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The Journal of Vascular Access Jan 2024Insertion of Peripherally Inserted Central Catheters (PICCs) is potentially associated with the risk of immediate/early adverse events, some of them minimal (repeated...
The SIP protocol update: Eight strategies, incorporating Rapid Peripheral Vein Assessment (RaPeVA), to minimize complications associated with peripherally inserted central catheter insertion.
Insertion of Peripherally Inserted Central Catheters (PICCs) is potentially associated with the risk of immediate/early adverse events, some of them minimal (repeated punctures) and some relevant (accidental arterial puncture or nerve-related injury). Several strategies adopted during the insertion process may minimize the risk of such events, including late complication risks such as infection, venous thrombosis, or catheter dislodgment and/or malposition. This paper describes an update version of the SIP protocol (Safe Insertion of PICCs), an insertion bundle which includes eight effective strategies that aims to minimize immediate, early, or late insertion-associated complications. These strategies include: preprocedural ultrasound assessment utilizing the RaPeVA (Rapid Peripheral Venous Assessment) protocol; appropriate skin antiseptic technique; choice of appropriate vein, adoption of the Zone Insertion Method™; clear identification of the median nerve and brachial artery; ultrasound-guided puncture; ultrasound-guided tip navigation; intra-procedural assessment of tip location; correct securement of the catheter, and appropriate protection of the exit site. This updated version of the SIP protocol includes several novelties based on the most recent evidence-based scientific literature on PICC insertion, such as the clinical relevance of the tunneling technique, the use of ultrasound for intra-procedural tip navigation and tip location, and the new technologies for the protection of the exit site (cyanoacrylate glue) and for the securement of the catheter (subcutaneous anchorage).
Topics: Humans; Catheterization, Central Venous; Central Venous Catheters; Catheters, Indwelling; Veins; Venous Thrombosis; Catheterization, Peripheral
PubMed: 35633065
DOI: 10.1177/11297298221099838 -
Ugeskrift For Laeger May 2024Individuals with antiphospholipid syndrome (APS) have antibodies directed against phospholipid-binding proteins (aPL). The condition is most associated with an increased... (Review)
Review
Individuals with antiphospholipid syndrome (APS) have antibodies directed against phospholipid-binding proteins (aPL). The condition is most associated with an increased risk of thromboembolism and obstetric complications. The 2023 classification criteria for APS include six clinical domains (venous thromboembolism, arterial thrombosis, microvascular events, obstetric events, cardiac valve, thrombocytopaenia) and two laboratory domains (lupus anticoagulant, and anti-cardiolipin or anti-β2-glycoprotein-I antibodies). Diagnosis and treatment of APS are specialist tasks and are summarised in this review.
Topics: Antiphospholipid Syndrome; Humans; Antibodies, Antiphospholipid; Pregnancy; Female; Anticoagulants; Thrombosis
PubMed: 38847311
DOI: 10.61409/V11230715 -
Journal of Advanced Research Jul 2023Environmental microparticle is becoming a global pollutant and the entire population is increasingly exposed to the microparticles from artificial materials. The...
INTRODUCTION
Environmental microparticle is becoming a global pollutant and the entire population is increasingly exposed to the microparticles from artificial materials. The accumulation of microparticles including microplastics and its subsequent effects need to be investigated timely to keep sustainable development of human society.
OBJECTIVES
This study aimed to explore the accumulation of environmental particles in thrombus, the pathological structure in the blood circulation system.
METHODS
Patients receiving cardiovascular surgical operations were screened and twenty-six thrombi were collected, digested and filtered. Non-soluble microparticles were enriched on the filter membrane and then were analyzed and identified with Raman Spectrometer. The associations of particle status (presence or absence) or particle number in the thrombus and clinical indicators were examined. One strict quality control-particle detection system was designed to eliminate environmental contaminations.
RESULTS
Among twenty-six thrombi, sixteen contained eighty-seven identified particles ranging from 2.1 to 26.0 μm in size. The number of microparticles in each thrombus ranged from one to fifteen with the median reaching five. All the particles found in thrombi were irregularly block-shaped. Totally, twenty-one phthalocyanine particles, one Hostasol-Green particle, and one low-density polyethylene microplastic, which were from synthetic materials, were identified in thrombi. The rest microparticles included iron compounds and metallic oxides. After the adjustment for potential confounders, a significantly positive association between microparticle number and blood platelet levels was detected (P < 0.01).
CONCLUSION
This study provides the first photograph and Raman spectrum evidence of microparticles in thrombi. A large number of non-soluble particles including synthetic material microparticles could accumulate in arteries, suggesting that the risk of microparticle exposure was under-estimated and the re-evaluation of its health effects is urgently needed. There will be a series of reports on assessing the health effects of microparticle exposure in humans in the future and this research provided clues for the subsequent research.
Topics: Humans; Microplastics; Plastics; Thrombosis; Blood Platelets; Polyethylene
PubMed: 36116710
DOI: 10.1016/j.jare.2022.09.004 -
International Journal of Molecular... Dec 2023Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation in the arteries, leading to narrowing and thrombosis that causes mortality. Emerging... (Review)
Review
Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation in the arteries, leading to narrowing and thrombosis that causes mortality. Emerging evidence has confirmed that atherosclerosis affects younger people and is involved in the majority of deaths worldwide. EVs are associated with critical steps in atherosclerosis, cholesterol metabolism, immune response, endothelial dysfunction, vascular inflammation, and remodeling. Endothelial cell-derived EVs can interact with platelets and monocytes, thereby influencing endothelial dysfunction, atherosclerotic plaque destabilization, and the formation of thrombus. EVs are potential diagnostic and prognostic biomarkers in atherosclerosis (AS) and cardiovascular disease (CVD). Importantly, EVs derived from stem/progenitor cells are essential mediators of cardiogenesis and cardioprotection and may be used in regenerative medicine and tissue engineering.
Topics: Humans; Atherosclerosis; Plaque, Atherosclerotic; Extracellular Vesicles; Cardiovascular Diseases; Arteries
PubMed: 38203558
DOI: 10.3390/ijms25010388 -
Arteriosclerosis, Thrombosis, and... Aug 2023MAGT1 (magnesium transporter 1) is a subunit of the oligosaccharide protein complex with thiol-disulfide oxidoreductase activity, supporting the process of...
BACKGROUND
MAGT1 (magnesium transporter 1) is a subunit of the oligosaccharide protein complex with thiol-disulfide oxidoreductase activity, supporting the process of N-glycosylation. MAGT1 deficiency was detected in human patients with X-linked immunodeficiency with magnesium defect syndrome and congenital disorders of glycosylation, resulting in decreased cation responses in lymphocytes, thereby inhibiting the immune response against viral infections. Curative hematopoietic stem cell transplantation of patients with X-linked immunodeficiency with magnesium defect causes fatal bleeding and thrombotic complications.
METHODS
We studied the role of MAGT1 deficiency in platelet function in relation to arterial thrombosis and hemostasis using several in vitro experimental settings and in vivo models of arterial thrombosis and transient middle cerebral artery occlusion model of ischemic stroke.
RESULTS
MAGT1-deficient mice () displayed accelerated occlusive arterial thrombus formation in vivo, a shortened bleeding time, and profound brain damage upon focal cerebral ischemia. These defects resulted in increased calcium influx and enhanced second wave mediator release, which further reinforced platelet reactivity and aggregation responses. Supplementation of MgCl or pharmacological blockade of TRPC6 (transient receptor potential cation channel, subfamily C, member 6) channel, but not inhibition of store-operated calcium entry, normalized the aggregation responses of platelets to the control level. GP (glycoprotein) VI activation of platelets resulted in hyperphosphorylation of Syk (spleen tyrosine kinase), LAT (linker for activation of T cells), and PLC (phospholipase C) γ2, whereas the inhibitory loop regulated by PKC (protein kinase C) was impaired. A hyperaggregation response to the GPVI agonist was confirmed in human platelets isolated from a MAGT1-deficient (X-linked immunodeficiency with magnesium defect) patient. Haploinsufficiency of TRPC6 in mice could normalize GPVI signaling, platelet aggregation, and thrombus formation in vivo.
CONCLUSIONS
These results suggest that MAGT1 and TRPC6 are functionally linked. Therefore, deficiency or impaired functionality of MAGT1 could be a potential risk factor for arterial thrombosis and stroke.
Topics: Animals; Humans; Mice; Blood Platelets; Calcium; Cations; Homeostasis; Ischemic Stroke; Magnesium; Platelet Activation; Platelet Aggregation; Platelet Membrane Glycoproteins; Thrombosis; TRPC6 Cation Channel; Infarction, Middle Cerebral Artery; Cation Transport Proteins
PubMed: 37381987
DOI: 10.1161/ATVBAHA.122.318115 -
Clinical and Translational Science Sep 2023Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can manifest itself in several ways, including... (Review)
Review
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can manifest itself in several ways, including coagulopathy and thrombosis. These complications can be the first and sometimes only manifestations of SARS-CoV-2 infection and can occur early or late in the course of the disease. However, these symptoms are more prevalent in hospitalized patients with venous thromboembolism, particularly those admitted to intensive care units. Moreover, various forms of arterial and venous thrombosis, or micro- or macro-vasculature embolisms, have been reported during the current pandemic. They have led to harmful consequences, such as neurological and cardiac events, nearly all resulting from the hypercoagulable state caused by this viral infection. The severe hypercoagulability observed in patients with COVID-19 accounts for most cases of the disease that become critical. Therefore, anticoagulants seem to be one of the most vital therapeutics for treating this potentially life-threatening condition. In the current paper, we present a thorough review of the pathophysiology of COVID-19-induced hypercoagulable state and the use of anticoagulants to treat SARS-CoV-2 infections in different patient groups, as well as their pros and cons.
Topics: Humans; COVID-19; SARS-CoV-2; Anticoagulants; Blood Coagulation Disorders; Thrombosis
PubMed: 37326220
DOI: 10.1111/cts.13569