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Arteriosclerosis, Thrombosis, and... Mar 2019Activation of the intrinsic pathway of coagulation contributes to the pathogenesis of arterial and venous thrombosis. Critical insights into the involvement of intrinsic... (Review)
Review
Activation of the intrinsic pathway of coagulation contributes to the pathogenesis of arterial and venous thrombosis. Critical insights into the involvement of intrinsic pathway factors have been derived from the study of gene-specific knockout animals and targeted inhibitors. Importantly, preclinical studies have indicated that targeting components of this pathway, including FXI (factor XI), FXII, and PKK (prekallikrein), reduces thrombosis with no significant effect on protective hemostatic pathways. This review highlights the advances made from studying the intrinsic pathway using gene-specific knockout animals and inhibitors in models of arterial and venous thrombosis. Development of inhibitors of activated FXI and FXII may reduce thrombosis with minimal increases in bleeding compared with current anticoagulant drugs.
Topics: Animals; Anticoagulants; Bleeding Time; Blood Coagulation; Blood Coagulation Factors; Disease Models, Animal; Drug Design; Enzyme Activation; Hemorrhage; Humans; Mice, Knockout; Primates; Rabbits; Rats; Thrombosis
PubMed: 30700128
DOI: 10.1161/ATVBAHA.118.312130 -
Vascular Health and Risk Management 2015In physiological hemostasis a prompt recruitment of platelets on the vessel damage prevents the bleeding by the rapid formation of a platelet plug. Qualitative and/or... (Review)
Review
In physiological hemostasis a prompt recruitment of platelets on the vessel damage prevents the bleeding by the rapid formation of a platelet plug. Qualitative and/or quantitative platelet defects promote bleeding, whereas the high residual reactivity of platelets in patients on antiplatelet therapies moves forward thromboembolic complications. The biochemical mechanisms of the different phases of platelet activation - adhesion, shape change, release reaction, and aggregation - have been well delineated, whereas their complete translation into laboratory assays has not been so fulfilled. Laboratory tests of platelet function, such as bleeding time, light transmission platelet aggregation, lumiaggregometry, impedance aggregometry on whole blood, and platelet activation investigated by flow cytometry, are traditionally utilized for diagnosing hemostatic disorders and managing patients with platelet and hemostatic defects, but their use is still limited to specialized laboratories. To date, a point-of-care testing (POCT) dedicated to platelet function, using pertinent devices much simpler to use, has now become available (ie, PFA-100, VerifyNow System, Multiplate Electrode Aggregometry [MEA]). POCT includes new methodologies which may be used in critical clinical settings and also in general laboratories because they are rapid and easy to use, employing whole blood without the necessity of sample processing. Actually, these different platelet methodologies for the evaluation of inherited and acquired bleeding disorders and/or for monitoring antiplatelet therapies are spreading and the study of platelet function is strengthening. In this review, well-tried and innovative platelet function tests and their methodological features and clinical applications are considered.
Topics: Animals; Blood Coagulation Disorders; Blood Platelets; Drug Monitoring; Equipment Design; Humans; Platelet Activation; Platelet Aggregation Inhibitors; Platelet Function Tests; Point-of-Care Systems; Predictive Value of Tests
PubMed: 25733843
DOI: 10.2147/VHRM.S44469 -
International Journal of Environmental... Mar 2022Under metabolic stress conditions, there is a higher demand for nutrients which needs to be met. This is to reduce the risk of delay in wound healing which could lead to...
BACKGROUND
Under metabolic stress conditions, there is a higher demand for nutrients which needs to be met. This is to reduce the risk of delay in wound healing which could lead to chronic wound.
AIM
This is a systematic review of the effect of on wound healing. is a traditional medicinal plant used due to its antimicrobial, antioxidant, anti-inflammatory, neuroprotective, and wound healing properties.
METHODS
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for the systematic review and four electronic databases were used.
RESULTS
Four clinical trials met the inclusion criteria. The following distinct areas were identified under : wound contraction and granulation; healing/bleeding time and re-epithelialization; VAS (visual analogue scale) scores; skin erythema and wound appearance.
CONCLUSIONS
might enhance wound healing resulting from improved angiogenesis. This might occur due to its stimulating effect on collagen I, Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) production. Besides, has shown an anti-inflammatory effect observed by the reduction in Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and Tumour Necrosis Factor α (TNFα), prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2), and lipoxygenase (LOX) activity. Delivery systems such as nanoencapsulation could be used to increase bioavailability. Nevertheless, more studies are needed in order to perform a meta-analysis and ascertain the effects of on wound healing and its different parameters.
Topics: Anti-Inflammatory Agents; Centella; Plant Extracts; Vascular Endothelial Growth Factor A; Wound Healing
PubMed: 35328954
DOI: 10.3390/ijerph19063266 -
Annals of the Royal College of Surgeons... Jan 2020An increasing number of patients are taking oral antiplatelet agents. As a result, there is an important patient safety concern in relation to the potential risk of... (Review)
Review
INTRODUCTION
An increasing number of patients are taking oral antiplatelet agents. As a result, there is an important patient safety concern in relation to the potential risk of bleeding complications following major oral and maxillofacial surgery. Surgeons are increasingly likely to be faced with a dilemma of either continuing antiplatelet therapy and risking serious haemorrhage or withholding therapy and risking fatal thromboembolic complications. While there are national recommendations for patients taking oral antiplatelet drugs undergoing invasive minor oral surgery, there are still no evidence-based guidelines for the management of these patients undergoing major oral and maxillofacial surgery.
METHODS
MEDLINE and EMBASE databases were searched to retrieve all relevant articles published to 31 December 2017.
FINDINGS
A brief outline of the commonly used antiplatelet agents including their pharmacology and therapeutic indications is discussed, together with the haemorrhagic and thromboembolic risks of continuing or altering the antiplatelet regimen in the perioperative period. Finally, a protocol for the management of oral and maxillofacial patients on antiplatelet agents is presented.
CONCLUSIONS
Most current evidence to guide decision making is based upon non-randomised observational studies, which attempts to provide the safest possible management of patients on antiplatelet therapy. Large randomised clinical trials are lacking.
Topics: Administration, Oral; Anticoagulants; Bleeding Time; Blood Loss, Surgical; Drug Substitution; Drug Therapy, Combination; Humans; Oral Surgical Procedures; Orthognathic Surgical Procedures; Patient Safety; Platelet Aggregation Inhibitors; Risk Factors; Thromboembolism
PubMed: 31755732
DOI: 10.1308/rcsann.2019.0154 -
Platelets May 2020Hemostasis is the normal process that produces a blood clot at a site of vascular injury. Mice are widely used to study hemostasis and abnormalities of blood coagulation... (Review)
Review
Hemostasis is the normal process that produces a blood clot at a site of vascular injury. Mice are widely used to study hemostasis and abnormalities of blood coagulation because their hemostatic system is similar in most respects to that of humans, and their genomes can be easily manipulated to create models of inherited human coagulation disorders. Two of the most widely used techniques for assessing hemostasis in mice are the tail bleeding time (TBT) and saphenous vein bleeding (SVB) models. Here we discuss the use of these methods in the evaluation of hemostasis, and the advantages and limits of using mice as surrogates for studying hemostasis in humans.
Topics: Animals; Bleeding Time; Blood Coagulation; Disease Models, Animal; Hemorrhage; Hemostasis; Humans; Lacerations; Liver; Mice; Saphenous Vein; Tail
PubMed: 31992118
DOI: 10.1080/09537104.2020.1719056 -
Journal of International Society of... Dec 2014To review hemophilia A with emphasis on its oral manifestations, investigations, and dental management. (Review)
Review
AIM
To review hemophilia A with emphasis on its oral manifestations, investigations, and dental management.
MATERIALS AND METHODS
Search was conducted using internet-based search engines, scholarly bibliographic databases, PubMed, and Medline with key words such as "Hemophilia A," "factor VIII," "bleeding and clotting disorders," and "dental management."
RESULTS
Hemophilia comprises a group of hereditary disorders caused due to the deficiency of one or more clotting factors leading to prolonged clotting time and excessive bleeding tendencies. It is broadly divided into hemophilia A, B, and C, which occur due to deficiency of factor VIII, IX, and XI, respectively. Hemophilia A is an X-linked recessive hereditary disorder and is the most common of the three, accounting for 80-85% of the cases.
CONCLUSION
Understanding this complex entity is very important for a dentist to provide appropriate dental treatment and avoid undesirable consequences.
PubMed: 25625071
DOI: 10.4103/2231-0762.149022 -
Indian Journal of Hematology & Blood... Jun 2016The hemorrhagic diseases are characterized by bleeding which can vary considerably according to their severity. The von Willebrand disease (VWD) is the most frequent... (Review)
Review
UNLABELLED
The hemorrhagic diseases are characterized by bleeding which can vary considerably according to their severity. The von Willebrand disease (VWD) is the most frequent hereditary hemorrhagic disease and the prevalence of clinically significant disease is probably closer to 1:1000, being an extremely heterogeneous and complex disorder that is related to the deficiency in concentration, structure or function of von Willebrand factor (VWF). The VWD is divided into type 1, with partial deficiency of the VWF, type 2, with qualitative defects in the molecule with four subdivisions, and type 3, with very low or undetectable levels of plasma and platelet VWF and ristocetin cofactor activity. The laboratory diagnosis of VWD is complex. Specific tests that assess the functionality and concentrations of the VWF and FVIII are needed. The routine tests are the bleeding time, the activated partial thromboplastin time and the platelet count, however, singly, they may not suggest the diagnosis of VWD, requiring further specific tests, such as VWF function evaluation through its ristocetin cofactor assay (VWF:RCo), VWF protein concentration immunoassay (VWF:Ag), the factor VIII coagulation assay (
FVIII
C), VWF binding to immobilized collagen (VWF:CB), ristocetin-induced platelet aggregation (RIPA), VWF multimers patterns, factor VIII binding of immobilized VWF (VWF:FVIIIB), among others. From the moment the diagnosis is confirmed, the appropriate treatment for each patient is sought, with the purpose of increasing plasma concentrations of the deficient protein, both in bleeding episodes, as for invasive procedures. Although diagnosis facilitates treatment other approach in the present scenario is prenatal diagnosis which, is the need of the hour.
PubMed: 27065574
DOI: 10.1007/s12288-015-0627-x