The Experts below are selected from a list of 402 Experts worldwide ranked by ideXlab platform
Jean Neemeh - One of the best experts on this subject based on the ideXlab platform.
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a low molecular weight Heparinoid compared with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke
Annals of Internal Medicine, 2020Co-Authors: A G Turpie, M Gent, Robert Cote, Mark Levine, Jeffrey S Ginsberg, Peter Powers, Jacques R Leclerc, Richard M Jay, William Geerts, Jean NeemehAbstract:Abstract ▪Objective:To compare the relative safety and efficacy of a low-molecular-weight Heparinoid (ORG 10172) with unfractionated heparin in the prevention of deep vein thrombosis in patients wi...
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a low molecular weight Heparinoid compared with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke a randomized double blind study
Annals of Internal Medicine, 1992Co-Authors: A G Turpie, M Gent, Robert Cote, Mark Levine, Jeffrey S Ginsberg, Peter Powers, Jacques R Leclerc, William H Geerts, Richard M Jay, Jean NeemehAbstract:Objective To compare the relative safety and efficacy of a low-molecular-weight Heparinoid (ORG 10172) with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke. Design Double-blind randomized trial. Setting Seven Canadian university-affiliated hospitals. Participants Eighty-seven patients with acute ischemic stroke resulting in lower-limb paresis. Intervention Patients received either low-molecular-weight Heparinoid, 750 anti-factor Xa units twice daily, or unfractionated heparin, 5000 units subcutaneously twice daily. Treatment was continued for 14 days or until hospital discharge if sooner. Measurements Deep vein thrombosis was diagnosed using 125I-labeled fibrinogen leg scanning and impedance plethysmography. Venography was indicated if either test was positive. Overt hemorrhage, major or minor, was assessed clinically. Results Venous thrombosis occurred in four patients (9%) given low-molecular-weight Heparinoid and in 13 patients (31%) given heparin (relative risk reduction, 71%; 95% CI, 16% to 93%. The corresponding rates for proximal vein thrombosis were 4% and 12%, respectively (relative risk reduction, 63%; P greater than 0.2). The incidence of hemorrhage was 2% in both groups. Conclusion Low-molecular-weight Heparinoid, given in a fixed dose of 750 anti-factor Xa units subcutaneously twice daily, is more effective than subcutaneous low-dose heparin for the prevention of deep vein thrombosis in patients with acute ischemic stroke.
Irina L. Opentanova - One of the best experts on this subject based on the ideXlab platform.
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PentaLyte � Does Not Decrease Heparinoid Release but Does Decrease Circulating Thrombotic Mediator Activity Associated with Aortic Occlusion-Reperfusion in Rabbits
2013Co-Authors: Irina L. OpentanovaAbstract:Hemorrhage and thrombosis are associated with major vascular and trauma surgery. Release of Heparinoids and thrombotic mediators may contribute to these complications and have been described in rabbits after aortic occlusion-reperfusion. We hypothesized that the resuscitative fluid used could reduce Heparinoid and thrombotic mediator release after aortic occlusionreperfusion in rabbits as assessed by thromboelastographic variables (R, reaction time; �, angle; and G, a measure of clot strength). Anesthetized rabbits were administered lactated Ringer’s solution (n � 8) or PentaLyte� (n � 8) at reperfusion after 30 min of ischemia. Blood was obtained before ischemia and after 30 min of reperfusion for thromboelastography under four conditions: 1) unmodified sample, 2) platelet inhibition, 3
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pentalyte does not decrease Heparinoid release but does decrease circulating thrombotic mediator activity associated with aortic occlusion reperfusion in rabbits
Anesthesia & Analgesia, 2001Co-Authors: Vance G Nielsen, Irina L. Opentanova, Valerie E Armstead, Brian T GearyAbstract:Hemorrhage and thrombosis are associated with major vascular and trauma surgery. Release of Heparinoids and thrombotic mediators may contribute to these complications and have been described in rabbits after aortic occlusion-reperfusion. We hypothesized that the resuscitative fluid used could reduce Heparinoid and thrombotic mediator release after aortic occlusion-reperfusion in rabbits as assessed by thromboelastographic variables (R, reaction time; alpha, angle; and G, a measure of clot strength). Anesthetized rabbits were administered lactated Ringer's solution (n = 8) or PentaLyte (n = 8) at reperfusion after 30 min of ischemia. Blood was obtained before ischemia and after 30 min of reperfusion for thromboelastography under four conditions: 1) unmodified sample, 2) platelet inhibition, 3) heparinase, and 4) platelet inhibition and heparinase. During reperfusion, unmodified samples demonstrated a significant increase in R and decrease in alpha and G that was not affected by PentaLyte. In the presence of heparinase, no significant fluid-specific thromboelastographic differences were noted. However, thrombotic mediator release (discerned by a decrease in R and an increase in alpha) during reperfusion in samples with platelet inhibition and heparinase was significantly attenuated by PentaLyte. PentaLyte administration does not decrease Heparinoid release but does decrease thrombotic mediator release after aortic occlusion-reperfusion.
A G Turpie - One of the best experts on this subject based on the ideXlab platform.
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a low molecular weight Heparinoid compared with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke
Annals of Internal Medicine, 2020Co-Authors: A G Turpie, M Gent, Robert Cote, Mark Levine, Jeffrey S Ginsberg, Peter Powers, Jacques R Leclerc, Richard M Jay, William Geerts, Jean NeemehAbstract:Abstract ▪Objective:To compare the relative safety and efficacy of a low-molecular-weight Heparinoid (ORG 10172) with unfractionated heparin in the prevention of deep vein thrombosis in patients wi...
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a low molecular weight Heparinoid compared with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke a randomized double blind study
Annals of Internal Medicine, 1992Co-Authors: A G Turpie, M Gent, Robert Cote, Mark Levine, Jeffrey S Ginsberg, Peter Powers, Jacques R Leclerc, William H Geerts, Richard M Jay, Jean NeemehAbstract:Objective To compare the relative safety and efficacy of a low-molecular-weight Heparinoid (ORG 10172) with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke. Design Double-blind randomized trial. Setting Seven Canadian university-affiliated hospitals. Participants Eighty-seven patients with acute ischemic stroke resulting in lower-limb paresis. Intervention Patients received either low-molecular-weight Heparinoid, 750 anti-factor Xa units twice daily, or unfractionated heparin, 5000 units subcutaneously twice daily. Treatment was continued for 14 days or until hospital discharge if sooner. Measurements Deep vein thrombosis was diagnosed using 125I-labeled fibrinogen leg scanning and impedance plethysmography. Venography was indicated if either test was positive. Overt hemorrhage, major or minor, was assessed clinically. Results Venous thrombosis occurred in four patients (9%) given low-molecular-weight Heparinoid and in 13 patients (31%) given heparin (relative risk reduction, 71%; 95% CI, 16% to 93%. The corresponding rates for proximal vein thrombosis were 4% and 12%, respectively (relative risk reduction, 63%; P greater than 0.2). The incidence of hemorrhage was 2% in both groups. Conclusion Low-molecular-weight Heparinoid, given in a fixed dose of 750 anti-factor Xa units subcutaneously twice daily, is more effective than subcutaneous low-dose heparin for the prevention of deep vein thrombosis in patients with acute ischemic stroke.
C Muellereckhardt - One of the best experts on this subject based on the ideXlab platform.
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laboratory diagnosis of heparin associated thrombocytopenia and comparison of platelet aggregation test heparin induced platelet activation test and platelet factor 4 heparin enzyme linked immunosorbent assay
Transfusion, 1994Co-Authors: Andreas Greinacher, J Amiral, V Dummel, A Vissac, V Kiefel, C MuellereckhardtAbstract:BACKGROUND: As clinical diagnosis of heparin-associated thrombocytopenia (HAT) is often difficult, confirmation by sensitive laboratory assays is desirable. STUDY DESIGN AND METHODS: The sensitivity of the heparin-induced platelet activation (HIPA) test and the platelet aggregation test (PAT) was prospectively compared by using the sera of 209 patients with the putative diagnosis of HAT. Both assays were performed concomitantly with platelets of the same four donors using a different combination of donors from day to day. Further, all sera were assessed with a platelet factor 4 (PF4)/heparin enzyme-linked immunosorbent assay (ELISA). RESULTS: Positive results were obtained with 33 percent of sera in the PF4/heparin ELISA, with 33.5 percent of sera in the HIPA test, and with 11.5 percent of sera in the PAT. The PF4/heparin ELISA and the HIPA test showed no difference in sensitivity (p = 0.27 by McNemar's test) and were more sensitive than PAT (p < 10(-8) by McNemar's test). However, they recognized different patient cohorts. Nine HIPA-indeterminate and 12 HIPA-negative sera were positive in the PF4/heparin ELISA. Eight of the nine indeterminate sera caused platelet activation with high heparin concentrations in the HIPA test. Eleven of the 12 negative sera contained no IgG, but 9 contained IgM and 2 contained IgA HAT antibodies. Four sera that were indeterminate in the PF4/heparin ELISA and 18 sera that were negative were positive in the HIPA test. None of the sera that were positive in the PAT was missed in the HIPA test, but two of those were negative in the PF4/heparin ELISA. All sera were assessed with four low-molecular-weight heparins and a low-molecular- weight Heparinoid in the HIPA test with platelets from the same four donors. Low-molecular-weight heparin caused platelet activation with positive sera in 98 percent of tests, and the Heparinoid did so in 10 percent; in a further 12.8 percent, crossreactivity to the low- molecular-weight Heparinoid could not be excluded. CONCLUSION: The majority of HAT antibodies react with a PF4/heparin complex, but there is strong evidence that other antigens are involved in some patients. The HIPA test and the PF4/heparin ELISA are sensitive for diagnosing HAT, and they complement one another.
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pregnancy complicated by heparin associated thrombocytopenia management by a prospectively in vitro selected Heparinoid org 10172
Thrombosis Research, 1993Co-Authors: Andreas Greinacher, Th Eckhardt, J Muβmann, C MuellereckhardtAbstract:A pregnant woman treated with unfractionated heparin for pelvic vein thrombosis in the 26th week of her first pregnancy developed heparin-associated thrombocytopenia. Diagnosis was verified by the heparin induced platelet activation (HIPA) assay, which revealed cross reactivity to various LMW heparins, but not to the LMW Heparinoid Org 10172. Upon intravenous (i.v.) anticoagulation with the Heparinoid Org 10172 the platelet count returned to normal within 6 days and remained stable throughout the entire treatment period. After 3 weeks i.v. treatment with Org 10172, administration was changed to the subcutaneous route. At term a healthy boy was delivered spontaneously. No Org 10172 was detected in the cord blood, while therapeutic levels were measured in the maternal blood. The infant's platelet count was normal, but serum from the cord blood induced platelet activation in the presence of heparin, indicating the transplacental passage of heparin-dependent maternal antibodies.
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heparin associated thrombocytopenia successful therapy with the Heparinoid org 10172 in a patient showing cross reaction to lmw heparins
Annals of Hematology, 1992Co-Authors: Andreas Greinacher, W Drost, I Michels, J Leitl, M Gottsmann, H J Kohl, M Glaser, C MuellereckhardtAbstract:A patient suffering from heparin-associated thrombocytopenia (HAT), recurrent arteriothromboses, and acute renal failure after treatment with standard heparin is described. He failed to improve when therapy was continued with low-molecular-weight (LMW) heparin (Fragmin, Kabi Pfrimmer, Erlangen, FRG). By means of the in vitro heparin-induced platelet activation (HIPA) assay it was shown that standard heparin and the LMW heparins Fragmin and Fraxiparin (Sanofi Labaz, Munich, FRG), as well as the enoxaparine Clexane (Nattermann, Cologne, FRG), all induced platelet activation with the patient's serum. In contrast, the LMW Heparinoid Org 10172 (Organon, Oss, The Netherlands) did not cause platelet activation. When the patient was subsequently treated by parenteral administration of Org 10172 as anticoagulant over a period of several weeks the number of platelets rapidly increased and the patient almost completely recovered. This case shows that strong in vivo and in vitro cross-reactivity between standard heparin and LMW heparins may occur, but can be avoided by the use of a novel Heparinoid, Org 10172. The HIPA assay provides a simple and sensitive laboratory method for the choice of an innocuous heparin or Heparinoid for continued parenteral anticoagulation.
Brian T Geary - One of the best experts on this subject based on the ideXlab platform.
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pentalyte does not decrease Heparinoid release but does decrease circulating thrombotic mediator activity associated with aortic occlusion reperfusion in rabbits
Anesthesia & Analgesia, 2001Co-Authors: Vance G Nielsen, Irina L. Opentanova, Valerie E Armstead, Brian T GearyAbstract:Hemorrhage and thrombosis are associated with major vascular and trauma surgery. Release of Heparinoids and thrombotic mediators may contribute to these complications and have been described in rabbits after aortic occlusion-reperfusion. We hypothesized that the resuscitative fluid used could reduce Heparinoid and thrombotic mediator release after aortic occlusion-reperfusion in rabbits as assessed by thromboelastographic variables (R, reaction time; alpha, angle; and G, a measure of clot strength). Anesthetized rabbits were administered lactated Ringer's solution (n = 8) or PentaLyte (n = 8) at reperfusion after 30 min of ischemia. Blood was obtained before ischemia and after 30 min of reperfusion for thromboelastography under four conditions: 1) unmodified sample, 2) platelet inhibition, 3) heparinase, and 4) platelet inhibition and heparinase. During reperfusion, unmodified samples demonstrated a significant increase in R and decrease in alpha and G that was not affected by PentaLyte. In the presence of heparinase, no significant fluid-specific thromboelastographic differences were noted. However, thrombotic mediator release (discerned by a decrease in R and an increase in alpha) during reperfusion in samples with platelet inhibition and heparinase was significantly attenuated by PentaLyte. PentaLyte administration does not decrease Heparinoid release but does decrease thrombotic mediator release after aortic occlusion-reperfusion.
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hepatoenteric ischemia reperfusion increases circulating Heparinoid activity in rabbits
Journal of Critical Care, 2000Co-Authors: Vance G Nielsen, Brian T GearyAbstract:Purpose: The purpose of this study was to determine if an increase in circulating Heparinoid activity contributes to the hemostatic abnormalities associated with hepatoenteric ischemia-reperfusion. Materials and Methods: Anesthetized rabbit (n = 18) underwent thoracic aorta occlusion for 30 minutes with a balloon catheter, followed by 30 minutes of reperfusion. Blood samples were obtained after 30 minutes of equilibration and 30 minutes of reperfusion. Hemostatic function was assessed by changes in the thrombelastographic variables R (reaction time), α (a measure of the speed of clot formation), and G (a measure of clot strength). Thrombelastography was performed on blood without platelet inhibition in the presence or absence of heparinase (n = 9 rabbits). Additional samples (n = 9) were exposed to cytochalasin D (platelet inhibitor) with or without heparinase. Results: Compared with preischemic values, blood samples with intact platelet function obtained during reperfusion demonstrated a decrease in hemostatic function evidenced by a significant (P < .05) increase in R, decrease in α, and decrease in G. R, α, and G values of samples without platelet inhibition exposed to heparinase did not significantly change after ischemia. Blood samples exposed to cytochalasin D displayed a similar pattern. Conclusion: An increase in circulating Heparinoid activity significantly contributes to the hemostatic disorder associated with hepatoenteric ischemia-reperfusion in rabbits. Copyright © 2000 by W.B. Saunders Company