No. 06 (2021)
       
  • Ablösung der In-Vitro-Diagnostika-Richtlinie auf die
           In-Vitro-Diagnostika-Verordnung (IVDR) 05/2022 und Programm für die
           BDDH-Veranstaltung im Rahmen des GTH-Kongresses 2022 in Leipzig

    • Authors: Sucker; Christoph, Kappert, Günther, Koscielny, Jürgen
      Pages: 506 - 508
      Abstract: Ablösung der In-Vitro-Diagnostika-Richtlinie auf die In-Vitro-Diagnostika-Verordnung (IVDR) 05/2022 (Christoph Sucker, Günther Kappert) Planmäßig soll am 26.05.2022 die bisher geltende In-Vitro-Diagnostika-Richtlinie durch die In-Vitro-Diagnostika-Verordnung (IVDR) ersetzt werden und würde dann an diesem Tag unmittelbar rechtlich wirksam.
      Citation: Hamostaseologie 2021; 41: 506-508
      PubDate: 2021-12-23T00:00:00+0100
      DOI: 10.1055/a-1370-0368
      Issue No: Vol. 41, No. 06 (2021)
       
  • Pulmonary Hypertension and COVID-19

    • Authors: Castiglione; Laura, Droppa, Michal
      Abstract: Coronavirus disease 2019 (COVID-19) is a primary respiratory infectious disease, which can result in pulmonary and cardiovascular complications. From its first appearance in the city of Wuhan (China), the infection spread worldwide, leading to its declaration as a pandemic on March 11, 2020. Clinical research on SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) suggests that the virus may determine changes in the pulmonary hemodynamics through mechanisms of endothelial dysfunction, vascular leak, thrombotic microangiopathy, and venous thromboembolism that are similar to those leading to pulmonary hypertension (PH). Current available studies report echocardiographic signs of PH in approximately 12 to 13% of hospitalized patients with COVID-19. Those with chronic pulmonary obstructive disease, congestive heart failure, pulmonary embolism, and prior PH are at increased risk to develop or worsen PH. Evidence of PH seems to be associated with increased disease severity and poor outcome. Because of the importance of the pulmonary hemodynamics in the pathophysiology of COVID-19, there is growing interest in exploring the potential therapeutical benefits of inhaled vasodilators in patients with COVID-19. Treatment with inhaled nitric oxide and prostacyclin has shown encouraging results through improvement of systemic oxygenation, reduction of systolic pulmonary arterial pressure, and prevention of right ventricular failure; however, data from randomized control trials are still required.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-12-21T00:00:00+0100
      DOI: 10.1055/a-1661-0240
       
  • Anticoagulation Therapy in Cancer Patients with Thrombosis in the
           Outpatient Sector of Germany (The CERTIFICAT Initiative)—German Practice
           of Anticoagulation Therapy of Cancer Patients with Thrombosis

    • Authors: Riess; Hanno, Kretzschmar, Albrecht, Heinken, Andreas, Mohebbi, Damon, May, Melanie, Schellong, Sebastian
      Abstract: Objective This article aims to investigate the reality of anticoagulation treatment for cancer patients with thrombosis in the outpatient sector of Germany. Methods For the analysis period 2012 to 2015, anonymized data from 4.1 million statutory insured patients were analyzed. Cancer patients with incident thrombosis and an outpatient prescription of anticoagulant drugs were identified and evaluated for three subsequent quarters with regard to anticoagulant use. Results A total of 7,313 cancer patients with incident thrombosis (ICD-10: I80*) were evaluated. About, 90% of patients with thromboses were diagnosed and treated in the ambulatory sector. More than 80% of the prescriptions were issued by general practitioners. And 57% of patients were anticoagulated predominantly (>50% of the time) with different low-molecular-weight heparins (LMWHs), 24% predominantly with vitamin K antagonists (VKAs), and 17% with direct oral anticoagulants (DOACs). Anticoagulants were prescribed for an average of 4.5 months. LMWH had a substantially longer prescription period (90–135 days) than VKA (53 days) or DOAC (47 days). Gastrointestinal bleeding in conjunction with hospitalization was documented in 1.76% of patients with a range of 1.3 to 3% for the different LMWHs. Conclusion The prescription practice documented by this representative and comprehensive evaluation demonstrates an anticoagulation duration in accordance with the guidelines, although the choice of the respective anticoagulant was often not in compliance with the contemporary label or guidelines.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-12-08T00:00:00+0100
      DOI: 10.1055/a-1554-4664
       
  • Platelet Dysregulation in the Pathobiology of COVID-19

    • Authors: Mellema; Rebecca A., Crandell, Jacob, Petrey, Aaron C.
      Abstract: Coronavirus disease 2019 (COVID-19) encompasses a broad spectrum of clinical manifestations caused by infection with severe acute respiratory syndrome coronavirus 2.Patients with severe disease present with hyperinflammation which can affect multiple organs which often include observations of microvascular and macrovascular thrombi. COVID-19 is increasingly recognized as a thromboinflammatory disease where alterations of both coagulation and platelets are closely linked to mortality and clinical outcomes. Although platelets are most well known as central mediators of hemostasis, they possess chemotactic molecules, cytokines, and adhesion molecules that are now appreciated as playing an important role in the regulation of immune response. This review summarizes the current knowledge of platelet alterations observed in the context of COVID-19 and their impact upon disease pathobiology.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-12-08T00:00:00+0100
      DOI: 10.1055/a-1646-3392
       
  • Venous Thrombosis and SARS-CoV-2

    • Authors: Zdanyte; Monika, Rath, Dominik, Gawaz, Meinrad, Geisler, Tobias
      Abstract: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is associated with high risk of venous and arterial thrombosis. Thrombotic complications, especially pulmonary embolism, lead to increased all-cause mortality in both intensive care unit and noncritically ill patients. Damage and activation of vascular endothelium, platelet activation, followed by thrombotic and fibrinolytic imbalance as well as hypercoagulability are the key pathomechanisms in immunothrombosis leading to a significant increase in thromboembolism in coronavirus disease 2019 (COVID-19) compared with other acute illnesses. In this review article, we discuss the incidence and prognosis, diagnosis, prevention, and treatment of venous thromboembolism in patients with COVID-19 disease, based on clinical experience and research available to date.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-12-08T00:00:00+0100
      DOI: 10.1055/a-1661-0283
       
  • Increasing Use of Anticoagulants in Germany and Its Impact on
           Hospitalization for Tooth Extraction

    • Authors: von Beckerath; Olga, Kröger, Knut, Santosa, Frans, Nasef, Ayat, Kowall, Bernd, Stang, Andreas
      Abstract: Objectives This article aimed to compare nationwide time trends of oral anticoagulant prescriptions with the time trend of hospitalization for tooth extraction (TE) in Germany from 2006 through 2017. Patients and Methods We derived the annual number of hospital admissions for TE from the Nationwide Hospital Referral File of the Federal Bureau of Statistics and defined daily doses (DDD) of prescribed anticoagulants in outpatients from reports of the drug information system of the statutory health insurance. Results From 2005 to 2017, annual oral anticoagulation (OAC) treatment rates increased by 143.7%. In 2017, direct oral anticoagulants (DOACs) represented 57.1% of all OAC treatments. The number of cases hospitalized for TE increased by 28.0 only. From all the cases hospitalized for TE in Germany in 2006, 14.2% had a documented history of long-term use of OACs. This proportion increased to 19.6% in 2017. Age-standardized hospitalization rates for all TE cases with long-term use of OACs increased from 6.6 in 2006 to 10.5 cases per 100,000 person-years in 2014 and remained almost unchanged thereafter. Conclusion Our comparison showed that the large increase in OAC treatment rates in general from 2006 to 2017 had only a small impact on hospitalized TE cases with long-term use of OAC which flattens since 2014.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-11-23T00:00:00+0100
      DOI: 10.1055/a-1528-0513
       
  • Non–Vitamin K Antagonist Oral Anticoagulants in Coronary Artery
           Disease

    • Authors: Al Said; Samer, Ellscheid, Michael, Beltsios, Eleftherios T., Frey, Norbert
      Abstract: The prevention of atherothrombotic events is the primary goal in the treatment of patients with arteriosclerotic disorders. Despite recent improvements in the management of coronary artery disease (CAD) with revascularization techniques and antiplatelet therapy, some patients remain at risk of recurrent cardiovascular events. This could be related to additional thrombin generation. As a result, there has been interest in developing novel therapies to prevent thromboembolic events, targeting thrombin-mediated pathways. These include non–vitamin K antagonist oral anticoagulants (NOACs). This article aims to summarize the recent clinical studies that investigated the role of NOACs in CAD.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-10-18T00:00:00+01:00
      DOI: 10.1055/a-1606-7523
       
  • COVID-19 as a Potential Trigger for Immune Thrombotic Thrombocytopenic
           Purpura and Reason for an Unusual Treatment: A Case Report

    • Authors: Schwaegermann; Marie-Kristin, Hobohm, Lukas, Rausch, Johanna, Reuter, Michael, Griemert, Thomas-Friedrich, Sivanathan, Visvakanth, Falter, Tanja, Sprinzl, Martin F., Lackner, Karl J., Galle, Peter R., Konstantinides, Stavros, Theobald, Matthias, von Auer, Charis
      Abstract: Immune thrombotic thrombocytopenic purpura (iTTP) is a rare autoimmune disorder characterized by severely reduced activity of the von Willebrand factor (VWF)-cleaving protease ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) due to autoantibodies. This leads to the development of pathogenic multimers of VWF, causing a thrombotic microangiopathy with decreased number of platelets, hemolysis, and life-threatening tissue ischemia of mostly brain, heart, and kidneys. Standard treatment of iTTP involves daily plasma exchange to remove ultra large multimers of VWF, inhibitors, substituting ADAMTS13, and the accompaniment of an immunosuppressive treatment with steroids. Recently, caplacizumab was approved for iTTP. Caplacizumab is a nanobody binding the A1 domain of VWF, blocking its interaction with glycoprotein Ib–IX–V platelet receptor and therefore preventing platelet aggregation. VWF activities may serve as therapeutic drug monitoring of caplacizumab, whereas ADAMTS13 activities may be used for biomarkers to guide caplacizumab treatment modalities and overall treatment duration. Additional immunosuppressive treatment by inhibiting autoantibody formation (e.g., the use of Rituximab, a chimeric monoclonal antibody directed against the B-cell antigen CD20) is a further treatment option. Infections are well-known causes for an acute episode for patients with iTTP. The novel SARS-CoV-2 virus is mainly associated with acute respiratory distress as well as diffuse endothelial inflammation and increased coagulopathy. However, little is known about an infection with SARS-CoV-2 virus triggering iTTP relapses. We herein report the case of an acute iTTP episode accompanying a SARS-CoV-2 infection.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-07-29T00:00:00+01:00
      DOI: 10.1055/a-1497-1054
       
  • Celiac Artery Thrombosis and Splenic Infarction as a Consequence of Mild
           COVID-19 Infection: Report of an Unusual Case

    • Authors: Arslan; Gokhan
      Abstract: COVID-19 has been associated with the hypercoagulable state in the literature. Patients who are admitted to the hospital with severe COVID-19 may have some thrombotic complications. These patients have a high risk for venous and arterial thrombosis of large and small vessels. Here, a 42-year-old female with celiac artery thrombosis and splenic infarction after a history of mild COVID-19 was presented.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-07-01T00:00:00+01:00
      DOI: 10.1055/a-1508-7388
       
  • Thrombosis and Dissection of the Abdominal Arteries Associated with
           Infarcts of Solid Organs in a Patient with COVID-19: A Novel Clinical
           Entity

    • Authors: Voci; Davide, Micieli, Evy, Johner, Fabian A., Kucher, Nils, Barco, Stefano
      Abstract: The clinical spectrum of patients with coronavirus disease 2019 (COVID-19) ranges from asymptomatic cases to severe pneumonia with acute respiratory distress syndrome. COVID-19 is associated with an increased risk of thromboembolic complications, notably pulmonary embolism and deep vein thrombosis. Arterial cardiovascular complications and myocarditis have also been described in association with COVID-19, but appear to be less prevalent. In this report of a 57-year-old man with multiple splanchnic infarctions, arterial dissections and COVID-19 as the sole potential trigger, we describe a novel type of complications and put it in the context of a growing literature on this topic.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-06-22T00:00:00+01:00
      DOI: 10.1055/a-1476-7907
       
  • Effect of DDAVP on Platelet Activation and Platelet-Derived Microparticle
           Generation

    • Authors: Persyn; Matthieu, Athanase, Nicolas, Trossaërt, Marc, Sigaud, Marianne, Ternisien, Catherine, Béné, Marie C., Fouassier, Marc
      Abstract: Background The way by which 1-deamino-8-D-arginine vasopressin (DDAVP) acts on platelets remains unclear. Data from the literature tend to show that there is no definite effect on platelet activation, but recent work has suggested that a subtype of platelets, activated by the combined action of collagen and thrombin, was triggered by DDAVP. Moreover, platelet microparticles (PMPs), which have been shown to be procoagulant, have rarely been studied in this context. The goal of this study was to analyze the effects of DDAVP on PMPs' release through platelet activation. Methods Fifteen out of 18 consecutive patients undergoing a therapeutic test with DDAVP were included. They were suffering from factor VIII deficiency or from von Willebrand disease. The expression of P-selectin and PAC-1 binding on platelets and the numbers of circulating PMPs were evaluated ex vivo before and after DDAVP infusion. Peripheral blood was collected on CTAD to limit artifactual platelet activation. Results DDAVP induced a significant decrease of platelet counts and volume. Only small changes of P-selectin expression and PAC-1 binding were observed. Considering PMPs, two populations of patients could be defined, respectively, with (120%, n = 6) or without (21%, n = 7) an increase of PMPs after DDAVP. The decrease in platelet counts and volume remained significant in the group of responders. Conclusion This study shows that DDAVP induces the generation/release of PMPs in some patients with factor VIII deficiency and von Willebrand disease 1 hour after DDAVP infusion.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-06-17T00:00:00+01:00
      DOI: 10.1055/a-1476-7768
       
  • Association of Thrombin-Activatable Fibrinolysis Inhibitor with Acute
           Pulmonary Embolism

    • Authors: Yıldız; Abdulkerim, Katar, Didem, Soydaş, Ayşe Özden, Albayrak, Murat
      Abstract: Background Thrombin-activatable fibrinolysis inhibitor (TAFI) inhibits fibrinolysis and high levels may have an association with thrombosis. The aim of the current study was to investigate the association of TAFI antigen levels with pulmonary thromboembolism (PTE). Patients and Methods A case–control study was conducted with 29 patients with PTE and 17 age- and gender-matched control individuals. Plasma levels of TAFI were measured at the time of diagnosis, then at 3 and 6 months after the event. Results Initial TAFI levels (%) were higher in patients with PTE than in the control group Initial TAFI levels (%) were higher in patients with PTE than in the control group (190,0 [65,0–250,0] vs 133,0 [83,0–153,0]; p = 0.003). TAFI levels significantly decreased at the third and sixth months after initial diagnosis (p  0.05). In the sixth month of treatment, patients with residual thrombosis were seen to have similar baseline levels and reductions of TAFI as patients without residual thrombosis (p > 0.05). Conclusion The result of this study suggests that high TAFI levels may have a role in the occurrence of PTE without impact on treatment outcome.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-06-17T00:00:00+01:00
      DOI: 10.1055/a-1411-7807
       
  • Spontaneous Intra-abdominal Hemorrhage in a Hemophilia A Patient
           Masquerading as Intra-abdominal Pseudotumor

    • Authors: Jayant; Divij, Sakaray, Yashwant, Thakur, Uttam, Kaman, Lileshwar, Jain, Arihant
      Abstract: Spontaneous intra-abdominal hemorrhage is very rare in hemophilia A patients. High index of suspicion is necessary for successful management. Surgical intervention may be required in cases of diagnostic uncertainty and for adequate hemostasis. Here we report a case of spontaneous hemorrhage in the peritoneal cavity in hemophilia A patient, who was managed with surgery and factor VIII supplementation. Patient did well in the postoperative periods.
      Citation: Hamostaseologie ; : -
      PubDate: 2021-04-15T00:00:00+01:00
      DOI: 10.1055/a-1384-3696
       
 
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